Softwere Laporan Puskesmas Tahun 2018

HASIL CAKUPAN IMUNISASI PER DESA/KELURAHAN PUSKESMAS PALANGGA KABUPATEN / KOTA KONAWE SELATAN TAHUN 2014.
PUSKESMAS : PALANGGA Warna Kuning yang diisi

BULAN : JANUARI 2014
HASIL IMUNISASI BAYI
JUMLAH PDDK SURVIVING INFANT
NO DESA / KELURAHAN BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB-Hib (1) POLIO2 DPT/HB-Hib (2)
TAHUN 2014 (0 - 11 BLN
L P JLH L P JLH #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L
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 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 1 6.3 0 0.0 1 3.1 2 12.5 1 8.0 3 9.4 3 18.8 1 6.3 4 12.5 0.0 0.0 0 0.0 2 12.5 3 18.8 5 15.6 0.0 0.0 0 0.0 1
2 WATUDEMBA 611 8 11 19 8 11 19 1 12.5 1 9.1 2 10.5 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 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 AOSOLE 935 20 16 36 20 16 36 0 0.0 1 6.3 1 2.8 0 0.0 0 #DIV/0! 0 0.0 0 0.0 2 12.5 2 5.6 0.0 0.0 0 0.0 1 5.0 0 0.0 1 2.8 0.0 0.0 0 0.0 1
4 ALAKAYA 616 13 5 18 13 5 18 0 0.0 1 20.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 3 23.1 2 40.0 5 27.8 0.0 0.0 0 0.0 0
5 WAWORAHA 535 7 6 13 7 6 13 2 28.6 0 0.0 2 15.4 1 14.3 0 0.0 1 7.7 0 0.0 1 16.7 1 7.7 0.0 0.0 0 0.0 1 14.3 1 16.7 2 15.4 0.0 0.0 0 0.0 0
6 KAPUJAYA 570 4 3 7 4 3 7 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 1 33.3 1 14.3 0.0 0.0 0 0.0 1 25.0 1 33.3 2 28.6 0.0 0.0 0 0.0 0
7 WAWOURU 985 8 19 27 8 19 27 1 12.5 1 5.3 2 7.4 0 0.0 0 #DIV/0! 0 0.0 1 12.5 3 15.8 4 14.8 0.0 0.0 0 0.0 1 12.5 1 5.3 2 7.4 0.0 0.0 0 0.0 0
8 MEKAR SARI 1,255 16 7 23 16 7 23 1 6.3 1 14.3 2 8.7 0 0.0 0 #DIV/0! 0 0.0 1 6.3 2 28.6 3 13.0 0.0 0.0 0 0.0 0 0.0 2 28.6 2 8.7 0.0 0.0 0 0.0 1
9 WATUMEREMBA 748 9 12 21 9 12 21 0 0.0 0 0.0 0 0.0 0 0.0 3 #DIV/0! 3 14.3 1 11.1 1 8.3 2 9.5 0.0 0.0 0 0.0 0 0.0 1 8.3 1 4.8 0.0 0.0 0 0.0 0
10 EEWA 584 5 6 11 5 6 11 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 1 20.0 0 0.0 1 9.1 0.0 0.0 0 0.0 2 40.0 0 0.0 2 18.2 0.0 0.0 0 0.0 0
11 ONEMBUTE 882 19 14 33 19 14 33 1 5.3 1 7.1 2 6.1 0 0.0 1 #DIV/0! 1 3.0 1 5.3 1 7.1 2 6.1 0.0 0.0 0 0.0 1 5.3 0 0.0 1 3.0 0.0 0.0 0 0.0 3
12 ANGGONDARA 682 17 10 27 17 10 27 0 0.0 0 0.0 0 0.0 1 5.9 1 17.0 2 7.4 2 11.8 1 10.0 3 11.1 0.0 0.0 0 0.0 3 17.6 1 10.0 4 14.8 0.0 0.0 0 0.0 2
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 0 0.0 0 0.0 0 0.0 3 21.4 3 14.0 6 17.6 0 0.0 1 5.0 1 2.9 0.0 0.0 0 0.0 3 21.4 2 10.0 5 14.7 0.0 0.0 0 0.0 1
14 WAWONGGURA 680 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 1 14.3 0 0.0 1 7.1 0.0 0.0 0 0.0 0 0.0 1 14.3 1 7.1 0.0 0.0 0 0.0 2
15 SANGGI-SANGGI 612 6 10 16 6 10 16 1 16.7 1 10.0 2 12.5 0 0.0 0 #DIV/0! 0 0.0 0 0.0 2 20.0 2 12.5 0.0 0.0 0 0.0 1 16.7 3 30.0 4 25.0 0.0 0.0 0 0.0 0
16 UPT.TOLIHE 960 5 4 9 5 4 9 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 2 40.0 0 0.0 2 22.2 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0
PALANGGA 13,357 174 166 340 174 166 340 8 4.6 7 4.2 15 4.4 7 4.0 9 223.7 16 4.7 13 7.5 16 9.6 29 8.5 0 0.0 0 0.0 0 0.0 19 10.9 18 10.8 37 10.9 0 0.0 0 0.0 0 0.0 11
LAPORAN VAKSIN, ALAT SUNTIK DAN SAFETY BOX INDEK PEMAKAIAN VAKSIN (IPK)
Jenis Vaksin / Alat Suntik & Penerimaan Pemakaian
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
Sisa Bln ini Permintaan No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Jumlah Keadaan MENGETAHUI : xxxxxxx, ………………….2014
(buah)
I. VAKSIN 1 BCG 16 dosis 5 Ampul 3.2 Baik Rusak Kepala Puskesmas ................Kab./Kota.................. Koordinator Jurim Puskesmas .................
1 Vak. BCG 19 10 29 5 24 (19) 2 DPT-HB #REF! dosis 27 Vial #REF!
2 Vak. DPT-HB 9 30 39 27 12 15 3 DPT-HB-Hib 0 dosis - Vial #DIV/0!
3 Vak. DPT-HB-Hib - - - - - - 4 POLIO 102 dosis 17 Vial 6
4 Vak. POLIO 32 20 52 17 35 (18) 5 CAMPAK 13 dosis 5 Vial 2.6 ................................... ...................................
5 Vak. CAMPAK 29 10 39 5 34 (29) 6 HB. UNIJECT 15 dosis 15 Buah 1 Nip. ........................... Nip. ...........................
6 Vak. HB. UNIJECT 75 - 75 15 60 (45) 7 TT 51 dosis 12 Vial 4.25
7 Vak. TT 35 10 45 12 33 (21)
II. ALAT SUNTIK
1 ADS 5 ml 27 20 47 11 36 (25)
2 ADS 0,5 ml 4 200 204 130 74 56
3 ADS 0,0 5 ml 154 100 254 18 236 (218)
4 Safety Box 5 liter - - -
5 Safety Box 0,25 liter - - -

BULAN : FEBRUARI 2014
TAHUN 2014 (0 - 11 BLN
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 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 1 6.3 1 6.3 2 6.3 0 0.0 0 #DIV/0! 0 0.0 1 6.3 1 6.3 2 6.3 0.0 0.0 0 0.0 2 12.5 1 6.3 3 9.4 0.0 0.0 0 0.0 2
2 WATUDEMBA 611 8 11 19 8 11 19 0 0.0 3 27.3 3 15.8 0 0.0 2 #DIV/0! 2 10.5 0 0.0 1 9.1 1 5.3 0.0 0.0 0 0.0 1 12.5 0 0.0 1 5.3 0.0 0.0 0 0.0 0
3 AOSOLE 935 20 16 36 20 16 36 1 5.0 0 0.0 1 2.8 0 0.0 3 #DIV/0! 3 8.3 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 2 10.0 1 6.3 3 8.3 0.0 0.0 0 0.0 1
4 ALAKAYA 616 13 5 18 13 5 18 0 0.0 0 0.0 0 0.0 2 15.4 0 0.0 2 11.1 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 1 20.0 1 5.6 0.0 0.0 0 0.0 2
5 WAWORAHA 535 7 6 13 7 6 13 0 0.0 0 0.0 0 0.0 2 28.6 0 0.0 2 15.4 1 14.3 0 0.0 1 7.7 0.0 0.0 0 0.0 0 0.0 1 16.7 1 7.7 0.0 0.0 0 0.0 0
6 KAPUJAYA 570 4 3 7 4 3 7 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 1 33.3 1 14.3 0.0 0.0 0 0.0 1
7 WAWOURU 985 8 19 27 8 19 27 2 25.0 0 0.0 2 7.4 1 12.5 2 16.0 3 11.1 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 3 15.8 3 11.1 0.0 0.0 0 0.0 1
8 MEKAR SARI 1,255 16 7 23 16 7 23 1 6.3 0 0.0 1 4.3 1 6.3 3 48.0 4 17.4 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1 6.3 2 28.6 3 13.0 0.0 0.0 0 0.0 0
9 WATUMEREMBA 748 9 12 21 9 12 21 1 11.1 0 0.0 1 4.8 0 0.0 0 #DIV/0! 0 0.0 0 0.0 3 25.0 3 14.3 0.0 0.0 0 0.0 1 11.1 1 8.3 2 9.5 0.0 0.0 0 0.0 0
10 EEWA 584 5 6 11 5 6 11 0 0.0 1 16.7 1 9.1 0 0.0 2 #DIV/0! 2 18.2 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1 20.0 0 0.0 1 9.1 0.0 0.0 0 0.0 0
11 ONEMBUTE 882 19 14 33 19 14 33 3 15.8 1 7.1 4 12.1 0 0.0 2 #DIV/0! 2 6.1 0 0.0 1 7.1 1 3.0 0.0 0.0 0 0.0 1 5.3 3 21.4 4 12.1 0.0 0.0 0 0.0 0
12 ANGGONDARA 682 17 10 27 17 10 27 1 5.9 2 20.0 3 11.1 0 0.0 0 #DIV/0! 0 0.0 2 11.8 1 10.0 3 11.1 0.0 0.0 0 0.0 1 5.9 4 40.0 5 18.5 0.0 0.0 0 0.0 1
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 2 14.3 1 5.0 3 8.8 0 0.0 0 #DIV/0! 0 0.0 0 0.0 2 10.0 2 5.9 0.0 0.0 0 0.0 0 0.0 2 10.0 2 5.9 0.0 0.0 0 0.0 3
14 WAWONGGURA 680 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1 14.3 1 14.3 2 14.3 0.0 0.0 0 0.0 1
16 UPT.TOLIHE 960 5 4 9 5 4 9 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1 20.0 0 0.0 1 11.1 0.0 0.0 0 0.0 0
PALANGGA 13,357 174 166 340 506 846 1,352 13 2.6 9 1.1 22 1.6 6 1.2 16 1349.3 22 1.6 4 0.8 9 1.1 13 1.0 0 0.0 0 0.0 0 0.0 12 2.4 22 2.6 34 2.5 0 0.0 0 0.0 0 0.0 13
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
(buah)
1 Vak. BCG 24 - 24 9 15 (6) 2 DPT-HB #REF! dosis 23 Vial #REF!
3 Vak. DPT-HB-Hib - - - - 4 POLIO 101 dosis 17 Vial 5.941176
5 Vak. CAMPAK 34 - 34 8 26 (18) 6 HB. UNIJECT 22 dosis 22 Buah 1 Nip. ........................... Nip. ...........................
6 Vak. HB. UNIJECT 60 50 110 22 88 (66) 7 TT 51 dosis 13 Vial 3.923077
7 Vak. TT 33 10 43 13 30 (17)
II. ALAT SUNTIK
1 ADS 5 ml 36 36 36 (36)
2 ADS 0,5 ml 74 74 74 (74)
3 ADS 0,0 5 ml 236 236 236 (236)
4 Safety Box 5 liter - - - -
5 Safety Box 0,25 liter - - - -

BULAN : MARET 2014
TAHUN 2014 (0 - 11 BLN
1 2 3 4 5 6 7 8 9 10 0 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 1 6.3 1 3.1 0.0 0.0 0 0.0 2 12.5 0 0.0 2 6.3 0.0 0.0 0 0.0 1
2 WATUDEMBA 611 8 11 19 8 11 19 2 25.0 1 9.1 3 15.8 0 0.0 0 #DIV/0! 0 0.0 0 0.0 3 27.3 3 15.8 0.0 0.0 0 0.0 1 12.5 3 27.3 4 21.1 0.0 0.0 0 0.0 1
3 AOSOLE 935 20 16 36 20 16 36 0 0.0 0 0.0 0 0.0 2 10.0 0 0.0 2 5.6 0 0.0 2 12.5 2 5.6 0.0 0.0 0 0.0 0 0.0 1 6.3 1 2.8 0.0 0.0 0 0.0 2
4 ALAKAYA 616 13 5 18 13 5 18 0 0.0 1 20.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 1 7.7 0 0.0 1 5.6 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1
5 WAWORAHA 535 7 6 13 7 6 13 1 14.3 1 16.7 2 15.4 0 0.0 0 #DIV/0! 0 0.0 2 28.6 0 0.0 2 15.4 0.0 0.0 0 0.0 1 14.3 0 0.0 1 7.7 0.0 0.0 0 0.0 0
6 KAPUJAYA 570 4 3 7 4 3 7 1 25.0 0 0.0 1 14.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 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 WAWOURU 985 8 19 27 8 19 27 1 12.5 0 0.0 1 3.7 0 0.0 0 #DIV/0! 0 0.0 1 12.5 2 10.5 3 11.1 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0
8 MEKAR SARI 1,255 16 7 23 16 7 23 0 0.0 1 14.3 1 4.3 0 0.0 0 #DIV/0! 0 0.0 1 6.3 1 14.3 2 8.7 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1
9 WATUMEREMBA 748 9 12 21 9 12 21 1 11.1 1 8.3 2 9.5 0 0.0 1 #DIV/0! 1 4.8 0 0.0 1 8.3 1 4.8 0.0 0.0 0 0.0 0 0.0 2 16.7 2 9.5 0.0 0.0 0 0.0 1
10 EEWA 584 5 6 11 5 6 11 0 0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 18.2 0 0.0 1 16.7 1 9.1 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1
11 ONEMBUTE 882 19 14 33 19 14 33 0 0.0 0 0.0 0 0.0 5 26.3 1 3.8 6 18.2 0 0.0 1 7.1 1 3.0 0.0 0.0 0 0.0 0 0.0 1 7.1 1 3.0 0.0 0.0 0 0.0 1
12 ANGGONDARA 682 17 10 27 17 10 27 3 17.6 0 0.0 3 11.1 2 11.8 2 17.0 4 14.8 1 5.9 0 0.0 1 3.7 0.0 0.0 0 0.0 3 17.6 1 10.0 4 14.8 0.0 0.0 0 0.0 1
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 2 10.0 2 5.9 0.0 0.0 0 0.0 0 0.0 4 20.0 4 11.8 0.0 0.0 0 0.0 0
14 WAWONGGURA 680 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 1 14.3 0 0.0 1 7.1 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1
15 SANGGI-SANGGI 612 6 10 16 6 10 16 0 0.0 1 10.0 1 6.3 2 33.3 1 3.0 3 18.8 0 0.0 1 10.0 1 6.3 0.0 0.0 0 0.0 0 0.0 1 10.0 1 6.3 0.0 0.0 0 0.0 0
16 UPT.TOLIHE 960 5 4 9 5 4 9 0 0.0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 1 25.0 1 11.1 0.0 0.0 0 0.0 1
PALANGGA 13,357 174 166 340 174 166 340 9 5.2 6 3.6 15 4.4 11 6.3 7 110.7 18 5.3 7 4.0 15 9.0 22 6.5 0 0.0 0 0.0 0 0.0 7 4.0 14 8.4 21 6.2 0 0.0 0 0.0 0 0.0 12
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
(buah)
2 Vak. DPT-HB 19 30 49 19 30 (11) 3 DPT-HB-Hib 0 dosis - Vial #DIV/0!
7 Vak. TT 30 - 30 14 16 (2)
II. ALAT SUNTIK
1 ADS 5 ml 36 36 36 (36)
2 ADS 0,5 ml 74 300 374 374 (374)
3 ADS 0,0 5 ml 236 236 236 (236)

BULAN : APRIL 2014
TAHUN 2014 (0 - 11 BLN
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 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 0 0.0 4 25.0 4 12.5 2 12.5 1 8.0 3 9.4 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1 6.3 1 6.3 2 6.3 0.0 0.0 0 0.0 2
2 WATUDEMBA 611 8 11 19 8 11 19 1 12.5 0 0.0 1 5.3 1 12.5 2 16.0 3 15.8 0 0.0 1 9.1 1 5.3 0.0 0.0 0 0.0 0 0.0 3 27.3 3 15.8 0.0 0.0 0 0.0 0
3 AOSOLE 935 20 16 36 20 16 36 1 5.0 0 0.0 1 2.8 0 0.0 0 #DIV/0! 0 0.0 1 5.0 0 0.0 1 2.8 0.0 0.0 0 0.0 0 0.0 1 6.3 1 2.8 0.0 0.0 0 0.0 0
4 ALAKAYA 616 13 5 18 13 5 18 1 7.7 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 1 7.7 0 0.0 1 5.6 0.0 0.0 0 0.0 1 7.7 0 0.0 1 5.6 0.0 0.0 0 0.0 1
5 WAWORAHA 535 7 6 13 7 6 13 0 0.0 0 0.0 0 0.0 2 28.6 1 3.5 3 23.1 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 2 28.6 0 0.0 2 15.4 0.0 0.0 0 0.0 1
6 KAPUJAYA 570 4 3 7 4 3 7 0 0.0 0 0.0 0 0.0 1 25.0 1 4.0 2 28.6 0 0.0 0 0.0 0 0.0 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 WAWOURU 985 8 19 27 8 19 27 1 12.5 0 0.0 1 3.7 2 25.0 0 0.0 2 7.4 0 0.0 1 5.3 1 3.7 0.0 0.0 0 0.0 1 12.5 2 10.5 3 11.1 0.0 0.0 0 0.0 0
8 MEKAR SARI 1,255 16 7 23 16 7 23 2 12.5 1 14.3 3 13.0 0 0.0 0 #DIV/0! 0 0.0 1 6.3 1 14.3 2 8.7 0.0 0.0 0 0.0 1 6.3 0 0.0 1 4.3 0.0 0.0 0 0.0 0
9 WATUMEREMBA 748 9 12 21 9 12 21 1 11.1 0 0.0 1 4.8 4 44.4 0 0.0 4 19.0 0 0.0 2 16.7 2 9.5 0.0 0.0 0 0.0 1 11.1 0 0.0 1 4.8 0.0 0.0 0 0.0 0
10 EEWA 584 5 6 11 5 6 11 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 9.1 0 0.0 2 33.3 2 18.2 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0
11 ONEMBUTE 882 19 14 33 19 14 33 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 3.0 3 15.8 1 7.1 4 12.1 0.0 0.0 0 0.0 0 0.0 1 7.1 1 3.0 0.0 0.0 0 0.0 0
12 ANGGONDARA 682 17 10 27 17 10 27 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 1 10.0 1 3.7 0.0 0.0 0 0.0 1 5.9 0 0.0 1 3.7 0.0 0.0 0 0.0 3
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 1 7.1 3 15.0 4 11.8 2 14.3 3 21.0 5 14.7 1 7.1 0 0.0 1 2.9 0.0 0.0 0 0.0 0 0.0 1 5.0 1 2.9 0.0 0.0 0 0.0 0
14 WAWONGGURA 680 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 1 14.3 0 0.0 1 7.1 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0
16 UPT.TOLIHE 960 5 4 9 5 4 9 1 20.0 0 0.0 1 11.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1 20.0 0 0.0 1 11.1 0.0 0.0 0 0.0 0
PALANGGA 13,357 174 166 340 174 166 340 9 5.2 8 4.8 17 5.0 14 8.0 10 124.3 24 7.1 9 5.2 9 5.4 18 5.3 0 0.0 0 0.0 0 0.0 9 5.2 9 5.4 18 5.3 0 0.0 0 0.0 0 0.0 7
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
(buah)
1 Vak. BCG 11 - 11 10 1 9 2 DPT-HB #REF! dosis 20 Vial #REF!
2 Vak. DPT-HB 30 - 30 20 10 10 3 DPT-HB-Hib 0 dosis - Vial #DIV/0!
4 Vak. POLIO 41 - 41 18 23 (5) 5 CAMPAK 29 dosis 7 Vial 4.142857 ................................... ...................................
5 Vak. CAMPAK 26 - 26 7 19 (12) 6 HB. UNIJECT 17 dosis 17 Buah 1 Nip. ........................... Nip. ...........................
7 Vak. TT 16 - 16 7 9 (2)
II. ALAT SUNTIK
1 ADS 5 ml 36 36 36 (36)
2 ADS 0,5 ml 374 374 374 (374)
3 ADS 0,0 5 ml 236 236 236 (236)

BULAN : MEI 2014
TAHUN 2014 (0 - 11 BLN
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 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 0 0.0 2 12.5 2 6.3 0 0.0 1 #DIV/0! 1 3.1 2 12.5 1 6.3 3 9.4 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0
2 WATUDEMBA 611 8 11 19 8 11 19 1 12.5 1 9.1 2 10.5 2 25.0 1 4.0 3 15.8 1 12.5 2 18.2 3 15.8 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1
3 AOSOLE 935 20 16 36 20 16 36 2 10.0 1 6.3 3 8.3 2 10.0 2 20.0 4 11.1 0 0.0 1 6.3 1 2.8 0.0 0.0 0 0.0 0 0.0 1 6.3 1 2.8 0.0 0.0 0 0.0 0
4 ALAKAYA 616 13 5 18 13 5 18 1 7.7 1 20.0 2 11.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 1 20.0 1 5.6 0.0 0.0 0 0.0 1 7.7 0 0.0 1 5.6 0.0 0.0 0 0.0 1
5 WAWORAHA 535 7 6 13 7 6 13 1 14.3 1 16.7 2 15.4 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0
6 KAPUJAYA 570 4 3 7 4 3 7 0 0.0 1 33.3 1 14.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 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 WAWOURU 985 8 19 27 8 19 27 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 3 37.5 0 0.0 3 11.1 0.0 0.0 0 0.0 0 0.0 1 5.3 1 3.7 0.0 0.0 0 0.0 1
8 MEKAR SARI 1,255 16 7 23 16 7 23 1 6.3 1 14.3 2 8.7 2 12.5 0 0.0 2 8.7 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 1 14.3 1 4.3 0.0 0.0 0 0.0 2
9 WATUMEREMBA 748 9 12 21 9 12 21 1 11.1 0 0.0 1 4.8 0 0.0 1 #DIV/0! 1 4.8 2 22.2 0 0.0 2 9.5 0.0 0.0 0 0.0 0 0.0 1 8.3 1 4.8 0.0 0.0 0 0.0 1
10 EEWA 584 5 6 11 5 6 11 0 0.0 1 16.7 1 9.1 1 20.0 0 0.0 1 9.1 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1 20.0 1 16.7 2 18.2 0.0 0.0 0 0.0 1
11 ONEMBUTE 882 19 14 33 19 14 33 2 10.5 0 0.0 2 6.1 0 0.0 4 #DIV/0! 4 12.1 2 10.5 0 0.0 2 6.1 0.0 0.0 0 0.0 2 10.5 1 7.1 3 9.1 0.0 0.0 0 0.0 0
12 ANGGONDARA 682 17 10 27 17 10 27 1 5.9 1 10.0 2 7.4 1 5.9 0 0.0 1 3.7 2 11.8 1 10.0 3 11.1 0.0 0.0 0 0.0 0 0.0 1 10.0 1 3.7 0.0 0.0 0 0.0 2
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 1 7.1 0 0.0 1 2.9 4 28.6 0 0.0 4 11.8 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 1 5.0 1 2.9 0.0 0.0 0 0.0 0
14 WAWONGGURA 680 7 7 14 7 7 14 1 14.3 0 0.0 1 7.1 1 14.3 1 7.0 2 14.3 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 0.0 0.0 0 0.0 0
16 UPT.TOLIHE 960 5 4 9 5 4 9 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1
PALANGGA 13,357 174 166 340 174 166 340 13 7.5 10 6.0 23 6.8 13 7.5 12 160.6 25 7.4 13 7.5 7 4.2 20 5.9 0 0.0 0 0.0 0 0.0 7 4.0 9 5.4 16 4.7 0 0.0 0 0.0 0 0.0 10
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
(buah)
1 Vak. BCG 1 30 31 8 23 (15) 2 DPT-HB #REF! dosis 15 Vial #REF!
7 Vak. TT 9 - 9 5 4 1
II. ALAT SUNTIK
1 ADS 5 ml 36 36 36 (36)
2 ADS 0,5 ml 374 374 374 (374)
3 ADS 0,0 5 ml 236 236 236 (236)

BULAN : JUNI 2014
JUMLAH PDDK
NO DESA / KELURAHAN
TAHUN 2014
TAHUN 2014 (0 - 11 BLN
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 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 0 0.0 1 6.3 1 3.1 0 0.0 4 #DIV/0! 4 12.5 0 0.0 1 6.3 1 3.1 0.0 0.0 0 0.0 1 6.3 1 6.3 2 6.3 0.0 0.0 0 0.0 1
2 WATUDEMBA 611 8 11 19 8 11 19 0 0.0 1 9.1 1 5.3 1 12.5 1 8.0 2 10.5 1 12.5 1 9.1 2 10.5 0.0 0.0 0 0.0 0 0.0 2 18.2 2 10.5 0.0 0.0 0 0.0 0
3 AOSOLE 935 20 16 36 20 16 36 2 10.0 2 12.5 4 11.1 1 5.0 3 60.0 4 11.1 0 0.0 2 12.5 2 5.6 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1
4 ALAKAYA 616 13 5 18 13 5 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0
5 WAWORAHA 535 7 6 13 7 6 13 1 14.3 1 16.7 2 15.4 2 28.6 0 0.0 2 15.4 2 28.6 1 16.7 3 23.1 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 2
6 KAPUJAYA 570 4 3 7 4 3 7 1 25.0 0 0.0 1 14.3 0 0.0 1 #DIV/0! 1 14.3 0 0.0 1 33.3 1 14.3 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 WAWOURU 985 8 19 27 8 19 27 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 3 37.5 0 0.0 3 11.1 0.0 0.0 0 0.0 0
8 MEKAR SARI 1,255 16 7 23 16 7 23 0 0.0 0 0.0 0 0.0 2 12.5 3 24.0 5 21.7 1 6.3 1 14.3 2 8.7 0.0 0.0 0 0.0 1 6.3 0 0.0 1 4.3 0.0 0.0 0 0.0 0
9 WATUMEREMBA 748 9 12 21 9 12 21 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 2 22.2 0 0.0 2 9.5 0.0 0.0 0 0.0 2 22.2 0 0.0 2 9.5 0.0 0.0 0 0.0 0
10 EEWA 584 5 6 11 5 6 11 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 1 16.7 1 9.1 0.0 0.0 0 0.0 0 0.0 1 16.7 1 9.1 0.0 0.0 0 0.0 0
11 ONEMBUTE 882 19 14 33 19 14 33 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 3 21.4 3 9.1 0.0 0.0 0 0.0 3 15.8 1 7.1 4 12.1 0.0 0.0 0 0.0 1
12 ANGGONDARA 682 17 10 27 17 10 27 1 5.9 0 0.0 1 3.7 0 0.0 0 #DIV/0! 0 0.0 1 5.9 0 0.0 1 3.7 0.0 0.0 0 0.0 2 11.8 1 10.0 3 11.1 0.0 0.0 0 0.0 0
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 1 7.1 0 0.0 1 2.9 0 0.0 0 #DIV/0! 0 0.0 1 7.1 0 0.0 1 2.9 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0
14 WAWONGGURA 680 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 0.0 0.0 0 0.0 1
16 UPT.TOLIHE 960 5 4 9 5 4 9 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 1 25.0 1 11.1 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0
PALANGGA 13,357 174 166 340 174 166 340 6 3.4 5 3.0 11 3.2 6 3.4 12 348.0 18 5.3 9 5.2 14 8.4 23 6.8 0 0.0 0 0.0 0 0.0 14 8.0 7 4.2 21 6.2 0 0.0 0 0.0 0 0.0 8
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
(buah)
7 Vak. TT 4 - 4 4 - 4
II. ALAT SUNTIK
1 ADS 5 ml 36 36 36 (36)
2 ADS 0,5 ml 374 374 374 (374)
3 ADS 0,0 5 ml 236 236 236 (236)

BULAN : JULI 2014
TAHUN 2014 (0 - 11 BLN
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 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
2 WATUDEMBA 611 8 11 19 8 11 19 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 AOSOLE 935 20 16 36 20 16 36 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
4 ALAKAYA 616 13 5 18 13 5 18 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
5 WAWORAHA 535 7 6 13 7 6 13 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
6 KAPUJAYA 570 4 3 7 4 3 7 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 WAWOURU 985 8 19 27 8 19 27 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
8 MEKAR SARI 1,255 16 7 23 16 7 23 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
9 WATUMEREMBA 748 9 12 21 9 12 21 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
10 EEWA 584 5 6 11 5 6 11 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
11 ONEMBUTE 882 19 14 33 19 14 33 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
12 ANGGONDARA 682 17 10 27 17 10 27 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
14 WAWONGGURA 680 7 7 14 7 7 14 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
15 SANGGI-SANGGI 612 6 10 16 6 10 16 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
16 UPT.TOLIHE 960 5 4 9 5 4 9 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
PALANGGA 13,357 174 166 340 174 166 340 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
(buah)
I. VAKSIN 1 BCG 0 dosis - Ampul #DIV/0! Baik Rusak Kepala Puskesmas ................Kab./Kota.................. Koordinator Jurim Puskesmas .................
1 Vak. BCG 18 18 18 (18) 2 DPT-HB #REF! dosis - Vial #REF!
2 Vak. DPT-HB 27 27 27 (27) 3 DPT-HB-Hib 0 dosis - Vial #DIV/0!
3 Vak. DPT-HB-Hib - - - - 4 POLIO 0 dosis - Vial #DIV/0!
4 Vak. POLIO 32 32 32 (32) 5 CAMPAK 0 dosis - Vial #DIV/0! ................................... ...................................
5 Vak. CAMPAK 30 30 30 (30) 6 HB. UNIJECT 0 dosis - Buah #DIV/0! Nip. ........................... Nip. ...........................
6 Vak. HB. UNIJECT 62 62 62 (62) 7 TT 0 dosis - Vial #DIV/0!
7 Vak. TT - - - -
II. ALAT SUNTIK
1 ADS 5 ml 36 36 36 (36)
2 ADS 0,5 ml 374 374 374 (374)
3 ADS 0,0 5 ml 236 236 236 (236)

BULAN : AGUSTUS 2014
TAHUN 2014 (0 - 11 BLN
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 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
2 WATUDEMBA 611 8 11 19 8 11 19 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 AOSOLE 935 20 16 36 20 16 36 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
4 ALAKAYA 616 13 5 18 13 5 18 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
5 WAWORAHA 535 7 6 13 7 6 13 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
6 KAPUJAYA 570 4 3 7 4 3 7 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 WAWOURU 985 8 19 27 8 19 27 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
8 MEKAR SARI 1,255 16 7 23 16 7 23 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
9 WATUMEREMBA 748 9 12 21 9 12 21 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
10 EEWA 584 5 6 11 5 6 11 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
11 ONEMBUTE 882 19 14 33 19 14 33 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
12 ANGGONDARA 682 17 10 27 17 10 27 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
14 WAWONGGURA 680 7 7 14 7 7 14 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
16 UPT.TOLIHE 960 5 4 9 5 4 9 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
PALANGGA 13,357 174 166 340 174 166 340 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
(buah)
7 Vak. TT - - - -
II. ALAT SUNTIK
1 ADS 5 ml 36 36 36 (36)
2 ADS 0,5 ml 374 374 374 (374)
3 ADS 0,0 5 ml 236 236 236 (236)

BULAN : SEPTEMBER 2014
TAHUN 2014 (0 - 11 BLN
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 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
2 WATUDEMBA 611 8 11 19 8 11 19 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 AOSOLE 935 20 16 36 20 16 36 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
4 ALAKAYA 616 13 5 18 13 5 18 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
5 WAWORAHA 535 7 6 13 7 6 13 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
6 KAPUJAYA 570 4 3 7 4 3 7 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 WAWOURU 985 8 19 27 8 19 27 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
8 MEKAR SARI 1,255 16 7 23 16 7 23 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
9 WATUMEREMBA 748 9 12 21 9 12 21 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
10 EEWA 584 5 6 11 5 6 11 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
11 ONEMBUTE 882 19 14 33 19 14 33 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
12 ANGGONDARA 682 17 10 27 17 10 27 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
14 WAWONGGURA 680 7 7 14 7 7 14 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
16 UPT.TOLIHE 960 5 4 9 5 4 9 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
PALANGGA 13,357 174 166 340 174 166 340 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
(buah)
7 Vak. TT - - - -
II. ALAT SUNTIK
1 ADS 5 ml 36 36 36 (36)
2 ADS 0,5 ml 374 374 374 (374)
3 ADS 0,0 5 ml 236 236 236 (236)

BULAN : OKTOBER 2014
TAHUN 2014 (0 - 11 BLN
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 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
2 WATUDEMBA 611 8 11 19 8 11 19 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 AOSOLE 935 20 16 36 20 16 36 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
4 ALAKAYA 616 13 5 18 13 5 18 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
5 WAWORAHA 535 7 6 13 7 6 13 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
6 KAPUJAYA 570 4 3 7 4 3 7 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 WAWOURU 985 8 19 27 8 19 27 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
8 MEKAR SARI 1,255 16 7 23 16 7 23 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
9 WATUMEREMBA 748 9 12 21 9 12 21 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
10 EEWA 584 5 6 11 5 6 11 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
11 ONEMBUTE 882 19 14 33 19 14 33 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
12 ANGGONDARA 682 17 10 27 17 10 27 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
14 WAWONGGURA 680 7 7 14 7 7 14 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
16 UPT.TOLIHE 960 5 4 9 5 4 9 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
PALANGGA 13,357 174 166 340 174 166 340 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
(buah)
7 Vak. TT - - - -
II. ALAT SUNTIK
1 ADS 5 ml 36 36 36 (36)
2 ADS 0,5 ml 374 374 374 (374)
3 ADS 0,0 5 ml 236 236 236 (236)

BULAN : NOPEMBER 2014
TAHUN 2014 (0 - 11 BLN
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 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
2 WATUDEMBA 611 8 11 19 8 11 19 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 AOSOLE 935 20 16 36 20 16 36 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
4 ALAKAYA 616 13 5 18 13 5 18 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
5 WAWORAHA 535 7 6 13 7 6 13 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
6 KAPUJAYA 570 4 3 7 4 3 7 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 WAWOURU 985 8 19 27 8 19 27 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
8 MEKAR SARI 1,255 16 7 23 16 7 23 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
9 WATUMEREMBA 748 9 12 21 9 12 21 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
10 EEWA 584 5 6 11 5 6 11 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
11 ONEMBUTE 882 19 14 33 19 14 33 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
12 ANGGONDARA 682 17 10 27 17 10 27 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
14 WAWONGGURA 680 7 7 14 7 7 14 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
16 UPT.TOLIHE 960 5 4 9 5 4 9 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
PALANGGA 13,357 174 166 340 174 166 340 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
(buah)
7 Vak. TT - - - -
II. ALAT SUNTIK
1 ADS 5 ml 36 36 36 (36)
2 ADS 0,5 ml 374 374 374 (374)
3 ADS 0,0 5 ml 236 236 236 (236)

BULAN : DESEMBER 2014
TAHUN 2014 (0 - 11 BLN
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 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
2 WATUDEMBA 611 8 11 19 8 11 19 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 AOSOLE 935 20 16 36 20 16 36 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
4 ALAKAYA 616 13 5 18 13 5 18 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
5 WAWORAHA 535 7 6 13 7 6 13 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
6 KAPUJAYA 570 4 3 7 4 3 7 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 WAWOURU 985 8 19 27 8 19 27 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
8 MEKAR SARI 1,255 16 7 23 16 7 23 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
9 WATUMEREMBA 748 9 12 21 9 12 21 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
10 EEWA 584 5 6 11 5 6 11 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
11 ONEMBUTE 882 19 14 33 19 14 33 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
12 ANGGONDARA 682 17 10 27 17 10 27 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
14 WAWONGGURA 680 7 7 14 7 7 14 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
16 UPT.TOLIHE 960 5 4 9 5 4 9 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
PALANGGA 13,357 174 166 340 174 166 340 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
(buah)
7 Vak. TT - - - -
II. ALAT SUNTIK
1 ADS 5 ml 36 36 36 (36)
2 ADS 0,5 ml 374 374 374 (374)
3 ADS 0,0 5 ml 236 236 236 (236)

BULAN : JANUARI S/D...................... 2014
TAHUN 2014 (0 - 11 BLN
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 33 34 35 36 37 38 39 40 41 42 43 44 51 52 53 54 55 56 57
1 KIAEA 1,647 16 16 32 16 16 32 2 12.5 8 50.0 10 31.3 4 25.0 7 28.0 11 34.4 6 37.5 5 31.3 11 34.4 0 0.0 0 0.0 0 0.0 8 50.0 6 37.5 14 43.8 0 0.0 0 0.0 0 0.0 7
2 WATUDEMBA 611 8 11 19 8 11 19 5 62.5 7 63.6 12 63.2 4 50.0 6 12.0 10 52.6 2 25.0 8 72.7 10 52.6 0 0.0 0 0.0 0 0.0 2 25.0 8 72.7 10 52.6 0 0.0 0 0.0 0 0.0 2
3 AOSOLE 935 20 16 36 20 16 36 6 30.0 4 25.0 10 27.8 5 25.0 8 32.0 13 36.1 1 5.0 7 43.8 8 22.2 0 0.0 0 0.0 0 0.0 3 15.0 4 25.0 7 19.4 0 0.0 0 0.0 0 0.0 5
4 ALAKAYA 616 13 5 18 13 5 18 2 15.4 3 60.0 5 27.8 2 15.4 0 0.0 2 11.1 2 15.4 1 20.0 3 16.7 0 0.0 0 0.0 0 0.0 5 38.5 3 60.0 8 44.4 0 0.0 0 0.0 0 0.0 5
5 WAWORAHA 535 7 6 13 7 6 13 5 71.4 3 50.0 8 61.5 7 100.0 1 1.0 8 61.5 5 71.4 2 33.3 7 53.8 0 0.0 0 0.0 0 0.0 4 57.1 2 33.3 6 46.2 0 0.0 0 0.0 0 0.0 3
6 KAPUJAYA 570 4 3 7 4 3 7 2 50.0 1 33.3 3 42.9 1 25.0 2 8.0 3 42.9 0 0.0 2 66.7 2 28.6 0 0.0 0 0.0 0 0.0 1 25.0 2 66.7 3 42.9 0 0.0 0 0.0 0 0.0 1
7 WAWOURU 985 8 19 27 8 19 27 5 62.5 1 5.3 6 22.2 3 37.5 2 5.3 5 18.5 5 62.5 6 31.6 11 40.7 0 0.0 0 0.0 0 0.0 5 62.5 7 36.8 12 44.4 0 0.0 0 0.0 0 0.0 2
8 MEKAR SARI 1,255 16 7 23 16 7 23 5 31.3 4 57.1 9 39.1 5 31.3 6 19.2 11 47.8 4 25.0 5 71.4 9 39.1 0 0.0 0 0.0 0 0.0 3 18.8 5 71.4 8 34.8 0 0.0 0 0.0 0 0.0 4
9 WATUMEREMBA 748 9 12 21 9 12 21 4 44.4 1 8.3 5 23.8 4 44.4 5 11.3 9 42.9 5 55.6 7 58.3 12 57.1 0 0.0 0 0.0 0 0.0 4 44.4 5 41.7 9 42.9 0 0.0 0 0.0 0 0.0 2
10 EEWA 584 5 6 11 5 6 11 0 0.0 2 33.3 2 18.2 1 20.0 5 25.0 6 54.5 1 20.0 4 66.7 5 45.5 0 0.0 0 0.0 0 0.0 4 80.0 2 33.3 6 54.5 0 0.0 0 0.0 0 0.0 2
11 ONEMBUTE 882 19 14 33 19 14 33 6 31.6 2 14.3 8 24.2 5 26.3 9 34.2 14 42.4 6 31.6 7 50.0 13 39.4 0 0.0 0 0.0 0 0.0 7 36.8 7 50.0 14 42.4 0 0.0 0 0.0 0 0.0 5
12 ANGGONDARA 682 17 10 27 17 10 27 6 35.3 3 30.0 9 33.3 4 23.5 3 12.8 7 25.9 8 47.1 4 40.0 12 44.4 0 0.0 0 0.0 0 0.0 10 58.8 8 80.0 18 66.7 0 0.0 0 0.0 0 0.0 9
13 KEL.PALANGGA 1,055 14 20 34 14 20 34 5 35.7 4 20.0 9 26.5 9 64.3 6 9.3 15 44.1 2 14.3 5 25.0 7 20.6 0 0.0 0 0.0 0 0.0 3 21.4 10 50.0 13 38.2 0 0.0 0 0.0 0 0.0 4
14 WAWONGGURA 680 7 7 14 7 7 14 1 14.3 0 0.0 1 7.1 1 14.3 1 7.0 2 14.3 3 42.9 0 0.0 3 21.4 0 0.0 0 0.0 0 0.0 3 42.9 2 28.6 5 35.7 0 0.0 0 0.0 0 0.0 5
15 SANGGI-SANGGI 612 6 10 16 6 10 16 3 50.0 2 20.0 5 31.3 2 33.3 5 15.0 7 43.8 3 50.0 6 60.0 9 56.3 0 0.0 0 0.0 0 0.0 4 66.7 7 70.0 11 68.8 0 0.0 0 0.0 0 0.0 3
16 UPT.TOLIHE 960 5 4 9 5 4 9 1 20.0 0 0.0 1 11.1 0 0.0 0 #DIV/0! 0 0.0 2 40.0 1 25.0 3 33.3 0 0.0 0 0.0 0 0.0 2 40.0 1 25.0 3 33.3 0 0.0 0 0.0 0 0.0 2
PALANGGA 13,357 174 166 340 174 166 340 58 33.3 45 27.1 103 30.3 57 32.8 66 201.5 123 36.2 55 31.6 70 42.2 125 36.8 0 0.0 0 0.0 0 0.0 68 39.1 79 47.6 147 43.2 0 0.0 0 0.0 0 0.0 61
No.
Safety Box
Stock Bln Lalu
Bln ini
Jumlah
Bln ini
(buah)
I. VAKSIN 1 BCG 123 dosis 41 Ampul 3 Baik Rusak Kepala Puskesmas ................Kab./Kota.................. Koordinator Jurim Puskesmas .................
1 Vak. BCG 18 40 58 41 17 24 2 DPT-HB #REF! dosis 122 Vial #REF!
3 Vak. DPT-HB-Hib - - - - - - 4 POLIO 571 dosis 100 Vial 5.71
4 Vak. POLIO 32 100 132 100 32 68 5 CAMPAK 164 dosis 49 Vial 3.346939 ................................... ...................................
5 Vak. CAMPAK 30 50 80 49 31 18 6 HB. UNIJECT 103 dosis 103 Buah 1 Nip. ........................... Nip. ...........................
6 Vak. HB. UNIJECT 62 90 152 103 49 54 7 TT 224 dosis 55 Vial 4.072727
7 Vak. TT - 20 20 55 (35) 90
II. ALAT SUNTIK
1 ADS 5 ml 36 20 56 11 45 (34)
2 ADS 0,5 ml 374 500 874 130 744 (614)
3 ADS 0,0 5 ml 236 100 336 18 318 (300)
4 Safety Box 5 liter - - - - - -
5 Safety Box 0,25 liter - - - - - -
HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIM
SASARAN
POLIO3 DPT/HB-Hib (3) POLIO4 CAMPAK IMUNISASI DASAR LENGKAP SASARAN BATITA DPT/HB/Hib CAMPAK BUMIL TT1 TT2 TT3
% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
6.3 2 12.5 3 9.4 0.0 0.0 0 0.0 1 6.3 0 0.0 1 3.1 1 6.3 0 0.0 1 3.1 1 6.3 0 0.0 1 3.1 37 56 93 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 2 5.7 1 2.8 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 27 50 0.0 0.0 0 0.0 0.0 0.0 0 0.0 21 0 0.0 0 0.0 0 0.0
5.0 2 12.5 3 8.3 0.0 0.0 0 0.0 0 0.0 1 6.3 1 2.8 0 0.0 1 6.3 1 2.8 0 0.0 1 6.3 1 2.8 31 38 69 0.0 0.0 0 0.0 0.0 0.0 0 0.0 40 0 0.0 6 15.2 0 0.0
0.0 1 20.0 1 5.6 0.0 0.0 0 0.0 2 15.4 0 0.0 2 11.1 2 15.4 0 0.0 2 11.1 2 15.4 0 0.0 2 11.1 23 19 42 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 1 5.1 0 0.0 0 0.0
0.0 2 33.3 2 15.4 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 22 13 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 14 0 0.0 2 14.0 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 1 13.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 4 21.1 4 14.8 0 0.0 4 21.1 4 14.8 0 0.0 4 21.1 4 14.8 33 35 68 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0
6.3 2 28.6 3 13.0 0.0 0.0 0 0.0 0 0.0 2 28.6 2 8.7 0 0.0 2 28.6 2 8.7 0 0.0 2 28.6 2 8.7 38 36 74 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 2 7.9 2 7.9 0 0.0
0.0 1 8.3 1 4.8 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 2 8.7 3 13.0 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 25 19 44 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 0 0.0 2 16.5 0 0.0
15.8 1 7.1 4 12.1 0.0 0.0 0 0.0 2 10.5 0 0.0 2 6.1 2 10.5 0 0.0 2 6.1 2 10.5 0 0.0 2 6.1 35 38 73 0.0 0.0 0 0.0 0.0 0.0 0 0.0 36 2 5.5 2 5.5 0 0.0
11.8 0 0.0 2 7.4 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 31 18 49 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 2 6.7 1 3.4 0 0.0
7.1 1 5.0 2 5.9 0.0 0.0 0 0.0 1 7.1 0 0.0 1 2.9 1 7.1 0 0.0 1 2.9 1 7.1 0 0.0 1 2.9 56 60 116 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 2 5.3 1 2.7 1 2.7
28.6 0 0.0 2 14.3 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 21 43 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 2 13.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 16 30 46 0.0 0.0 0 0.0 0.0 0.0 0 0.0 18 1 5.7 2 11.4 2 11.4
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 9 13 22 0.0 0.0 0 0.0 0.0 0.0 0 0.0 10 0 0.0 3 30.3 0 0.0
6.3 12 7.2 23 6.8 0 0.0 0 0.0 0 0.0 6 3.4 7 4.2 13 3.8 6 3.4 7 4.2 13 3.8 6 3.4 7 4.2 13 3.8 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 17 4.5 25 6.7 3 0.8
IDENTITAS DIDUGA KIPI (1) IMUNISASI IDENTITAS DIDUGA KIPI (2) IMUNISASI
mas ................. 1 Nama Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir)
2 Kelamin Jumlah dosis 2 Kelamin :
Imunisasi Tgl. Cara Pemberian (Intra kutan, Lokasi Imunisasi Tgl. Cara Pemberian (Intra kutan,
Tgl Jam No. Batch VVM vaksin (ml / Tgl Jam No. Batch VVM
3 Tggl / Lahir (Vaksin) Kadaluarsa Sub-kutan, IM, tetes) penyuntikan 3 Tggl / Lahir : (Vaksin) Kadaluarsa Sub-kutan, IM, tetes)
tetes)
4 Umur 4 Umur :
5 Nama ayah 5 Nama ayah :
6 Nama ibu 6 Nama ibu :
7 Alamat 7 Alamat :
a. Reaksi timbul pada tgl .......................................... a. Jalan ………………………… Nomor …. RT/RW ………………. Reaksi timbul pada tgl ..........................................
b. Gejala & Waktu timbulnya gejala ......................................................... b. Dusun/Kampung…………….. Desa/Kelurahan ………………… Gejala & Waktu timbulnya gejala .........................................................
c. c. Kecamatan ………………….. Kabupaten …………………………
d. d. Provinsi Sulawesi Tenggara
8 Jumlah saudara kandung : 8 Jumlah saudara kandung :

SASARAN

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
12.5 3 18.8 5 15.6 0.0 0.0 0 0.0 1 6.3 2 12.5 3 9.4 1 6.3 2 12.5 3 9.4 1 6.3 2 12.5 3 9.4 37 56 93 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 4 11.4 3 8.5 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 23 27 50 0.0 0.0 0 0.0 0.0 0.0 0 0.0 21 3 14.4 1 4.8 0 0.0
5.0 0 0.0 1 2.8 0.0 0.0 0 0.0 2 10.0 2 12.5 4 11.1 2 10.0 2 12.5 4 11.1 2 10.0 2 12.5 4 11.1 31 38 69 0.0 0.0 0 0.0 0.0 0.0 0 0.0 40 0 0.0 0 0.0 2 5.1
15.4 2 40.0 4 22.2 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 19 42 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 0 0.0 1 5.1 0 0.0
0.0 2 33.3 2 15.4 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 22 13 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 14 0 0.0 0 0.0 0 0.0
25.0 0 0.0 1 14.3 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 1 13.0 1 13.0 0 0.0
12.5 1 5.3 2 7.4 0.0 0.0 0 0.0 1 12.5 2 10.5 3 11.1 1 12.5 2 10.5 3 11.1 1 12.5 2 10.5 3 11.1 33 35 68 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 2 6.7 0 0.0 0 0.0
0.0 1 14.3 1 4.3 0.0 0.0 0 0.0 4 25.0 0 0.0 4 17.4 4 25.0 0 0.0 4 17.4 4 25.0 0 0.0 4 17.4 38 36 74 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 2 7.9 2 7.9 0 0.0
0.0 1 8.3 1 4.8 0.0 0.0 0 0.0 2 22.2 1 8.3 3 14.3 2 22.2 1 8.3 3 14.3 2 22.2 1 8.3 3 14.3 32 27 59 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 0 0.0 4 17.3 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 25 19 44 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 2 16.5 0 0.0 0 0.0
0.0 1 7.1 1 3.0 0.0 0.0 0 0.0 1 5.3 1 7.1 2 6.1 1 5.3 1 7.1 2 6.1 1 5.3 1 7.1 2 6.1 35 38 73 0.0 0.0 0 0.0 0.0 0.0 0 0.0 36 1 2.8 4 11.0 0 0.0
5.9 1 10.0 2 7.4 0.0 0.0 0 0.0 1 5.9 2 20.0 3 11.1 1 5.9 2 20.0 3 11.1 1 5.9 2 20.0 3 11.1 31 18 49 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0 0.0 3 10.1 0 0.0
21.4 1 5.0 4 11.8 0.0 0.0 0 0.0 1 7.1 2 10.0 3 8.8 1 7.1 2 10.0 3 8.8 1 7.1 2 10.0 3 8.8 56 60 116 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 1 2.7 3 8.0 0 0.0
14.3 0 0.0 1 7.1 0.0 0.0 0 0.0 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 22 21 43 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 0 0.0 2 13.0 0 0.0
16.7 1 10.0 2 12.5 0.0 0.0 0 0.0 0 0.0 1 10.0 1 6.3 0 0.0 1 10.0 1 6.3 0 0.0 1 10.0 1 6.3 16 30 46 0.0 0.0 0 0.0 0.0 0.0 0 0.0 18 0 0.0 1 5.7 1 5.7
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0.0 0.0 0 0.0 0.0 0.0 0 0.0 10 0 0.0 1 10.1 0 0.0
2.6 14 1.7 27 2.0 0 0.0 0 0.0 0 0.0 13 2.6 14 1.7 27 2.0 13 2.6 14 1.7 27 2.0 13 2.6 14 1.7 27 2.0 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 16 4.3 26 7.0 3 0.8
tetes)
4 Umur 4 Umur :
7 Alamat 7 Alamat :

SASARAN

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
6.3 0 0.0 1 3.1 0.0 0.0 0 0.0 3 18.8 0 0.0 3 9.4 3 18.8 0 0.0 3 9.4 3 18.8 0 0.0 3 9.4 37 56 93 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 1 2.8 2 5.7 0 0.0
12.5 0 0.0 1 5.3 0.0 0.0 0 0.0 0 0.0 2 18.2 2 10.5 0 0.0 2 18.2 2 10.5 0 0.0 2 18.2 2 10.5 23 27 50 0.0 0.0 0 0.0 0.0 0.0 0 0.0 21 2 9.6 2 9.6 0 0.0
10.0 0 0.0 2 5.6 0.0 0.0 0 0.0 1 5.0 0 0.0 1 2.8 1 5.0 0 0.0 1 2.8 1 5.0 0 0.0 1 2.8 31 38 69 0.0 0.0 0 0.0 0.0 0.0 0 0.0 40 1 2.5 0 0.0 1 2.5
7.7 0 0.0 1 5.6 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 19 42 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
0.0 1 16.7 1 7.7 0.0 0.0 0 0.0 1 14.3 0 0.0 1 7.7 1 14.3 0 0.0 1 7.7 1 14.3 0 0.0 1 7.7 22 13 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 14 1 7.0 2 14.0 0 0.0
0.0 2 66.7 2 28.6 0.0 0.0 0 0.0 2 50.0 0 0.0 2 28.6 2 50.0 0 0.0 2 28.6 2 50.0 0 0.0 2 28.6 19 16 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 0 0.0 1 13.0 0 0.0
0.0 3 15.8 3 11.1 0.0 0.0 0 0.0 0 0.0 1 5.3 1 3.7 0 0.0 1 5.3 1 3.7 0 0.0 1 5.3 1 3.7 33 35 68 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 1 3.4 2 6.7 0 0.0
6.3 1 14.3 2 8.7 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 38 36 74 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 0 0.0 2 7.9 0 0.0
11.1 1 8.3 2 9.5 0.0 0.0 0 0.0 1 11.1 2 16.7 3 14.3 1 11.1 2 16.7 3 14.3 1 11.1 2 16.7 3 14.3 32 27 59 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 2 8.7 0 0.0 0 0.0
20.0 0 0.0 1 9.1 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 25 19 44 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 0 0.0 0 0.0 0 0.0
5.3 2 14.3 3 9.1 0.0 0.0 0 0.0 0 0.0 2 14.3 2 6.1 0 0.0 2 14.3 2 6.1 0 0.0 2 14.3 2 6.1 35 38 73 0.0 0.0 0 0.0 0.0 0.0 0 0.0 36 0 0.0 0 0.0 0 0.0
5.9 1 10.0 2 7.4 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 31 18 49 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 2 6.7 1 3.4 0 0.0
0.0 1 5.0 1 2.9 0.0 0.0 0 0.0 1 7.1 3 15.0 4 11.8 1 7.1 3 15.0 4 11.8 1 7.1 3 15.0 4 11.8 56 60 116 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 0 0.0 0 0.0 0 0.0
14.3 0 0.0 1 7.1 0.0 0.0 0 0.0 1 14.3 2 28.6 3 21.4 1 14.3 2 28.6 3 21.4 1 14.3 2 28.6 3 21.4 22 21 43 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0
0.0 3 30.0 3 18.8 0.0 0.0 0 0.0 1 16.7 0 0.0 1 6.3 1 16.7 0 0.0 1 6.3 1 16.7 0 0.0 1 6.3 16 30 46 0.0 0.0 0 0.0 0.0 0.0 0 0.0 18 1 5.7 0 0.0 0 0.0
20.0 0 0.0 1 11.1 0.0 0.0 0 0.0 1 20.0 0 0.0 1 11.1 1 20.0 0 0.0 1 11.1 1 20.0 0 0.0 1 11.1 9 13 22 0.0 0.0 0 0.0 0.0 0.0 0 0.0 10 0 0.0 0 0.0 1 10.1
6.9 15 9.0 27 7.9 0 0.0 0 0.0 0 0.0 12 6.9 12 7.2 24 7.1 12 6.9 12 7.2 24 7.1 12 6.9 12 7.2 24 7.1 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 11 2.9 12 3.2 2 0.5
tetes)
4 Umur 4 Umur :
7 Alamat 7 Alamat :

SASARAN

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
12.5 1 6.3 3 9.4 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 37 56 93 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 1 2.8 1 2.8 0 0.0
0.0 2 18.2 2 10.5 0.0 0.0 0 0.0 1 12.5 0 0.0 1 5.3 1 12.5 0 0.0 1 5.3 1 12.5 0 0.0 1 5.3 23 27 50 0.0 0.0 0 0.0 0.0 0.0 0 0.0 21 1 4.8 3 14.4 0 0.0
0.0 1 6.3 1 2.8 0.0 0.0 0 0.0 2 10.0 2 12.5 4 11.1 2 10.0 2 12.5 4 11.1 2 10.0 2 12.5 4 11.1 31 38 69 0.0 0.0 0 0.0 0.0 0.0 0 0.0 40 2 5.1 1 2.5 0 0.0
7.7 1 20.0 2 11.1 0.0 0.0 0 0.0 2 15.4 1 20.0 3 16.7 2 15.4 1 20.0 3 16.7 2 15.4 1 20.0 3 16.7 23 19 42 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 1 5.1 0 0.0 0 0.0
14.3 0 0.0 1 7.7 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 13 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 14 2 14.0 1 7.0 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 0 0.0 1 13.0 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 2 10.5 2 7.4 0 0.0 2 10.5 2 7.4 0 0.0 2 10.5 2 7.4 33 35 68 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 1 3.4 5 16.8 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 2 12.5 0 0.0 2 8.7 2 12.5 0 0.0 2 8.7 2 12.5 0 0.0 2 8.7 38 36 74 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 0 0.0 0 0.0 0 0.0
0.0 1 8.3 1 4.8 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 4 17.3 1 4.3 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 25 19 44 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 2 16.5 1 8.3 0 0.0
0.0 2 14.3 2 6.1 0.0 0.0 0 0.0 4 21.1 1 7.1 5 15.2 4 21.1 1 7.1 5 15.2 4 21.1 1 7.1 5 15.2 35 38 73 0.0 0.0 0 0.0 0.0 0.0 0 0.0 36 0 0.0 0 0.0 0 0.0
17.6 1 10.0 4 14.8 0.0 0.0 0 0.0 1 5.9 3 30.0 4 14.8 1 5.9 3 30.0 4 14.8 1 5.9 3 30.0 4 14.8 31 18 49 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0 0.0 2 6.7 0 0.0
0.0 4 20.0 4 11.8 0.0 0.0 0 0.0 2 14.3 1 5.0 3 8.8 2 14.3 1 5.0 3 8.8 2 14.3 1 5.0 3 8.8 56 60 116 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 2 5.3 0 0.0 0 0.0
0.0 1 14.3 1 7.1 0.0 0.0 0 0.0 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 22 21 43 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 2 13.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 16 30 46 0.0 0.0 0 0.0 0.0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0
0.0 1 25.0 1 11.1 0.0 0.0 0 0.0 2 40.0 1 25.0 3 33.3 2 40.0 1 25.0 3 33.3 2 40.0 1 25.0 3 33.3 9 13 22 0.0 0.0 0 0.0 0.0 0.0 0 0.0 10 0 0.0 1 10.1 0 0.0
4.0 15 9.0 22 6.5 0 0.0 0 0.0 0 0.0 18 10.3 11 6.6 29 8.5 18 10.3 11 6.6 29 8.5 18 10.3 11 6.6 29 8.5 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 18 4.8 17 4.5 0 0.0
tetes)
4 Umur 4 Umur :
7 Alamat 7 Alamat :

SASARAN

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 1 6.3 3 18.8 4 12.5 1 6.3 3 18.8 4 12.5 1 6.3 3 18.8 4 12.5 37 56 93 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 3 8.5 0 0.0 0 0.0
12.5 3 27.3 4 21.1 0.0 0.0 0 0.0 1 12.5 2 18.2 3 15.8 1 12.5 2 18.2 3 15.8 1 12.5 2 18.2 3 15.8 23 27 50 0.0 0.0 0 0.0 0.0 0.0 0 0.0 21 1 4.8 1 4.8 0 0.0
0.0 1 6.3 1 2.8 0.0 0.0 0 0.0 6 30.0 1 6.3 7 19.4 6 30.0 1 6.3 7 19.4 6 30.0 1 6.3 7 19.4 31 38 69 0.0 0.0 0 0.0 0.0 0.0 0 0.0 40 0 0.0 2 5.1 0 0.0
7.7 0 0.0 1 5.6 0.0 0.0 0 0.0 5 38.5 0 0.0 5 27.8 5 38.5 0 0.0 5 27.8 5 38.5 0 0.0 5 27.8 23 19 42 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 13 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 14 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 0 0.0 0 0.0 0 0.0
12.5 2 10.5 3 11.1 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 33 35 68 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0 0.0 1 3.4 0 0.0
12.5 1 14.3 3 13.0 0.0 0.0 0 0.0 2 12.5 1 14.3 3 13.0 2 12.5 1 14.3 3 13.0 2 12.5 1 14.3 3 13.0 38 36 74 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 0 0.0 1 4.0 0 0.0
11.1 0 0.0 1 4.8 0.0 0.0 0 0.0 1 11.1 0 0.0 1 4.8 1 11.1 0 0.0 1 4.8 1 11.1 0 0.0 1 4.8 32 27 59 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 2 8.7 2 8.7 0 0.0
20.0 0 0.0 1 9.1 0.0 0.0 0 0.0 1 20.0 0 0.0 1 9.1 1 20.0 0 0.0 1 9.1 1 20.0 0 0.0 1 9.1 25 19 44 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 1 8.3 0 0.0 0 0.0
0.0 1 7.1 1 3.0 0.0 0.0 0 0.0 2 10.5 1 7.1 3 9.1 2 10.5 1 7.1 3 9.1 2 10.5 1 7.1 3 9.1 35 38 73 0.0 0.0 0 0.0 0.0 0.0 0 0.0 36 3 8.3 0 0.0 0 0.0
11.8 0 0.0 2 7.4 0.0 0.0 0 0.0 2 11.8 0 0.0 2 7.4 2 11.8 0 0.0 2 7.4 2 11.8 0 0.0 2 7.4 31 18 49 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 3 10.1 0 0.0 0 0.0
0.0 2 10.0 2 5.9 0.0 0.0 0 0.0 0 0.0 1 5.0 1 2.9 0 0.0 1 5.0 1 2.9 0 0.0 1 5.0 1 2.9 56 60 116 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 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 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 22 21 43 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 0 0.0 2 13.0 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 1 10.0 1 6.3 0 0.0 1 10.0 1 6.3 0 0.0 1 10.0 1 6.3 16 30 46 0.0 0.0 0 0.0 0.0 0.0 0 0.0 18 1 5.7 1 5.7 0 0.0
20.0 0 0.0 1 11.1 0.0 0.0 0 0.0 0 0.0 2 50.0 2 22.2 0 0.0 2 50.0 2 22.2 0 0.0 2 50.0 2 22.2 9 13 22 0.0 0.0 0 0.0 0.0 0.0 0 0.0 10 0 0.0 0 0.0 0 0.0
5.7 10 6.0 20 5.9 0 0.0 0 0.0 0 0.0 22 12.6 12 7.2 34 10.0 22 12.6 12 7.2 34 10.0 22 12.6 12 7.2 34 10.0 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 14 3.7 10 2.7 0 0.0
tetes)
4 Umur 4 Umur :
7 Alamat 7 Alamat :

SASARAN
BUMIL
SASARAN

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
6.3 0 0.0 1 3.1 0.0 0.0 0 0.0 4 25.0 0 0.0 4 12.5 4 25.0 0 0.0 4 12.5 4 25.0 0 0.0 4 12.5 37 56 93 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 1 2.8 2 5.7 0 0.0
0.0 1 9.1 1 5.3 0.0 0.0 0 0.0 2 25.0 2 18.2 4 21.1 2 25.0 2 18.2 4 21.1 2 25.0 2 18.2 4 21.1 23 27 50 0.0 0.0 0 0.0 0.0 0.0 0 0.0 21 1 4.8 1 4.8 0 0.0
5.0 0 0.0 1 2.8 0.0 0.0 0 0.0 0 0.0 2 12.5 2 5.6 0 0.0 2 12.5 2 5.6 0 0.0 2 12.5 2 5.6 31 38 69 0.0 0.0 0 0.0 0.0 0.0 0 0.0 40 1 2.5 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 23 19 42 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
28.6 0 0.0 2 15.4 0.0 0.0 0 0.0 1 14.3 3 50.0 4 30.8 1 14.3 3 50.0 4 30.8 1 14.3 3 50.0 4 30.8 22 13 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 14 2 14.0 3 21.0 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 2 66.7 2 28.6 0 0.0 2 66.7 2 28.6 0 0.0 2 66.7 2 28.6 19 16 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 0 0.0 0 0.0 0 0.0
0.0 1 5.3 1 3.7 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 33 35 68 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 4 13.5 0 0.0 0 0.0
0.0 1 14.3 1 4.3 0.0 0.0 0 0.0 2 12.5 1 14.3 3 13.0 2 12.5 1 14.3 3 13.0 2 12.5 1 14.3 3 13.0 38 36 74 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 0 0.0 0 0.0 1 4.0
0.0 1 8.3 1 4.8 0.0 0.0 0 0.0 0 0.0 2 16.7 2 9.5 0 0.0 2 16.7 2 9.5 0 0.0 2 16.7 2 9.5 32 27 59 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 0 0.0 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 16.7 1 9.1 0 0.0 1 16.7 1 9.1 0 0.0 1 16.7 1 9.1 25 19 44 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 0 0.0 0 0.0 0 0.0
5.3 1 7.1 2 6.1 0.0 0.0 0 0.0 1 5.3 4 28.6 5 15.2 1 5.3 4 28.6 5 15.2 1 5.3 4 28.6 5 15.2 35 38 73 0.0 0.0 0 0.0 0.0 0.0 0 0.0 36 0 0.0 0 0.0 0 0.0
0.0 1 10.0 1 3.7 0.0 0.0 0 0.0 3 17.6 1 10.0 4 14.8 3 17.6 1 10.0 4 14.8 3 17.6 1 10.0 4 14.8 31 18 49 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0
0.0 1 5.0 1 2.9 0.0 0.0 0 0.0 0 0.0 2 10.0 2 5.9 0 0.0 2 10.0 2 5.9 0 0.0 2 10.0 2 5.9 56 60 116 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 0 0.0 0 0.0 0 0.0
14.3 0 0.0 1 7.1 0.0 0.0 0 0.0 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 22 21 43 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0
33.3 1 10.0 3 18.8 0.0 0.0 0 0.0 1 16.7 2 20.0 3 18.8 1 16.7 2 20.0 3 18.8 1 16.7 2 20.0 3 18.8 16 30 46 0.0 0.0 0 0.0 0.0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0.0 0.0 0 0.0 0.0 0.0 0 0.0 10 0 0.0 0 0.0 0 0.0
4.6 8 4.8 16 4.7 0 0.0 0 0.0 0 0.0 14 8.0 23 13.9 37 10.9 14 8.0 23 13.9 37 10.9 14 8.0 23 13.9 37 10.9 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 9 2.4 6 1.6 1 0.3
tetes)
4 Umur 4 Umur :
7 Alamat 7 Alamat :

SASARAN

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 56 93 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 27 50 0.0 0.0 0 0.0 0.0 0.0 0 0.0 21 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 31 38 69 0.0 0.0 0 0.0 0.0 0.0 0 0.0 40 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 19 42 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 22 13 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 14 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 19 16 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 33 35 68 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 38 36 74 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 32 27 59 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 19 44 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 38 73 0.0 0.0 0 0.0 0.0 0.0 0 0.0 36 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 31 18 49 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 56 60 116 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 22 21 43 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 16 30 46 0.0 0.0 0 0.0 0.0 0.0 0 0.0 18 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 9 13 22 0.0 0.0 0 0.0 0.0 0.0 0 0.0 10 0.0 0.0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 0 0.0 0 0.0 0 0.0
tetes)
4 Umur 4 Umur :
7 Alamat 7 Alamat :

SASARAN

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 56 93 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 27 50 0.0 0.0 0 0.0 0.0 0.0 0 0.0 21 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 31 38 69 0.0 0.0 0 0.0 0.0 0.0 0 0.0 40 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 19 42 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 22 13 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 14 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 19 16 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 33 35 68 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 38 36 74 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 32 27 59 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 19 44 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 38 73 0.0 0.0 0 0.0 0.0 0.0 0 0.0 36 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 31 18 49 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 56 60 116 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 22 21 43 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 16 30 46 0.0 0.0 0 0.0 0.0 0.0 0 0.0 18 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 9 13 22 0.0 0.0 0 0.0 0.0 0.0 0 0.0 10 0.0 0.0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 0 0.0 0 0.0 0 0.0
tetes)
4 Umur 4 Umur :
7 Alamat 7 Alamat :

SASARAN

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 56 93 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 27 50 0.0 0.0 0 0.0 0.0 0.0 0 0.0 21 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 31 38 69 0.0 0.0 0 0.0 0.0 0.0 0 0.0 40 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 19 42 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 22 13 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 14 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 19 16 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 33 35 68 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 38 36 74 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 32 27 59 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 19 44 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 38 73 0.0 0.0 0 0.0 0.0 0.0 0 0.0 36 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 31 18 49 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 56 60 116 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 22 21 43 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 16 30 46 0.0 0.0 0 0.0 0.0 0.0 0 0.0 18 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 9 13 22 0.0 0.0 0 0.0 0.0 0.0 0 0.0 10 0.0 0.0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 0 0.0 0 0.0 0 0.0
tetes)
4 Umur 4 Umur :
7 Alamat 7 Alamat :

SASARAN

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 56 93 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 27 50 0.0 0.0 0 0.0 0.0 0.0 0 0.0 21 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 31 38 69 0.0 0.0 0 0.0 0.0 0.0 0 0.0 40 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 19 42 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 22 13 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 14 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 19 16 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 33 35 68 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 38 36 74 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 32 27 59 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 19 44 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 38 73 0.0 0.0 0 0.0 0.0 0.0 0 0.0 36 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 31 18 49 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 56 60 116 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 22 21 43 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 16 30 46 0.0 0.0 0 0.0 0.0 0.0 0 0.0 18 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 9 13 22 0.0 0.0 0 0.0 0.0 0.0 0 0.0 10 0.0 0.0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 0 0.0 0 0.0 0 0.0
tetes)
4 Umur 4 Umur :
7 Alamat 7 Alamat :

SASARAN

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 56 93 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 27 50 0.0 0.0 0 0.0 0.0 0.0 0 0.0 21 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 31 38 69 0.0 0.0 0 0.0 0.0 0.0 0 0.0 40 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 19 42 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 22 13 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 14 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 19 16 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 33 35 68 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 38 36 74 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 32 27 59 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 19 44 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 38 73 0.0 0.0 0 0.0 0.0 0.0 0 0.0 36 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 31 18 49 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 56 60 116 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 22 21 43 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 16 30 46 0.0 0.0 0 0.0 0.0 0.0 0 0.0 18 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 9 13 22 0.0 0.0 0 0.0 0.0 0.0 0 0.0 10 0.0 0.0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 0 0.0 0 0.0 0 0.0
tetes)
4 Umur 4 Umur :
7 Alamat 7 Alamat :

SASARAN

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 56 93 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 27 50 0.0 0.0 0 0.0 0.0 0.0 0 0.0 21 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 31 38 69 0.0 0.0 0 0.0 0.0 0.0 0 0.0 40 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 19 42 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 22 13 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 14 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 19 16 35 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 33 35 68 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 38 36 74 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 32 27 59 0.0 0.0 0 0.0 0.0 0.0 0 0.0 23 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 25 19 44 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 35 38 73 0.0 0.0 0 0.0 0.0 0.0 0 0.0 36 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 31 18 49 0.0 0.0 0 0.0 0.0 0.0 0 0.0 30 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 56 60 116 0.0 0.0 0 0.0 0.0 0.0 0 0.0 37 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 22 21 43 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 16 30 46 0.0 0.0 0 0.0 0.0 0.0 0 0.0 18 0.0 0.0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 9 13 22 0.0 0.0 0 0.0 0.0 0.0 0 0.0 10 0.0 0.0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 0 0.0 0 0.0 0 0.0
tetes)
4 Umur 4 Umur :
7 Alamat 7 Alamat :
SASARAN

58 59 60 61 62 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
43.8 6 37.5 13 40.6 0 0.0 0 0.0 0 0.0 10 62.5 5 31.3 15 46.9 10 62.5 5 31.3 15 46.9 10 62.5 5 31.3 15 46.9 37 56 93 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 35 12 34.1 9 25.6 0 0.0
25.0 6 54.5 8 42.1 0 0.0 0 0.0 0 0.0 4 50.0 6 54.5 10 52.6 4 50.0 6 54.5 10 52.6 4 50.0 6 54.5 10 52.6 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 21 8 38.3 8 38.3 0 0.0
25.0 4 25.0 9 25.0 0 0.0 0 0.0 0 0.0 11 55.0 8 50.0 19 52.8 11 55.0 8 50.0 19 52.8 11 55.0 8 50.0 19 52.8 31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 40 4 10.1 9 22.7 3 7.6
38.5 4 80.0 9 50.0 0 0.0 0 0.0 0 0.0 9 69.2 1 20.0 10 55.6 9 69.2 1 20.0 10 55.6 9 69.2 1 20.0 10 55.6 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 2 10.1 1 5.1 0 0.0
42.9 5 83.3 8 61.5 0 0.0 0 0.0 0 0.0 2 28.6 3 50.0 5 38.5 2 28.6 3 50.0 5 38.5 2 28.6 3 50.0 5 38.5 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 14 5 35.0 8 55.9 0 0.0
25.0 2 66.7 3 42.9 0 0.0 0 0.0 0 0.0 2 50.0 2 66.7 4 57.1 2 50.0 2 66.7 4 57.1 2 50.0 2 66.7 4 57.1 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 2 26.0 3 39.0 0 0.0
25.0 7 36.8 9 33.3 0 0.0 0 0.0 0 0.0 1 12.5 9 47.4 10 37.0 1 12.5 9 47.4 10 37.0 1 12.5 9 47.4 10 37.0 33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 8 26.9 8 26.9 0 0.0
25.0 6 85.7 10 43.5 0 0.0 0 0.0 0 0.0 10 62.5 4 57.1 14 60.9 10 62.5 4 57.1 14 60.9 10 62.5 4 57.1 14 60.9 38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 25 4 15.8 7 27.7 1 4.0
22.2 5 41.7 7 33.3 0 0.0 0 0.0 0 0.0 4 44.4 5 41.7 9 42.9 4 44.4 5 41.7 9 42.9 4 44.4 5 41.7 9 42.9 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 10 43.3 10 43.3 0 0.0
40.0 0 0.0 2 18.2 0 0.0 0 0.0 0 0.0 1 20.0 1 16.7 2 18.2 1 20.0 1 16.7 2 18.2 1 20.0 1 16.7 2 18.2 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 12 5 41.3 3 24.8 0 0.0
26.3 8 57.1 13 39.4 0 0.0 0 0.0 0 0.0 10 52.6 9 64.3 19 57.6 10 52.6 9 64.3 19 57.6 10 52.6 9 64.3 19 57.6 35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 36 6 16.5 6 16.5 0 0.0
52.9 4 40.0 13 48.1 0 0.0 0 0.0 0 0.0 7 41.2 6 60.0 13 48.1 7 41.2 6 60.0 13 48.1 7 41.2 6 60.0 13 48.1 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 7 23.6 7 23.6 0 0.0
28.6 10 50.0 14 41.2 0 0.0 0 0.0 0 0.0 5 35.7 9 45.0 14 41.2 5 35.7 9 45.0 14 41.2 5 35.7 9 45.0 14 41.2 56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 37 5 13.4 4 10.7 1 2.7
71.4 1 14.3 6 42.9 0 0.0 0 0.0 0 0.0 4 57.1 4 57.1 8 57.1 4 57.1 4 57.1 8 57.1 4 57.1 4 57.1 8 57.1 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 15 4 26.0 4 26.0 0 0.0
50.0 5 50.0 8 50.0 0 0.0 0 0.0 0 0.0 2 33.3 4 40.0 6 37.5 2 33.3 4 40.0 6 37.5 2 33.3 4 40.0 6 37.5 16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 3 17.0 4 22.7 3 17.0
40.0 1 25.0 3 33.3 0 0.0 0 0.0 0 0.0 3 60.0 3 75.0 6 66.7 3 60.0 3 75.0 6 66.7 3 60.0 3 75.0 6 66.7 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 10 0 0.0 5 50.5 1 10.1
35.1 74 44.6 135 39.7 0 0.0 0 0.0 0 0.0 85 48.9 79 47.6 164 48.2 85 48.9 79 47.6 164 48.2 85 48.9 79 47.6 164 48.2 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 374 85 22.7 96 25.7 9 2.4
mas .................
NTASE IBU HAMIL DIIMUNISASI JMLH & JUMLAH DAN PERSENTASE WUS TIDAK HAMIL DIIMUNISASI JUMLAH TOTAL DAN PERSENTASE WUS (HAMIL+TIDAK HAMIL) DIIMUNISASI TT2+ BUMIL
PERSENTASE
TT4 TT5 WUS TDK HAMIL TT1 TT2 TT3 TT4 TT5 TT1 TT2 TT3 TT4 TT5 TT2+
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 1 2.8 361 0.0 0.0 0.0 0.0 0.0 2 0.5 1 0.3 0 0.0 0 0.0 1 0.3 2 5.7
0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 205 0.0 0.0 0.0 0.0 0.0 0 0.0 6 2.5 0 0.0 0 0.0 0 0.0 6 15.2
1 5.1 0 0.0 135 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 1 0.6 0 0.0 1 5.1
0 0.0 0 0.0 117 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.5 0 0.0 0 0.0 0 0.0 2 14.0
0 0.0 0 0.0 125 0.0 0.0 0.0 0.0 0.0 1 0.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 216 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 275 0.0 0.0 0.0 0.0 0.0 2 0.7 2 0.7 0 0.0 0 0.0 0 0.0 2 7.9
1 4.3 0 0.0 164 0.0 0.0 0.0 0.0 0.0 2 1.1 3 1.6 0 0.0 1 0.5 0 0.0 4 17.3
0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.4 0 0.0 0 0.0 0 0.0 2 16.5
1 2.8 0 0.0 193 0.0 0.0 0.0 0.0 0.0 2 0.9 2 0.9 0 0.0 1 0.4 0 0.0 3 8.3
0 0.0 0 0.0 149 0.0 0.0 0.0 0.0 0.0 2 1.1 1 0.6 0 0.0 0 0.0 0 0.0 1 3.4
2 5.3 0 0.0 231 0.0 0.0 0.0 0.0 0.0 2 0.7 1 0.4 1 0.4 2 0.7 0 0.0 4 10.7
0 0.0 0 0.0 149 0.0 0.0 0.0 0.0 0.0 2 1.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 1 0.7 2 1.3 2 1.3 0 0.0 0 0.0 4 22.7
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 3 1.4 0 0.0 0 0.0 0 0.0 3 30.3
5 1.3 1 0.3 2925 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0.5 25 0.8 3 0.1 5 0.2 1 0.0 34 9.1
Jumlah dosis
mberian (Intra kutan,
vaksin (ml / Lokasi penyuntikan
kutan, IM, tetes)
tetes)
PERSENTASE
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 2 5.7 361 0.0 0.0 0.0 0.0 0.0 4 1.0 3 0.8 0 0.0 0 0.0 2 0.5 5 14.2
0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 3 1.9 1 0.6 0 0.0 0 0.0 0 0.0 1 4.8
0 0.0 2 5.1 205 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 0.8 0 0.0 2 0.8 4 10.1
0 0.0 0 0.0 135 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 5.1
0 0.0 0 0.0 117 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 125 0.0 0.0 0.0 0.0 0.0 1 0.8 1 0.8 0 0.0 0 0.0 0 0.0 1 13.0
1 3.4 0 0.0 216 0.0 0.0 0.0 0.0 0.0 2 0.8 0 0.0 0 0.0 1 0.4 0 0.0 1 3.4
1 4.0 0 0.0 275 0.0 0.0 0.0 0.0 0.0 2 0.7 2 0.7 0 0.0 1 0.3 0 0.0 3 11.9
0 0.0 0 0.0 164 0.0 0.0 0.0 0.0 0.0 0 0.0 4 2.1 0 0.0 0 0.0 0 0.0 4 17.3
0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 2 1.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 193 0.0 0.0 0.0 0.0 0.0 1 0.4 4 1.7 0 0.0 0 0.0 0 0.0 4 11.0
0 0.0 0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 3 1.7 0 0.0 0 0.0 0 0.0 3 10.1
0 0.0 0 0.0 231 0.0 0.0 0.0 0.0 0.0 1 0.4 3 1.1 0 0.0 0 0.0 0 0.0 3 8.0
0 0.0 0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.2 0 0.0 0 0.0 0 0.0 2 13.0
0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.7 1 0.7 0 0.0 0 0.0 2 11.4
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 10.1
2 0.5 4 1.1 2925 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 16 0.5 26 0.8 3 0.1 2 0.1 4 0.1 35 9.4
Jumlah dosis
kutan, IM, tetes)
tetes)
PERSENTASE
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 361 0.0 0.0 0.0 0.0 0.0 1 0.3 2 0.5 0 0.0 0 0.0 0 0.0 2 5.7
0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 2 1.3 2 1.3 0 0.0 0 0.0 0 0.0 2 9.6
3 7.6 1 2.5 205 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 1 0.4 3 1.2 1 0.4 5 12.6
1 5.1 0 0.0 135 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 1 5.1
0 0.0 0 0.0 117 0.0 0.0 0.0 0.0 0.0 1 0.8 2 1.5 0 0.0 0 0.0 0 0.0 2 14.0
0 0.0 1 13.0 125 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.8 0 0.0 0 0.0 1 0.8 2 26.0
0 0.0 0 0.0 216 0.0 0.0 0.0 0.0 0.0 1 0.4 2 0.8 0 0.0 0 0.0 0 0.0 2 6.7
0 0.0 0 0.0 275 0.0 0.0 0.0 0.0 0.0 0 0.0 2 0.7 0 0.0 0 0.0 0 0.0 2 7.9
0 0.0 0 0.0 164 0.0 0.0 0.0 0.0 0.0 2 1.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 8.3 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.7 1 8.3
0 0.0 0 0.0 193 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 3.4 149 0.0 0.0 0.0 0.0 0.0 2 1.1 1 0.6 0 0.0 0 0.0 1 0.6 2 6.7
0 0.0 1 2.7 231 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 1 2.7
0 0.0 0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 1 0.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 1 10.1
4 1.1 5 1.3 2925 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 0.3 12 0.4 2 0.1 4 0.1 5 0.2 23 6.1
Jumlah dosis
kutan, IM, tetes)
tetes)
PERSENTASE
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 361 0.0 0.0 0.0 0.0 0.0 1 0.3 1 0.3 0 0.0 0 0.0 0 0.0 1 2.8
0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 1 0.6 3 1.9 0 0.0 0 0.0 0 0.0 3 14.4
1 2.5 0 0.0 205 0.0 0.0 0.0 0.0 0.0 2 0.8 1 0.4 0 0.0 1 0.4 0 0.0 2 5.1
0 0.0 0 0.0 135 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 7.0 117 0.0 0.0 0.0 0.0 0.0 2 1.5 1 0.8 0 0.0 0 0.0 1 0.8 2 14.0
0 0.0 0 0.0 125 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.8 0 0.0 0 0.0 0 0.0 1 13.0
0 0.0 1 3.4 216 0.0 0.0 0.0 0.0 0.0 1 0.4 5 2.0 0 0.0 0 0.0 1 0.4 6 20.2
0 0.0 1 4.0 275 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 1 4.0
0 0.0 0 0.0 164 0.0 0.0 0.0 0.0 0.0 4 2.1 1 0.5 0 0.0 0 0.0 0 0.0 1 4.3
0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 2 1.4 1 0.7 0 0.0 0 0.0 0 0.0 1 8.3
0 0.0 0 0.0 193 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.1 0 0.0 0 0.0 0 0.0 2 6.7
0 0.0 0 0.0 231 0.0 0.0 0.0 0.0 0.0 2 0.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 6.5 0 0.0 149 0.0 0.0 0.0 0.0 0.0 2 1.2 0 0.0 0 0.0 1 0.6 0 0.0 1 6.5
0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 10.1
2 0.5 3 0.8 2925 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0.5 17 0.5 0 0.0 2 0.1 3 0.1 22 5.9
Jumlah dosis
kutan, IM, tetes)
tetes)
PERSENTASE
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 1 2.8 361 0.0 0.0 0.0 0.0 0.0 3 0.8 0 0.0 0 0.0 0 0.0 1 0.3 1 2.8
0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 0 0.0 1 4.8
0 0.0 0 0.0 205 0.0 0.0 0.0 0.0 0.0 0 0.0 2 0.8 0 0.0 0 0.0 0 0.0 2 5.1
0 0.0 0 0.0 135 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 117 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 125 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 216 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1 3.4
1 4.0 0 0.0 275 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.3 0 0.0 1 0.3 0 0.0 2 7.9
0 0.0 0 0.0 164 0.0 0.0 0.0 0.0 0.0 2 1.1 2 1.1 0 0.0 0 0.0 0 0.0 2 8.7
0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 1 0.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 193 0.0 0.0 0.0 0.0 0.0 3 1.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 149 0.0 0.0 0.0 0.0 0.0 3 1.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 231 0.0 0.0 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 6.5 0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.2 0 0.0 1 0.6 0 0.0 3 19.5
0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 1 0.7 1 0.7 0 0.0 0 0.0 0 0.0 1 5.7
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 0.5 1 0.3 2925 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 14 0.4 10 0.3 0 0.0 2 0.1 1 0.0 13 3.5
Jumlah dosis
kutan, IM, tetes)
tetes)
PERSENTASE
WUS TDK HAMIL
DIIMUNISASI
JMLH &
PERSENTASE
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 361 0.0 0.0 0.0 0.0 0.0 1 0.3 2 0.5 0 0.0 0 0.0 0 0.0 2 5.7
1 4.8 0 0.0 134 0.0 0.0 0.0 0.0 0.0 1 0.6 1 0.6 0 0.0 1 0.6 0 0.0 2 9.6
0 0.0 0 0.0 205 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 135 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 117 0.0 0.0 0.0 0.0 0.0 2 1.5 3 2.3 0 0.0 0 0.0 0 0.0 3 21.0
1 13.0 0 0.0 125 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.8 0 0.0 1 13.0
0 0.0 0 0.0 216 0.0 0.0 0.0 0.0 0.0 4 1.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 4.0 2 7.9 275 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.3 1 0.3 2 0.7 4 15.8
0 0.0 0 0.0 164 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 193 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 231 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 210 0.0 0.0 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 0.8 2 0.5 2925 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0.3 6 0.2 1 0.0 3 0.1 2 0.1 12 3.2
Jumlah dosis
kutan, IM, tetes)
tetes)
PERSENTASE
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 361 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 205 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 135 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 117 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 125 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 216 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 275 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 164 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 193 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 231 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 2925 0 0.0 0 0.0 0 0.0 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 dosis
kutan, IM, tetes)
tetes)
PERSENTASE
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 361 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 205 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 135 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 117 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 125 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 216 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 275 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 164 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 193 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 231 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 2925 0 0.0 0 0.0 0 0.0 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 dosis
kutan, IM, tetes)
tetes)
PERSENTASE
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 361 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 205 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 135 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 117 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 125 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 216 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 275 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 164 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 193 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 231 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 2925 0 0.0 0 0.0 0 0.0 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 dosis
kutan, IM, tetes)
tetes)
PERSENTASE
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 361 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 205 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 135 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 117 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 125 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 216 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 275 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 164 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 193 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 231 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 2925 0 0.0 0 0.0 0 0.0 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 dosis
kutan, IM, tetes)
tetes)
PERSENTASE
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 361 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 205 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 135 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 117 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 125 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 216 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 275 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 164 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 193 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 231 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 2925 0 0.0 0 0.0 0 0.0 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 dosis
kutan, IM, tetes)
tetes)
PERSENTASE
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 361 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 205 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 135 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 117 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 125 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 216 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 275 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 164 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 193 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 231 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 149 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 2925 0 0.0 0 0.0 0 0.0 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 dosis
kutan, IM, tetes)
tetes)
PERSENTASE
DIIMUNISASI
# % # % # % # % # % # % # % # % # % # % # % # % # %
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 4 11.4 361 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 12 3.0 9 2.3 0 0.0 0 0.0 4 1.0 13 36.9
1 4.8 0 0.0 134 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 5.2 8 5.2 0 0.0 1 0.6 0 0.0 9 43.1
4 10.1 3 7.6 205 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 1.6 9 3.7 3 1.2 4 1.6 3 1.2 19 48.0
2 10.1 0 0.0 135 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 1.3 1 0.6 0 0.0 2 1.3 0 0.0 3 15.2
0 0.0 1 7.0 117 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 3.8 8 6.1 0 0.0 0 0.0 1 0.8 9 62.9
1 13.0 1 13.0 125 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 1.5 3 2.3 0 0.0 1 0.8 1 0.8 5 64.9
1 3.4 1 3.4 216 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 3.3 8 3.3 0 0.0 1 0.4 1 0.4 10 33.7
3 11.9 3 11.9 275 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 1.3 7 2.3 1 0.3 3 1.0 3 1.0 14 55.3
1 4.3 0 0.0 164 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 10 5.4 10 5.4 0 0.0 1 0.5 0 0.0 11 47.6
0 0.0 1 8.3 128 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 3.6 3 2.1 0 0.0 0 0.0 1 0.7 4 33.1
1 2.8 0 0.0 193 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 2.6 6 2.6 0 0.0 1 0.4 0 0.0 7 19.3
0 0.0 1 3.4 149 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 3.9 7 3.9 0 0.0 0 0.0 1 0.6 8 26.9
2 5.3 1 2.7 231 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 1.9 4 1.5 1 0.4 2 0.7 1 0.4 8 21.4
2 13.0 0 0.0 149 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 2.4 4 2.4 0 0.0 2 1.2 0 0.0 6 39.0
0 0.0 0 0.0 134 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 2.0 4 2.6 3 2.0 0 0.0 0 0.0 7 39.8
0 0.0 0 0.0 210 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 2.3 1 0.5 0 0.0 0 0.0 6 60.6
18 4.8 16 4.3 2925 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 85 2.6 96 2.9 9 0.3 18 0.5 16 0.5 139 37.2
TANGGAL PENGIRIMAN LAPORAN DESA/KELURAHAN KE PUSKESMAS T
DESA / BULAN
NO
KELURAHAN JAN FEB MAR APR MEI JUNI JULI
1 KIAEA
2 WATUDEMBA
3 AOSOLE
4 ALAKAYA
5 WAWORAHA
6 KAPUJAYA
7 WAWOURU
8 MEKAR SARI
9 WATUMEREMBA
10 EEWA
11 ONEMBUTE
12 ANGGONDARA
13 KEL.PALANGGA
14 WAWONGGURA
15 SANGGI-SANGGI
16 UPT.TOLIHE
MENGETAHUI :
Kepala Puskesmas Palangga Kab.Konsel
Syamsuddin Para'pean,SKM
Nip. 19720702 200012 1 001
AHAN KE PUSKESMAS TAHUN 2016
LAN
KET
AGUT SEP OKT NOP DES
Palangga, ………………….2016
Koordinator Jurim Puskesmas Palangga
Iwan Setiawan
Nip.19730720 199502 1 001
NO DESA / KELURAHAN BAYI BARU LAHIR (0 - HB0 (0<7 HARI) BCG POLIO1 DPT/HB (1) DPT/HB-Hib (1) POLIO2
TAHUN 2017
11 BLN
L P JLH L P JLH #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML %
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 0 0.0 2 11.1 2 5.6 1 5.6 0 0.0 1 2.8 1 5.6 0 0.0 1 2.8 0 0.0 0 0.0 0 0.0 2 11.1 1 5.6 3 8.3 2 11.1 1 5.6 3 8.3
2 WATUDEMBA 665 9 9 18 14 14 28 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 AOSOLE 1,018 14 14 24 14 13 27 1 7.1 0 0.0 1 3.7 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 1 7.7 2 7.4 1 7.1 1 7.7 2 7.4
4 ALAKAYA 669 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 22.2 2 11.1 0 0.0 2 22.2 2 11.1
5 WAWORAHA 583 8 8 16 8 8 16 0 0.0 0 0.0 0 0.0 2 25.0 3 12.0 5 31.3 2 25.0 3 37.5 5 31.3 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5
6 KAPUJAYA 620 9 8 17 8 8 16 2 25.0 0 0.0 2 12.5 1 12.5 2 16.0 3 18.8 1 12.5 2 25.0 3 18.8 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3
7 WAWOURU 1,072 15 15 30 14 14 28 1 7.1 0 0.0 1 3.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
8 MEKAR SARI 1,367 19 19 38 8 8 16 1 12.5 1 12.5 2 12.5 4 50.0 0 0.0 4 25.0 4 50.0 0 0.0 4 25.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5
9 WATUMEREMBE 814 12 11 23 11 11 22 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5
10 EEWA 636 9 9 18 9 8 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 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 12.5 1 5.9 0 0.0 1 12.5 1 5.9
11 ONEMBUTE 960 14 13 27 13 12 25 0 0.0 2 16.7 2 8.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
12 ANGGONDARA 741 11 10 21 10 10 20 2 20.0 1 10.0 3 15.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 0 0.0 0 0.0 0 0.0 4 25.0 1 4.0 5 16.1 4 25.0 1 6.7 5 16.1 0 0.0 0 0.0 0 0.0 1 6.3 3 20.0 4 12.9 1 6.3 3 20.0 4 12.9
14 WAWONGGURA 740 11 10 21 10 10 20 1 10.0 1 10.0 2 10.0 1 10.0 1 10.0 2 10.0 1 10.0 1 10.0 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
15 SANGGI-SANGGI 666 9 9 18 9 9 18 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 0 0.0 0 0.0 0 0.0 2 22.2 1 11.1 3 16.7 2 22.2 1 11.1 3 16.7
16 UPT.TOLIHE 436 6 6 12 6 6 12 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 197 190 383 177 173 350 9 5.1 7 4.0 16 4.6 14 7.9 7 88.5 21 6.0 14 7.9 7 4.0 21 6.0 0 0.0 0 0.0 0 0.0 7 4.0 14 8.1 21 6.0 7 4.0 14 8.1 21 6.0
LAPORAN VAKSIN, ALAT SUNTIK DAN SAFETY BOX INDEK PEMAKAIAN VAKSIN (IPK) LAPORAN COLD CHAIN
Jenis Vaksin / Alat Suntik &

No. Stock Bln Lalu Penerimaa Jumlah Pemakaian Sisa Bln ini Permintaa No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Jumlah Keadaan
Safety Box No. Jenis Cold Chain
n Bln ini Bln ini n (buah)
I. VAKSIN 1 BCG 21 dosis 5 Ampul 4.2 Baik Rusak
1 Vak. BCG 23 - 23 5 18 (13) 2 DPT-HB 0 dosis - Vial #DIV/0! 1 Lemari ES
2 Vak. DPT-HB - - - - - - 3 DPT-HB-Hib 71 dosis 24 Vial 2.958333 2 M. Freezer
3 Vak. DPT-HB-Hib 10 30 40 24 16 8 4 POLIO 78 dosis 15 Vial 5.2 3 V. Crrier
4 Vak. POLIO 28 10 38 15 23 (8) 5 CAMPAK 35 dosis 10 Vial 3.5 4 Thermos
5 Vak. CAMPAK 22 10 32 10 22 (12) 6 HB. UNIJECT 16 dosis 17 Buah 0.941176
6 Vak. HB. UNIJECT 130 - 130 17 113 (96) 7 TT 26 dosis 9 Vial 2.888889 MENGETAHUI :
7 Vak. TT 16 10 26 9 17 (8) Kepala Puskesmas Palangga.Kab.Konawe selatan..
II. ALAT SUNTIK
1 ADS 5 ml 42 - 42 15 27 (12)
2 ADS 0,5 ml 410 200 610 142 468 (326)
3 ADS 0,0 5 ml 50 - 50 21 29 (8) Amrin,S.Kep
4 Safety Box 5 liter - - - - Nip.196506021987031017
TAHUN 2017
11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 0 0.0 0 0.0 0 0.0 1 5.6 3 54.0 4 11.1 1 1.0 3 16.7 4 11.1 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
2 WATUDEMBA 665 9 9 18 14 14 28 0 0.0 1 7.1 1 3.6 0 0.0 0 #DIV/0! 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 7.1 1 3.6 0 0.0 1 7.1 1 3.6
3 AOSOLE 1,018 14 14 24 14 13 27 0 0.0 0 0.0 0 0.0 2 14.3 0 0.0 2 7.4 2 14.3 0 0.0 2 7.4 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
4 ALAKAYA 669 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 583 8 8 16 8 8 16 0 0.0 1 12.5 1 6.3 0 0.0 0 #DIV/0! 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 12.5 1 6.3 0 0.0 1 12.5 1 6.3
6 KAPUJAYA 620 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 1 8.0 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 0 0.0 0 0.0 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5
7 WAWOURU 1,072 15 15 30 14 14 28 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 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 7.1 1 3.6 0 0.0 1 7.1 1 3.6
8 MEKAR SARI 1,367 19 19 38 8 8 16 0 0.0 1 12.5 1 6.3 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 0 0.0 0 0.0 0 0.0 4 50.0 1 12.5 5 31.3 4 50.0 1 12.5 5 31.3
9 WATUMEREMBE 814 12 11 23 11 11 22 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 EEWA 636 9 9 18 9 8 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 2 25.0 3 17.6 1 11.1 2 25.0 3 17.6
11 ONEMBUTE 960 14 13 27 13 12 25 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 4.0 0 0.0 1 8.3 1 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
12 ANGGONDARA 741 11 10 21 10 10 20 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 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
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 0 0.0 0 0.0 0 0.0 1 6.3 1 16.0 2 6.5 1 6.3 1 6.7 2 6.5 0 0.0 0 0.0 0 0.0 3 18.8 2 13.3 5 16.1 3 18.8 2 13.3 5 16.1
14 WAWONGGURA 740 11 10 21 10 10 20 1 10.0 0 0.0 1 5.0 1 10.0 1 10.0 2 10.0 1 10.0 1 10.0 2 10.0 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 5.0
15 SANGGI-SANGGI 666 9 9 18 9 9 18 0 0.0 0 0.0 0 0.0 4 44.4 1 2.3 5 27.8 4 44.4 1 11.1 5 27.8 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6
16 UPT.TOLIHE 436 6 6 12 6 6 12 0 0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 16.7 0 0.0 2 33.3 2 16.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 197 190 387 177 173 350 1 0.6 3 1.7 4 1.1 13 7.3 10 136.2 23 6.6 13 7.3 10 5.8 23 6.6 0 0.0 0 0.0 0 0.0 10 5.6 10 5.8 20 5.7 10 5.6 10 5.8 20 5.7

1 Vak. BCG 18 10 28 10 18 (8) 2 DPT-HB 0 dosis - Vial #DIV/0! 1 Lemari ES
2 Vak. Polio IPV - 5 5 - 5 (5) 3 DPT-HB-Hib 76 dosis 28 Vial 2.714286 2 M. Freezer
4 Vak. POLIO 23 - 23 21 2 19 5 CAMPAK 37 dosis 11 Vial 3.363636 4 Thermos
5 Vak. CAMPAK 22 10 32 11 21 (10) 6 HB. UNIJECT 4 dosis 4 Buah 1
6 Vak. HB. UNIJECT 113 - 113 4 109 (105) 7 TT 33 dosis 11 Vial 3
7 Vak. TT 17 10 27 11 16 (5) MENGETAHUI :
II. ALAT SUNTIK Kepala Puskesmas Palangga Kab.Konsel
1 ADS 5 ml 27 20 47 21 26 (5)
2 ADS 0,5 ml 468 200 668 150 518 (368)
3 ADS 0,0 5 ml 29 100 129 25 104 (79)
4 Safety Box 5 liter - - - - - Amrin,S.Kep
5 Safety Box 0,25 liter - - - - - Nip.196506021987031017
BULAN : MARET 2017
TAHUN 2017
11 BLN
1 2 3 4 5 6 7 8 9 10 0 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 1 5.6 2 11.1 3 8.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 5.6 1 5.6 2 5.6 1 6,3 1 5.6 2 5.6
2 WATUDEMBA 665 9 9 18 14 14 28 0 0.0 0 0.0 0 0.0 1 7.1 1 14.0 2 7.1 1 7.1 1 7.1 2 7.1 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
3 AOSOLE 1,018 14 14 24 14 13 27 0 0.0 0 0.0 0 0.0 1 7.1 3 42.0 4 14.8 1 7.1 3 23.1 4 14.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 ALAKAYA 669 10 9 19 9 9 18 1 11.1 1 11.1 2 11.1 3 33.3 3 9.0 6 33.3 3 33.3 3 33.3 6 33.3 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6
5 WAWORAHA 583 8 8 16 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 620 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 1 8.0 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 0 0.0 0 0.0 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5
7 WAWOURU 1,072 15 15 30 14 14 28 0 0.0 0 0.0 0 0.0 1 7.1 2 28.0 3 10.7 1 7.1 2 14.3 3 10.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
8 MEKAR SARI 1,367 19 19 38 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5
9 WATUMEREMBE 814 12 11 23 11 11 22 0 0.0 2 18.2 2 9.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 EEWA 636 9 9 18 9 8 17 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 5.9 0 0.0 1 12.5 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 960 14 13 27 13 12 25 0 0.0 0 0.0 0 0.0 1 7.7 1 13.0 2 8.0 1 0,0 1 8.3 2 8.0 0 0.0 0 0.0 0 0.0 0 0.0 1 8.3 1 4.0 0 0.0 1 8.3 1 4.0
12 ANGGONDARA 741 11 10 21 10 10 20 0 0.0 1 10.0 1 5.0 1 10.0 1 10.0 2 10.0 1 10.0 1 10.0 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 3.2 0 0.0 1 6.7 1 3.2 0 0.0 0 0.0 0 0.0 1 6.3 0 0.0 1 3.2 1 6.3 0 0.0 1 3.2
14 WAWONGGURA 740 11 10 21 10 10 20 1 10.0 1 10.0 2 10.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 2 20.0 3 15.0 1 10.0 2 20.0 3 15.0
15 SANGGI-SANGGI 666 9 9 18 9 9 18 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 0 0.0 0 0.0 0 0.0 3 33.3 0 0.0 3 16.7 3 33.3 0 0.0 3 16.7
16 UPT.TOLIHE 436 6 6 12 6 6 12 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 197 190 387 177 173 350 3 1.7 7 4.0 10 2.9 11 6.2 16 257.5 27 7.7 11 6.2 16 9.2 27 7.7 0 0.0 0 0.0 0 0.0 9 5.1 6 3.5 15 4.3 9 5.1 6 3.5 15 4.3

1 Vak. BCG 18 - 18 7 11 (4) 2 DPT-HB 0 dosis 5 Vial 0 1 Lemari ES
2 Vak. Polio IPV 5 - 5 5 - 5 3 DPT-HB-Hib 63 dosis 18 Vial 3.5 2 M. Freezer
3 Vak. DPT-HB-HIB 18 - 18 18 - 18 4 POLIO 81 dosis 2 Vial 40.5 3 V. Crrier
4 Vak. POLIO 2 - 2 2 - 2 5 CAMPAK 46 dosis 12 Vial 3.833333 4 Thermos
5 Vak. CAMPAK 21 - 21 12 9 3 6 HB. UNIJECT 10 dosis 9 Buah 1.111111
7 Vak. TT 16 - 16 8 8 - MENGETAHUI :
II. ALAT SUNTIK Kepala Puskesmas .Palangga.Kab.Konsel
1 ADS 5 ml 26 - 26 20 6 14
2 ADS 0,5 ml 518 - 518 130 388 (258)
3 ADS 0,0 5 ml 104 - 104 27 77 (50)
5 Safety Box 0,25 liter - - - - Nip.196506021987031017
BULAN : APRIL 2017
TAHUN 2017
11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 2 11.1 1 5.6 3 8.3 0 0.0 0 #DIV/0! 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 5.6 1 2.8 0 0.0 1 5.6 1 2.8
2 WATUDEMBA 665 9 9 18 14 14 28 1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6 0 0.0 0 0.0 0 0.0 2 14.3 0 0.0 2 7.1 2 14.3 0 0.0 2 7.1
3 AOSOLE 1,018 14 14 24 14 13 27 0 0.0 0 0.0 0 0.0 1 7.1 1 14.0 2 7.4 1 7.1 1 7.7 2 7.4 0 0.0 0 0.0 0 0.0 1 7.1 1 7.7 2 7.4 1 7.1 1 7.7 2 7.4
4 ALAKAYA 669 10 9 19 9 9 18 2 22.2 0 0.0 2 11.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 22.2 2 22.2 4 22.2 2 22.2 2 22.2 4 22.2
5 WAWORAHA 583 8 8 16 8 8 16 1 12.5 0 0.0 1 6.3 0 0.0 0 #DIV/0! 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 12.5 1 6.3 0 0.0 1 12.5 1 6.3
6 KAPUJAYA 620 9 8 17 8 8 16 1 12.5 0 0.0 1 6.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5
7 WAWOURU 1,072 15 15 30 14 14 28 0 0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 7.1 0 0.0 2 14.3 2 7.1 0 0.0 0 0.0 0 0.0 1 7.1 1 7.1 2 7.1 1 7.1 1 7.1 2 7.1
8 MEKAR SARI 1,367 19 19 38 8 8 16 1 12.5 0 0.0 1 6.3 0 0.0 4 #DIV/0! 4 25.0 0 0.0 4 50.0 4 25.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
9 WATUMEREMBE 814 12 11 23 11 11 22 0 0.0 1 9.1 1 4.5 1 9.1 4 44.0 5 22.7 1 9.1 4 36.4 5 22.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 EEWA 636 9 9 18 9 8 17 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.9 1 11.1 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 960 14 13 27 13 12 25 1 7.7 1 8.3 2 8.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.7 1 8.3 2 8.0 1 7.7 1 8.3 2 8.0
12 ANGGONDARA 741 11 10 21 10 10 20 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 20.0 4 20.0 2 20.0 2 20.0 4 20.0 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 1 6.3 0 0.0 1 3.2 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 18.8 1 6.7 4 12.9 3 18.8 1 6.7 4 12.9
14 WAWONGGURA 740 11 10 21 10 10 20 0 0.0 1 10.0 1 5.0 3 30.0 0 0.0 3 15.0 3 30.0 0 0.0 3 15.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
15 SANGGI-SANGGI 666 9 9 18 9 9 18 1 11.1 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 22.2 1 11.1 3 16.7 2 22.2 1 11.1 3 16.7
16 UPT.TOLIHE 436 6 6 12 6 6 12 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 8.3 1 16.7 0 0.0 1 8.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 197 190 387 177 173 350 11 6.2 4 2.3 15 4.3 8 4.5 11 243.4 19 5.4 8 4.5 11 6.4 19 5.4 2 1.1 2 1.2 4 1.1 15 8.5 12 6.9 27 7.7 13 7.3 10 5.8 23 6.6

3 Vak. DPT-HB-Hib - 30 30 26 4 22 4 POLIO 97 dosis 19 Vial 5.105263 3 V. Crrier
4 Vak. POLIO 2 30 32 19 13 6 5 CAMPAK 48 dosis 10 Vial 4.8 4 Thermos
5 Vak. CAMPAK 9 10 19 10 9 1 6 HB. UNIJECT 15 dosis 14 Buah 1.071429
II. ALAT SUNTIK Kepala Puskesmas Palangga .Kab.Konsel
1 ADS 5 ml 6 20 26 17 9 8
2 ADS 0,5 ml 388 20 408 180 228 (48)
3 ADS 0,0 5 ml 77 - 77 22 55 (33)
4 Safety Box 5 liter - - - - Amrin,S.Kep
BULAN : MEI 2017
TAHUN 2017
11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 2 11.1 1 5.6 3 8.3 3 16.7 1 6.0 4 11.1 3 16.7 1 5.6 4 11.1 0 0.0 0 0.0 0 0.0 1 5.6 3 16.7 4 11.1 1 5.6 3 16.7 4 11.1
2 WATUDEMBA 665 9 9 18 14 14 28 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 1 7.1 2 7.1 1 7.1 1 7.1 2 7.1
3 AOSOLE 1,018 14 14 24 14 13 27 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 2 15.4 3 11.1 1 7.1 2 15.4 3 11.1
4 ALAKAYA 669 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 3 33.3 2 6.0 5 27.8 3 33.3 2 22.2 5 27.8 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6
5 WAWORAHA 583 8 8 16 8 8 16 1 12.5 0 0.0 1 6.3 1 12.5 1 8.0 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3
6 KAPUJAYA 620 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 3 37.5 0 0.0 3 18.8 3 37.5 0 0.0 3 18.8 0 0.0 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 WAWOURU 1,072 15 15 30 14 14 28 1 7.1 0 0.0 1 3.6 0 0.0 2 14.3 2 7.1 0 0.0 2 14.3 2 7.1 0 0.0 0 0.0 0 0.0 0 0.0 3 21.4 3 10.7 0 0.0 3 21.4 3 10.7
8 MEKAR SARI 1,367 19 19 38 8 8 16 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 0 0.0 0 0.0 0 0.0 0 0.0 4 50.0 4 25.0 0 0.0 4 50.0 4 25.0
9 WATUMEREMBE 814 12 11 23 11 11 22 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 18.2 2 9.1 0 0.0 2 18.2 2 9.1
10 EEWA 636 9 9 18 9 8 17 0 0.0 0 0.0 0 0.0 0 0.0 0 2.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 960 14 13 27 13 12 25 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 4.0 0 0.0 1 8.3 1 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
12 ANGGONDARA 741 11 10 21 10 10 20 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 5.0 0 0.0 1 10.0 1 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
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 1 6.3 1 6.7 2 6.5 4 25.0 0 0.0 4 12.9 4 25.0 0 0.0 4 12.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
14 WAWONGGURA 740 11 10 21 10 10 20 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 30.0 0 0.0 3 15.0 3 30.0 1 10.0 3 15.0
16 UPT.TOLIHE 436 6 6 12 6 6 12 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 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 16.7 1 8.3 0 0.0 1 16.7 1 8.3
PALANGGA 13,929 197 190 387 177 173 350 7 4.0 2 1.2 9 2.6 16 9.0 8 88.5 24 6.9 16 9.0 8 4.6 24 6.9 0 0.0 0 0.0 0 0.0 8 4.5 17 9.8 25 7.1 8 4.5 18 10.4 25 7.1

I. VAKSIN 1 BCG 24 dosis 6 Ampul 4 Baik Rusak
1 Vak. BCG 14 10 24 6 18 (12) 2 IPV 0 dosis 2 Vial 0 1 Lemari ES
2 IPV - 5 5 2 3 (1) 3 DPT-HB-Hib 75 dosis 22 Vial 3.409091 2 M. Freezer
5 Vak. CAMPAK 9 10 19 11 8 3 6 HB. UNIJECT 9 dosis 9 Buah 1
7 Vak. TT 10 - 10 7 3 4
II. ALAT SUNTIK MENGETAHUI :
1 ADS 5 ml 9 20 29 17 12 5 Kepala Puskesmas Palangga Kab. Konsel
2 ADS 0,5 ml 228 200 428 130 298 (168)
3 ADS 0,0 5 ml 55 100 155 25 130 (105)
5 Safety Box 0,25 liter - - - - Amrin,S.Kep.Ns
Nip. 196506021987031017
BULAN : JUNI 2017
TAHUN 2017
11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 0 0.0 0 0.0 0 0.0 5 27.8 0.0 5 13.9 5 27.8 0 0.0 5 13.9 0 0.0 0 0.0 0 0.0 0 0.0 1 5.6 1 2.8 0 0.0 1 5.6 1 2.8
2 WATUDEMBA 665 9 9 18 14 14 28 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6
3 AOSOLE 1,018 14 14 24 14 13 27 1 7.1 0 0.0 1 3.7 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 1 7.7 2 7.4 1 7.1 1 7.7 2 7.4
4 ALAKAYA 669 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 583 8 8 16 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5
6 KAPUJAYA 620 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5
7 WAWOURU 1,072 15 15 30 14 14 28 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 14.3 2 7.1 0 0.0 2 14.3 2 7.1
8 MEKAR SARI 1,367 19 19 38 8 8 16 0 0.0 1 12.5 1 6.3 2 25.0 3 12.0 5 31.3 2 25.0 3 37.5 5 31.3 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3
9 WATUMEREMBE 814 12 11 23 11 11 22 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 0 0.0 0 0.0 1 9.1 1 9.1 2 9.1 1 9.1 1 9.1 2 9.1
10 EEWA 636 9 9 18 9 8 17 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 5.9 0 0.0 1 12.5 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 960 14 13 27 13 12 25 1 7.7 0 0.0 1 4.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
12 ANGGONDARA 741 11 10 21 10 10 20 0 0.0 0 0.0 0 0.0 2 20.0 1 5.0 3 15.0 2 20.0 1 10.0 3 15.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 1 6.3 0 0.0 1 3.2 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 12.5 0 0.0 2 6.5 2 12.5 0 0.0 2 6.5
14 WAWONGGURA 740 11 10 21 10 10 20 0 0.0 0.0 0 0.0 0 0.0 3 #DIV/0! 3 15.0 0 0.0 3 30.0 3 15.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 436 6 6 12 6 6 12 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 197 190 383 177 173 350 3 1.7 2 1.2 5 1.4 10 5.6 9 159.3 19 5.4 10 5.6 9 5.2 19 5.4 0 0.0 0 0.0 0 0.0 8 4.5 7 4.0 15 4.3 8 4.5 7 4.0 15 4.3

2 Vak. DPT-HB - - - - 3 DPT-HB-Hib 64 dosis 14 Vial 4.571429 2 M. Freezer
3 Vak. DPT-HB-Hib 12 30 42 14 28 (14) 4 POLIO 74 dosis 11 Vial 6.727273 3 V. Crrier
6 Vak. HB. UNIJECT 77 77 5 72 (67) 7 TT 11 dosis 3 Vial 3.666667
7 Vak. TT 3 20 23 3 20 (17)
1 ADS 5 ml 12 20 32 13 19 (6) Kepala Puskesmas .Palangga Kab.Konsel
2 ADS 0,5 ml 298 200 498 112 386 (274)
3 ADS 0,0 5 ml 130 - 130 21 109 (88)
5 Safety Box 0,25 liter - - - - Amrin,S.Kep
Nip.196506021987031017
BULAN : JULI 2017
TAHUN 2017
11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 1 5.6 0 0.0 1 2.8 3 16.7 2 12.0 5 13.9 3 16.7 2 11.1 5 13.9 0 0.0 0 0.0 0 0.0 3 16.7 0 0.0 3 8.3 3 16.7 0 0.0 3 8.3
2 WATUDEMBA 665 9 9 18 14 14 28 0 0.0 0 0.0 0 0.0 1 7.1 2 28.0 3 10.7 1 7.1 2 14.3 3 10.7 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 1 3.6 0 0.0 1 7.1 1 3.6
3 AOSOLE 1,018 14 14 24 14 13 27 0 0.0 0 0.0 0 0.0 1 7.1 1 14.0 2 7.4 1 7.1 1 7.7 2 7.4 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 3.7 1 7.1 0 0.0 1 3.7
4 ALAKAYA 669 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 3 33.3 0 0.0 3 16.7 3 33.3 0 0.0 3 16.7 0 0.0 0 0.0 0 0.0 3 33.3 2 22.2 5 27.8 3 33.3 2 22.2 5 27.8
5 WAWORAHA 583 8 8 16 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 620 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 1 8.0 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3
7 WAWOURU 1,072 15 15 30 14 14 28 0 0.0 1 7.1 1 3.6 2 14.3 1 7.0 3 10.7 2 14.3 1 7.1 3 10.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
8 MEKAR SARI 1,367 19 19 38 8 8 16 1 12.5 1 12.5 2 12.5 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 0 0.0 0 0.0 0 0.0 3 37.5 2 25.0 5 31.3 3 37.5 2 25.0 5 31.3
9 WATUMEREMBE 814 12 11 23 11 11 22 0 0.0 0 0.0 0 0.0 1 9.1 2 22.0 3 13.6 1 9.1 2 18.2 3 13.6 0 0.0 0 0.0 0 0.0 0 0.0 2 18.2 2 9.1 0 0.0 2 18.2 2 9.1
10 EEWA 636 9 9 18 9 8 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 960 14 13 27 13 12 25 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.7 1 8.3 2 8.0 1 7.7 1 8.3 2 8.0
12 ANGGONDARA 741 11 10 21 10 10 20 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 10.0 0 0.0 2 20.0 2 10.0
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 0 0.0 2 13.3 2 6.5 3 18.8 1 5.3 4 12.9 3 18.8 1 6.7 4 12.9 0 0.0 0 0.0 0 0.0 4 25.0 0 0.0 4 12.9 4 25.0 0 0.0 4 12.9
14 WAWONGGURA 740 11 10 21 10 10 20 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 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 30.0 3 15.0 0 0.0 3 30.0 3 15.0
15 SANGGI-SANGGI 666 9 9 18 9 9 18 0 0.0 0 0.0 0 0.0 3 33.3 1 3.0 4 22.2 3 33.3 1 11.1 4 22.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 436 6 6 12 6 6 12 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 197 190 383 177 173 350 2 1.1 4 2.3 6 1.7 20 11.3 12 106.2 32 9.1 20 11.3 12 6.9 32 9.1 0 0.0 0 0.0 0 0.0 16 9.0 13 7.5 29 8.3 16 9.0 13 7.5 29 8.3

2 Vak. DPT-HB - - - - - 3 DPT-HB-Hib 89 dosis 25 Vial 3.56 2 M. Freezer
7 Vak. TT 20 10 30 8 22 (14)
1 ADS 5 ml 19 20 39 19 20 (1) Kepala Puskesmas Palangga .Kab.Konawe selatan.
2 ADS 0,5 ml 386 200 586 146 440 (294)
3 ADS 0,0 5 ml 109 - 109 35 74 (39)
5 Safety Box 0,25 liter - - - - Amrin,S.Kep.Ns.
Nip.196506021987031017
TAHUN 2017
11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 2 11.1 0 0.0 2 5.6 1 5.6 2 36.0 3 8.3 1 5.6 2 11.1 3 8.3 0 0.0 0 0.0 0 0.0 3 16.7 2 11.1 5 13.9 3 16.7 2 11.1 5 13.9
2 WATUDEMBA 665 9 9 18 14 14 28 0 0.0 0 0.0 0 0.0 1 7.1 1 14.0 2 7.1 1 7.1 1 7.1 2 7.1 0 0.0 0 0.0 0 0.0 1 7.1 2 14.3 3 10.7 1 7.1 2 14.3 3 10.7
3 AOSOLE 1,018 14 14 24 14 13 27 0 0.0 0 0.0 0 0.0 1 7.1 1 14.0 2 7.4 1 7.1 1 7.7 2 7.4 0 0.0 0 0.0 0 0.0 0 0.0 1 7.7 1 3.7 0 0.0 1 7.7 1 3.7
4 ALAKAYA 669 10 9 19 9 9 18 1 11.1 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 33.3 0 0.0 3 16.7 3 33.3 0 0.0 3 16.7
5 WAWORAHA 583 8 8 16 8 8 16 0 0.0 1 12.5 1 6.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5
6 KAPUJAYA 620 9 8 17 8 8 16 0 0.0 1 12.5 1 6.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5
7 WAWOURU 1,072 15 15 30 14 14 28 1 7.1 2 14.3 3 10.7 2 14.3 1 7.0 3 10.7 2 14.3 1 7.1 3 10.7 0 0.0 0 0.0 0 0.0 2 14.3 0 0.0 2 7.1 2 14.3 0 0.0 2 7.1
8 MEKAR SARI 1,367 19 19 38 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 2 16.0 3 18.8 1 12.5 2 25.0 3 18.8 0 0.0 0 0.0 0 0.0 3 37.5 1 12.5 4 25.0 3 37.5 1 12.5 4 25.0
9 WATUMEREMBE 814 12 11 23 11 11 22 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 2 18.2 3 13.6 1 9.1 2 18.2 3 13.6
10 EEWA 636 9 9 18 9 8 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 1 12.5 2 11.8 1 11.1 1 12.5 2 11.8
11 ONEMBUTE 960 14 13 27 13 12 25 0 0.0 0 0.0 0 0.0 3 23.1 4 17.3 7 28.0 3 23.1 4 33.3 7 28.0 0 0.0 0 0.0 0 0.0 1 7.7 1 8.3 2 8.0 1 7.7 1 8.3 2 8.0
12 ANGGONDARA 741 11 10 21 10 10 20 0 0.0 1 10.0 1 5.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 0 0.0 2 10.0 2 20.0 0 0.0 2 10.0
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 12.5 1 6.7 3 9.7 2 12.5 1 6.7 3 9.7
14 WAWONGGURA 740 11 10 21 10 10 20 1 10.0 0 0.0 1 5.0 2 20.0 0 0.0 2 10.0 2 20.0 0 0.0 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
15 SANGGI-SANGGI 666 9 9 18 9 9 18 1 11.1 0 0.0 1 5.6 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 0 0.0 0 0.0 0 0.0 5 55.6 1 11.1 6 33.3 5 55.6 1 11.1 6 33.3
16 UPT.TOLIHE 436 6 6 12 6 6 12 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 197 190 383 177 173 350 6 3.4 5 2.9 11 3.1 13 7.3 11 149.8 24 6.9 13 7.3 11 6.4 24 6.9 0 0.0 0 0.0 0 0.0 26 14.7 14 8.1 40 11.4 26 14.7 14 8.1 40 11.4

5 Vak. CAMPAK 13 10 23 13 10 3 6 HB. UNIJECT 11 dosis 11 Buah 1
7 Vak. Td 12 10 22 11 11 -
1 ADS 5 ml 20 20 40 19 21 (2) Kepala Puskesmas Palangga Kab.Konsel
2 ADS 0,5 ml 440 200 640 218 422 (204)
3 ADS 0,0 5 ml 74 - 74 24 50 (26)
Nip.196506021987031017
TAHUN 2017
11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 0 1.0 0 0.0 0 0.0 3 16.7 1 6.0 4 11.1 3 16.7 1 5.6 4 11.1 0 0.0 0 0.0 0 0.0 2 11.1 1 5.6 3 8.3 2 11.1 1 5.6 3 8.3
2 WATUDEMBA 665 9 9 18 14 14 28 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 1 7.1 2 7.1 1 7.1 1 7.1 2 7.1
3 AOSOLE 1,018 14 14 24 14 13 27 0 0.0 1 7.7 1 3.7 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 3.7 1 7.1 0 0.0 1 3.7
4 ALAKAYA 669 10 9 19 9 9 18 0 0.0 1 11.1 1 5.6 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 583 8 8 16 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 620 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 WAWOURU 1,072 15 15 30 14 14 28 0 0.0 1 7.1 1 3.6 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0 0.0 0 0.0 2 14.3 2 7.1 0 0.0 0 0.0 0 0.0
8 MEKAR SARI 1,367 19 19 38 8 8 16 1 12.5 0 0.0 1 6.3 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5
9 WATUMEREMBE 814 12 11 23 11 11 22 1 9.1 0 0.0 1 4.5 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
10 EEWA 636 9 9 18 9 8 17 1 11.1 0 0.0 1 5.9 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 960 14 13 27 13 12 25 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 15.4 1 8.3 3 12.0 2 15.4 1 8.3 3 12.0
12 ANGGONDARA 741 11 10 21 10 10 20 0 0.0 1 10.0 1 5.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 1 6.3 1 6.7 2 6.5 2 12.5 1 8.0 3 9.7 2 12.5 1 6.7 3 9.7 0 0.0 0 0.0 0 0.0 1 6.3 0 0.0 1 3.2 1 6.3 0 0.0 1 3.2
14 WAWONGGURA 740 11 10 21 10 10 20 0 0.0 1 10.0 1 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 2 20.0 0 0.0 2 10.0 2 20.0 0 0.0 2 10.0
15 SANGGI-SANGGI 666 9 9 18 9 9 18 0 0.0 0 0.0 0 0.0 2 22.2 2 9.0 4 22.2 2 22.2 2 22.2 4 22.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 436 6 6 12 6 6 12 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 197 190 383 177 173 350 4 2.3 6 3.5 10 2.9 7 4.0 4 101.1 11 3.1 7 4.0 4 2.3 11 3.1 0 0.0 0 0.0 0 0.0 10 5.6 7 4.0 17 4.9 9 5.1 5 2.9 14 4.0

4 Vak. POLIO 31 20 51 10 41 (31) 5 CAMPAK 24 dosis 6 Vial 4 4 Thermos
7 Vak. Td 11 20 31 5 26 (21) MENGETAHUI :
1 ADS 5 ml 21 20 41 9 32 (23)
2 ADS 0,5 ml 422 200 622 112 510 (398)
3 ADS 0,0 5 ml 50 100 150 11 139 (128)
TAHUN 2017
11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 2 11.1 0 0.0 2 5.6 1 5.6 5 90.0 6 16.7 1 5.6 5 27.8 6 16.7 0 0.0 0 0.0 0 0.0 4 22.2 2 11.1 6 16.7 4 22.2 2 11.1 6 16.7
2 WATUDEMBA 665 9 9 18 14 14 28 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6
3 AOSOLE 1,018 14 14 24 14 13 27 1 7.1 0 0.0 1 3.7 1 7.1 2 28.0 3 11.1 1 7.1 2 15.4 3 11.1 0 0.0 0 0.0 0 0.0 2 14.3 1 7.7 3 11.1 2 14.3 1 7.7 3 11.1
4 ALAKAYA 669 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 583 8 8 16 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 620 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 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 WAWOURU 1,072 15 15 30 14 14 28 1 7.1 0 0.0 1 3.6 1 7.1 5 70.0 6 21.4 1 7.1 5 35.7 6 21.4 0 0.0 0 0.0 0 0.0 2 14.3 0 0.0 2 7.1 2 14.3 0 0.0 2 7.1
8 MEKAR SARI 1,367 19 19 38 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 5 40.0 6 37.5 1 12.5 5 62.5 6 37.5 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3
9 WATUMEREMBE 814 12 11 23 11 11 22 0 0.0 1 9.1 1 4.5 4 36.4 0 0.0 4 18.2 4 36.4 0 0.0 4 18.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 EEWA 636 9 9 18 9 8 17 1 11.1 0 0.0 1 5.9 1 11.1 0 0.0 1 5.9 1 11.1 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 960 14 13 27 13 12 25 0 0.0 0 0.0 0 0.0 1 7.7 2 26.0 3 12.0 1 7.7 2 16.7 3 12.0 0 0.0 0 0.0 0 0.0 1 7.7 1 8.3 2 8.0 1 7.7 1 8.3 2 8.0
12 ANGGONDARA 741 11 10 21 10 10 20 0 0.0 0 0.0 0 0.0 3 30.0 1 3.3 4 20.0 3 30.0 1 10.0 4 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 1 6.3 1 6.7 2 6.5 0 0.0 4 #DIV/0! 4 12.9 0 0.0 4 26.7 4 12.9 0 0.0 0 0.0 0 0.0 2 12.5 1 6.7 3 9.7 2 12.5 1 6.7 3 9.7
14 WAWONGGURA 740 11 10 21 10 10 20 0 0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 10.0 0 0.0 2 20.0 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
15 Sanggi - Sanggi 666 9 9 18 9 9 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 22.2 2 22.2 4 22.2 2 22.2 2 22.2 4 22.2
16 UPT.TOLIHE 436 6 6 12 6 6 12 1 16.7 0 0.0 1 8.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 197 190 383 177 173 350 7 4.0 2 1.2 9 2.6 13 7.3 28 381.2 41 11.7 13 7.3 28 16.2 41 11.7 0 0.0 0 0.0 0 0.0 15 8.5 7 4.0 22 6.3 15 8.5 7 4.0 22 6.3

6 Vak. HB. UNIJECT 45 100 145 9 136 (127) 7 TT 32 dosis 8 Vial 4
II. ALAT SUNTIK Kepala Puskesmas .Palangga.Kab./Kota.Konsel.
1 ADS 5 ml 32 10 42 20 22 (2)
2 ADS 0,5 ml 510 200 710 175 535 (360)
3 ADS 0,0 5 ml 139 - 139 41 98 (57)
4 Safety Box 5 liter - - - - - - Amrin,S.Kep
5 Safety Box 0,25 liter - - - - - - Nip.196506021987031017
TAHUN 2017
11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 2 11.1 0 0.0 2 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 5.6 5 27.8 6 16.7 1 5.6 5 27.8 6 16.7
2 WATUDEMBA 665 9 9 18 14 14 28 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 AOSOLE 1,018 14 14 24 14 13 27 1 0.0 0 0.0 1 3.7 2 14.3 1 7.0 3 11.1 2 14.3 1 7.7 3 11.1 0 0.0 0 0.0 0 0.0 0 0.0 2 15.4 2 7.4 0 0.0 2 15.4 2 7.4
4 ALAKAYA 669 10 9 19 9 9 18 1 11.1 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6
5 WAWORAHA 583 8 8 16 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 620 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5
7 WAWOURU 1,072 15 15 30 14 14 28 0 0.0 0 0.0 0 0.0 2 14.3 0 0.0 2 7.1 2 14.3 0 0.0 2 7.1 0 0.0 0 0.0 0 0.0 1 7.1 5 35.7 6 21.4 1 7.1 5 35.7 6 21.4
8 MEKAR SARI 1,367 19 19 38 8 8 16 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 1 12.5 5 62.5 6 37.5 1 12.5 5 62.5 6 37.5
9 WATUMEREMBE 814 12 11 23 11 11 22 0 0.0 0 0.0 0 0.0 1 9.1 2 22.0 3 13.6 1 9.1 2 18.2 3 13.6 0 0.0 0 0.0 0 0.0 4 36.4 0 0.0 4 0.0 4 36.4 0 0.0 4 18.2
10 EEWA 636 9 9 18 9 8 17 0 0.0 0 0.0 0 0.0 1 11.1 1 9.0 2 11.8 1 11.1 1 12.5 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 5.9 0 0.0 1 12.5 1 5.9
11 ONEMBUTE 960 14 13 27 13 12 25 0 0.0 0 0.0 0 0.0 1 7.7 0 0.0 1 4.0 1 7.7 0 0.0 1 4.0 0 0.0 0 0.0 0 0.0 0 0.0 4 33.3 4 16.0 0 0.0 4 33.3 4 16.0
12 ANGGONDARA 741 11 10 21 10 10 20 0 0.0 0 0.0 0 0.0 0 0.0 3 #DIV/0! 3 15.0 0 0.0 3 30.0 3 15.0 0 0.0 0 0.0 0 0.0 3 30.0 1 10.0 4 20.0 3 30.0 1 10.0 4 20.0
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 1 6.3 0 0.0 1 3.2 3 18.8 2 10.7 5 16.1 3 18.8 2 13.3 5 16.1 0 0.0 0 0.0 0 0.0 0 0.0 5 33.3 5 16.1 0 0.0 5 33.3 5 16.1
14 WAWONGGURA 740 11 10 21 10 10 20 1 10.0 0 0.0 1 5.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 5.0 0 0.0 1 10.0 1 5.0 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 436 6 6 12 6 6 12 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 8.3 1 16.7 0 0.0 1 8.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 197 190 383 177 173 350 7 4.0 0 0.0 7 2.0 12 6.8 9 132.8 21 6.0 12 6.8 9 5.2 21 6.0 0 0.0 1 0.6 1 0.3 11 6.2 31 17.9 42 12.0 11 6.2 30 17.3 41 11.7
1

3 Vak. DPT-HB-Hib 18 30 48 30 18 12 4 POLIO 108 dosis 18 Vial 6 3 V. Crrier
II. ALAT SUNTIK Kepala Puskesmas .Palangga Kab. Konsel
1 ADS 5 ml 22 20 42 21 21 -
2 ADS 0,5 ml 535 200 735 172 563 (391)
3 ADS 0,0 5 ml 98 - 98 21 77 (56)
TAHUN 2017
11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 0 0.0 1 5.6 1 2.8 2 11.1 0 0.0 2 5.6 2 11.1 0 0.0 2 5.6 0 0.0 0 0.0 0 0.0 0 0.0 2 11.1 2 5.6 0 0.0 2 11.1 2 5.6
2 WATUDEMBA 665 9 9 18 14 14 28 0 0.0 1 7.1 1 3.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 AOSOLE 1,018 14 14 24 14 13 27 2 14.3 0 0.0 2 7.4 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 1 7.1 0 0.0 1 3.7 1 7.1 0 0.0 1 3.7
4 ALAKAYA 669 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 583 8 8 16 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 620 9 8 17 8 8 16 1 12.5 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 WAWOURU 1,072 15 15 30 14 14 28 0 0.0 1 7.1 1 3.6 1 7.1 1 7.1 2 7.1 1 7.1 1 7.1 2 7.1 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6
8 MEKAR SARI 1,367 19 19 38 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 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 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3
9 WATUMEREMBE 814 12 11 23 11 11 22 0 0.0 0 0.0 0 0.0 0 0.0 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 9.1 1 9.1 2 9.1 1 9.1 1 9.1 2 9.1
10 EEWA 636 9 9 18 9 8 17 0 0.0 1 12.5 1 5.9 0 0.0 0 0.0 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 12.5 1 5.9 0 0.0 1 12.5 1 5.9
11 ONEMBUTE 960 14 13 27 13 12 25 0 0.0 1 8.3 1 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 2 15.4 0 0.0 2 8.0 2 15.4 0 0.0 2 8.0
12 ANGGONDARA 741 11 10 21 10 10 20 0 0.0 2 20.0 2 10.0 0 0.0 0 0.0 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 10.0 1 5.0 0 0.0 1 10.0 1 5.0
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 0 0.0 1 6.7 1 3.2 0 0.0 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 6.3 3 20.0 4 12.9 1 6.3 3 20.0 4 12.9
14 WAWONGGURA 740 11 10 21 10 10 20 0 0.0 0 0.0 0 0.0 1 10.0 2 20.0 3 15.0 1 10.0 2 20.0 3 15.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 5.0 0 0.0 1 0.0 1 5.0
15 SANGGI-SANGGI 666 9 9 18 9 9 18 1 11.1 1 11.1 2 11.1 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
16 UPT.TOLIHE 436 6 6 12 6 6 12 0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 0 0.0 1 8.3 1 16.7 0 0.0 1 8.3
PALANGGA 13,929 197 190 383 177 173 350 4 2.3 9 5.2 13 3.7 5 2.8 3 1.7 8 2.3 5 2.8 3 1.7 8 2.3 0 0.0 0 0.0 0 0.0 8 4.5 9 5.2 17 4.9 8 4.5 9 5.2 17 4.9

7 Vak. TT 25 10 35 20 15 5 MENGETAHUI :
II. ALAT SUNTIK Kepala Puskesmas Palangga.Kab. Konsel
1 ADS 5 ml 21 20 41 15 26 (11)
2 ADS 0,5 ml 563 200 763 216 547 (331)
3 ADS 0,0 5 ml 77 100 177 11 166 (155)
BULAN : JANUARI S/D.desember 2017
TAHUN 2017
11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,794 25 24 49 18 18 36 12 66.7 7 38.9 19 52.8 20 111.1 14 12.6 34 94.4 20 111.1 14 77.8 34 94.4 0 0.0 0 0.0 0 0.0 17 94.4 19 105.6 36 100.0 17 94.4 19 105.6 36 100.0
2 WATUDEMBA 665 9 9 18 14 14 28 1 7.1 2 14.3 3 10.7 4 28.6 4 14.0 8 28.6 4 28.6 4 28.6 8 28.6 0 0.0 0 0.0 0 0.0 7 50.0 6 42.9 13 46.4 7 50.0 6 42.9 13 46.4
3 AOSOLE 1,018 14 14 24 14 13 27 6 42.9 1 7.7 7 25.9 9 64.3 9 14.0 18 66.7 9 64.3 9 69.2 18 66.7 0 0.0 0 0.0 0 0.0 9 64.3 9 69.2 18 66.7 9 64.3 9 69.2 18 66.7
4 ALAKAYA 669 10 9 19 9 9 18 5 55.6 2 22.2 7 38.9 10 111.1 5 4.5 15 83.3 10 111.1 5 55.6 15 83.3 0 0.0 0 0.0 0 0.0 10 111.1 7 77.8 17 94.4 10 111.1 7 77.8 17 94.4
5 WAWORAHA 583 8 8 16 8 8 16 2 25.0 2 25.0 4 25.0 4 50.0 7 14.0 11 68.8 4 50.0 7 87.5 11 68.8 0 0.0 0 0.0 0 0.0 2 25.0 7 87.5 9 56.3 2 25.0 7 87.5 9 56.3
6 KAPUJAYA 620 9 8 17 8 8 16 4 50.0 1 12.5 5 31.3 7 87.5 6 6.9 13 81.3 7 87.5 6 75.0 13 81.3 0 0.0 0 0.0 0 0.0 7 87.5 7 87.5 14 87.5 7 87.5 7 87.5 14 87.5
7 WAWOURU 1,072 15 15 30 14 14 28 4 28.6 5 35.7 9 32.1 9 64.3 14 21.8 23 82.1 9 64.3 14 100.0 23 82.1 0 0.0 0 0.0 0 0.0 7 50.0 14 100.0 21 75.0 7 50.0 12 85.7 19 67.9
8 MEKAR SARI 1,367 19 19 38 8 8 16 7 87.5 4 50.0 11 68.8 15 187.5 15 8.0 30 187.5 15 187.5 15 187.5 30 187.5 0 0.0 0 0.0 0 0.0 15 187.5 18 225.0 33 206.3 15 187.5 18 225.0 33 206.3
9 WATUMEREMBE 814 12 11 23 11 11 22 1 9.1 4 36.4 5 22.7 7 63.6 9 14.1 16 72.7 7 63.6 9 81.8 16 72.7 0 0.0 0 0.0 0 0.0 8 72.7 8 72.7 16 72.7 8 72.7 8 72.7 16 72.7
10 EEWA 636 9 9 18 9 8 17 2 22.2 1 12.5 3 17.6 3 33.3 3 9.0 6 35.3 3 33.3 3 37.5 6 35.3 0 0.0 0 0.0 0 0.0 3 33.3 6 75.0 9 52.9 2 22.2 6 75.0 8 47.1
11 ONEMBUTE 960 14 13 27 13 12 25 2 15.4 4 33.3 6 24.0 6 46.2 9 19.5 15 60.0 6 46.2 9 75.0 15 60.0 0 0.0 0 0.0 0 0.0 8 61.5 10 83.3 18 72.0 8 61.5 10 83.3 18 72.0
12 ANGGONDARA 741 11 10 21 10 10 20 2 20.0 6 60.0 8 40.0 7 70.0 7 10.0 14 70.0 7 70.0 7 70.0 14 70.0 2 20.0 2 20.0 4 20.0 7 70.0 6 60.0 13 65.0 5 50.0 4 40.0 9 45.0
13 KEL.PALANGGA 1,148 16 16 32 16 15 31 6 37.5 6 40.0 12 38.7 17 106.3 11 10.4 28 90.3 17 106.3 11 73.3 28 90.3 0 0.0 0 0.0 0 0.0 20 125.0 16 106.7 36 116.1 20 125.0 16 106.7 36 116.1
14 WAWONGGURA 740 11 10 21 10 10 20 5 50.0 4 40.0 9 45.0 8 80.0 9 11.3 17 85.0 8 80.0 9 90.0 17 85.0 0 0.0 1 10.0 1 5.0 7 70.0 7 70.0 14 70.0 7 70.0 7 70.0 14 70.0
15 SANGGI-SANGGI 666 9 9 18 9 9 18 4 44.4 2 22.2 6 33.3 14 155.6 4 2.6 18 100.0 14 155.6 4 44.4 18 100.0 0 0.0 0 0.0 0 0.0 15 166.7 6 66.7 21 116.7 15 166.7 6 66.7 21 116.7
16 UPT.TOLIHE 436 6 6 12 6 6 12 1 16.7 0 0.0 1 8.3 2 33.3 2 6.0 4 33.3 2 33.3 2 33.3 4 33.3 0 0.0 0 0.0 0 0.0 1 16.7 1 16.7 2 16.7 1 16.7 1 16.7 2 16.7
PALANGGA 13,929 197 190 383 177 173 350 70 39.5 51 29.5 121 34.6 142 80.2 128 159.5 270 77.1 142 80.2 128 74.0 270 77.1 2 1.1 3 1.7 5 1.4 143 80.8 147 85.0 290 82.9 140 79.1 143 82.7 283 80.9
92 108 108 108 95% 104 90

1 Vak. BCG 26 100 126 81 45 36 2 DPT-HB 11 dosis 7 Vial 1.571429 1 Lemari ES
2 Vak. DPT-HB - 10 10 7 3 4 3 DPT-HB-Hib 1044 dosis 292 Vial 3.575342 2 M. Freezer
4 Vak. POLIO 33 220 253 187 66 121 5 CAMPAK 453 dosis 100 Vial 4.53 4 Thermos
5 Vak. CAMPAK 18 120 138 100 38 62 6 HB. UNIJECT 121 dosis 210 Buah 0.57619
6 Vak. HB. UNIJECT 20 100 120 210 (90) 300 7 TT 307 dosis 111 Vial 2.765766
1 ADS 5 ml 26 190 216 206 10 196
2 ADS 0,5 ml 547 2,020 2,567 1,883 684 1,199
3 ADS 0,0 5 ml 122 400 522 318 204 114
DPT/HB (2) DPT/HB-Hib (2) POLIO3 DPT/HB (3) DPT/HB-Hib (3) POLIO4 CAMPAK IMUNISASI DASAR LENGKAP
#L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML %

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
0 0.0 0 0.0 0 0.0 1 5.6 1 5.6 2 5.6 1 5.6 1 5.6 2 5.6 0 0.0 0 0.0 0 0.0 2 11.1 0 0.0 2 5.6 2 11.1 0 0.0 2 5.6 1 5.6 2 11.1 3 8.3 1 5.6 2 11.1 3 8.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 7.1 1 7.7 2 7.4 1 7.1 1 7.7 2 7.4 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 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 1 11.1 2 11.1 1 11.1 1 11.1 2 11.1
0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 12.5 1 6.3 0 0.0 1 12.5 1 6.3 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3
0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 1 3.6 0 0.0 1 7.1 1 3.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3
0 0.0 0 0.0 0 0.0 1 9.1 1 9.1 2 9.1 1 9.1 1 9.1 2 9.1 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 2 18.2 2 9.1 0 0.0 2 18.2 2 9.1
0 0.0 0 0.0 0 0.0 2 22.2 2 25.0 4 23.5 2 22.2 2 25.0 4 23.5 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.9 1 11.1 0 0.0 1 5.9 0 0.0 1 12.5 1 5.9 0 0.0 1 12.5 1 5.9
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 8.3 1 4.0 0 0.0 1 8.3 1 4.0 4 30.8 0 0.0 4 16.0 4 30.8 0 0.0 4 16.0
0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 10.0 0 0.0 2 20.0 2 10.0 0 0.0 0 0.0 0 0.0 1 10.0 1 10.0 2 10.0 1 10.0 1 10.0 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 2 12.5 1 6.7 3 9.7 2 12.5 1 6.7 3 9.7 0 0.0 0 0.0 0 0.0 3 18.8 2 13.3 5 16.1 3 18.8 2 13.3 5 16.1 3 18.8 2 13.3 5 16.1 3 18.8 2 13.3 5 16.1
0 0.0 0 0.0 0 0.0 2 20.0 0 0.0 2 10.0 2 20.0 0 0.0 2 10.0 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 5.0 1 10.0 2 20.0 3 15.0 1 10.0 2 20.0 3 15.0
0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 10 5.6 8 4.6 18 5.1 10 5.6 8 4.6 18 5.1 0 0.0 0 0.0 0 0.0 11 6.2 7 4.0 18 5.1 11 6.2 7 4.0 18 5.1 13 7.3 10 5.8 23 6.6 13 7.3 10 5.8 23 6.6
Palangga ...................................................2017
IDENTITAS DIDUGA KIPI (1) IMUNISASI IDENTITAS DIDUGA KIPI (2)
Koordinator Jurim Puskesmas Palangga 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) 1 Nama
2 Kelamin : Jumlah dosis 2 Kelamin
Imunisasi Cara Pemberian (Intra kutan, Lokasi
Tgl Jam No. Batch Tgl. Kadaluarsa VVM vaksin (ml /
3 Tggl / Lahir : (Vaksin) Sub-kutan, IM, tetes) penyuntikan 3 Tggl / Lahir
tetes)
4 Umur : 4 Umur
Iwan Setiawan.SKM 5 Nama ayah : 5 Nama ayah
Nip. 19730720 199502 1001 6 Nama ibu : 6 Nama ibu
7 Alamat : 7 Alamat
a. Jalan ………………………… Nomor …. RT/RW ………………. Reaksi timbul pada tgl .......................................... a.
b. Dusun/Kampung…………….. Desa/Kelurahan ………………… Gejala & Waktu timbulnya gejala ......................................................... b.
c. Kecamatan ………………….. Kabupaten ………………………… c.
d. Provinsi Sulawesi Tenggara d.

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
0 0.0 0 0.0 0 0.0 2 11.1 0 0.0 2 5.6 2 11.1 0 0.0 2 5.6 0 0.0 0 0.0 0 0.0 1 5.6 1 5.6 2 5.6 1 5.6 1 5.6 2 5.6 0 0.0 3 16.7 3 8.3 0 0.0 3 16.7 3 8.3
0 0.0 0 0.0 0 0.0 0 0.0 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 7.1 3 21.4 4 14.3 1 7.1 3 21.4 4 14.3 3 21.4 1 7.1 4 14.3 3 21.4 1 7.1 4 14.3
0 0.0 0 0.0 0 0.0 2 14.3 1 7.7 3 11.1 2 14.3 1 7.7 3 11.1 0 0.0 0 0.0 0 0.0 2 14.3 2 15.4 4 14.8 2 14.3 2 15.4 4 14.8 3 21.4 1 7.7 4 14.8 3 21.4 1 7.7 4 14.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5
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 1 7.1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6 2 14.3 0 0.0 2 7.1 2 14.3 0 0.0 2 7.1
0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0 3 37.5 0 0.0 3 18.8 3 37.5 0 0.0 3 18.8 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5
0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 0 0.0 0 0.0 0 0.0 1 9.1 1 9.1 2 9.1 1 9.1 1 9.1 2 9.1 1 9.1 3 27.3 4 18.2 1 9.1 3 27.3 4 18.2
0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 11.8 0 0.0 2 25.0 2 11.8 0 0.0 0 0.0 0 0.0 2 22.2 2 25.0 4 23.5 2 22.2 2 25.0 4 23.5 1 11.1 0 0.0 1 5.9 1 11.1 0 0.0 1 5.9
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 7.7 1 8.3 2 8.0 1 7.7 1 8.3 2 8.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 2 12.5 2 13.3 4 12.9 2 12.5 2 13.3 4 12.9 0 0.0 0 0.0 0 0.0 1 6.3 1 6.7 2 6.5 1 6.3 1 6.7 2 6.5 2 12.5 2 13.3 4 12.9 2 12.5 2 13.3 4 12.9
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 0 0.0 2 10.0 2 20.0 0 0.0 2 10.0 0 0.0 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 11.1 1 11.1 2 11.1 1 11.1 1 11.1 2 11.1 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6
0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 8.3 0 0.0 1 16.7 1 8.3 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 8.3 0 0.0 1 16.7 1 8.3 0 0.0 1 16.7 1 8.3 0 0.0 1 16.7 1 8.3
0 0.0 0 0.0 0 0.0 8 4.5 10 5.8 18 5.1 8 4.5 10 5.8 18 5.1 0 0.0 0 0.0 0 0.0 15 8.5 12 6.9 27 7.7 15 8.5 12 6.9 27 7.7 13 7.3 18 10.4 31 8.9 13 7.3 18 10.4 31 8.9
Palangga, 29 Februari 2016

tetes)
4 Umur : 4 Umur
Iwan Setiawan,SKM 5 Nama ayah : 5 Nama ayah
Nip. 19730720 199502 1 001 6 Nama ibu : 6 Nama ibu
7 Alamat : 7 Alamat

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
0 0.0 0 0.0 0 0.0 0 0.0 1 5.6 1 2.8 0 0.0 1 5.6 1 2.8 0 0.0 0 0.0 0 0.0 3 16.7 0 0.0 3 8.3 3 16.7 0 0.0 3 8.3 1 5.6 2 11.1 3 8.3 1 5.6 2 11.1 3 8.3
0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 1 3.6 0 0.0 1 7.1 1 3.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 14.3 2 7.1 0 0.0 2 14.3 2 7.1
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 2 14.3 1 7.7 3 11.1 2 14.3 1 7.7 3 11.1 2 14.3 3 23.1 5 18.5 2 14.3 3 23.1 5 18.5
0 0.0 0 0.0 0 0.0 2 22.2 2 22.2 4 22.2 2 22.2 2 22.2 4 22.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1
0 0.0 0 0.0 0 0.0 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8
0 0.0 0 0.0 0 0.0 1 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8
0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 1 3.6 0 0.0 1 7.1 1 3.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 14.3 1 7.1 3 10.7 2 14.3 1 7.1 3 10.7
0 0.0 0 0.0 0 0.0 4 50.0 1 12.5 5 31.3 4 50.0 1 12.5 5 31.3 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 3 37.5 0 0.0 3 18.8 3 37.5 0 0.0 3 18.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 11.8 0 0.0 2 25.0 2 11.8 0 0.0 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 11.1 1 12.5 2 11.8 1 11.1 1 12.5 2 11.8
0 0.0 0 0.0 0 0.0 1 7.7 0 0.0 1 4.0 1 7.7 0 0.0 1 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 2 15.4 1 8.3 3 12.0 2 15.4 1 8.3 3 12.0
0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 5.0 0 0.0 1 10.0 1 5.0 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 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 2 12.5 3 20.0 5 16.1 2 12.5 3 20.0 5 16.1 0 0.0 0 0.0 0 0.0 1 6.3 0 0.0 1 3.2 1 6.3 0 0.0 1 3.2 0 0.0 2 13.3 2 6.5 0 0.0 2 13.3 2 6.5
0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 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 3 30.0 3 15.0 0 0.0 3 30.0 3 15.0
0 0.0 0 0.0 0 0.0 0 0.0 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 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 1 11.1 2 11.1 1 11.1 1 11.1 2 11.1
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 1 16.7 1 8.3 0 0.0 1 16.7 1 8.3 0 0.0 2 33.3 2 16.7 0 0.0 2 33.3 2 16.7
0 0.0 0 0.0 0 0.0 12 6.8 15 8.7 27 7.7 12 6.8 15 8.7 27 7.7 0 0.0 0 0.0 0 0.0 8 4.5 4 2.3 12 3.4 8 4.5 4 2.3 12 3.4 18 10.2 20 11.6 38 10.9 18 10.2 20 11.6 38 10.9
Palangga, ………………….2016
tetes)
4 Umur : 4 Umur
7 Alamat : 7 Alamat

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
0 0.0 0 0.0 0 0.0 1 5.6 2 11.1 3 8.3 1 5.6 2 11.1 3 8.3 0 0.0 0 0.0 0 0.0 1 5.6 1 5.6 2 5.6 1 5.6 1 5.6 2 5.6 6 33.3 0 0.0 6 16.7 6 33.3 0 0.0 6 16.7
0 0.0 0 0.0 0 0.0 0 0.0 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 7.1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6 1 7.1 1 7.1 2 7.1 1 7.1 1 7.1 2 7.1
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 0.0 1 7.1 2 15.4 3 11.1 1 7.1 2 15.4 3 11.1
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 2 22.2 2 22.2 4 22.2 2 22.2 2 22.2 4 22.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 0 0.0 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 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 0 0.0 0 0.0 1 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 14.3 2 7.1 0 0.0 2 14.3 2 7.1
0 0.0 0 0.0 0 0.0 2 25.0 1 12.5 3 18.8 2 21.4 1 12.5 3 18.8 0 0.0 0 0.0 0 0.0 3 37.5 1 12.5 4 25.0 3 37.5 1 12.5 4 25.0 4 50.0 2 25.0 6 37.5 4 50.0 2 25.0 6 37.5
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 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 1 9.1 1 9.1 2 9.1 1 9.1 1 9.1 2 9.1
0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 5.9 0 0.0 1 12.5 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 4 50.0 4 23.5 0 0.0 4 50.0 4 23.5 1 11.1 0 0.0 1 5.9 1 11.1 0 0.0 1 5.9
0 0.0 0 0.0 0 0.0 0 0.0 1 8.3 1 4.0 0 0.0 1 8.3 1 4.0 0 0.0 0 0.0 0 0.0 1 7.7 0 0.0 1 4.0 1 7.7 0 0.0 1 4.0 1 7.7 3 25.0 4 16.0 1 7.7 3 25.0 4 16.0
1 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 5.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 5.0 0 0.0 1 10.0 1 5.0 1 10.0 2 20.0 3 15.0 1 10.0 2 20.0 3 15.0
0 0.0 0 0.0 0 0.0 2 12.5 1 6.7 3 9.7 2 12.5 1 6.7 3 9.7 0 0.0 0 0.0 0 0.0 3 18.8 6 40.0 9 29.0 3 18.8 6 40.0 9 29.0 4 25.0 1 6.7 5 16.1 4 25.0 1 6.7 5 16.1
0 0.0 0 0.0 0 0.0 1 10.0 2 20.0 3 15.0 1 10.0 2 20.0 3 15.0 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 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 3 33.3 0 0.0 3 16.7 3 33.3 0 0.0 3 16.7 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 1 11.1 1 11.1 2 11.1 1 11.1 1 11.1 2 11.1
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 0.0 1 16.7 0 0.0 1 8.3 1 16.7 0 0.0 1 8.3
1 0.6 0 0.0 1 0.3 11 6.2 9 5.2 20 5.7 10 5.6 9 5.2 19 5.4 0 0.0 0 0.0 0 0.0 17 9.6 19 11.0 36 10.3 17 9.6 19 11.0 36 10.3 22 12.4 15 8.7 37 10.6 22 12.4 15 8.7 37 10.6
Palangga, 30 April 2016

tetes)
4 Umur : 4 Umur
7 Alamat : 7 Alamat

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 11.1 2 5.6 0 0.0 2 11.1 2 5.6 3 16.7 1 5.6 4 11.1 3 16.7 1 5.6 4 11.1
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 1 7.1 1 3.6 0 0.0 1 7.1 1 3.6 0 0.0 1 7.1 1 3.6 0 0.0 1 7.1 1 3.6
0 0.0 0 0.0 0 0.0 1 7.1 1 7.7 2 7.4 1 7.1 1 7.7 2 7.4 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 1 7.1 1 7.7 2 7.4 1 7.1 1 7.7 2 7.4
0 0.0 0 0.0 0 0.0 2 22.2 1 11.1 3 16.7 2 22.2 1 11.1 3 16.7 0 0.0 0 0.0 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 11.1 1 5.6 0 0.0 1 11.1 1 5.6
0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 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 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5
0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 0 0.0 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 7.1 1 7.1 2 7.1 1 7.1 1 7.1 2 7.1 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 1 3.6 0 0.0 1 7.1 1 3.6 1 7.1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5
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 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 7.7 1 8.3 2 8.0 1 7.7 1 8.3 2 8.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 2 20.0 1 10.0 3 15.0 2 20.0 1 10.0 3 15.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 5.0 0 0.0 1 10.0 1 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 4 25.0 2 13.3 6 19.4 4 25.0 2 13.3 6 19.4 0 0.0 0 0.0 0 0.0 2 12.5 2 13.3 4 12.9 2 12.5 2 13.3 4 12.9 3 18.8 1 6.7 4 12.9 3 18.8 1 6.7 4 12.9
0 0.0 0 0.0 0 0.0 0 0.0 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 10.0 2 20.0 3 15.0 1 10.0 2 20.0 3 15.0 0 0.0 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 11.1 1 11.1 2 11.1 1 11.1 1 11.1 2 11.1 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 1 11.1 1 11.1 2 11.1 1 11.1 1 11.1 2 11.1
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 0.0 0 0.0 1 16.7 1 8.3 0 0.0 1 16.7 1 8.3
0 0.0 0 0.0 0 0.0 12 6.8 11 6.4 23 6.6 12 6.8 11 6.4 23 6.6 0 0.0 0 0.0 0 0.0 8 4.5 9 5.2 17 4.9 8 4.5 9 5.2 17 4.9 12 6.8 8 4.6 20 5.7 12 6.8 8 4.6 20 5.7
Palangga, 30 Mei 2017

tetes)
4 Umur : 4 Umur
Nip. ........................... 6 Nama ibu : 6 Nama ibu
7 Alamat : 7 Alamat

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
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Palangga, ………………….2017
Koordinator Jurim Puskesmas .Palangga 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) 1 Nama
tetes)
4 Umur : 4 Umur
7 Alamat : 7 Alamat

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
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0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 2 16.7 0 0.0 2 33.3 2 16.7 0 0.0 1 16.7 1 8.3 0 0.0 1 16.7 1 8.3
0 0.0 0 0.0 0 0.0 13 7.3 10 5.8 23 6.6 13 7.3 10 5.8 23 6.6 0 0.0 0 0.0 0 0.0 7 4.0 14 8.1 21 6.0 7 4.0 14 8.1 21 6.0 12 6.8 11 6.4 23 6.6 12 6.8 11 6.4 23 6.6
Palangga ..................................................2016
Koordinator Jurim Puskesmas Palangga. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) 1 Nama
tetes)
4 Umur : 4 Umur
Iwan Setiawan 5 Nama ayah : 5 Nama ayah
7 Alamat : 7 Alamat

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
0 0.0 0 0.0 0 0.0 2 11.1 0 0.0 2 5.6 2 11.1 0 0.0 2 5.6 0 0.0 0 0.0 0 0.0 1 5.6 2 11.1 3 8.3 1 5.6 2 11.1 3 8.3 0 0.0 1 5.6 1 2.8 0 0.0 1 5.6 1 2.8
0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 1 3.6 0 0.0 1 7.1 1 3.6 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6 0 0.0 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 7.1 1 7.7 2 7.4 1 7.1 1 7.7 2 7.4 0 0.0 0 0.0 0 0.0 2 14.3 0 0.0 2 7.4 2 14.3 0 0.0 2 7.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
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Palangga, 31 Agustus 2017

Koordinator Jurim Puskesmas .Palangga 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) 1 Nama
tetes)
4 Umur : 4 Umur
7 Alamat : 7 Alamat

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
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0 0.0 0 0.0 0 0.0 4 44.4 1 11.1 5 27.8 4 44.4 1 11.1 5 27.8 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 2 22.2 1 11.1 3 16.7 2 22.2 1 11.1 3 16.7
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 10.2 8 4.6 26 7.4 18 10.2 8 4.6 26 7.4 0 0.0 0 0.0 0 0.0 17 9.6 9 5.2 26 7.4 17 9.6 9 5.2 26 7.4 14 7.9 9 5.2 23 6.6 14 7.9 9 5.2 23 6.6
Palangga, ………………….2016
Koordinator Jurim Puskesmas .palangga 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) 1 Nama
tetes)
4 Umur : 4 Umur
Iwan Setiawan.SKM 5 Nama ayah : 5 Nama ayah
Nip. 19730720 199502 1 001. 6 Nama ibu : 6 Nama ibu
7 Alamat : 7 Alamat

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
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0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6 0 0.0 0 0.0 0 0.0 0 0.0 2 14.3 2 7.1 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6
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0 0.0 0 0.0 0 0.0 1 7.1 2 14.3 3 10.7 1 7.1 2 14.3 3 10.7 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 3.6 1 7.1 0 0.0 1 3.6 1 7.1 1 7.1 2 7.1 1 7.1 1 7.1 2 7.1
0 0.0 0 0.0 0 0.0 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5
0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 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 1 12.5 1 5.9 0 0.0 1 12.5 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 7.7 1 8.3 2 8.0 1 7.7 1 8.3 2 8.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 2 20.0 0 0.0 2 10.0 2 20.0 0 0.0 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 0 0.0 2 10.0 2 20.0 0 0.0 2 10.0
0 0.0 0 0.0 0 0.0 1 6.3 0 0.0 1 3.2 1 6.3 0 0.0 1 3.2 0 0.0 0 0.0 0 0.0 3 18.8 0 0.0 3 9.7 3 18.8 0 0.0 3 9.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 2 20.0 0 0.0 2 10.0 2 20.0 0 0.0 2 10.0 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 5.0 0 0.0 2 20.0 2 10.0 0 0.0 2 20.0 2 10.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 22.2 1 11.1 3 16.7 2 22.2 1 11.1 3 16.7 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1
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 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 14 7.9 9 5.2 23 6.6 14 7.9 9 5.2 23 6.6 0 0.0 0 0.0 0 0.0 12 6.8 10 5.8 22 6.3 12 6.8 8 4.6 20 5.7 12 6.8 7 4.0 19 5.4 12 6.8 7 4.0 19 5.4
Palangga, 31 Oktober 2017

Koordinator Jurim Puskesmas Palangga. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) 1 Nama
tetes)
4 Umur : 4 Umur
Nip. .19730720 199502 1 oo1. 6 Nama ibu : 6 Nama ibu
7 Alamat : 7 Alamat

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
0 0.0 0 0.0 0 0.0 3 16.7 2 11.1 5 13.9 3 0.0 2 11.1 5 13.9 0 0.0 0 0.0 0 0.0 3 16.7 3 16.7 6 16.7 3 16.7 3 16.7 6 16.7 0 0.0 3 16.7 3 8.3 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 7.1 1 7.1 2 7.1 1 7.1 1 7.1 2 7.1 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 3.6 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 1 3.6 0 0.0 1 7.1 1 3.6
0 0.0 0 0.0 0 0.0 1 7.1 1 7.7 2 7.4 1 7.1 1 7.7 2 7.4 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 3.7 1 7.1 0 0.0 1 3.7 1 7.1 2 15.4 3 11.1 1 7.1 2 15.4 3 11.1
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 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 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 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 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 12.5 1 6.3 0 0.0 1 12.5 1 6.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 6.3 0 0.0 1 12.5 1 6.3
0 0.0 0 0.0 0 0.0 2 14.3 0 0.0 2 7.1 2 14.3 0 0.0 2 7.1 0 0.0 0 0.0 0 0.0 1 7.1 1 7.1 2 7.1 1 7.1 1 7.1 2 7.1 0 0.0 2 14.3 2 7.1 0 0.0 2 14.3 2 7.1
0 0.0 0 0.0 0 0.0 1 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 0 0.0 0 0.0 0 0.0 3 37.5 0 0.0 3 18.8 3 37.5 0 0.0 3 18.8 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5
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 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 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 1 11.1 1 12.5 2 11.8 1 11.1 1 12.5 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 7.7 1 8.3 2 8.0 1 7.7 1 8.3 2 8.0 0 0.0 0 0.0 0 0.0 1 7.7 0 0.0 1 4.0 1 7.7 0 0.0 1 4.0 1 7.7 0 0.0 1 4.0 1 7.7 0 0.0 1 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 1 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 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 2 12.5 1 6.7 3 2.0 2 12.5 1 6.7 3 9.7 0 0.0 0 0.0 0 0.0 1 6.3 0 0.0 1 3.2 1 6.3 0 0.0 1 3.2 1 6.3 0 0.0 1 3.2 1 6.3 0 0.0 1 3.2
0 0.0 0 0.0 0 0.0 0 0.0 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 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 5.0 2 20.0 0 0.0 2 10.0 2 20.0 0 0.0 2 10.0
0 0.0 0 0.0 0 0.0 2 22.2 1 11.1 3 16.7 2 22.2 1 11.1 3 16.7 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 3 33.3 1 11.1 4 22.2 3 33.3 1 11.1 4 22.2
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 1 8.3 0 0.0 1 16.7 1 8.3
0 0.0 0 0.0 0 0.0 14 7.9 11 6.4 25 7.1 14 7.9 11 6.4 25 7.1 0 0.0 0 0.0 0 0.0 17 9.6 5 2.9 22 6.3 16 9.0 5 2.9 21 6.0 8 4.5 14 8.1 22 6.3 8 4.5 11 6.4 19 5.4
Palangga, ………………….2017
Koordinator Jurim Puskesmas .Palangga. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) 1 Nama
tetes)
4 Umur : 4 Umur
7 Alamat : 7 Alamat

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
0 0.0 0 0.0 0 0.0 1 5.6 3 16.7 4 11.1 1 5.6 3 16.7 4 11.1 0 0.0 0 0.0 0 0.0 2 11.1 2 11.1 4 11.1 2 11.1 2 11.1 4 11.1 0 0.0 1 5.6 1 2.8 0 0.0 1 5.6 1 2.8
0 0.0 0 0.0 0 0.0 0 0.0 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 7.1 1 7.1 2 7.1 1 7.1 1 7.1 2 7.1 2 14.3 0 0.0 2 7.1 2 14.3 0 0.0 2 7.1
0 0.0 0 0.0 0 0.0 0 0.0 2 15.4 2 7.4 0 0.0 2 15.4 2 7.4 0 0.0 0 0.0 0 0.0 1 7.1 1 7.7 2 7.4 1 7.1 1 7.7 2 7.4 0 0.0 1 7.7 1 3.7 0 0.0 1 7.7 1 3.7
0 0.0 0 0.0 0 0.0 1 11.1 1 11.1 2 11.1 1 11.1 1 11.1 2 11.1 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 3 33.3 2 22.2 5 27.8 3 33.3 2 22.2 5 27.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 12.5 1 6.3 0 0.0 1 12.5 1 6.3 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3
0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 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 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3
0 0.0 0 0.0 0 0.0 1 7.1 5 35.7 6 21.4 1 7.1 5 35.7 6 21.4 0 0.0 0 0.0 0 0.0 1 7.1 1 7.1 2 7.1 1 7.1 1 7.1 2 7.1 0 0.0 1 7.1 1 3.6 0 0.0 1 7.1 1 3.6
0 0.0 0 0.0 0 0.0 1 12.5 5 62.5 6 37.5 1 12.5 5 62.5 6 37.5 0 0.0 0 0.0 0 0.0 1 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8
0 0.0 0 0.0 0 0.0 3 27.3 0 0.0 3 13.6 3 27.3 0 0.0 3 13.6 0 0.0 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 9.1 3 27.3 4 18.2 1 9.1 3 27.3 4 18.2
0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 5.9 0 0.0 1 12.5 1 5.9 0 0.0 0 0.0 0 0.0 1 11.1 1 12.5 2 11.8 1 11.1 1 12.5 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 2 16.7 2 8.0 0 0.0 2 16.7 2 8.0 0 0.0 0 0.0 0 0.0 1 7.7 2 16.7 3 12.0 1 7.7 2 16.7 3 12.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 2 20.0 1 10.0 3 15.0 2 20.0 1 10.0 3 15.0 0 0.0 0 0.0 0 0.0 1 10.0 1 10.0 2 10.0 1 10.0 1 10.0 2 10.0 0 0.0 2 20.0 2 10.0 0 0.0 2 20.0 2 10.0
1 6.3 4 26.7 5 16.1 1 6.3 4 26.7 5 16.1 1 6.3 4 26.7 5 16.1 0 0.0 0 0.0 0 0.0 2 12.5 1 6.7 3 9.7 2 12.5 1 6.7 0 0.0 3 18.8 0 0.0 3 9.7 3 18.8 0 0.0 3 9.7
0 0.0 0 0.0 0 0.0 0 0.0 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 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 5.0 1 10.0 0 0.0 1 5.0
0 0.0 0 0.0 0 0.0 1 11.1 2 22.2 3 16.7 1 11.1 2 22.2 3 16.7 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 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 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 0.6 4 2.3 5 1.4 11 6.2 28 16.2 39 11.1 11 6.2 28 16.2 39 11.1 0 0.0 0 0.0 0 0.0 14 7.9 13 7.5 27 7.7 14 7.9 13 7.5 27 7.7 14 7.9 11 6.4 25 7.1 14 7.9 11 6.4 25 7.1
Palangga, ………………….2016
Koordinator Jurim Puskesmas ................. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) 1 Nama
tetes)
4 Umur : 4 Umur
Iwan Setiawan. 5 Nama ayah : 5 Nama ayah
Nip. 19730720 199502 1 001. 6 Nama ibu : 6 Nama ibu
7 Alamat : 7 Alamat

45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92
0 0.0 0 0.0 0 0.0 18 100.0 14 77.8 32 88.9 18 100.0 14 77.8 32 88.9 0 0.0 0 0.0 0 0.0 18 100.0 11 61.1 29 80.6 18 100.0 11 61.1 29 80.6 16 88.9 17 94.4 33 91.7 16 88.9 17 94.4 33 91.7
0 0.0 0 0.0 0 0.0 6 42.9 1 7.1 7 25.0 6 42.9 5 35.7 11 39.3 0 0.0 0 0.0 0 0.0 7 50.0 7 50.0 14 50.0 6 42.9 5 35.7 11 39.3 8 57.1 9 64.3 17 60.7 8 57.1 9 64.3 17 60.7
0 0.0 0 0.0 0 0.0 8 57.1 9 69.2 17 63.0 8 57.1 9 69.2 17 63.0 0 0.0 0 0.0 0 0.0 11 78.6 10 76.9 21 77.8 11 78.6 10 76.9 21 77.8 12 85.7 13 100.0 25 92.6 12 85.7 13 100.0 25 92.6
0 0.0 0 0.0 0 0.0 12 133.3 8 88.9 20 111.1 12 133.3 8 88.9 20 111.1 0 0.0 0 0.0 0 0.0 10 111.1 5 55.6 15 83.3 10 111.1 5 55.6 15 83.3 11 122.2 7 77.8 18 100.0 11 122.2 7 77.8 18 100.0
0 0.0 0 0.0 0 0.0 3 37.5 8 100.0 11 68.8 3 37.5 8 100.0 11 68.8 0 0.0 0 0.0 0 0.0 3 37.5 8 100.0 11 68.8 3 37.5 8 100.0 11 68.8 5 62.5 8 100.0 13 81.3 5 62.5 8 100.0 13 81.3
0 0.0 0 0.0 0 0.0 5 62.5 8 100.0 13 81.3 5 62.5 8 100.0 13 81.3 0 0.0 0 0.0 0 0.0 6 75.0 7 87.5 13 81.3 6 75.0 7 87.5 13 81.3 7 87.5 7 87.5 14 87.5 7 87.5 7 87.5 14 87.5
0 0.0 0 0.0 0 0.0 7 50.0 14 100.0 21 75.0 7 50.0 14 100.0 21 75.0 0 0.0 0 0.0 0 0.0 5 35.7 10 71.4 15 53.6 5 35.7 10 71.4 15 53.6 6 42.9 8 57.1 14 50.0 6 42.9 8 57.1 14 50.0
0 0.0 0 0.0 0 0.0 14 175.0 18 225.0 32 200.0 14 175.0 18 225.0 32 200.0 0 0.0 0 0.0 0 0.0 16 200.0 11 137.5 27 168.8 16 200.0 11 137.5 27 168.8 17 212.5 10 125.0 27 168.8 17 212.5 10 125.0 27 168.8
0 0.0 0 0.0 0 0.0 7 63.6 8 72.7 15 68.2 7 63.6 8 72.7 15 68.2 0 0.0 0 0.0 0 0.0 3 27.3 8 72.7 11 50.0 3 27.3 8 72.7 11 50.0 5 45.5 11 100.0 16 72.7 5 45.5 11 100.0 16 72.7
0 0.0 0 0.0 0 0.0 4 44.4 10 125.0 14 82.4 4 44.4 10 125.0 14 82.4 0 0.0 0 0.0 0 0.0 5 55.6 8 100.0 13 76.5 5 55.6 8 100.0 13 76.5 6 66.7 9 112.5 15 88.2 6 66.7 9 112.5 15 88.2
0 0.0 0 0.0 0 0.0 4 30.8 6 50.0 10 40.0 4 30.8 6 50.0 10 40.0 0 0.0 0 0.0 0 0.0 6 46.2 6 50.0 12 48.0 6 46.2 6 50.0 12 48.0 12 92.3 7 58.3 19 76.0 12 92.3 7 58.3 19 76.0
1 10.0 0 0.0 1 5.0 7 70.0 8 80.0 15 75.0 6 60.0 8 80.0 14 70.0 0 0.0 0 0.0 0 0.0 7 70.0 7 70.0 14 70.0 7 70.0 7 70.0 14 70.0 5 50.0 6 60.0 11 55.0 5 50.0 6 60.0 11 55.0
1 6.3 4 26.7 5 16.1 23 143.8 14 93.3 37 119.4 23 143.8 14 93.3 37 119.4 0 0.0 0 0.0 0 0.0 24 150.0 14 93.3 38 122.6 23 143.8 14 93.3 37 119.4 27 168.8 17 113.3 44 141.9 27 168.8 17 113.3 44 141.9
0 0.0 0 0.0 0 0.0 8 80.0 4 40.0 12 60.0 8 80.0 4 40.0 12 60.0 0 0.0 0 0.0 0 0.0 9 90.0 4 40.0 13 65.0 9 90.0 4 40.0 13 65.0 10 100.0 7 70.0 17 85.0 10 100.0 7 70.0 17 85.0
0 0.0 0 0.0 0 0.0 15 166.7 7 77.8 22 122.2 15 166.7 7 77.8 22 122.2 0 0.0 0 0.0 0 0.0 17 188.9 4 44.4 21 116.7 17 188.9 4 44.4 21 116.7 14 155.6 7 77.8 21 116.7 14 155.6 7 77.8 21 116.7
0 0.0 0 0.0 0 0.0 0 0.0 3 50.0 3 25.0 0 0.0 3 50.0 3 25.0 0 0.0 0 0.0 0 0.0 0 0.0 4 66.7 4 33.3 0 0.0 4 66.7 4 16.6 1 16.7 7 116.7 8 66.7 1 16.7 7 116.7 8 66.7
2 1.1 4 2.3 6 1.7 141 79.7 140 80.9 281 80.3 140 79.1 144 83.2 284 81.1 0 0.0 0 0.0 0 0.0 147 83.1 124 71.7 271 77.4 145 81.9 122 70.5 267 76.3 162 91.5 150 86.7 312 89.1 162 91.5 150 86.7 312 89.1
90 90 90 90 90
Palangga, 31 Oktober 2015 Desa Uci 37,5 %
Iwan Setiawan,SKM
Nip. 19730720 199502 1 001
HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIMUNISASI JMLH & JUMLAH DAN PERSENTASE WUS TIDAK HAMIL DIIMUNISASI JUMLAH TOTAL DAN PERSENTASE WUS (HAMIL+TIDAK HAMIL) DI
TT2+ BUMIL
PERSENTASE
SASARAN
SASARAN BATITA DPT/HB/Hib CAMPAK TT1 TT2 TT3 TT4 TT5 WUS TDK TT1 TT2 TT3 TT4 TT5 TT1 TT2 TT3 TT4 TT5 TT2+
BUMIL
HAMIL
L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # % # % # % DIIMUNISASI # % # % # % # % # % # % # % # % # % # % # %
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 40 1 2.5 2 5.1 0 0.0 0 0.0 2 5.1 393 0.0 0.0 0.0 0.0 0.0 1 0.2 2 0.5 0 0.0 0 0.0 2 0.5 4 10.1
23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
23 19 42 0 0.0 0 0.0 0 0.0 2 8.7 1 5.3 3 7.1 20 0 0.0 1 5.1 0 0.0 0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 5.1
22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 128 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
19 16 35 1 5.3 0 0.0 1 2.9 0 0.0 1 6.3 1 2.9 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 1 3.1 1 3.1 0 0.0 0 0.0 1 3.1 235 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 1 0.4 2 6.3
38 36 74 0 0.0 0 0.0 0 0.0 1 2.6 1 2.8 2 2.7 41 1 2.4 1 2.4 1 2.4 0 0.0 1 2.4 299 0.0 0.0 0.0 0.0 0.0 1 0.3 1 0.3 1 0.3 0 0.0 1 0.3 3 7.3
32 27 59 0 0.0 1 3.7 1 1.7 0 0.0 0 0.0 0 0.0 24 1 4.1 0 0.0 0 0.0 0 0.0 1 4.1 178 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 0.5 1 4.1
25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 1 5.3 1 5.3 0 0.0 0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 0 0.0 1 5.3
35 38 73 1 2.9 3 7.9 4 5.5 0 0.0 0 0.0 0 0.0 29 2 6.9 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 2 0.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 0 0.0 0 0.0 0 0.0 0 0.0 3 13.6 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 1.6 3 13.6
56 60 116 3 5.4 3 5.0 6 5.2 0 0.0 2 3.3 2 1.7 34 1 2.9 1 2.9 1 2.9 0 0.0 0 0.0 251 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 1 0.4 0 0.0 0 0.0 2 5.9
22 21 43 1 4.5 1 4.8 2 4.7 1 4.5 1 4.8 2 4.7 22 0 0.0 0 0.0 0 0.0 0 0.0 1 4.5 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 1 4.5
16 30 46 0 0.0 0 0.0 0 0.0 1 6.3 1 3.3 2 4.3 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
452 466 918 6 1.3 8 1.7 14 1.5 5 1.1 7 1.5 12 1.3 401 8 2.0 7 1.7 2 0.5 0 0.0 9 2.2 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 0.2 7 0.2 2 0.1 0 0.0 9 0.3 18 4.5
TAS DIDUGA KIPI (2) IMUNISASI

ama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir)
: Cara Pemberian (Intra Jumlah
elamin Imunisasi
Tgl Jam No. Batch Tgl. Kadaluarsa VVM kutan, Sub-kutan, IM, dosis vaksin Lokasi penyuntikan
ggl / Lahir : (Vaksin)
tetes) (ml / tetes)
mur :
ama ayah :
ama ibu :
lamat :
Jalan ………………………… Nomor …. RT/RW ………………. Reaksi timbul pada tgl ..........................................
Dusun/Kampung…………….. Desa/Kelurahan ………………… Gejala & Waktu timbulnya gejala .........................................................
Kecamatan ………………….. Kabupaten …………………………
Provinsi Sulawesi Tenggara
umlah saudara kandung :
TT2+ BUMIL
PERSENTASE
SASARAN
BUMIL
HAMIL
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 0 0.0 0 0.0 0 0.0 1 2.7 1 1.8 2 2.2 40 1 2.5 1 2.5 0 0.0 0 0.0 0 0.0 393 2 0.5 0.0 0.0 0.0 0.0 3 0.7 1 0.2 0 0.0 0 0.0 0 0.0 1 2.5
23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.0 2 10.0 0 0.0 1 5.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 2 1.2 0 0.0 1 0.6 4 20.0
31 38 69 1 3.2 2 5.3 3 4.3 0 0.0 1 2.6 1 1.4 30 0 0.0 0 0.0 0 0.0 0 0.0 1 3.3 223 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 1 3.3
23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
22 13 35 0 0.0 1 7.7 1 2.9 0 0.0 0 0.0 0 0.0 17 0 0.0 1 5.9 1 5.9 0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.7 1 0.7 0 0.0 0 0.0 2 11.8
19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 1 2.9 1 1.5 32 1 3.1 1 3.1 3 9.4 0 0.0 0 0.0 235 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 3 1.1 0 0.0 0 0.0 4 12.5
38 36 74 2 5.3 0 0.0 2 2.7 0 0.0 2 5.6 2 2.7 41 1 2.4 1 2.4 2 4.9 0 0.0 2 4.9 299 2 0.7 0.0 0.0 0.0 0.0 3 0.9 1 0.3 2 0.6 0 0.0 2 0.6 5 12.2
32 27 59 2 6.3 0 0.0 2 3.4 0 0.0 0 0.0 0 0.0 24 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 0 0.0 0 0.0 1 4.5 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 1 4.5
56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 0 0.0 1 2.9 0 0.0 0 0.0 3 0.0 251 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 3 1.1 4 11.8
22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 2 9.1 1 4.5 0 0.0 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 2 1.1 1 0.5 0 0.0 0 0.0 0 0.0 1 4.5
16 30 46 0 0.0 3 10.0 3 6.5 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 1 0.7 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
452 466 918 5 1.1 6 1.3 11 1.2 1 0.2 5 1.1 6 0.7 401 5 1.2 7 1.7 9 2.2 0 0.0 7 1.7 #REF! 5 #REF! 0 #REF! 0 #REF! 0 #REF! 0 #REF! 10 #REF! 7 #REF! 9 #REF! 0 #REF! 7 #REF! 23 5.7

elamin : Cara Pemberian (Intra Jumlah
Imunisasi
tetes) (ml / tetes)
mur :
ama ayah :
ama ibu :
lamat :
TT2+ BUMIL
PERSENTASE
SASARAN
BUMIL
HAMIL
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 0 0.0 0 0.0 0 0.0 1 2.7 0 0.0 1 1.1 40 2 5.1 1 2.5 1 2.5 0 0.0 2 5.1 393 0.0 0.0 0.0 0.0 0.0 2 0.5 1 0.2 1 0.2 0 0.0 2 0.5 4 10.1
23 27 50 0 0.0 1 3.7 1 2.0 0 0.0 1 3.7 1 2.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 38 69 1 3.2 0 0.0 1 1.4 1 3.2 0 0.0 1 1.4 30 1 3.3 0 0.0 0 0.0 0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
23 19 42 0 0.0 1 5.3 1 2.4 0 0.0 0 0.0 0 0.0 20 1 5.1 0 0.0 0 0.0 0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
22 13 35 0 0.0 2 15.4 2 5.7 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 128 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
19 16 35 0 0.0 1 6.3 1 2.9 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
33 35 68 1 3.0 1 2.9 2 2.9 1 3.0 0 0.0 1 1.5 32 0 0.0 0 0.0 0 0.0 0 0.0 1 3.1 235 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 1 3.1
38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 2 4.9 1 2.4 1 2.4 1 2.4 0 0.0 299 0.0 0.0 0.0 0.0 0.0 2 0.6 1 0.3 1 0.3 1 0.3 0 0.0 3 7.3
32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 24 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 2 10.7 0 0.0 0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.3 0 0.0 0 0.0 0 0.0 2 10.7
35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 0 0.0 1 3.4 0 0.0 0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1 3.4
31 18 49 2 6.5 1 5.6 3 6.1 0 0.0 0 0.0 0 0.0 22 1 4.5 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
56 60 116 2 3.6 2 3.3 4 3.4 3 5.4 0 0.0 3 2.6 34 0 0.0 1 2.9 0 0.0 0 0.0 0 0.0 251 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1 2.9
22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 0 0.0 0 0.0 0 0.0 1 4.5 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 1 4.5
16 30 46 2 12.5 0 0.0 2 4.3 1 6.3 0 0.0 1 2.2 20 1 5.1 0 0.0 2 10.1 0 0.0 1 5.1 146 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 2 1.2 0 0.0 1 0.6 3 15.2
9 13 22 2 22.2 0 0.0 2 9.1 0 0.0 0 0.0 0 0.0 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
452 466 918 0 0.0 9 1.9 9 1.0 7 1.5 1 0.2 8 0.9 401 8 2.0 6 1.5 4 1.0 2 0.5 4 1.0 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 0.2 6 0.2 4 0.1 2 0.1 4 0.1 16 4.0

Imunisasi
tetes) (ml / tetes)
mur :
ama ayah :
ama ibu :
lamat :
TT2+ BUMIL
PERSENTASE
SASARAN
BUMIL
HAMIL
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 40 5 12.6 3 7.6 0 0.0 0 0.0 0 0.0 393 1 0.3 0.0 0.0 0.0 0.0 6 1.4 3 0.7 0 0.0 0 0.0 0 0.0 3 7.6
23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 38 69 0 0.0 3 7.9 3 4.3 0 0.0 0 0.0 0 0.0 30 1 3.3 1 3.3 1 3.3 0 0.0 0 0.0 223 1 0.4 0.0 0.0 0.0 0.0 2 0.8 1 0.4 1 0.4 0 0.0 0 0.0 2 6.7
23 19 42 1 4.3 0 0.0 1 2.4 1 4.3 0 0.0 1 2.4 20 5 25.3 0 0.0 0 0.0 0 0.0 0 0.0 147 1 0.7 0.0 0.0 0.0 0.0 6 3.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
22 13 35 0 0.0 0 0.0 0 0.0 1 4.5 0 0.0 1 2.9 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
19 16 35 1 5.3 0 0.0 1 2.9 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 1 5.3 0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1 5.3
33 35 68 1 3.0 1 2.9 2 2.9 3 9.1 0 0.0 3 4.4 32 1 3.1 1 3.1 0 0.0 0 0.0 0 0.0 235 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1 3.1
38 36 74 2 5.3 1 2.8 3 4.1 1 2.6 0 0.0 1 1.4 41 2 4.9 1 2.4 0 0.0 0 0.0 0 0.0 299 0 0.0 0.0 0.0 0.0 0.0 2 0.6 1 0.3 0 0.0 0 0.0 0 0.0 1 2.4
32 27 59 0 0.0 2 7.4 2 3.4 0 0.0 0 0.0 0 0.0 24 0 0.0 2 8.3 2 8.3 0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.0 2 1.0 0 0.0 0 0.0 4 16.5
25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 1 5.3 0 0.0 0 0.0 0 0.0 1 5.3 139 1 0.7 0.0 0.0 0.0 0.0 2 1.3 0 0.0 0 0.0 0 0.0 1 0.6 1 5.3
35 38 73 0 0.0 0 0.0 0 0.0 1 2.9 0 0.0 1 1.4 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 0 0.0 1 4.5 1 4.5 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 2 9.1
56 60 116 0 0.0 1 1.7 1 0.9 0 0.0 3 5.0 3 2.6 34 0 0.0 0 0.0 0 0.0 0 0.0 1 2.9 251 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 1 2.9
22 21 43 1 4.5 0 0.0 1 2.3 0 0.0 0 0.0 0 0.0 22 0 0.0 1 4.5 1 4.5 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 2 9.1
16 30 46 1 6.3 0 0.0 1 2.2 0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.1 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 5.1
9 13 22 0 0.0 1 7.7 1 4.5 0 0.0 1 7.7 1 4.5 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
452 466 918 7 1.5 9 1.9 16 1.7 7 1.5 4 0.9 11 1.2 401 15 3.7 11 2.7 6 1.5 0 0.0 2 0.5 3050 4 0.1 0 0.0 0 0.0 0 0.0 0 0.0 19 0.6 11 0.3 6 0.2 0 0.0 2 0.1 19 4.7

Imunisasi
tetes) (ml / tetes)
mur :
ama ayah :
ama ibu :
lamat :
TT2+ BUMIL
PERSENTASE
SASARAN
BUMIL
HAMIL
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 0 0.0 1 1.8 1 1.1 1 2.7 1 1.8 2 2.2 40 1 2.5 2 5.1 0 0.0 0 0.0 1 2.5 393 0.0 0.0 0.0 0.0 0.0 1 0.2 2 0.5 0 0.0 0 0.0 1 0.2 3 7.6
23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 38 69 1 3.2 0 0.0 1 1.4 0 0.0 0 0.0 0 0.0 30 0 0.0 1 3.3 2 6.7 0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 2 0.8 0 0.0 0 0.0 3 10.0
23 19 42 0 0.0 1 5.3 1 2.4 0 0.0 2 10.5 2 4.8 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
22 13 35 0 0.0 0 0.0 0 0.0 1 4.5 1 7.7 2 5.7 17 0 0.0 0 0.0 1 5.9 0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.7 0 0.0 0 0.0 1 5.9
19 16 35 0 0.0 1 6.3 1 2.9 1 5.3 0 0.0 1 2.9 19 0 0.0 0 0.0 0 0.0 0 0.0 1 5.3 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 1 5.3
33 35 68 0 0.0 1 2.9 1 1.5 4 12.1 0 0.0 4 5.9 32 1 3.1 1 3.1 0 0.0 0 0.0 0 0.0 235 2 0.9 0.0 0.0 0.0 0.0 3 1.1 1 0.4 0 0.0 0 0.0 0 0.0 1 3.1
38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 1 2.4 2 4.9 0 0.0 0 0.0 0 0.0 299 1 0.3 0.0 0.0 0.0 0.0 2 0.6 2 0.6 0 0.0 0 0.0 0 0.0 2 4.9
32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 24 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
35 38 73 1 2.9 0 0.0 1 1.4 1 2.9 0 0.0 1 1.4 29 1 3.4 1 3.4 1 3.4 0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 1 0.4 0 0.0 0 0.0 2 6.9
31 18 49 0 0.0 1 5.6 1 2.0 0 0.0 0 0.0 0 0.0 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 1 0.6 0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
56 60 116 0 0.0 1 1.7 1 0.9 0 0.0 2 3.3 2 1.7 34 1 2.9 0 0.0 0 0.0 0 0.0 1 2.9 251 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1 0.4 1 2.9
22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 30 46 0 0.0 1 3.3 1 2.2 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
9 13 22 0 0.0 1 7.7 1 4.5 0 0.0 0 0.0 0 0.0 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
452 466 918 2 0.4 8 1.7 10 1.1 8 1.8 6 1.3 14 1.5 401 5 1.2 7 1.7 4 1.0 0 0.0 3 0.7 3050 4 0.1 0 0.0 0 0.0 0 0.0 0 0.0 9 0.3 7 0.2 4 0.1 0 0.0 3 0.1 14 3.5

Imunisasi
tetes) (ml / tetes)
mur :
ama ayah :
ama ibu :
lamat :
TT2+ BUMIL
PERSENTASE
SASARAN
BUMIL
HAMIL
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 1 2.7 1 1.8 2 2.2 0 0.0 0 0.0 0 0.0 40 1 2.5 0 0.0 0 0.0 0 0.0 1 2.5 393 0.0 0.0 0.0 0.0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 1 0.2 1 2.5
23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 4 14.8 4 8.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 1 5.9 0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.7 0 0.0 0 0.0 1 5.9
19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
33 35 68 0 0.0 0 0.0 0 0.0 1 3.0 0 0.0 1 1.5 32 0 0.0 1 3.1 1 3.1 0 0.0 0 0.0 235 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 2 6.3
38 36 74 1 2.6 0 0.0 1 1.4 2 5.3 1 2.8 3 4.1 41 1 2.4 1 2.4 1 2.4 0 0.0 0 0.0 299 1 0.3 0.0 0.0 0.0 0.0 2 0.6 1 0.3 1 0.3 0 0.0 0 0.0 2 4.9
32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 24 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
35 38 73 0 0.0 0 0.0 0 0.0 1 2.9 0 0.0 1 1.4 29 0 0.0 0 0.0 1 3.4 0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 1 3.4
31 18 49 2 6.5 3 16.7 5 10.2 0 0.0 0 0.0 0 0.0 22 0 0.0 1 4.5 0 0.0 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 4.5
56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 251 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
452 466 918 4 0.9 4 0.9 8 0.9 4 0.9 5 1.1 9 1.0 401 2 0.5 3 0.7 4 1.0 0 0.0 1 0.2 3050 1 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 0.1 3 0.1 4 0.1 0 0.0 1 0.0 8 2.0

Imunisasi
tetes) (ml / tetes)
mur :
ama ayah :
ama ibu :
lamat :
TT2+ BUMIL
PERSENTASE
SASARAN
BUMIL
HAMIL
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 5 13.5 1 1.8 6 6.5 0 0.0 2 3.6 2 2.2 40 1 2.5 2 5.1 0 0.0 0 0.0 0 0.0 393 0.0 0.0 0.0 0.0 0.0 1 0.2 2 0.5 0 0.0 0 0.0 0 0.0 2 5.1
23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 1 5.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1 5.0
31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 1 3.3 0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 1 3.3
23 19 42 1 4.3 1 5.3 2 4.8 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 128 1 0.8 0.0 0.0 0.0 0.0 1 0.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 1 5.3 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 1 5.3
33 35 68 1 3.0 1 2.9 2 2.9 0 0.0 0 0.0 0 0.0 32 1 3.1 1 3.1 0 0.0 0 0.0 0 0.0 235 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1 3.1
38 36 74 2 5.3 1 2.8 3 4.1 0 0.0 0 0.0 0 0.0 41 0 0.0 1 2.4 0 0.0 0 0.0 0 0.0 299 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.3 0 0.0 0 0.0 0 0.0 1 2.4
32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 24 1 4.1 0 0.0 0 0.0 0 0.0 1 4.1 178 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 0.5 1 4.1
25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
56 60 116 1 1.8 1 1.7 2 1.7 2 3.6 1 1.7 3 2.6 34 0 0.0 0 0.0 1 2.9 0 0.0 0 0.0 251 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 1 2.9
22 21 43 1 4.5 0 0.0 1 2.3 0 0.0 0 0.0 0 0.0 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 1 5.1 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1 5.1
9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 13 0 0.0 0 0.0 1 7.6 0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.9 0 0.0 0 0.0 1 7.6
452 466 918 11 2.4 5 1.1 16 1.7 2 0.4 3 0.6 5 0.5 401 3 0.7 4 1.0 5 1.2 1 0.2 1 0.2 3050 1 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 0.1 4 0.1 5 0.1 1 0.0 1 0.0 11 2.7

Imunisasi
tetes) (ml / tetes)
mur :
ama ayah :
ama ibu :
lamat :
TT2+ BUMIL
PERSENTASE
SASARAN
BUMIL
HAMIL
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 1 2.7 1 1.8 2 2.2 0 0.0 0 0.0 0 0.0 40 4 10.1 3 7.6 0 0.0 0 0.0 1 2.5 393 1 0.3 0.0 0.0 0.0 0.0 5 1.2 3 0.7 0 0.0 0 0.0 1 0.2 4 10.1
23 27 50 2 8.7 0 0.0 2 4.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 38 69 1 3.2 0 0.0 1 1.4 1 3.2 0 0.0 1 1.4 30 1 3.3 1 3.3 2 6.7 0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 2 0.8 0 0.0 0 0.0 3 10.0
23 19 42 0 0.0 1 5.3 1 2.4 0 0.0 0 0.0 0 0.0 20 3 15.2 0 0.0 0 0.0 0 0.0 1 5.1 147 0.0 0.0 0.0 0.0 0.0 3 1.8 0 0.0 0 0.0 0 0.0 1 0.6 1 5.1
22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
19 16 35 1 5.3 0 0.0 1 2.9 1 5.3 1 6.3 2 5.7 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
33 35 68 1 3.0 0 0.0 1 1.5 0 0.0 0 0.0 0 0.0 32 0 0.0 1 3.1 0 0.0 0 0.0 0 0.0 235 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1 3.1
38 36 74 2 5.3 0 0.0 2 2.7 2 5.3 0 0.0 2 2.7 41 1 2.4 0 0.0 2 4.9 0 0.0 1 2.4 299 1 0.3 0.0 0.0 0.0 0.0 2 0.6 0 0.0 2 0.6 0 0.0 1 0.3 3 7.3
32 27 59 1 3.1 0 0.0 1 1.7 0 0.0 1 3.7 1 1.7 24 1 4.1 0 0.0 0 0.0 0 0.0 1 4.1 178 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 0.5 1 4.1
25 19 44 2 8.0 0 0.0 2 4.5 0 0.0 0 0.0 0 0.0 19 1 5.3 0 0.0 0 0.0 0 0.0 1 5.3 139 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 0.6 1 5.3
35 38 73 0 0.0 1 2.6 1 1.4 1 2.9 1 2.6 2 2.7 29 1 3.4 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 18 49 0 0.0 1 5.6 1 2.0 1 3.2 1 5.6 2 4.1 22 0 0.0 1 4.5 0 0.0 0 0.0 1 4.5 162 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 1 0.5 2 9.1
56 60 116 2 3.6 3 5.0 5 4.3 3 5.4 2 3.3 5 4.3 34 0 0.0 2 5.9 1 2.9 0 0.0 0 0.0 251 0.0 0.0 0.0 0.0 0.0 0 0.0 2 0.7 1 0.4 0 0.0 0 0.0 3 8.8
22 21 43 0 0.0 2 9.5 2 4.7 0 0.0 0 0.0 0 0.0 22 0 0.0 2 9.1 3 13.6 0 0.0 1 4.5 162 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.1 3 1.6 0 0.0 1 0.5 6 27.3
16 30 46 0 0.0 1 3.3 1 2.2 1 6.3 1 3.3 2 4.3 20 0 0.0 0 0.0 1 5.1 0 0.0 1 5.1 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 1 0.6 2 10.1
9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 13 1 7.6 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 1 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
452 466 918 13 2.9 10 2.1 23 2.5 10 2.2 7 1.5 17 1.9 401 13 3.2 10 2.5 9 2.2 0 0.0 8 2.0 3050 2 0.1 0 0.0 0 0.0 0 0.0 0 0.0 15 0.4 10 0.3 9 0.3 0 0.0 8 0.2 27 6.7

Imunisasi
tetes) (ml / tetes)
mur :
ama ayah :
ama ibu :
lamat :
TT2+ BUMIL
PERSENTASE
SASARAN
BUMIL
HAMIL
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 1 2.7 1 1.8 2 2.2 0 0.0 0 0.0 0 0.0 40 2 5.1 1 2.5 0 0.0 0 0.0 0 0.0 393 0.0 0.0 0.0 0.0 0.0 2 0.5 1 0.2 0 0.0 0 0.0 0 0.0 1 2.5
23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 1 5.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 1 5.0
31 38 69 0 0.0 2 5.3 2 2.9 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 1 5.3 1 2.4 20 0 0.0 3 15.2 0 0.0 0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 3 1.8 0 0.0 0 0.0 0 0.0 3 15.2
22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 2 11.8 0 0.0 1 5.9 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 1.4 0 0.0 1 0.7 3 17.6
19 16 35 2 10.5 0 0.0 2 5.7 0 0.0 0 0.0 0 0.0 19 1 5.3 1 5.3 0 0.0 0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 0 0.0 1 5.3
33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 235 1 0.4 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 299 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 24 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 251 1 0.4 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 0 0.0 0 0.0 1 4.5 0 0.0 1 4.5 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 1 0.5 2 9.1
16 30 46 0 0.0 1 3.3 1 2.2 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
452 466 918 3 0.7 4 0.9 7 0.8 0 0.0 1 0.2 1 0.1 401 3 0.7 5 1.2 3 0.7 1 0.2 2 0.5 3050 2 0.1 0 0.0 0 0.0 0 0.0 0 0.0 5 0.1 5 0.1 3 0.1 1 0.0 2 0.1 11 2.7

Imunisasi
tetes) (ml / tetes)
mur :
ama ayah :
ama ibu :
lamat :
TT2+ BUMIL
PERSENTASE
SASARAN
BUMIL
HAMIL
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 1 2.7 2 3.6 3 3.2 0 0.0 1 1.8 1 1.1 40 0 0.0 2 5.1 0 0.0 0 0.0 1 2.5 393 0 0.0 0.0 0.0 0.0 0.0 0 0.0 2 0.5 0 0.0 0 0.0 1 0.2 3 7.6
23 27 50 2 8.7 0 0.0 2 4.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 1 2.6 1 1.4 30 0 0.0 1 3.3 1 3.3 0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 2 6.7
23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 147 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 1 7.7 1 2.9 17 0 0.0 0 0.0 0 0.0 0 0.0 1 5.9 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.7 1 5.9
19 16 35 1 5.3 1 6.3 2 5.7 1 5.3 0 0.0 1 2.9 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
33 35 68 4 12.1 1 2.9 5 7.4 2 6.1 0 0.0 2 2.9 32 0 0.0 0 0.0 2 6.3 0 0.0 0 0.0 235 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 0.7 0 0.0 0 0.0 2 6.3
38 36 74 1 2.6 0 0.0 1 1.4 2 5.3 1 2.8 3 4.1 41 0 0.0 0 0.0 0 0.0 0 0.0 2 4.9 299 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 0.6 2 4.9
32 27 59 2 6.3 3 11.1 5 8.5 0 0.0 0 0.0 0 0.0 24 1 4.1 1 4.1 0 0.0 0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 0 0.0 1 4.1
25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 1 5.3 0 0.0 1 5.3 0 0.0 2 10.7 139 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 1 0.6 0 0.0 2 1.3 3 16.0
35 38 73 1 2.9 2 5.3 3 4.1 1 2.9 1 2.6 2 2.7 29 2 6.9 1 3.4 4 13.8 2 6.9 1 3.4 210 0.0 0.0 0.0 0.0 0.0 2 0.8 1 0.4 4 1.7 2 0.8 1 0.4 8 27.6
31 18 49 0 0.0 2 11.1 2 4.1 1 3.2 1 5.6 2 4.1 22 2 9.1 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 2 1.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
56 60 116 1 1.8 2 3.3 3 2.6 0 0.0 0 0.0 0 0.0 34 1 2.9 0 0.0 0 0.0 0 0.0 3 8.8 251 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 3 1.1 3 8.8
22 21 43 2 9.1 1 4.8 3 7.0 3 13.6 0 0.0 3 7.0 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 30 46 2 12.5 0 0.0 2 4.3 1 6.3 2 6.7 3 6.5 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
452 466 918 17 3.8 14 3.0 31 3.4 11 2.4 8 1.7 19 2.1 401 7 1.7 5 1.2 8 2.0 2 0.5 10 2.5 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 0.2 5 0.1 8 0.2 2 0.1 10 0.3 25 6.2

Imunisasi
tetes) (ml / tetes)
mur :
ama ayah :
ama ibu :
lamat :
TT2+ BUMIL
PERSENTASE
SASARAN
BUMIL
HAMIL
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 0 0.0 1 1.8 1 1.1 1 2.7 0 0.0 1 1.1 40 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 393 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 2 10.0 0 0.0 0 0.0 0 0.0 1 5.0 146 0.0 0.0 0.0 0.0 0.0 2 1.2 0 0.0 0 0.0 0 0.0 1 0.6 1 5.0
31 38 69 1 3.2 1 2.6 2 2.9 1 3.2 2 5.3 3 4.3 30 1 3.3 0 0.0 0 0.0 0 0.0 0 0.0 223 0 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
23 19 42 0 0.0 2 10.5 2 4.8 2 8.7 1 5.3 3 7.1 20 1 5.1 0 0.0 0 0.0 0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 1 5.9 1 5.9 0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.7 1 0.7 0 0.0 0 0.0 2 11.8
19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 1 3.1 0 0.0 0 0.0 0 0.0 0 0.0 235 0 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
38 36 74 0 0.0 0 0.0 0 0.0 1 2.6 0 0.0 1 1.4 41 0 0.0 0 0.0 0 0.0 0 0.0 2 4.9 299 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 0.6 2 4.9
32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 24 0 0.0 0 0.0 0 0.0 0 0.0 1 4.1 178 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 1 4.1
25 19 44 0 0.0 1 5.3 1 2.3 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
35 38 73 1 2.9 1 2.6 2 2.7 2 5.7 1 2.6 3 4.1 29 1 3.4 1 3.4 4 13.8 0 0.0 2 6.9 210 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 4 1.7 0 0.0 2 0.8 7 24.1
31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 1 4.5 0 0.0 1 4.5 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 1 0.5 0 0.0 0 0.0 1 4.5
56 60 116 2 3.6 2 3.3 4 3.4 2 3.6 2 3.3 4 3.4 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 251 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 30 46 1 6.3 1 3.3 2 4.3 1 6.3 1 3.3 2 4.3 20 0 0.0 1 5.1 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 5.1
9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
452 466 918 5 1.1 9 1.9 14 1.5 10 2.2 7 1.5 17 1.9 401 7 1.7 3 0.7 6 1.5 0 0.0 6 1.5 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 0.2 3 0.1 6 0.2 0 0.0 6 0.2 15 3.7

Imunisasi
tetes) (ml / tetes)
mur :
ama ayah :
ama ibu :
lamat :
TT2+ BUMIL
PERSENTASE
SASARAN
BUMIL
HAMIL
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 3 8.1 3 5.4 6 6.5 1 2.7 1 1.8 2 2.2 40 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 393 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
23 27 50 0 0.0 1 3.7 1 2.0 0 0.0 0 0.0 0 0.0 20 0 0.0 2 10.0 0 0.0 0 0.0 2 10.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.2 0 0.0 0 0.0 2 1.2 4 20.0
31 38 69 0 0.0 2 5.3 2 2.9 1 3.2 1 2.6 2 2.9 30 1 3.3 1 3.3 0 0.0 0 0.0 0 0.0 223 0 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1 3.3
23 19 42 0 0.0 1 5.3 1 2.4 1 4.3 0 0.0 1 2.4 20 1 5.1 0 0.0 0 0.0 0 0.0 1 5.1 147 0 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 0.6 1 5.1
22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.7 0 0.0 0 0.0 0 0.0 1 5.9
19 16 35 1 5.3 0 0.0 1 2.9 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
33 35 68 3 9.1 0 0.0 0 0.0 0 0.0 1 2.9 1 1.5 32 0 0.0 0 0.0 2 6.3 0 0.0 0 0.0 235 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 0.7 0 0.0 0 0.0 2 6.3
38 36 74 2 5.3 1 2.8 3 4.1 1 2.6 1 2.8 2 2.7 41 0 0.0 0 0.0 1 2.4 0 0.0 0 0.0 299 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.3 0 0.0 0 0.0 1 2.4
32 27 59 1 3.1 0 0.0 1 1.7 1 3.1 2 7.4 3 5.1 24 0 0.0 1 4.1 3 12.4 0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 3 1.5 0 0.0 0 0.0 4 16.5
25 19 44 1 4.0 0 0.0 1 2.3 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
35 38 73 7 20.0 1 2.6 8 11.0 1 2.9 0 0.0 1 1.4 29 1 3.4 1 3.4 2 6.9 0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 2 0.8 0 0.0 0 0.0 3 10.3
31 18 49 0 0.0 0 0.0 0 0.0 2 6.5 2 11.1 4 8.2 22 0 0.0 1 4.5 0 0.0 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 4.5
56 60 116 2 3.6 2 3.3 4 3.4 1 1.8 2 3.3 3 2.6 34 1 2.9 0 0.0 2 5.9 0 0.0 1 2.9 251 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 2 0.7 0 0.0 1 0.4 3 8.8
22 21 43 0 0.0 1 4.8 1 2.3 1 4.5 1 4.8 2 4.7 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 30 46 0 0.0 1 3.3 1 2.2 1 6.3 0 0.0 1 2.2 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
452 466 918 20 4.4 13 2.8 33 3.6 11 2.4 11 2.4 22 2.4 401 4 1.0 7 1.7 10 2.5 0 0.0 4 1.0 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 0.1 7 0.2 10 0.3 0 0.0 4 0.1 21 5.2

Imunisasi
tetes) (ml / tetes)
mur :
ama ayah :
ama ibu :
lamat :
TT2+ BUMIL
PERSENTASE
SASARAN
BUMIL
HAMIL
93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
37 56 93 12 32.4 11 19.6 23 24.7 5 13.5 6 10.7 11 11.8 40 18 45.5 17 42.9 1 18,3 0 0.0 8 20.2 393 4 1.0 0 0.0 0 0.0 0 0.0 0 0.0 22 5.1 17 3.9 1 0.2 0 0.0 8 1.8 26 65.7
23 27 50 4 17.4 2 7.4 6 12.0 0 0.0 5 18.5 5 10.0 20 2 10.0 3 15.0 3 15.0 1 5.0 4 20.0 146 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 1.2 3 1.8 3 1.8 1 0.6 4 2.4 11 55.0
31 38 69 5 16.1 10 26.3 15 21.7 4 12.9 5 13.2 9 13.0 30 5 16.7 5 16.7 7 23.3 0 0.0 1 3.3 223 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 6 2.4 5 2.0 7 2.8 0 0.0 1 0.4 13 43.3
23 19 42 2 8.7 7 36.8 9 21.4 6 26.1 5 26.3 11 26.2 20 11 55.6 4 20.2 0 0.0 0 0.0 2 10.1 147 1 0.7 0 0.0 0 0.0 0 0.0 0 0.0 12 7.2 4 2.4 0 0.0 0 0.0 2 1.2 6 30.3
22 13 35 0 0.0 3 23.1 3 8.6 2 9.1 2 15.4 4 11.4 17 0 0.0 3 17.6 6 35.3 0 0.0 2 11.8 128 1 0.8 0 0.0 0 0.0 0 0.0 0 0.0 1 0.7 3 2.1 6 4.1 0 0.0 2 1.4 11 64.7
19 16 35 7 36.8 3 18.8 10 28.6 3 15.8 2 12.5 5 14.3 19 1 5.3 1 5.3 1 5.3 1 5.3 1 5.3 136 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 1 0.6 1 0.6 1 0.6 1 0.6 4 21.1
33 35 68 11 33.3 5 14.3 16 23.5 11 33.3 2 5.7 13 19.1 32 6 18.8 7 21.9 8 25.0 0 0.0 2 6.3 235 3 1.3 0 0.0 0 0.0 0 0.0 0 0.0 9 3.4 7 2.6 8 3.0 0 0.0 2 0.7 17 53.1
38 36 74 12 31.6 3 8.3 15 20.3 10 26.3 6 16.7 16 21.6 41 9 22.0 8 19.5 8 19.5 1 2.4 8 19.5 299 5 1.7 0 0.0 0 0.0 0 0.0 0 0.0 14 4.1 8 2.4 8 2.4 1 0.3 8 2.4 25 61.0
32 27 59 6 18.8 6 22.2 12 20.3 1 3.1 3 11.1 4 6.8 24 4 16.5 4 16.5 5 20.7 0 0.0 4 16.5 178 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 2.0 4 2.0 5 2.5 0 0.0 4 2.0 13 53.7
25 19 44 3 12.0 1 5.3 4 9.1 0 0.0 0 0.0 0 0.0 19 4 21.4 3 16.0 1 5.3 0 0.0 4 21.4 139 1 0.7 0 0.0 0 0.0 0 0.0 0 0.0 5 3.2 3 1.9 1 0.6 0 0.0 4 2.5 8 42.8
35 38 73 11 31.4 8 21.1 19 26.0 8 22.9 3 7.9 11 15.1 29 8 27.6 5 17.2 12 41.4 2 6.9 3 10.3 210 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 3.3 5 2.1 12 5.0 2 0.8 3 1.3 22 75.9
31 18 49 4 12.9 8 44.4 12 24.5 4 12.9 4 22.2 8 16.3 22 4 18.2 4 18.2 3 13.6 0 0.0 4 18.2 162 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 5 2.7 4 2.2 3 1.6 0 0.0 4 2.2 11 50.0
56 60 116 13 23.2 17 28.3 30 25.9 11 19.6 14 23.3 25 21.6 34 4 11.8 5 14.7 5 14.7 0 0.0 9 26.5 251 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 5 1.8 5 1.8 5 1.8 0 0.0 9 3.2 19 55.9
22 21 43 5 22.7 5 23.8 10 23.3 5 22.7 2 9.5 7 16.3 22 2 9.1 4 18.2 5 22.7 1 4.5 3 13.6 162 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 1.1 4 2.2 5 2.7 1 0.5 3 1.6 13 59.1
16 30 46 6 37.5 8 26.7 14 30.4 6 37.5 5 16.7 11 23.9 20 1 5.1 2 10.1 4 20.2 0 0.0 2 10.1 146 1 0.7 0 0.0 0 0.0 0 0.0 0 0.0 2 1.2 2 1.2 4 2.4 0 0.0 2 1.2 8 40.4
9 13 22 2 22.2 2 15.4 4 18.2 0 0.0 1 7.7 1 4.5 13 1 7.6 0 0.0 1 7.6 0 0.0 0 0.0 95 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.9 0 0.0 1 0.9 0 0.0 0 0.0 1 7.6
452 466 918 103 22.8 99 21.2 202 22.0 76 16.8 65 13.9 141 15.4 401 80 19.9 75 18.7 70 17.4 6 1.5 57 14.2 3050 19 0.6 0 0.0 0 0.0 0 0.0 0 0.0 99 2.9 75 2.2 70 2.0 6 0.2 57 1.7 208 51.8
90 90 80
PENCATATAN HASIL VAKSINASI
Nama Desa :............................................. Jumlah Penduduk :..........................................Jiwa Tahun :.........................................
Nama Posyandu :............................................. Jumlah Bayi :.........................................Bayi
Kode Posyandu :............................................. Jumlah Bumil :.........................................Ibu
( RT/RW)
Tanggal / Vaksinasi HASIL IMUNISASI BATITA
Tgl Lahir BCG POLIO1 HB 0< 7 HR DPT/HB-Hib (1) POLIO2 DPT/HB-Hib (2) POLIO 3 DPT/HB-Hib (3 ) POLIO 4 CPK DPT/HB/Hib CAMPAK
NO Nama Bayi/ Orang Tua
Alamat
( Umur)
L P L P L P L P L P L P L P L P L P L P L P L P
1 2 3 4 5 6 9 10 11 12 13 14 17 18 19 20 21 22 23 24 25 26 27 28 32 33 34 35
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
Keterangan : Bila Sudah Mendapatkan Kontak lengkapb BCG, DPT-HB.1.2.3 Polio 1.2.3 HB. Dan Campak Maka nomor urut pada baris yang bersangkutan beri tanda o ( Lingkaran )
: Setiap anak yang suda mendapat Imunisasi Lengkap segra di Registrasi ke Buku Kohort TT, WUS dan ditulis Status Ttnya.
JUMLAH HASIL IMUNISASI BAYI
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR (0 - HB0 (0<7 HARI) BCG POLIO1 DPT/HB (1) DPT/HB-Hib (1) POLIO2 DPT/HB (2) DPT/HB-Hib (2) POLIO3
KELURAHAN TAHUN
L P JLH L 11 BLN
P JLH #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P
2017
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 0 0.0 2 13.3 2 5.6 1 4.8 0 0.0 1 2.8 1 4.8 0 0.0 1 2.8 0 0.0 0 0.0 0 0.0 2 9.5 1 6.7 3 8.3 2 9.5 1 6.7 3 8.3 0 0.0 0 0.0 0 0.0 1 4.8 1 6.7 2 5.6 1 4.8 1
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 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 AOSOLE 1,018 9 11 20 9 11 20 1 11.1 0 0.0 1 5.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 1 9.1 2 10.0 1 11.1 1 9.1 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 2 40.0 3 7.5 5 38.5 2 40.0 3 37.5 5 38.5 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 15.4 0 0.0 2 25.0 2 15.4 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 7.7 0 0.0 1
6 KAPUJAYA 620 8 6 14 8 6 14 2 25.0 0 0.0 2 14.3 1 12.5 2 16.0 3 21.4 1 12.5 2 33.3 3 21.4 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 7.1 0 0.0 1 16.7 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
7 WAWOURU 1,072 6 8 14 6 8 14 1 16.7 0 0.0 1 7.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 0 0.0 1 7.1 1 16.7 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 1 6.3 1 10.0 2 7.7 4 25.0 0 0.0 4 15.4 4 25.0 0 0.0 4 15.4 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 7.7 0 0.0 2 20.0 2 7.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 5.9 1 20.0 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 1 20.0 1 8.3 2 11.8 1 20.0 1
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 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 11.1 1 6.3 0 0.0 1 11.1 1 6.3 0 0.0 0 0.0 0 0.0 2 28.6 2 22.2 4 25.0 2 28.6 2
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 2 25.0 2 11.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
12 ANGGONDARA 741 4 6 10 4 6 10 2 50.0 1 16.7 3 30.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 2 20.0 0 0.0 2
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 0 0.0 0 0.0 4 17.4 1 5.8 5 12.5 4 17.4 1 5.9 5 12.5 0 0.0 0 0.0 0 0.0 1 4.3 3 17.6 4 10.0 1 4.3 3 17.6 4 10.0 0 0.0 0 0.0 0 0.0 2 8.7 1 5.9 3 7.5 2 8.7 1
14 WAWONGGURA 740 10 8 18 10 8 18 1 10.0 1 12.5 2 11.1 1 10.0 1 10.0 2 11.1 1 10.0 1 12.5 2 11.1 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 2 20.0 0 0.0 2 11.1 2 20.0 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8 0 0.0 0 0.0 0 0.0 2 14.3 1 14.3 3 14.3 2 14.3 1 14.3 3 14.3 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 4.8 1 7.1 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
PALANGGA 13,929 160 146 306 160 146 306 9 5.6 7 4.8 16 5.2 14 8.8 7 80.0 21 6.9 14 8.8 7 4.8 21 6.9 0 0.0 0 0.0 0 0.0 7 4.4 14 9.6 21 6.9 7 4.4 14 9.6 21 6.9 0 0.0 0 0.0 0 0.0 10 6.3 8 5.5 18 5.9 10 6.3 8
Jenis Vaksin / Alat Stock Bln Sisa Bln

No.
Suntik & Safety Box Lalu
Penerimaa Jumlah Pemakaian
ini Permintaan
No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Jumlah Keadaan Palangga ...................................................2017
n Bln ini Bln ini No. Jenis Cold Chain
(buah)
I. VAKSIN 1 BCG 21 dosis 5 Ampul 4.2 Baik Rusak Koordinator Jurim Puskesmas Palangga
4 Vak. POLIO 28 10 38 15 23 (8) 5 CAMPAK 35 dosis 10 Vial 3.5 4 Thermos Iwan Setiawan.SKM
5 Vak. CAMPAK 22 10 32 10 22 (12) 6 HB. UNIJECT 16 dosis 17 Buah 0.941176 Nip. 19730720 199502 1001
6 Vak. HB. UNIJECT 130 - 130 17 113 (96) 7 TT 26 dosis 9 Vial 2.888889 MENGETAHUI :
II. ALAT SUNTIK
1 ADS 5 ml 42 - 42 15 27 (12)
2 ADS 0,5 ml 410 200 610 142 468 (326)
3 ADS 0,0 5 ml 50 - 50 21 29 (8) Amrin,S.Kep

SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L 11 BLN
2017
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 0 0.0 0 0.0 0 0.0 1 4.8 3 63.0 4 11.1 1 1.0 3 20.0 4 11.1 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 2 9.5 0 0.0 2 5.6 2 9.5 0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 1 16.7 1 5.9 0 0.0 0 #DIV/0! 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 16.7 1 5.9 0 0.0 1 16.7 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 10.0 2 22.2 0 0.0 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 22.2 1 9.1 3 15.0 2 22.2 1
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 1 12.5 1 7.7 0 0.0 0 #DIV/0! 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 12.5 1 7.7 0 0.0 1 12.5 1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 15.4 0 0.0 2
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 1 12.5 1 8.0 2 14.3 1 12.5 1 16.7 2 14.3 0 0.0 0 0.0 0 0.0 1 12.5 1 16.7 2 14.3 1 12.5 1 16.7 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 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 12.5 1 7.1 0 0.0 1 12.5 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 1 10.0 1 3.8 2 12.5 0 0.0 2 7.7 2 12.5 0 0.0 2 7.7 0 0.0 0 0.0 0 0.0 4 25.0 1 10.0 5 19.2 4 25.0 1 10.0 5 19.2 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 3.8 0 0.0 1
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 20.0 0 0.0 1 5.9 1 20.0 0
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 2 22.2 3 18.8 1 14.3 2 22.2 3 18.8 0 0.0 0 0.0 0 0.0 0 0.0 2 22.2 2 12.5 0 0.0 2
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 0 0.0 0 0.0 1 4.3 1 23.0 2 5.0 1 4.3 1 5.9 2 5.0 0 0.0 0 0.0 0 0.0 3 13.0 2 11.8 5 12.5 3 13.0 2 11.8 5 12.5 0 0.0 0 0.0 0 0.0 2 8.7 2 11.8 4 10.0 2 8.7 2
14 WAWONGGURA 740 10 8 18 10 8 18 1 10.0 0 0.0 1 5.6 1 10.0 1 10.0 2 11.1 1 10.0 1 12.5 2 11.1 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0 0.0 0 0.0 0 0.0 4 28.6 1 3.5 5 23.8 4 28.6 1 14.3 5 23.8 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 4.8 0 0.0 1 14.3 1 4.8 0 0.0 0 0.0 0 0.0 1 7.1 1 14.3 2 9.5 1 7.1 1
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 25.0 0 0.0 2 28.6 2 25.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 14.3 1 12.5 0 0.0 1
PALANGGA 13,929 160 146 306 160 146 306 1 0.6 3 2.1 4 1.3 13 8.1 10 123.1 23 7.5 13 8.1 10 6.8 23 7.5 0 0.0 0 0.0 0 0.0 10 6.3 10 6.8 20 6.5 10 6.3 10 6.8 20 6.5 0 0.0 0 0.0 0 0.0 8 5.0 10 6.8 18 5.9 8 5.0 10

No.
ini Permintaan
No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Jumlah Keadaan Palangga, 29 Februari 2016
(buah)
2 Vak. Polio IPV - 5 5 - 5 (5) 3 DPT-HB-Hib 76 dosis 28 Vial 2.714286 2 M. Freezer
4 Vak. POLIO 23 - 23 21 2 19 5 CAMPAK 37 dosis 11 Vial 3.363636 4 Thermos Iwan Setiawan,SKM
5 Vak. CAMPAK 22 10 32 11 21 (10) 6 HB. UNIJECT 4 dosis 4 Buah 1 Nip. 19730720 199502 1 001
1 ADS 5 ml 27 20 47 21 26 (5)
2 ADS 0,5 ml 468 200 668 150 518 (368)
3 ADS 0,0 5 ml 29 100 129 25 104 (79)

BULAN : MARET 2017
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
11 BLN
DESA /
NO
KELURAHAN TAHUN
2017 L P JLH L P JLH #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P
1 2 3 4 5 6 7 8 9 10 0 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 1 4.8 2 13.3 3 8.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 4.8 1 6.7 2 5.6 1 6,3 1 6.7 2 5.6 0 0.0 0 0.0 0 0.0 0 0.0 1 6.7 1 2.8 0 0.0 1
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 1 9.1 1 11.0 2 11.8 1 9.1 1 16.7 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 1 5.9 0 0.0 1
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 1 11.1 3 27.0 4 20.0 1 11.1 3 27.3 4 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
4 ALAKAYA 669 10 8 18 10 8 18 1 10.0 1 12.5 2 11.1 3 30.0 3 10.0 6 33.3 3 30.0 3 37.5 6 33.3 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 2 20.0 2 25.0 4 22.2 2 20.0 2
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 7.7 0 0.0 1 12.5 1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 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 20.0 1 12.5 2 15.4 1 20.0 1
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 1 12.5 1 8.0 2 14.3 1 12.5 1 16.7 2 14.3 0 0.0 0 0.0 0 0.0 1 12.5 1 16.7 2 14.3 1 12.5 1 16.7 2 14.3 0 0.0 0 0.0 0 0.0 1 12.5 2 33.3 3 21.4 1 12.5 2
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 1 16.7 2 12.0 3 21.4 1 16.7 2 25.0 3 21.4 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 1 12.5 1 7.1 0 0.0 1
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 3.8 0 0.0 1 10.0 1 3.8 0 0.0 0 0.0 0 0.0 2 12.5 0 0.0 2 7.7 2 12.5 0 0.0 2 7.7 0 0.0 0 0.0 0 0.0 4 25.0 1 10.0 5 19.2 4 25.0 1
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 2 16.7 2 11.8 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 6.3 0 0.0 1 11.1 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 22.2 2 12.5 0 0.0 2
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 1 10.0 1 10.0 2 11.1 1 0,0 1 12.5 2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 1 16.7 1 10.0 1 25.0 1 4.0 2 20.0 1 25.0 1 16.7 2 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 1 10.0 0 0.0 1
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 2.5 0 0.0 1 5.9 1 2.5 0 0.0 0 0.0 0 0.0 1 4.3 0 0.0 1 2.5 1 4.3 0 0.0 1 2.5 0 0.0 0 0.0 0 0.0 2 8.7 3 17.6 5 12.5 2 8.7 3
14 WAWONGGURA 740 10 8 18 10 8 18 1 10.0 1 12.5 2 11.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 2 25.0 3 16.7 1 10.0 2 25.0 3 16.7 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0 0.0 0 0.0 0 0.0 2 14.3 0 0.0 2 9.5 2 14.3 0 0.0 2 9.5 0 0.0 0 0.0 0 0.0 3 21.4 0 0.0 3 14.3 3 21.4 0 0.0 3 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
PALANGGA 13,929 160 146 306 160 146 306 3 1.9 7 4.8 10 3.3 11 6.9 16 232.7 27 8.8 11 6.9 16 11.0 27 8.8 0 0.0 0 0.0 0 0.0 9 5.6 6 4.1 15 4.9 9 5.6 6 4.1 15 4.9 0 0.0 0 0.0 0 0.0 12 7.5 15 10.3 27 8.8 12 7.5 15

No.
ini Permintaan
No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Jumlah Keadaan Palangga, ………………….2016
(buah)
1 Vak. BCG 18 - 18 7 11 (4) 2 DPT-HB 0 dosis 5 Vial 0 1 Lemari ES
2 Vak. Polio IPV 5 - 5 5 - 5 3 DPT-HB-Hib 63 dosis 18 Vial 3.5 2 M. Freezer
3 Vak. DPT-HB-HIB 18 - 18 18 - 18 4 POLIO 81 dosis 2 Vial 40.5 3 V. Crrier
4 Vak. POLIO 2 - 2 2 - 2 5 CAMPAK 46 dosis 12 Vial 3.833333 4 Thermos Iwan Setiawan,SKM
5 Vak. CAMPAK 21 - 21 12 9 3 6 HB. UNIJECT 10 dosis 9 Buah 1.111111 Nip. 19730720 199502 1 001
7 Vak. TT 16 - 16 8 8 - MENGETAHUI :
1 ADS 5 ml 26 - 26 20 6 14
2 ADS 0,5 ml 518 - 518 130 388 (258)
3 ADS 0,0 5 ml 104 - 104 27 77 (50)

BULAN : APRIL 2017
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L 11 BLN
2017
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 2 9.5 1 6.7 3 8.3 0 0.0 0 #DIV/0! 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 6.7 1 2.8 0 0.0 1 6.7 1 2.8 0 0.0 0 0.0 0 0.0 1 4.8 2 13.3 3 8.3 1 4.8 2
2 WATUDEMBA 665 11 6 17 11 6 17 1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 2 18.2 0 0.0 2 11.8 2 18.2 0 0.0 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 1 11.1 1 9.0 2 10.0 1 11.1 1 9.1 2 10.0 0 0.0 0 0.0 0 0.0 1 11.1 1 9.1 2 10.0 1 11.1 1 9.1 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
4 ALAKAYA 669 10 8 18 10 8 18 2 20.0 0 0.0 2 11.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 25.0 4 22.2 2 20.0 2 25.0 4 22.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
5 WAWORAHA 583 5 8 13 5 8 13 1 20.0 0 0.0 1 7.7 0 0.0 0 #DIV/0! 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 12.5 1 7.7 0 0.0 1 12.5 1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
6 KAPUJAYA 620 8 6 14 8 6 14 1 12.5 0 0.0 1 7.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 16.7 2 14.3 1 12.5 1 16.7 2 14.3 0 0.0 0 0.0 0 0.0 1 12.5 1 16.7 2 14.3 1 12.5 1
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 14.3 0 0.0 2 25.0 2 14.3 0 0.0 0 0.0 0 0.0 1 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 1 6.3 0 0.0 1 3.8 0 0.0 4 #DIV/0! 4 15.4 0 0.0 4 40.0 4 15.4 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 2 12.5 1 10.0 3 11.5 2 21.4 1
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 1 8.3 1 5.9 1 20.0 4 20.0 5 29.4 1 20.0 4 33.3 5 29.4 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
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 11.1 1 6.3 0 0.0 1
11 ONEMBUTE 960 10 8 18 10 8 18 1 10.0 1 12.5 2 11.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 5.6 0 0.0 1
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 2 50.0 2 33.3 4 40.0 2 50.0 2 33.3 4 40.0 0 0.0 0 0.0 0 0.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 0 0.0 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1 4.3 0 0.0 1 2.5 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 13.0 1 5.9 4 10.0 3 13.0 1 5.9 4 10.0 0 0.0 0 0.0 0 0.0 2 8.7 1 5.9 3 7.5 2 8.7 1
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 1 12.5 1 5.6 3 30.0 0 0.0 3 16.7 3 30.0 0 0.0 3 16.7 0 0.0 0 0.0 0 0.0 0 0.0 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 10.0 2 25.0 3 16.7 1 10.0 2
15 SANGGI-SANGGI 666 14 7 21 14 7 21 1 7.1 0 0.0 1 4.8 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 14.3 1 14.3 3 14.3 2 14.3 1 14.3 3 14.3 0 0.0 0 0.0 0 0.0 3 21.4 0 0.0 3 14.3 3 21.4 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 1 100.0 0 0.0 1 12.5 1 100.0 0 0.0 1 12.5 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
PALANGGA 13,929 160 146 306 160 146 306 11 6.9 4 2.7 15 4.9 8 5.0 11 220.0 19 6.2 8 5.0 11 7.5 19 6.2 2 1.3 2 1.4 4 1.3 15 9.4 12 8.2 27 8.8 13 8.1 10 6.8 23 7.5 1 0.6 0 0.0 1 0.3 11 6.9 9 6.2 20 6.5 10 6.3 9

No.
ini Permintaan
No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Jumlah Keadaan Palangga, 30 April 2016
(buah)
4 Vak. POLIO 2 30 32 19 13 6 5 CAMPAK 48 dosis 10 Vial 4.8 4 Thermos Iwan Setiawan,SKM
5 Vak. CAMPAK 9 10 19 10 9 1 6 HB. UNIJECT 15 dosis 14 Buah 1.071429 Nip. 19730720 199502 1 001
1 ADS 5 ml 6 20 26 17 9 8
2 ADS 0,5 ml 388 20 408 180 228 (48)
3 ADS 0,0 5 ml 77 - 77 22 55 (33)

BULAN : MEI 2017
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L 11 BLN
2017
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 2 9.5 1 6.7 3 8.3 3 14.3 1 7.0 4 11.1 3 14.3 1 6.7 4 11.1 0 0.0 0 0.0 0 0.0 1 4.8 3 20.0 4 11.1 1 4.8 3 20.0 4 11.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 1 16.7 2 11.8 1 9.1 1 16.7 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 2 18.2 3 15.0 1 11.1 2 18.2 3 15.0 0 0.0 0 0.0 0 0.0 1 11.1 1 9.1 2 10.0 1 11.1 1
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 3 30.0 2 6.7 5 27.8 3 30.0 2 25.0 5 27.8 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 0 0.0 0 0.0 0 0.0 2 20.0 1 12.5 3 16.7 2 20.0 1
5 WAWORAHA 583 5 8 13 5 8 13 1 20.0 0 0.0 1 7.7 1 20.0 1 5.0 2 15.4 1 20.0 1 12.5 2 15.4 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 7.7 0 0.0 1 12.5 1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 7.7 0 0.0 1
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 3 37.5 0 0.0 3 21.4 3 37.5 0 0.0 3 21.4 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 2 33.3 2 14.3 0 0.0 2
7 WAWOURU 1,072 6 8 14 6 8 14 1 16.7 0 0.0 1 7.1 0 0.0 2 14.3 2 14.3 0 0.0 2 25.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 3 37.5 3 21.4 0 0.0 3 37.5 3 21.4 0 0.0 0 0.0 0 0.0 1 16.7 1 12.5 2 14.3 1 16.7 1
8 MEKAR SARI 1,367 16 10 26 16 10 26 2 12.5 0 0.0 2 7.7 2 12.5 0 0.0 2 7.7 2 12.5 0 0.0 2 7.7 0 0.0 0 0.0 0 0.0 0 0.0 4 40.0 4 15.4 0 0.0 4 40.0 4 15.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 16.7 2 11.8 0 0.0 2 16.7 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 0 0.0 0 2.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 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 10.0 1 12.5 2 11.1 1 10.0 1
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 10.0 0 0.0 1 16.7 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 50.0 1 16.7 3 30.0 2 50.0 1
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1 4.3 1 5.9 2 5.0 4 17.4 0 0.0 4 10.0 4 17.4 0 0.0 4 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 17.4 2 11.8 6 15.0 4 17.4 2
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 30.0 0 0.0 3 16.7 3 30.0 1 12.5 3 16.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 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 14.3 1 12.5 0 0.0 1 14.3 1 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
PALANGGA 13,929 160 146 306 160 146 306 7 4.4 2 1.4 9 2.9 16 10.0 8 80.0 24 7.8 16 10.0 8 5.5 24 7.8 0 0.0 0 0.0 0 0.0 8 5.0 17 11.6 25 8.2 8 5.0 18 12.3 25 8.2 0 0.0 0 0.0 0 0.0 12 7.5 11 7.5 23 7.5 12 7.5 11

No.
ini Permintaan
No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Jumlah Keadaan Palangga, 30 Mei 2017
(buah)
I. VAKSIN 1 BCG 24 dosis 6 Ampul 4 Baik Rusak Koordinator Jurim Puskesmas Palangga
1 Vak. BCG 14 10 24 6 18 (12) 2 IPV 0 dosis 2 Vial 0 1 Lemari ES
2 IPV - 5 5 2 3 (1) 3 DPT-HB-Hib 75 dosis 22 Vial 3.409091 2 M. Freezer
4 Vak. POLIO 13 20 33 15 18 (3) 5 CAMPAK 34 dosis 11 Vial 3.090909 4 Thermos Iwan Setiawan,SKM
5 Vak. CAMPAK 9 10 19 11 8 3 6 HB. UNIJECT 9 dosis 9 Buah 1 Nip. ...........................
7 Vak. TT 10 - 10 7 3 4
1 ADS 5 ml 9 20 29 17 12 5 Kepala Puskesmas Palangga Kab. Konsel
2 ADS 0,5 ml 228 200 428 130 298 (168)
3 ADS 0,0 5 ml 55 100 155 25 130 (105)
Nip. 196506021987031017

BULAN : JUNI 2017
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L 11 BLN
2017
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 0 0.0 0 0.0 0 0.0 5 23.8 0.0 5 13.9 5 23.8 0 0.0 5 13.9 0 0.0 0 0.0 0 0.0 0 0.0 1 6.7 1 2.8 0 0.0 1 6.7 1 2.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 5.9 1 9.1 0
3 AOSOLE 1,018 9 11 20 9 11 20 1 11.1 0 0.0 1 5.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 1 9.1 2 10.0 1 11.1 1 9.1 2 10.0 0 0.0 0 0.0 0 0.0 1 11.1 2 18.2 3 15.0 1 11.1 2
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 11.1 0 0.0 2
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 7.7 1 20.0 0 0.0 1 7.7 0 0.0 0 0.0 0 0.0 1 20.0 1 12.5 2 15.4 1 20.0 1 12.5 2 15.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 0 0.0 2 14.3 2 25.0 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 14.3 0 0.0 2 25.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 3 37.5 3 21.4 0 0.0 3
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 1 10.0 1 3.8 2 12.5 3 24.0 5 19.2 2 12.5 3 30.0 5 19.2 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 3.8 0 0.0 1 10.0 1 3.8 0 0.0 0 0.0 0 0.0 0 0.0 4 40.0 4 15.4 0 0.0 4
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 5.9 0 0.0 1 8.3 1 5.9 0 0.0 0 0.0 0 0.0 1 20.0 1 8.3 2 11.8 1 20.0 1 8.3 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0 1 8.3 1 5.9 0 0.0 1
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 6.3 0 0.0 1 11.1 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 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 14.3 0 0.0 1 6.3 1 14.3 0
11 ONEMBUTE 960 10 8 18 10 8 18 1 10.0 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 2 50.0 1 2.0 3 30.0 2 50.0 1 16.7 3 30.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 20.0 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1 4.3 0 0.0 1 2.5 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 8.7 0 0.0 2 5.0 2 8.7 0 0.0 2 5.0 0 0.0 0 0.0 0 0.0 1 4.3 0 0.0 1 2.5 1 4.3 0
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0.0 0 0.0 0 0.0 3 #DIV/0! 3 16.7 0 0.0 3 37.5 3 16.7 0 0.0 0 0.0 0 0.0 0 0.0 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 10.0 0 0.0 1 5.6 1 10.0 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 2 25.0 0 0.0 2
PALANGGA 13,929 160 146 306 160 146 306 3 1.9 2 1.4 5 1.6 10 6.3 9 144.0 19 6.2 10 6.3 9 6.2 19 6.2 0 0.0 0 0.0 0 0.0 8 5.0 7 4.8 15 4.9 8 5.0 7 4.8 15 4.9 0 0.0 0 0.0 0 0.0 5 3.1 14 9.6 19 6.2 5 3.1 14

No.
ini Permintaan
(buah)
I. VAKSIN 1 BCG 19 dosis 6 Ampul 3.166667 Baik Rusak Koordinator Jurim Puskesmas .Palangga
2 Vak. DPT-HB - - - - 3 DPT-HB-Hib 64 dosis 14 Vial 4.571429 2 M. Freezer
7 Vak. TT 3 20 23 3 20 (17)
1 ADS 5 ml 12 20 32 13 19 (6) Kepala Puskesmas .Palangga Kab.Konsel
2 ADS 0,5 ml 298 200 498 112 386 (274)
3 ADS 0,0 5 ml 130 - 130 21 109 (88)
5 Safety Box 0,25 liter - - - - Amrin,S.Kep
Nip.196506021987031017

BULAN : JULI 2017
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L 11 BLN
2017
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 1 4.8 0 0.0 1 2.8 3 14.3 2 14.0 5 13.9 3 14.3 2 13.3 5 13.9 0 0.0 0 0.0 0 0.0 3 14.3 0 0.0 3 8.3 3 14.3 0 0.0 3 8.3 0 0.0 0 0.0 0 0.0 1 4.8 2 13.3 3 8.3 1 4.8 2
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 1 9.1 2 22.0 3 17.6 1 9.1 2 33.3 3 17.6 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9 0 0.0 0 0.0 0 0.0 2 18.2 0 0.0 2 11.8 2 18.2 0
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 1 11.1 1 9.0 2 10.0 1 11.1 1 9.1 2 10.0 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.0 1 11.1 0 0.0 1 5.0 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.0 1 11.1 0
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 3 30.0 0 0.0 3 16.7 3 30.0 0 0.0 3 16.7 0 0.0 0 0.0 0 0.0 3 30.0 2 25.0 5 27.8 3 30.0 2 25.0 5 27.8 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 7.7 0 0.0 1 12.5 1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 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 20.0 1 12.5 2 15.4 1 20.0 1
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 1 12.5 1 8.0 2 14.3 1 12.5 1 16.7 2 14.3 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 2 25.0 0 0.0 2 14.3 2 25.0 0
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 1 12.5 1 7.1 2 33.3 1 3.0 3 21.4 2 33.3 1 12.5 3 21.4 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 2 25.0 2 14.3 0 0.0 2
8 MEKAR SARI 1,367 16 10 26 16 10 26 1 6.3 1 10.0 2 7.7 2 12.5 0 0.0 2 7.7 2 12.5 0 0.0 2 7.7 0 0.0 0 0.0 0 0.0 3 18.8 2 20.0 5 19.2 3 18.8 2 20.0 5 19.2 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 3.8 0 0.0 1
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 1 20.0 2 10.0 3 17.6 1 20.0 2 16.7 3 17.6 0 0.0 0 0.0 0 0.0 0 0.0 2 16.7 2 11.8 0 0.0 2 16.7 2 11.8 0 0.0 0 0.0 0 0.0 1 20.0 2 16.7 3 17.6 1 20.0 2
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 2 20.0 0 0.0 2 33.3 2 20.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 10.0 0 0.0 1
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 2 11.8 2 5.0 3 13.0 1 7.7 4 10.0 3 13.0 1 5.9 4 10.0 0 0.0 0 0.0 0 0.0 4 17.4 0 0.0 4 10.0 4 17.4 0 0.0 4 10.0 0 0.0 0 0.0 0 0.0 1 4.3 0 0.0 1 2.5 1 4.3 0
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 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 37.5 3 16.7 0 0.0 3 37.5 3 16.7 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0 0.0 0 0.0 0 0.0 3 21.4 1 4.7 4 19.0 3 21.4 1 14.3 4 19.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 14.3 1 14.3 3 14.3 2 14.3 1
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
PALANGGA 13,929 160 146 306 160 146 306 2 1.3 4 2.7 6 2.0 20 12.5 12 96.0 32 10.5 20 12.5 12 8.2 32 10.5 0 0.0 0 0.0 0 0.0 16 10.0 13 8.9 29 9.5 16 10.0 13 8.9 29 9.5 0 0.0 0 0.0 0 0.0 13 8.1 10 6.8 23 7.5 13 8.1 10

No.
ini Permintaan
No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Jumlah Keadaan Palangga ..................................................2016
(buah)
I. VAKSIN 1 BCG 32 dosis 11 Ampul 2.909091 Baik Rusak Koordinator Jurim Puskesmas Palangga.
2 Vak. DPT-HB - - - - - 3 DPT-HB-Hib 89 dosis 25 Vial 3.56 2 M. Freezer
4 Vak. POLIO 37 30 67 16 51 (35) 5 CAMPAK 28 dosis 8 Vial 3.5 4 Thermos Iwan Setiawan
7 Vak. TT 20 10 30 8 22 (14)
2 ADS 0,5 ml 386 200 586 146 440 (294)
3 ADS 0,0 5 ml 109 - 109 35 74 (39)
5 Safety Box 0,25 liter - - - - Amrin,S.Kep.Ns.
Nip.196506021987031017

SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L 11 BLN
2017
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 2 9.5 0 0.0 2 5.6 1 4.8 2 42.0 3 8.3 1 4.8 2 13.3 3 8.3 0 0.0 0 0.0 0 0.0 3 14.3 2 13.3 5 13.9 3 14.3 2 13.3 5 13.9 0 0.0 0 0.0 0 0.0 2 9.5 0 0.0 2 5.6 2 9.5 0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 1 9.1 1 11.0 2 11.8 1 9.1 1 16.7 2 11.8 0 0.0 0 0.0 0 0.0 1 9.1 2 33.3 3 17.6 1 9.1 2 33.3 3 17.6 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 5.9 0 0.0 1
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 1 11.1 1 9.0 2 10.0 1 11.1 1 9.1 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 1 5.0 0 0.0 1 9.1 1 5.0 0 0.0 0 0.0 0 0.0 1 11.1 1 9.1 2 10.0 1 11.1 1
4 ALAKAYA 669 10 8 18 10 8 18 1 10.0 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 30.0 0 0.0 3 16.7 3 30.0 0 0.0 3 16.7 0 0.0 0 0.0 0 0.0 3 30.0 2 25.0 5 27.8 3 30.0 2
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 1 12.5 1 7.7 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 1 12.5 2 15.4 1 20.0 1 12.5 2 15.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 1 16.7 1 7.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 16.7 2 14.3 1 12.5 1 16.7 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
7 WAWOURU 1,072 6 8 14 6 8 14 1 16.7 2 25.0 3 21.4 2 33.3 1 3.0 3 21.4 2 33.3 1 12.5 3 21.4 0 0.0 0 0.0 0 0.0 2 33.3 0 0.0 2 14.3 2 33.3 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 0 0.0 0 0.0 1 6.3 2 32.0 3 11.5 1 6.3 2 20.0 3 11.5 0 0.0 0 0.0 0 0.0 3 18.8 1 10.0 4 15.4 3 18.8 1 10.0 4 15.4 0 0.0 0 0.0 0 0.0 3 18.8 2 20.0 5 19.2 3 18.8 2
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 2 16.7 3 17.6 1 20.0 2 16.7 3 17.6 0 0.0 0 0.0 0 0.0 0 0.0 2 16.7 2 11.8 0 0.0 2
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 11.1 2 12.5 1 14.3 1 11.1 2 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 3 30.0 4 13.3 7 38.9 3 30.0 4 50.0 7 38.9 0 0.0 0 0.0 0 0.0 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 1 16.7 1 10.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 50.0 0 0.0 2 20.0 2 50.0 0 0.0 2 20.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 10.0 0 0.0 1
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 8.7 1 5.9 3 7.5 2 8.7 1 5.9 3 7.5 0 0.0 0 0.0 0 0.0 4 21.4 0 0.0 4 10.0 4 17.4 0
14 WAWONGGURA 740 10 8 18 10 8 18 1 10.0 0 0.0 1 5.6 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 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 2 25.0 2 11.1 0 0.0 2
15 SANGGI-SANGGI 666 14 7 21 14 7 21 1 7.1 0 0.0 1 4.8 2 14.3 0 0.0 2 9.5 2 14.3 0 0.0 2 9.5 0 0.0 0 0.0 0 0.0 5 35.7 1 14.3 6 28.6 5 35.7 1 14.3 6 28.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
PALANGGA 13,929 160 146 306 160 146 306 6 3.8 5 3.4 11 3.6 13 8.1 11 135.4 24 7.8 13 8.1 11 7.5 24 7.8 0 0.0 0 0.0 0 0.0 26 16.3 14 9.6 40 13.1 26 16.3 14 9.6 40 13.1 0 0.0 0 0.0 0 0.0 13 8.1 11 7.5 24 7.8 13 8.1 11

No.
ini Permintaan
No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Jumlah Keadaan Palangga, 31 Agustus 2017
(buah)
I. VAKSIN 1 BCG 24 dosis 6 Ampul 4 Baik Rusak Koordinator Jurim Puskesmas .Palangga
5 Vak. CAMPAK 13 10 23 13 10 3 6 HB. UNIJECT 11 dosis 11 Buah 1 Nip. 19730720 199502 1 001
7 Vak. Td 12 10 22 11 11 -
1 ADS 5 ml 20 20 40 19 21 (2) Kepala Puskesmas Palangga Kab.Konsel
2 ADS 0,5 ml 440 200 640 218 422 (204)
3 ADS 0,0 5 ml 74 - 74 24 50 (26)
Nip.196506021987031017

SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L 11 BLN
2017
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 0 1.0 0 0.0 0 0.0 3 14.3 1 7.0 4 11.1 3 14.3 1 6.7 4 11.1 0 0.0 0 0.0 0 0.0 2 9.5 1 6.7 3 8.3 2 9.5 1 6.7 3 8.3 0 0.0 0 0.0 0 0.0 4 19.0 0 0.0 4 11.1 4 19.0 0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 1 16.7 2 11.8 1 9.1 1 16.7 2 11.8 0 0.0 0 0.0 0 0.0 1 9.1 2 33.3 3 17.6 1 9.1 2
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 1 9.1 1 5.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.0 1 11.1 0 0.0 1 5.0 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 1 5.0 0 0.0 1
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 1 12.5 1 5.6 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 0 0.0 2 11.1 2 20.0 0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 20.0 1 12.5 2 15.4 1 20.0 1
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 12.5 1 16.7 2 14.3 1 12.5 1
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 1 12.5 1 7.1 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 2 25.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 1 6.3 0 0.0 1 3.8 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 7.7 0 0.0 2 20.0 2 7.7 0 0.0 0 0.0 0 0.0 2 12.5 0 0.0 2 7.7 2 12.5 0
9 WATUMEREMBE 814 5 12 17 5 12 17 1 20.0 0 0.0 1 5.9 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0 0.0 0 0.0 0 0.0 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 20.0 1 8.3 2 11.8 1 20.0 1
10 EEWA 636 7 9 16 7 9 16 1 14.3 0 0.0 1 6.3 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 1 12.5 3 16.7 2 20.0 1 12.5 3 16.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 1 16.7 1 10.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 1 10.0 0 0.0 1
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1 4.3 1 5.9 2 5.0 2 8.7 1 11.5 3 7.5 2 8.7 1 5.9 3 7.5 0 0.0 0 0.0 0 0.0 1 4.3 0 0.0 1 2.5 1 4.3 0 0.0 1 2.5 0.0 0 0.0 0 0.0 1 4.3 0 0.0 1 2.5 1 4.3 0
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 1 12.5 1 5.6 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0 0.0 0 0.0 0 0.0 2 14.3 2 14.0 4 19.0 2 14.3 2 28.6 4 19.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 28.6 1 14.3 5 23.8 4 28.6 1
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
PALANGGA 13,929 160 146 306 160 146 306 4 2.5 6 4.1 10 3.3 7 4.4 4 91.4 11 3.6 7 4.4 4 2.7 11 3.6 0 0.0 0 0.0 0 0.0 10 6.3 7 4.8 17 5.6 9 5.6 5 3.4 14 4.6 0 0.0 0 0.0 0 0.0 18 11.3 8 5.5 26 8.5 18 11.3 8

No.
ini Permintaan
(buah)
I. VAKSIN 1 BCG 11 dosis 3 Ampul 3.666667 Baik Rusak Koordinator Jurim Puskesmas .palangga
4 Vak. POLIO 31 20 51 10 41 (31) 5 CAMPAK 24 dosis 6 Vial 4 4 Thermos Iwan Setiawan.SKM
5 Vak. CAMPAK 10 10 20 6 14 (8) 6 HB. UNIJECT 10 dosis 10 Buah 1 Nip. 19730720 199502 1 001.
7 Vak. Td 11 20 31 5 26 (21) MENGETAHUI :
1 ADS 5 ml 21 20 41 9 32 (23)
2 ADS 0,5 ml 422 200 622 112 510 (398)
3 ADS 0,0 5 ml 50 100 150 11 139 (128)

SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L 11 BLN
2017
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 0 0.0 0 0.0 0 0.0 1 4.8 5 105.0 6 16.7 1 4.8 5 33.3 6 16.7 0 0.0 0 0.0 0 0.0 4 19.0 2 13.3 6 16.7 4 19.0 2 13.3 6 16.7 0 0.0 0 0.0 0 0.0 3 14.3 3 20.0 6 16.7 3 14.3 3
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 5.9 1 9.1 0
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 1 11.1 2 18.0 3 15.0 1 11.1 2 18.2 3 15.0 0 0.0 0 0.0 0 0.0 2 22.2 1 9.1 3 15.0 2 22.2 1 9.1 3 15.0 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.0 1 11.1 0
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 10.0 0 0.0 1 5.6 1 10.0 0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 7.7 0 0.0 1 12.5 1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 7.1 0 0.0 1 16.7 1 7.1 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
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 1 16.7 5 30.0 6 42.9 1 16.7 5 62.5 6 42.9 0 0.0 0 0.0 0 0.0 2 33.3 0 0.0 2 14.3 2 33.3 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 1 16.7 2 25.0 3 21.4 1 16.7 2
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 0 0.0 0 0.0 1 6.3 5 80.0 6 23.1 1 6.3 5 50.0 6 23.1 0 0.0 0 0.0 0 0.0 1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8 0 0.0 0 0.0 0 0.0 1 6.3 1 10.0 2 7.7 1 6.3 1
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 4 80.0 0 0.0 4 23.5 4 80.0 0 0.0 4 23.5 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 1 8.3 1 5.9 0 0.0 1
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 11.1 1 6.3 0 0.0 1
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 1 10.0 2 20.0 3 16.7 1 10.0 2 25.0 3 16.7 0 0.0 0 0.0 0 0.0 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 0 0.0 0 0.0 0 0.0 1 10.0 1 12.5 2 11.1 1 10.0 1
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 3 75.0 1 1.3 4 40.0 3 75.0 1 16.7 4 40.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 50.0 0 0.0 2 20.0 2 50.0 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 0 0.0 0 0.0 0 0.0 4 #DIV/0! 4 10.0 0 0.0 4 23.5 4 10.0 0 0.0 0 0.0 0 0.0 2 8.7 1 5.9 3 7.5 2 8.7 1 5.9 3 7.5 0 0.0 0 0.0 0 0.0 1 4.3 0 0.0 1 2.5 1 4.3 0
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 11.1 0 0.0 2 25.0 2 11.1 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 2 20.0 0 0.0 2 11.1 2 20.0 0
15 Sanggi - Sanggi 666 14 7 21 14 7 21 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 14.3 2 28.6 4 19.0 2 14.3 2 28.6 4 19.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
PALANGGA 13,929 160 146 306 160 146 306 0 0.0 0 0.0 0 0.0 13 8.1 28 344.6 41 13.4 13 8.1 28 19.2 41 13.4 0 0.0 0 0.0 0 0.0 15 9.4 7 4.8 22 7.2 15 9.4 7 4.8 22 7.2 0 0.0 0 0.0 0 0.0 14 8.8 9 6.2 23 7.5 14 8.8 9

No.
ini Permintaan
No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Jumlah Keadaan Palangga, 31 Oktober 2015
(buah)
I. VAKSIN 1 BCG 41 dosis - Ampul #DIV/0! Baik Rusak Koordinator Jurim Puskesmas Palangga.
1 Vak. BCG 16 - 16 - - - 2 DPT-HB 0 dosis - Vial #DIV/0! 1 Lemari ES
2 Vak. DPT-HB - - - - - - 3 DPT-HB-Hib 98 dosis - Vial #DIV/0! 2 M. Freezer
3 Vak. DPT-HB-Hib 20 - - - - - 4 POLIO 108 dosis - Vial #DIV/0! 3 V. Crrier
4 Vak. POLIO 41 - 41 - 41 (41) 5 CAMPAK 38 dosis - Vial #DIV/0! 4 Thermos Iwan Setiawan,SKM
5 Vak. CAMPAK 14 - 14 - 14 (14) 6 HB. UNIJECT 0 dosis - Buah #DIV/0! Nip. .19730720 199502 1 oo1.
6 Vak. HB. UNIJECT 45 - 45 - 45 (45) 7 TT 32 dosis - Vial #DIV/0!
7 Vak. TT 26 - 26 - 26 (26) MENGETAHUI :
1 ADS 5 ml 32 - 32 - 32 (32)
2 ADS 0,5 ml 510 - 510 - 510 (510)
3 ADS 0,0 5 ml 139 - - - - -

SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L 11 BLN
2017
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 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 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 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 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
PALANGGA 13,929 160 146 306 160 146 306 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 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

No.
ini Permintaan
(buah)
I. VAKSIN 1 BCG 0 dosis - Ampul #DIV/0! Baik Rusak Koordinator Jurim Puskesmas .Palangga.
1 Vak. BCG - - - - - - 2 DPT-HB 0 dosis - Vial #DIV/0! 1 Lemari ES
3 Vak. DPT-HB-Hib - - - - - - 4 POLIO 0 dosis - Vial #DIV/0! 3 V. Crrier
4 Vak. POLIO 41 - 41 - 41 (41) 5 CAMPAK 3 dosis - Vial #DIV/0! 4 Thermos Iwan Setiawan,SKM
5 Vak. CAMPAK 14 - 14 - 14 (14) 6 HB. UNIJECT 1 dosis - Buah #DIV/0! Nip. 19730720 199502 1 001
6 Vak. HB. UNIJECT - - - - - - 7 TT 0 dosis - Vial #DIV/0!
1 ADS 5 ml 32 - 32 - 32 (32)
2 ADS 0,5 ml 510 - 510 - 510 (510)
3 ADS 0,0 5 ml - - - - - -

SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L 11 BLN
2017
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 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 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 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 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
PALANGGA 13,929 160 146 306 160 146 306 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0

No.
ini Permintaan
(buah)
I. VAKSIN 1 BCG 0 dosis - Ampul #DIV/0! Baik Rusak Koordinator Jurim Puskesmas .................
1 Vak. BCG - - - - - - 2 DPT-HB 0 dosis - Vial #DIV/0! 1 Lemari ES
3 Vak. DPT-HB-Hib - - - - - - 4 POLIO 0 dosis - Vial #DIV/0! 3 V. Crrier
4 Vak. POLIO 41 - 41 - 41 (41) 5 CAMPAK 0 dosis - Vial #DIV/0! 4 Thermos Iwan Setiawan.
5 Vak. CAMPAK 14 - 14 - 14 (14) 6 HB. UNIJECT 0 dosis - Buah #DIV/0! Nip. 19730720 199502 1 001.
6 Vak. HB. UNIJECT - - - - - - 7 TT 0 dosis - Vial #DIV/0!
1 ADS 5 ml 32 - 32 - 32 (32)
2 ADS 0,5 ml 510 - 510 - 510 (510)
3 ADS 0,0 5 ml - - - - - -

BULAN : JANUARI S/D.DESEMBER 2017
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L 11 BLN
2017
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59
1 KIAEA 1,794 21 15 36 21 15 36 8 38.1 6 40.0 14 38.9 18 85.7 14 16.3 32 88.9 18 85.7 14 93.3 32 88.9 0 0.0 0 0.0 0 0.0 16 76.2 12 80.0 28 77.8 16 76.2 12 80.0 28 77.8 0 0.0 0 0.0 0 0.0 14 66.7 9 60.0 23 63.9 14 66.7 9
2 WATUDEMBA 665 11 6 17 11 6 17 1 9.1 1 16.7 2 11.8 4 36.4 4 11.0 8 47.1 4 36.4 4 66.7 8 47.1 0 0.0 0 0.0 0 0.0 7 63.6 6 100.0 13 76.5 7 63.6 6 100.0 13 76.5 0 0.0 0 0.0 0 0.0 5 45.5 1 16.7 6 35.3 5 45.5 4
3 AOSOLE 1,018 9 11 20 9 11 20 2 22.2 1 9.1 3 15.0 7 77.8 8 10.3 15 75.0 7 77.8 8 72.7 15 75.0 0 0.0 0 0.0 0 0.0 8 88.9 7 63.6 15 75.0 8 88.9 7 63.6 15 75.0 0 0.0 0 0.0 0 0.0 7 77.8 6 54.5 13 65.0 7 77.8 6
4 ALAKAYA 669 10 8 18 10 8 18 4 40.0 2 25.0 6 33.3 9 90.0 5 5.6 14 77.8 9 90.0 5 62.5 14 77.8 0 0.0 0 0.0 0 0.0 9 90.0 7 87.5 16 88.9 9 90.0 7 87.5 16 88.9 0 0.0 0 0.0 0 0.0 11 110.0 7 87.5 18 100.0 11 110.0 7
5 WAWORAHA 583 5 8 13 5 8 13 2 40.0 2 25.0 4 30.8 4 80.0 7 8.8 11 84.6 4 80.0 7 87.5 11 84.6 0 0.0 0 0.0 0 0.0 2 40.0 7 87.5 9 69.2 2 40.0 7 87.5 9 69.2 0 0.0 0 0.0 0 0.0 3 60.0 7 87.5 10 76.9 3 60.0 7
6 KAPUJAYA 620 8 6 14 8 6 14 3 37.5 1 16.7 4 28.6 7 87.5 6 6.9 13 92.9 7 87.5 6 100.0 13 92.9 0 0.0 0 0.0 0 0.0 7 87.5 5 83.3 12 85.7 7 87.5 5 83.3 12 85.7 0 0.0 0 0.0 0 0.0 5 62.5 6 100.0 11 78.6 5 62.5 6
7 WAWOURU 1,072 6 8 14 6 8 14 3 50.0 4 50.0 7 50.0 6 100.0 13 13.0 19 135.7 6 100.0 13 162.5 19 135.7 0 0.0 0 0.0 0 0.0 5 83.3 9 112.5 14 100.0 5 83.3 7 87.5 12 85.7 0 0.0 0 0.0 0 0.0 4 66.7 9 112.5 13 92.9 4 66.7 9
8 MEKAR SARI 1,367 16 10 26 16 10 26 6 37.5 4 40.0 10 38.5 14 87.5 15 17.1 29 111.5 14 87.5 15 150.0 29 111.5 0 0.0 0 0.0 0 0.0 13 81.3 13 130.0 26 100.0 13 81.3 13 130.0 26 100.0 0 0.0 0 0.0 0 0.0 12 75.0 11 110.0 23 88.5 12 75.0 11
9 WATUMEREMBE 814 5 12 17 5 12 17 1 20.0 3 25.0 4 23.5 6 120.0 7 5.8 13 76.5 6 120.0 7 58.3 13 76.5 0 0.0 0 0.0 0 0.0 3 60.0 7 58.3 10 58.8 3 60.0 7 58.3 10 58.8 0 0.0 0 0.0 0 0.0 4 80.0 8 66.7 12 70.6 4 80.0 8
10 EEWA 636 7 9 16 7 9 16 1 14.3 0 0.0 1 6.3 2 28.6 2 7.0 4 25.0 2 28.6 2 22.2 4 25.0 0 0.0 0 0.0 0 0.0 3 42.9 4 44.4 7 43.8 2 28.6 4 44.4 6 37.5 0 0.0 0 0.0 0 0.0 3 42.9 8 88.9 11 68.8 3 42.9 8
11 ONEMBUTE 960 10 8 18 10 8 18 2 20.0 3 37.5 5 27.8 5 50.0 9 18.0 14 77.8 5 50.0 9 112.5 14 77.8 0 0.0 0 0.0 0 0.0 6 60.0 6 75.0 12 66.7 6 60.0 6 75.0 12 66.7 0 0.0 0 0.0 0 0.0 3 30.0 3 37.5 6 33.3 3 30.0 3
12 ANGGONDARA 741 4 6 10 4 6 10 2 50.0 4 66.7 6 60.0 7 175.0 4 2.3 11 110.0 7 175.0 4 66.7 11 110.0 2 50.0 2 33.3 4 40.0 4 100.0 4 66.7 8 80.0 2 50.0 2 33.3 4 40.0 1 25.0 0 0.0 1 10.0 5 125.0 7 116.7 12 120.0 4 100.0 7
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 4 17.4 4 23.5 8 20.0 14 60.9 9 14.8 23 57.5 14 60.9 9 52.9 23 57.5 0 0.0 0 0.0 0 0.0 19 82.6 8 47.1 27 67.5 19 82.6 8 47.1 27 67.5 0 0.0 0 0.0 0 0.0 20 87.0 9 52.9 29 72.5 20 87.0 9
14 WAWONGGURA 740 10 8 18 10 8 18 4 40.0 4 50.0 8 44.4 7 70.0 7 10.0 14 77.8 7 70.0 7 87.5 14 77.8 0 0.0 0 0.0 0 0.0 7 70.0 5 62.5 12 66.7 7 70.0 6 75.0 13 72.2 0 0.0 0 0.0 0 0.0 8 80.0 4 50.0 12 66.7 8 80.0 4
15 SANGGI-SANGGI 666 14 7 21 14 7 21 3 21.4 1 14.3 4 19.0 14 100.0 4 4.0 18 85.7 14 100.0 4 57.1 18 85.7 0 0.0 0 0.0 0 0.0 15 107.1 6 85.7 21 100.0 15 107.1 6 85.7 21 100.0 0 0.0 0 0.0 0 0.0 12 85.7 4 57.1 16 76.2 12 85.7 4
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 1 100.0 2 2.0 3 37.5 1 100.0 2 28.6 3 37.5 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 12.5 0 0.0 1 14.3 1 12.5 0 0.0 0 0.0 0 0.0 0 0.0 3 42.9 3 37.5 0 0.0 3
PALANGGA 13,929 160 146 306 160 146 306 52 32.5 40 27.4 92 30.1 125 78.1 116 148.5 241 78.8 125 78.1 116 79.5 241 78.8 2 1.3 2 1.4 4 1.3 124 77.5 107 73.3 231 75.5 121 75.6 104 71.2 225 73.5 1 0.6 0 0.0 1 0.3 116 72.5 102 69.9 218 71.2 115 71.9 105
79% 79% 79% 79% 79%

No.
ini Permintaan
No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Jumlah Keadaan Palangga, 31 Oktober 2015
(buah)
1 Vak. BCG - 70 70 61 9 52 2 DPT-HB 5 dosis 7 Vial 0.714286 1 Lemari ES
2 Vak. DPT-HB - 10 10 7 3 4 3 DPT-HB-Hib 830 dosis 200 Vial 4.15 2 M. Freezer
4 Vak. POLIO 41 170 211 129 82 47 5 CAMPAK 362 dosis 100 Vial 3.62 4 Thermos Iwan Setiawan,SKM
5 Vak. CAMPAK 14 80 94 100 (6) 106 6 HB. UNIJECT 92 dosis 210 Buah 0.438095 Nip. 19730720 199502 1 001
6 Vak. HB. UNIJECT 20 - 20 210 (190) 400 7 TT 260 dosis 70 Vial 3.714286
1 ADS 5 ml 32 140 172 150 22 128
2 ADS 0,5 ml 510 1,420 1,930 1,320 610 710
3 ADS 0,0 5 ml 122 300 422 318 104 214
PERSEN
HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIMUNISASI TASE JUMLAH DAN PER
SASARA WUS
POLIO3 DPT/HB (3) DPT/HB-Hib (3) POLIO4 CAMPAK IMUNISASI DASAR LENGKAP SASARAN BATITA DPT/HB/Hib CAMPAK TT1 TT2 TT3 TT4 TT5 TT1
N BUMIL TDK
% # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # % # % # % HAMIL # %
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
6.7 2 5.6 0 0.0 0 0.0 0 0.0 2 9.5 0 0.0 2 5.6 2 9.5 0 0.0 2 5.6 1 4.8 2 13.3 3 8.3 1 4.8 2 13.3 3 8.3 37 56 93 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 40 1 2.5 2 5.1 0 0.0 0 0.0 2 5.1 393 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 1 9.1 2 10.0 1 11.1 1 9.1 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 223 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 23 19 42 0 0.0 0 0.0 0 0.0 2 8.7 1 5.3 3 7.1 20 0 0.0 1 5.1 0 0.0 0 0.0 0 0.0 147 0.0
12.5 1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 128 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 7.1 0 0.0 1 16.7 1 7.1 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0 1 7.1 19 16 35 1 5.3 0 0.0 1 2.9 0 0.0 1 6.3 1 2.9 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0
0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 7.1 0 0.0 1 12.5 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 1 3.1 1 3.1 0 0.0 0 0.0 1 3.1 235 0.0
0.0 0 0.0 0 0.0 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 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8 38 36 74 0 0.0 0 0.0 0 0.0 1 2.6 1 2.8 2 2.7 41 1 2.4 1 2.4 1 2.4 0 0.0 1 2.4 299 0.0
8.3 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 16.7 2 11.8 0 0.0 2 16.7 2 11.8 32 27 59 0 0.0 1 3.7 1 1.7 0 0.0 0 0.0 0 0.0 19 1 5.3 0 0.0 0 0.0 0 0.0 1 5.3 178 0.0
22.2 4 25.0 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 0 0.0 1 11.1 1 6.3 0 0.0 1 11.1 1 6.3 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 1 5.7 1 5.7 0 0.0 0 0.0 0 0.0 139 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 4 40.0 0 0.0 4 22.2 4 40.0 0 0.0 4 22.2 35 38 73 1 2.9 3 7.9 4 5.5 0 0.0 0 0.0 0 0.0 29 2 6.9 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0
33.3 2 20.0 0 0.0 0 0.0 0 0.0 1 25.0 1 16.7 2 20.0 1 25.0 1 16.7 2 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 3 27.3 162 0.0
5.9 3 7.5 0 0.0 0 0.0 0 0.0 3 13.0 2 11.8 5 12.5 3 13.0 2 11.8 5 12.5 3 13.0 2 11.8 5 12.5 3 13.0 2 11.8 5 12.5 56 60 116 3 5.4 3 5.0 6 5.2 0 0.0 2 3.3 2 1.7 34 1 2.9 1 2.9 1 2.9 0 0.0 0 0.0 251 0.0
0.0 2 11.1 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 1 10.0 2 25.0 3 16.7 1 10.0 2 25.0 3 16.7 22 21 43 1 4.5 1 4.8 2 4.7 1 4.5 1 4.8 2 4.7 20 0 0.0 0 0.0 0 0.0 0 0.0 1 5.1 162 0.0
0.0 1 4.8 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8 16 30 46 0 0.0 0 0.0 0 0.0 1 6.3 1 3.3 2 4.3 23 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0
5.5 18 5.9 0 0.0 0 0.0 0 0.0 11 6.9 7 4.8 18 5.9 11 6.9 7 4.8 18 5.9 13 8.1 10 6.8 23 7.5 13 8.1 10 6.8 23 7.5 452 466 918 6 1.3 8 1.7 14 1.5 5 1.1 7 1.5 12 1.3 380 8 2.1 7 1.8 2 0.5 0 0.0 9 2.4 3050 0 0.0
1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir)
2 Kelamin : Jumlah dosis 2 Kelamin : Jumlah dosis
Imunisasi Tgl. Cara Pemberian (Intra kutan, Lokasi Imunisasi Tgl. Cara Pemberian (Intra kutan, Lokasi
Tgl Jam No. Batch VVM vaksin (ml / Tgl Jam No. Batch VVM vaksin (ml /
3 Tggl / Lahir : (Vaksin) Kadaluarsa Sub-kutan, IM, tetes) penyuntikan 3 Tggl / Lahir : (Vaksin) Kadaluarsa Sub-kutan, IM, tetes) penyuntikan
tetes) tetes)
4 Umur : 4 Umur :
5 Nama ayah : 5 Nama ayah :
6 Nama ibu : 6 Nama ibu :
7 Alamat : 7 Alamat :
a. Jalan ………………………… Nomor …. RT/RW ………………. Reaksi timbul pada tgl .......................................... a. Jalan ………………………… Nomor …. RT/RW ………………. Reaksi timbul pada tgl ..........................................
b. Dusun/Kampung…………….. Desa/Kelurahan ………………… Gejala & Waktu timbulnya gejala ......................................................... b. Dusun/Kampung…………….. Desa/Kelurahan ………………… Gejala & Waktu timbulnya gejala .........................................................
c. Kecamatan ………………….. Kabupaten ………………………… c. Kecamatan ………………….. Kabupaten …………………………
d. Provinsi Sulawesi Tenggara d. Provinsi Sulawesi Tenggara
PERSEN
SASARA WUS
N BUMIL TDK
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
0.0 2 5.6 0 0.0 0 0.0 0 0.0 1 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6 0 0.0 3 20.0 3 8.3 0 0.0 3 20.0 3 8.3 37 56 93 0 0.0 0 0.0 0 0.0 1 2.7 1 1.8 2 2.2 40 1 2.5 1 2.5 0 0.0 0 0.0 0 0.0 393 2 0.5
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 3 50.0 4 23.5 1 9.1 3 50.0 4 23.5 3 27.3 1 16.7 4 23.5 3 27.3 1 16.7 4 23.5 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.0 2 10.0 0 0.0 1 5.0 146 0.0
9.1 3 15.0 0 0.0 0 0.0 0 0.0 2 22.2 2 18.2 4 20.0 2 22.2 2 18.2 4 20.0 3 33.3 1 9.1 4 20.0 3 33.3 1 9.1 4 20.0 31 38 69 1 3.2 2 5.3 3 4.3 0 0.0 1 2.6 1 1.4 30 0 0.0 0 0.0 0 0.0 0 0.0 1 3.3 223 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 147 0.0
25.0 2 15.4 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 7.7 0 0.0 1 12.5 1 7.7 0 0.0 1 12.5 1 7.7 0 0.0 1 12.5 1 7.7 22 13 35 0 0.0 1 7.7 1 2.9 0 0.0 0 0.0 0 0.0 17 0 0.0 1 5.9 1 5.9 0 0.0 0 0.0 128 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 2 14.3 0 0.0 2 33.3 2 14.3 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 2 33.3 0 0.0 2 14.3 2 33.3 0 0.0 2 14.3 33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 1 2.9 1 1.5 32 1 3.1 1 3.1 3 9.4 0 0.0 0 0.0 235 0.0
10.0 1 3.8 0 0.0 0 0.0 0 0.0 3 18.8 0 0.0 3 11.5 3 18.8 0 0.0 3 11.5 0 0.0 2 20.0 2 7.7 0 0.0 2 20.0 2 7.7 38 36 74 2 5.3 0 0.0 2 2.7 0 0.0 2 5.6 2 2.7 41 1 2.4 1 2.4 2 4.9 0 0.0 2 4.9 299 2 0.7
0.0 1 5.9 0 0.0 0 0.0 0 0.0 1 20.0 1 8.3 2 11.8 1 20.0 1 8.3 2 11.8 1 20.0 3 25.0 4 23.5 1 20.0 3 25.0 4 23.5 32 27 59 2 6.3 0 0.0 2 3.4 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 178 0.0
22.2 2 12.5 0 0.0 0 0.0 0 0.0 2 28.6 2 22.2 4 25.0 2 28.6 2 22.2 4 25.0 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0.0
0.0 0 0.0 0 0.0 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 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 1 9.1 0 0.0 0 0.0 162 0.0
11.8 4 10.0 0 0.0 0 0.0 0 0.0 1 4.3 1 5.9 2 5.0 1 4.3 1 5.9 2 5.0 2 8.7 2 11.8 4 10.0 2 8.7 2 11.8 4 10.0 56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 0 0.0 1 2.9 0 0.0 0 0.0 3 0.0 251 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 2 10.1 1 5.1 0 0.0 0 0.0 0 0.0 162 0.0
14.3 2 9.5 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8 0 0.0 1 14.3 1 4.8 0 0.0 1 14.3 1 4.8 16 30 46 0 0.0 3 10.0 3 6.5 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 1 0.7
14.3 1 12.5 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 12.5 0 0.0 1 14.3 1 12.5 0 0.0 1 14.3 1 12.5 0 0.0 1 14.3 1 12.5 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0
6.8 18 5.9 0 0.0 0 0.0 0 0.0 15 9.4 12 8.2 27 8.8 15 9.4 12 8.2 27 8.8 13 8.1 18 12.3 31 10.1 13 8.1 18 12.3 31 10.1 452 466 918 5 1.1 6 1.3 11 1.2 1 0.2 5 1.1 6 0.7 380 5 1.3 7 1.8 9 2.4 0 0.0 7 1.8 #REF! 5 #REF!
tetes) tetes)
4 Umur : 4 Umur :
PERSEN
SASARA WUS
N BUMIL TDK
SASARA
N BUMIL TDK
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
6.7 1 2.8 0 0.0 0 0.0 0 0.0 3 14.3 0 0.0 3 8.3 3 14.3 0 0.0 3 8.3 1 4.8 2 13.3 3 8.3 1 4.8 2 13.3 3 8.3 37 56 93 0 0.0 0 0.0 0 0.0 1 2.7 0 0.0 1 1.1 40 2 5.1 1 2.5 1 2.5 0 0.0 2 5.1 393 0.0
16.7 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 2 11.8 0 0.0 2 33.3 2 11.8 23 27 50 0 0.0 1 3.7 1 2.0 0 0.0 1 3.7 1 2.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 22.2 1 9.1 3 15.0 2 22.2 1 9.1 3 15.0 2 22.2 3 27.3 5 25.0 2 22.2 3 27.3 5 25.0 31 38 69 1 3.2 0 0.0 1 1.4 1 3.2 0 0.0 1 1.4 30 1 3.3 0 0.0 0 0.0 0 0.0 0 0.0 223 0.0
25.0 4 22.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 23 19 42 0 0.0 1 5.3 1 2.4 0 0.0 0 0.0 0 0.0 20 1 5.1 0 0.0 0 0.0 0 0.0 0 0.0 147 0.0
12.5 2 15.4 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 7.7 0 0.0 1 12.5 1 7.7 2 40.0 1 12.5 3 23.1 2 40.0 1 12.5 3 23.1 22 13 35 0 0.0 2 15.4 2 5.7 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 128 0 0.0
33.3 3 21.4 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 2 25.0 1 16.7 3 21.4 2 25.0 1 16.7 3 21.4 19 16 35 0 0.0 1 6.3 1 2.9 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0
12.5 1 7.1 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 2 33.3 1 12.5 3 21.4 2 33.3 1 12.5 3 21.4 33 35 68 1 3.0 1 2.9 2 2.9 1 3.0 0 0.0 1 1.5 32 0 0.0 0 0.0 0 0.0 0 0.0 1 3.1 235 0.0
10.0 5 19.2 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 3.8 0 0.0 1 10.0 1 3.8 3 18.8 0 0.0 3 11.5 3 18.8 0 0.0 3 11.5 38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 2 4.9 1 2.4 1 2.4 1 2.4 0 0.0 299 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 178 0.0
22.2 2 12.5 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 1 14.3 1 11.1 2 12.5 1 14.3 1 11.1 2 12.5 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0 0.0 2 11.4 0 0.0 0 0.0 0 0.0 139 0.0
0.0 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 1 12.5 3 16.7 2 20.0 1 12.5 3 16.7 35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 0 0.0 1 3.4 0 0.0 0 0.0 0 0.0 210 0.0
16.7 1 10.0 0 0.0 0 0.0 0 0.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 18 49 2 6.5 1 5.6 3 6.1 0 0.0 0 0.0 0 0.0 11 1 9.1 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0
17.6 5 12.5 0 0.0 0 0.0 0 0.0 1 4.3 0 0.0 1 2.5 1 4.3 0 0.0 1 2.5 0 0.0 2 11.8 2 5.0 0 0.0 2 11.8 2 5.0 56 60 116 2 3.6 2 3.3 4 3.4 3 5.4 0 0.0 3 2.6 34 0 0.0 1 2.9 0 0.0 0 0.0 0 0.0 251 0.0
0.0 1 5.6 0 0.0 0 0.0 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 37.5 3 16.7 0 0.0 3 37.5 3 16.7 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 1 5.1 0 0.0 162 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8 1 7.1 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5 16 30 46 2 12.5 0 0.0 2 4.3 1 6.3 0 0.0 1 2.2 23 1 4.3 0 0.0 2 8.7 0 0.0 1 4.3 146 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 12.5 0 0.0 1 14.3 1 12.5 0 0.0 2 28.6 2 25.0 0 0.0 2 28.6 2 25.0 9 13 22 2 22.2 0 0.0 2 9.1 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0
10.3 27 8.8 0 0.0 0 0.0 0 0.0 8 5.0 4 2.7 12 3.9 8 5.0 4 2.7 12 3.9 18 11.3 20 13.7 38 12.4 18 11.3 20 13.7 38 12.4 452 466 918 0 0.0 9 1.9 9 1.0 7 1.5 1 0.2 8 0.9 380 8 2.1 6 1.6 4 1.1 2 0.5 4 1.1 3050 0 0.0
tetes) tetes)
4 Umur : 4 Umur :
PERSEN
SASARA WUS
N BUMIL TDK
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
13.3 3 8.3 0 0.0 0 0.0 0 0.0 1 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6 6 28.6 0 0.0 6 16.7 6 28.6 0 0.0 6 16.7 37 56 93 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 40 5 12.6 3 7.6 0 0.0 0 0.0 0 0.0 393 1 0.3
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 1 9.1 1 16.7 2 11.8 1 9.1 1 16.7 2 11.8 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 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 11.1 2 18.2 3 15.0 1 11.1 2 18.2 3 15.0 31 38 69 0 0.0 3 7.9 3 4.3 0 0.0 0 0.0 0 0.0 30 1 3.3 1 3.3 1 3.3 0 0.0 0 0.0 223 1 0.4
0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 25.0 4 22.2 2 20.0 2 25.0 4 22.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 19 42 1 4.3 0 0.0 1 2.4 1 4.3 0 0.0 1 2.4 20 5 25.3 0 0.0 0 0.0 0 0.0 0 0.0 147 1 0.7
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 2 25.0 3 23.1 1 20.0 2 25.0 3 23.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 13 35 0 0.0 0 0.0 0 0.0 1 4.5 0 0.0 1 2.9 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 128 0.0
16.7 2 14.3 0 0.0 0 0.0 0 0.0 1 12.5 2 33.3 3 21.4 1 12.5 2 33.3 3 21.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 1 5.3 0 0.0 1 2.9 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 1 5.3 0 0.0 0 0.0 136 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 14.3 0 0.0 2 25.0 2 14.3 33 35 68 1 3.0 1 2.9 2 2.9 3 9.1 0 0.0 3 4.4 32 1 3.1 1 3.1 0 0.0 0 0.0 0 0.0 235 0.0
10.0 3 11.5 0 0.0 0 0.0 0 0.0 3 18.8 1 10.0 4 15.4 3 18.8 1 10.0 4 15.4 4 25.0 2 20.0 6 23.1 4 25.0 2 20.0 6 23.1 38 36 74 2 5.3 1 2.8 3 4.1 1 2.6 0 0.0 1 1.4 41 2 4.9 1 2.4 0 0.0 0 0.0 0 0.0 299 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 5.9 1 20.0 0 0.0 1 5.9 1 20.0 1 8.3 2 11.8 1 20.0 1 8.3 2 11.8 32 27 59 0 0.0 2 7.4 2 3.4 0 0.0 0 0.0 0 0.0 19 0 0.0 2 10.7 2 10.7 0 0.0 0 0.0 178 0.0
11.1 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 4 44.4 4 25.0 0 0.0 4 44.4 4 25.0 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 1 5.7 0 0.0 0 0.0 0 0.0 1 5.7 139 1 0.7
12.5 1 5.6 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 1 10.0 3 37.5 4 22.2 1 10.0 3 37.5 4 22.2 35 38 73 0 0.0 0 0.0 0 0.0 1 2.9 0 0.0 1 1.4 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0 1 25.0 2 33.3 3 30.0 1 25.0 2 33.3 3 30.0 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 0 0.0 1 9.1 1 9.1 0 0.0 0 0.0 162 0.0
5.9 3 7.5 0 0.0 0 0.0 0 0.0 3 13.0 6 35.3 9 22.5 3 13.0 6 35.3 9 22.5 4 17.4 1 5.9 5 12.5 4 17.4 1 5.9 5 12.5 56 60 116 0 0.0 1 1.7 1 0.9 0 0.0 3 5.0 3 2.6 34 0 0.0 0 0.0 0 0.0 0 0.0 1 2.9 251 0.0
25.0 3 16.7 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 21 43 1 4.5 0 0.0 1 2.3 0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.1 1 5.1 0 0.0 0 0.0 162 0.0
0.0 3 14.3 0 0.0 0 0.0 0 0.0 2 14.3 0 0.0 2 9.5 2 14.3 0 0.0 2 9.5 1 7.1 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5 16 30 46 1 6.3 0 0.0 1 2.2 0 0.0 0 0.0 0 0.0 23 0 0.0 1 4.3 0 0.0 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 100.0 0 0.0 1 12.5 1 100.0 0 0.0 1 12.5 9 13 22 0 0.0 1 7.7 1 4.5 0 0.0 1 7.7 1 4.5 9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0
6.2 19 6.2 0 0.0 0 0.0 0 0.0 17 10.6 19 13.0 36 11.8 17 10.6 19 13.0 36 11.8 22 13.8 15 10.3 37 12.1 22 13.8 15 10.3 37 12.1 452 466 918 7 1.5 9 1.9 16 1.7 7 1.5 4 0.9 11 1.2 380 15 3.9 11 2.9 6 1.6 0 0.0 2 0.5 3050 4 0.1
tetes) tetes)
4 Umur : 4 Umur :
PERSEN
SASARA WUS
N BUMIL TDK
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 13.3 2 5.6 0 0.0 2 13.3 2 5.6 3 14.3 1 6.7 4 11.1 3 14.3 1 6.7 4 11.1 37 56 93 0 0.0 1 1.8 1 1.1 1 2.7 1 1.8 2 2.2 40 1 2.5 2 5.1 0 0.0 0 0.0 1 2.5 393 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
9.1 2 10.0 0 0.0 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 11.1 1 9.1 2 10.0 1 11.1 1 9.1 2 10.0 31 38 69 1 3.2 0 0.0 1 1.4 0 0.0 0 0.0 0 0.0 30 0 0.0 1 3.3 2 6.7 0 0.0 0 0.0 223 0.0
12.5 3 16.7 0 0.0 0 0.0 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 12.5 1 5.6 0 0.0 1 12.5 1 5.6 23 19 42 0 0.0 1 5.3 1 2.4 0 0.0 2 10.5 2 4.8 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 147 0.0
12.5 1 7.7 0 0.0 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 20.0 1 12.5 2 15.4 1 20.0 1 12.5 2 15.4 22 13 35 0 0.0 0 0.0 0 0.0 1 4.5 1 7.7 2 5.7 17 0 0.0 0 0.0 1 5.9 0 0.0 0 0.0 128 0.0
33.3 2 14.3 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0 0.0 1 6.3 1 2.9 1 5.3 0 0.0 1 2.9 19 0 0.0 0 0.0 0 0.0 0 0.0 1 5.3 136 0.0
12.5 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 7.1 0 0.0 1 12.5 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 33 35 68 0 0.0 1 2.9 1 1.5 4 12.1 0 0.0 4 5.9 32 1 3.1 1 3.1 0 0.0 0 0.0 0 0.0 235 2 0.9
0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 12.5 0 0.0 2 7.7 2 12.5 0 0.0 2 7.7 2 12.5 0 0.0 2 7.7 2 12.5 0 0.0 2 7.7 38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 1 2.4 2 4.9 0 0.0 0 0.0 0 0.0 299 1 0.3
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 178 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0 0.0
12.5 2 11.1 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 35 38 73 1 2.9 0 0.0 1 1.4 1 2.9 0 0.0 1 1.4 29 1 3.4 1 3.4 1 3.4 0 0.0 0 0.0 210 0.0
16.7 3 30.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 18 49 0 0.0 1 5.6 1 2.0 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 1 0.6
11.8 6 15.0 0 0.0 0 0.0 0 0.0 2 8.7 2 11.8 4 10.0 2 8.7 2 11.8 4 10.0 3 13.0 1 5.9 4 10.0 3 13.0 1 5.9 4 10.0 56 60 116 0 0.0 1 1.7 1 0.9 0 0.0 2 3.3 2 1.7 34 1 2.9 0 0.0 0 0.0 0 0.0 1 2.9 251 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 2 25.0 3 16.7 1 10.0 2 25.0 3 16.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0
14.3 2 9.5 0 0.0 0 0.0 0 0.0 2 14.3 0 0.0 2 9.5 2 14.3 0 0.0 2 9.5 1 7.1 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5 16 30 46 0 0.0 1 3.3 1 2.2 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 0 0.0 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 14.3 1 12.5 0 0.0 1 14.3 1 12.5 9 13 22 0 0.0 1 7.7 1 4.5 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0
7.5 23 7.5 0 0.0 0 0.0 0 0.0 8 5.0 9 6.2 17 5.6 8 5.0 9 6.2 17 5.6 12 7.5 8 5.5 20 6.5 12 7.5 8 5.5 20 6.5 452 466 918 2 0.4 8 1.7 10 1.1 8 1.8 6 1.3 14 1.5 380 5 1.3 7 1.8 4 1.1 0 0.0 3 0.8 3050 4 0.1
tetes) tetes)
4 Umur : 4 Umur :
PERSEN
SASARA WUS
N BUMIL TDK
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 4.8 0 0.0 1 2.8 1 4.8 0 0.0 1 2.8 3 14.3 0 0.0 3 8.3 3 14.3 0 0.0 3 8.3 37 56 93 1 2.7 1 1.8 2 2.2 0 0.0 0 0.0 0 0.0 40 1 2.5 0 0.0 0 0.0 0 0.0 1 2.5 393 0.0
0.0 1 5.9 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 1 9.1 2 33.3 3 17.6 1 9.1 2 33.3 3 17.6 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 4 14.8 4 8.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
18.2 3 15.0 0 0.0 0 0.0 0 0.0 1 11.1 1 9.1 2 10.0 1 11.1 1 9.1 2 10.0 0 0.0 1 9.1 1 5.0 0 0.0 1 9.1 1 5.0 31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 223 0.0
25.0 2 11.1 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 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 147 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 7.7 0 0.0 1 12.5 1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 1 5.9 0 0.0 0 0.0 128 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 50.0 3 21.4 0 0.0 3 50.0 3 21.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0
37.5 3 21.4 0 0.0 0 0.0 0 0.0 1 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 33 35 68 0 0.0 0 0.0 0 0.0 1 3.0 0 0.0 1 1.5 32 0 0.0 1 3.1 1 3.1 0 0.0 0 0.0 235 0.0
40.0 4 15.4 0 0.0 0 0.0 0 0.0 1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 38 36 74 1 2.6 0 0.0 1 1.4 2 5.3 1 2.8 3 4.1 41 1 2.4 1 2.4 1 2.4 0 0.0 0 0.0 299 1 0.3
8.3 1 5.9 0 0.0 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 20.0 2 16.7 3 17.6 1 20.0 2 16.7 3 17.6 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 178 0.0
0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 1 6.3 0 0.0 1 11.1 1 6.3 1 14.3 2 22.2 3 18.8 1 14.3 2 22.2 3 18.8 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 25.0 4 22.2 2 20.0 2 25.0 4 22.2 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 35 38 73 0 0.0 0 0.0 0 0.0 1 2.9 0 0.0 1 1.4 29 0 0.0 0 0.0 1 3.4 0 0.0 0 0.0 210 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 25.0 1 16.7 2 20.0 1 25.0 1 16.7 2 20.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0 31 18 49 2 6.5 3 16.7 5 10.2 0 0.0 0 0.0 0 0.0 11 0 0.0 1 9.1 0 0.0 0 0.0 0 0.0 162 0.0
0.0 1 2.5 0 0.0 0 0.0 0 0.0 3 13.0 1 5.9 4 10.0 2 8.7 1 5.9 3 7.5 2 8.7 1 5.9 3 7.5 2 8.7 1 5.9 3 7.5 56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 251 0.0
0.0 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
28.6 2 25.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0
9.6 19 6.2 0 0.0 0 0.0 0 0.0 11 6.9 11 7.5 22 7.2 10 6.3 11 7.5 21 6.9 13 8.1 9 6.2 22 7.2 13 8.1 9 6.2 22 7.2 452 466 918 4 0.9 4 0.9 8 0.9 4 0.9 5 1.1 9 1.0 380 2 0.5 3 0.8 4 1.1 0 0.0 1 0.3 3050 1 0.0
tetes) tetes)
4 Umur : 4 Umur :
PERSEN
SASARA WUS
N BUMIL TDK
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
13.3 3 8.3 0 0.0 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 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6 37 56 93 5 13.5 1 1.8 6 6.5 0 0.0 2 3.6 2 2.2 40 1 2.5 2 5.1 0 0.0 0 0.0 0 0.0 393 0.0
0.0 2 11.8 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 1 5.0 0 0.0 0 0.0 146 0.0
0.0 1 5.0 0 0.0 0 0.0 0 0.0 0 0.0 2 18.2 2 10.0 0 0.0 2 18.2 2 10.0 1 11.1 0 0.0 1 5.0 1 11.1 0 0.0 1 5.0 31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 1 3.3 0 0.0 0 0.0 223 0.0
0.0 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 19 42 1 4.3 1 5.3 2 4.8 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 147 0.0
12.5 2 15.4 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 1 12.5 1 7.7 0 0.0 1 12.5 1 7.7 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 128 1 0.8
0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 1 5.3 0 0.0 136 0.0
25.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 3 37.5 3 21.4 0 0.0 3 37.5 3 21.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 33 35 68 1 3.0 1 2.9 2 2.9 0 0.0 0 0.0 0 0.0 32 1 3.1 1 3.1 0 0.0 0 0.0 0 0.0 235 0.0
10.0 1 3.8 0 0.0 0 0.0 0 0.0 0 0.0 3 30.0 3 11.5 0 0.0 3 30.0 3 11.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 38 36 74 2 5.3 1 2.8 3 4.1 0 0.0 0 0.0 0 0.0 41 0 0.0 1 2.4 0 0.0 0 0.0 0 0.0 299 0.0
16.7 3 17.6 0 0.0 0 0.0 0 0.0 0 0.0 1 8.3 1 5.9 0 0.0 1 8.3 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 1 5.3 0 0.0 0 0.0 0 0.0 1 5.3 178 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 1 14.3 2 22.2 3 18.8 1 14.3 2 22.2 3 18.8 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0
16.7 1 10.0 0 0.0 0 0.0 0 0.0 2 50.0 0 0.0 2 20.0 2 50.0 0 0.0 2 20.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0
0.0 1 2.5 0 0.0 0 0.0 0 0.0 1 4.3 0 0.0 1 2.5 1 4.3 0 0.0 1 2.5 2 8.7 4 23.5 6 15.0 2 8.7 4 23.5 6 15.0 56 60 116 1 1.8 1 1.7 2 1.7 2 3.6 1 1.7 3 2.6 34 0 0.0 0 0.0 1 2.9 0 0.0 0 0.0 251 0.0
0.0 1 5.6 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 22 21 43 1 4.5 0 0.0 1 2.3 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0
14.3 3 14.3 0 0.0 0 0.0 0 0.0 1 7.1 2 28.6 3 14.3 1 7.1 2 28.6 3 14.3 2 14.3 1 14.3 3 14.3 2 14.3 1 14.3 3 14.3 16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 1 4.3 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 2 25.0 0 0.0 2 28.6 2 25.0 0 0.0 1 14.3 1 12.5 0 0.0 1 14.3 1 12.5 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 1 11.4 0 0.0 0 0.0 95 0.0
6.8 23 7.5 0 0.0 0 0.0 0 0.0 7 4.4 14 9.6 21 6.9 7 4.4 14 9.6 21 6.9 12 7.5 11 7.5 23 7.5 12 7.5 11 7.5 23 7.5 452 466 918 11 2.4 5 1.1 16 1.7 2 0.4 3 0.6 5 0.5 380 3 0.8 4 1.1 5 1.3 1 0.3 1 0.3 3050 1 0.0
tetes) tetes)
4 Umur : 4 Umur :
PERSEN
SASARA WUS
N BUMIL TDK
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
0.0 2 5.6 0 0.0 0 0.0 0 0.0 1 4.8 2 13.3 3 8.3 1 4.8 2 13.3 3 8.3 0 0.0 1 6.7 1 2.8 0 0.0 1 6.7 1 2.8 37 56 93 1 2.7 1 1.8 2 2.2 0 0.0 0 0.0 0 0.0 40 4 10.1 3 7.6 0 0.0 0 0.0 1 2.5 393 1 0.3
16.7 1 5.9 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 27 50 2 8.7 0 0.0 2 4.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
9.1 2 10.0 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 10.0 2 22.2 0 0.0 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 38 69 1 3.2 0 0.0 1 1.4 1 3.2 0 0.0 1 1.4 30 1 3.3 1 3.3 2 6.7 0 0.0 0 0.0 223 0.0
25.0 5 27.8 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 1 10.0 2 25.0 3 16.7 1 10.0 2 25.0 3 16.7 23 19 42 0 0.0 1 5.3 1 2.4 0 0.0 0 0.0 0 0.0 20 3 15.2 0 0.0 0 0.0 0 0.0 1 5.1 147 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 1 12.5 2 15.4 1 20.0 1 12.5 2 15.4 0 0.0 2 25.0 2 15.4 0 0.0 2 25.0 2 15.4 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 128 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0 1 7.1 0 0.0 2 33.3 2 14.3 0 0.0 2 33.3 2 14.3 19 16 35 1 5.3 0 0.0 1 2.9 1 5.3 1 6.3 2 5.7 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 14.3 0 0.0 2 25.0 2 14.3 0 0.0 1 12.5 1 7.1 0 0.0 1 12.5 1 7.1 33 35 68 1 3.0 0 0.0 1 1.5 0 0.0 0 0.0 0 0.0 32 0 0.0 1 3.1 0 0.0 0 0.0 0 0.0 235 0.0
20.0 5 19.2 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 7.7 0 0.0 2 20.0 2 7.7 3 18.8 3 30.0 6 23.1 3 18.8 3 30.0 6 23.1 38 36 74 2 5.3 0 0.0 2 2.7 2 5.3 0 0.0 2 2.7 41 1 2.4 0 0.0 2 4.9 0 0.0 1 2.4 299 1 0.3
16.7 2 11.8 0 0.0 0 0.0 0 0.0 1 20.0 1 8.3 2 11.8 1 20.0 1 8.3 2 11.8 1 20.0 0 0.0 1 5.9 1 20.0 0 0.0 1 5.9 32 27 59 1 3.1 0 0.0 1 1.7 0 0.0 1 3.7 1 1.7 19 1 5.3 0 0.0 0 0.0 0 0.0 1 5.3 178 0.0
0.0 0 0.0 0 0.0 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 14.3 2 22.2 3 18.8 1 14.3 2 22.2 3 18.8 25 19 44 2 8.0 0 0.0 2 4.5 0 0.0 0 0.0 0 0.0 18 1 5.7 0 0.0 0 0.0 0 0.0 1 5.7 139 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1 35 38 73 0 0.0 1 2.6 1 1.4 1 2.9 1 2.6 2 2.7 29 1 3.4 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0
16.7 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 31 18 49 0 0.0 1 5.6 1 2.0 1 3.2 1 5.6 2 4.1 11 0 0.0 1 9.1 0 0.0 0 0.0 1 9.1 162 0.0
0.0 4 10.0 0 0.0 0 0.0 0 0.0 1 4.3 1 5.9 2 5.0 1 4.3 1 5.9 2 5.0 3 13.0 2 11.8 5 12.5 3 13.0 2 11.8 5 12.5 56 60 116 2 3.6 3 5.0 5 4.3 3 5.4 2 3.3 5 4.3 34 0 0.0 2 5.9 1 2.9 0 0.0 0 0.0 251 0.0
25.0 2 11.1 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 22 21 43 0 0.0 2 9.5 2 4.7 0 0.0 0 0.0 0 0.0 20 0 0.0 2 10.1 3 15.2 0 0.0 1 5.1 162 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8 16 30 46 0 0.0 1 3.3 1 2.2 1 6.3 1 3.3 2 4.3 23 0 0.0 0 0.0 1 4.3 0 0.0 1 4.3 146 0.0
0.0 0 0.0 0 0.0 0 0.0 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 14.3 1 12.5 0 0.0 1 14.3 1 12.5 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 1 11.4 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0
7.5 24 7.8 0 0.0 0 0.0 0 0.0 10 6.3 11 7.5 21 6.9 10 6.3 11 7.5 21 6.9 11 6.9 18 12.3 29 9.5 11 6.9 18 12.3 29 9.5 452 466 918 13 2.9 10 2.1 23 2.5 10 2.2 7 1.5 17 1.9 380 13 3.4 10 2.6 9 2.4 0 0.0 8 2.1 3050 2 0.1
tetes) tetes)
4 Umur : 4 Umur :
PERSEN
SASARA WUS
N BUMIL TDK
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
0.0 4 11.1 0 0.0 0 0.0 0 0.0 2 9.5 0 0.0 2 5.6 2 9.5 0 0.0 2 5.6 1 4.8 2 13.3 3 8.3 1 4.8 2 13.3 3 8.3 37 56 93 1 2.7 1 1.8 2 2.2 0 0.0 0 0.0 0 0.0 40 2 5.1 1 2.5 0 0.0 0 0.0 0 0.0 393 0.0
33.3 3 17.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 1 5.0 0 0.0 146 0.0
9.1 1 5.0 0 0.0 0 0.0 0 0.0 1 11.1 1 9.1 2 10.0 1 11.1 1 9.1 2 10.0 1 11.1 0 0.0 1 5.0 1 11.1 0 0.0 1 5.0 31 38 69 0 0.0 2 5.3 2 2.9 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 223 0.0
0.0 2 11.1 0 0.0 0 0.0 0 0.0 3 30.0 1 12.5 4 22.2 3 30.0 1 12.5 4 22.2 2 20.0 1 12.5 3 16.7 2 20.0 1 12.5 3 16.7 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 1 5.3 1 2.4 20 0 0.0 3 15.2 0 0.0 0 0.0 0 0.0 147 0.0
12.5 2 15.4 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 1 20.0 1 12.5 2 15.4 1 20.0 1 12.5 2 15.4 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 2 11.8 0 0.0 1 5.9 128 0.0
16.7 2 14.3 0 0.0 0 0.0 0 0.0 2 25.0 0 0.0 2 14.3 2 25.0 0 0.0 2 14.3 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0 1 7.1 19 16 35 2 10.5 0 0.0 2 5.7 0 0.0 0 0.0 0 0.0 19 1 5.3 1 5.3 0 0.0 0 0.0 0 0.0 136 0.0
0.0 1 7.1 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 33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 235 1 0.4
0.0 2 7.7 0 0.0 0 0.0 0 0.0 3 18.8 0 0.0 3 11.5 3 18.8 0 0.0 3 11.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 299 0.0
8.3 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0 3 25.0 3 17.6 0 0.0 3 25.0 3 17.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 178 0.0
0.0 0 0.0 0 0.0 0 0.0 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 11.1 1 6.3 0 0.0 1 11.1 1 6.3 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0
16.7 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0
0.0 1 2.5 0 0.0 0 0.0 0 0.0 3 13.0 0 0.0 3 7.5 3 13.0 0 0.0 3 7.5 4 17.4 2 11.8 6 15.0 4 17.4 2 11.8 6 15.0 56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 251 1 0.4
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 1 5.1 0 0.0 1 5.1 162 0.0
14.3 5 23.8 0 0.0 0 0.0 0 0.0 2 14.3 0 0.0 2 9.5 2 14.3 0 0.0 2 9.5 2 14.3 1 14.3 3 14.3 2 14.3 1 14.3 3 14.3 16 30 46 0 0.0 1 3.3 1 2.2 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0
5.5 26 8.5 0 0.0 0 0.0 0 0.0 17 10.6 9 6.2 26 8.5 17 10.6 9 6.2 26 8.5 14 8.8 9 6.2 23 7.5 14 8.8 9 6.2 23 7.5 452 466 918 3 0.7 4 0.9 7 0.8 0 0.0 1 0.2 1 0.1 380 3 0.8 5 1.3 3 0.8 1 0.3 2 0.5 3050 2 0.1
tetes) tetes)
4 Umur : 4 Umur :
PERSEN
SASARA WUS
N BUMIL TDK
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
20.0 6 16.7 0 0.0 0 0.0 0 0.0 2 9.5 0 0.0 2 5.6 2 9.5 0 0.0 2 5.6 0 0.0 1 6.7 1 2.8 0 0.0 1 6.7 1 0.0 37 56 93 1 2.7 2 3.6 3 3.2 0 0.0 1 1.8 1 1.1 40 0 0.0 2 5.1 0 0.0 0 0.0 1 2.5 393 0 0.0
0.0 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 2 11.8 0 0.0 2 33.3 2 11.8 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 23 27 50 2 8.7 0 0.0 2 4.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
0.0 1 5.0 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 1 5.0 0 0.0 1 9.1 1 5.0 2 22.2 2 18.2 4 20.0 2 22.2 2 18.2 4 20.0 31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 1 2.6 1 1.4 30 0 0.0 1 3.3 1 3.3 0 0.0 0 0.0 223 0.0
0.0 1 5.6 0 0.0 0 0.0 0 0.0 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 147 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 1 12.5 2 15.4 1 20.0 1 12.5 2 15.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 1 7.7 1 2.9 17 0 0.0 0 0.0 0 0.0 0 0.0 1 5.9 128 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 16.7 2 14.3 1 12.5 1 16.7 2 14.3 2 25.0 1 16.7 3 21.4 2 25.0 1 16.7 3 21.4 19 16 35 1 5.3 1 6.3 2 5.7 1 5.3 0 0.0 1 2.9 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0
25.0 3 21.4 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3 33 35 68 4 12.1 1 2.9 5 7.4 2 6.1 0 0.0 2 2.9 32 0 0.0 0 0.0 2 6.3 0 0.0 0 0.0 235 0 0.0
10.0 2 7.7 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 7.7 0 0.0 2 20.0 2 7.7 2 12.5 0 0.0 2 7.7 2 12.5 0 0.0 2 7.7 38 36 74 1 2.6 0 0.0 1 1.4 2 5.3 1 2.8 3 4.1 41 0 0.0 0 0.0 0 0.0 0 0.0 2 4.9 299 0.0
8.3 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 1 8.3 1 5.9 0 0.0 1 8.3 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 2 6.3 3 11.1 5 8.5 0 0.0 0 0.0 0 0.0 19 1 5.3 1 5.3 0 0.0 0 0.0 0 0.0 178 0.0
11.1 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 1 5.7 0 0.0 1 5.7 0 0.0 2 11.4 139 0.0
12.5 2 11.1 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 35 38 73 1 2.9 2 5.3 3 4.1 1 2.9 1 2.6 2 2.7 29 2 6.9 1 3.4 4 13.8 2 6.9 1 3.4 210 0.0
0.0 2 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 50.0 0 0.0 2 20.0 2 50.0 0 0.0 2 20.0 31 18 49 0 0.0 2 11.1 2 4.1 1 3.2 1 5.6 2 4.1 11 2 18.2 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0
0.0 1 2.5 0 0.0 0 0.0 0 0.0 3 13.0 0 0.0 3 7.5 3 13.0 0 0.0 3 7.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 56 60 116 1 1.8 2 3.3 3 2.6 0 0.0 0 0.0 0 0.0 34 1 2.9 0 0.0 0 0.0 0 0.0 3 8.8 251 0.0
0.0 2 11.1 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1 22 21 43 2 9.1 1 4.8 3 7.0 3 13.6 0 0.0 3 7.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 14.3 1 14.3 3 14.3 2 14.3 1 14.3 3 14.3 2 14.3 0 0.0 2 9.5 2 14.3 0 0.0 2 9.5 16 30 46 2 12.5 0 0.0 2 4.3 1 6.3 2 6.7 3 6.5 23 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0
6.2 23 7.5 0 0.0 0 0.0 0 0.0 12 7.5 10 6.8 22 7.2 12 7.5 10 6.8 22 7.2 12 7.5 7 4.8 19 6.2 12 7.5 7 4.8 19 6.2 452 466 918 17 3.8 14 3.0 31 3.4 11 2.4 8 1.7 19 2.1 380 7 1.8 5 1.3 8 2.1 2 0.5 10 2.6 3050 0 0.0
tetes) tetes)
4 Umur : 4 Umur :
PERSEN
SASARA WUS
N BUMIL TDK
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
0.0 0 0.0 0 0.0 0 0.0 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 20.0 3 8.3 0 0.0 0 0.0 0 0.0 37 56 93 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 40 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 393 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 223 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 147 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 128 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 235 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 299 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 178 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 251 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0
0.0 0 0.0 0 0.0 0 0.0 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 2.1 3 1.0 0 0.0 0 0.0 0 0.0 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 380 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3050 0 0.0
tetes) tetes)
4 Umur : 4 Umur :
PERSEN
SASARA WUS
N BUMIL TDK
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 37 56 93 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 40 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 393 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 223 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 147 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 128 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 136 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 235 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 299 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 178 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 139 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 210 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 251 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 162 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 95 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 380 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3050 0 0.0
tetes) tetes)
4 Umur : 4 Umur :
PERSEN
SASARA WUS
N BUMIL TDK
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 DIIMUNI
119 120 121
60.0 23 63.9 0 0.0 0 0.0 0 0.0 13 61.9 6 40.0 19 52.8 13 61.9 6 40.0 19 52.8 16 76.2 8 53.3 24 66.7 16 76.2 8 53.3 24 66.7 37 56 93 9 24.3 7 12.5 16 17.2 3 8.1 5 8.9 8 8.6 40 18 45.5 17 42.9 1 18,3 0 0.0 8 20.2 393 4 1.0
66.7 9 52.9 0 0.0 0 0.0 0 0.0 5 45.5 6 100.0 11 64.7 5 45.5 6 100.0 11 64.7 6 54.5 8 133.3 14 82.4 6 54.5 8 133.3 14 82.4 23 27 50 4 17.4 1 3.7 5 10.0 0 0.0 5 18.5 5 10.0 20 0 0.0 1 5.0 3 15.0 1 5.0 1 5.0 146 0 0.0
54.5 13 65.0 0 0.0 0 0.0 0 0.0 9 100.0 9 81.8 18 90.0 9 100.0 9 81.8 18 90.0 11 122.2 10 90.9 21 105.0 11 122.2 10 90.9 21 105.0 31 38 69 4 12.9 7 18.4 11 15.9 2 6.5 2 5.3 4 5.8 30 3 10.0 4 13.3 7 23.3 0 0.0 1 3.3 223 1 0.4
87.5 18 100.0 0 0.0 0 0.0 0 0.0 8 80.0 5 62.5 13 72.2 8 80.0 5 62.5 13 72.2 8 80.0 5 62.5 13 72.2 8 80.0 5 62.5 13 72.2 23 19 42 2 8.7 4 21.1 6 14.3 3 13.0 4 21.1 7 16.7 20 9 45.5 4 20.2 0 0.0 0 0.0 1 5.1 147 1 0.7
87.5 10 76.9 0 0.0 0 0.0 0 0.0 3 60.0 7 87.5 10 76.9 3 60.0 7 87.5 10 76.9 4 80.0 7 87.5 11 84.6 4 80.0 7 87.5 11 84.6 22 13 35 0 0.0 3 23.1 3 8.6 2 9.1 2 15.4 4 11.4 17 0 0.0 1 5.9 5 29.4 0 0.0 2 11.8 128 1 0.8
100.0 11 78.6 0 0.0 0 0.0 0 0.0 6 75.0 7 116.7 13 92.9 6 75.0 7 116.7 13 92.9 6 75.0 6 100.0 12 85.7 6 75.0 6 100.0 12 85.7 19 16 35 6 31.6 3 18.8 9 25.7 3 15.8 2 12.5 5 14.3 19 1 5.3 1 5.3 1 5.3 1 5.3 1 5.3 136 0 0.0
112.5 13 92.9 0 0.0 0 0.0 0 0.0 3 50.0 8 100.0 11 78.6 3 50.0 8 100.0 11 78.6 6 100.0 5 62.5 11 78.6 6 100.0 5 62.5 11 78.6 33 35 68 8 24.2 5 14.3 13 19.1 11 33.3 1 2.9 12 17.6 32 5 15.6 7 21.9 6 18.8 0 0.0 2 6.3 235 3 1.3
110.0 23 88.5 0 0.0 0 0.0 0 0.0 12 75.0 9 90.0 21 80.8 12 75.0 9 90.0 21 80.8 15 93.8 7 70.0 22 84.6 15 93.8 7 70.0 22 84.6 38 36 74 10 26.3 2 5.6 12 16.2 8 21.1 5 13.9 13 17.6 41 9 22.0 8 19.5 7 17.1 1 2.4 6 14.6 299 5 1.7
66.7 12 70.6 0 0.0 0 0.0 0 0.0 3 60.0 7 58.3 10 58.8 3 60.0 7 58.3 10 58.8 4 80.0 8 66.7 12 70.6 4 80.0 8 66.7 12 70.6 32 27 59 5 15.6 6 22.2 11 18.6 0 0.0 1 3.7 1 1.7 19 4 21.4 3 16.0 2 10.7 0 0.0 3 16.0 178 0 0.0
88.9 11 68.8 0 0.0 0 0.0 0 0.0 4 57.1 7 77.8 11 68.8 4 57.1 7 77.8 11 68.8 6 85.7 9 100.0 15 93.8 6 85.7 9 100.0 15 93.8 25 19 44 2 8.0 0 0.0 2 4.5 0 0.0 0 0.0 0 0.0 18 4 22.7 3 17.0 1 5.7 0 0.0 4 22.7 139 1 0.7
37.5 6 33.3 0 0.0 0 0.0 0 0.0 4 40.0 4 50.0 8 44.4 4 40.0 4 50.0 8 44.4 11 110.0 7 87.5 18 100.0 11 110.0 7 87.5 18 100.0 35 38 73 3 8.6 6 15.8 9 12.3 5 14.3 2 5.3 7 9.6 29 6 20.7 3 10.3 6 20.7 2 6.9 1 3.4 210 0 0.0
116.7 11 110.0 0 0.0 0 0.0 0 0.0 5 125.0 6 100.0 11 110.0 5 125.0 6 100.0 11 110.0 5 125.0 4 66.7 9 90.0 5 125.0 4 66.7 9 90.0 31 18 49 4 12.9 8 44.4 12 24.5 2 6.5 2 11.1 4 8.2 11 3 27.3 3 27.3 2 18.2 0 0.0 4 36.4 162 1 0.6
52.9 29 72.5 0 0.0 0 0.0 0 0.0 21 91.3 13 76.5 34 85.0 20 87.0 13 76.5 33 82.5 23 100.0 17 100.0 40 100.0 23 100.0 17 100.0 40 100.0 56 60 116 9 16.1 13 21.7 22 19.0 8 14.3 10 16.7 18 15.5 34 3 8.8 5 14.7 3 8.8 0 0.0 8 23.5 251 1 0.4
50.0 12 66.7 0 0.0 0 0.0 0 0.0 7 70.0 4 50.0 11 61.1 7 70.0 4 50.0 11 61.1 7 70.0 7 87.5 14 77.8 7 70.0 7 87.5 14 77.8 22 21 43 5 22.7 4 19.0 9 20.9 4 18.2 1 4.8 5 11.6 20 2 10.1 4 20.2 5 25.3 1 5.1 3 15.2 162 0 0.0
57.1 16 76.2 0 0.0 0 0.0 0 0.0 13 92.9 8 114.3 21 100.0 13 92.9 4 57.1 17 81.0 11 78.6 6 85.7 17 81.0 11 78.6 6 85.7 17 81.0 16 30 46 5 31.3 6 20.0 11 23.9 4 25.0 4 13.3 8 17.4 23 1 4.3 1 4.3 4 17.3 0 0.0 2 8.7 146 1 0.7
42.9 3 37.5 0 0.0 0 0.0 0 0.0 0 0.0 4 57.1 4 50.0 0 0.0 4 57.1 4 16.6 1 100.0 6 85.7 7 87.5 1 100.0 4 57.1 6 75.0 9 13 22 2 22.2 2 15.4 4 18.2 0 0.0 1 7.7 1 4.5 9 1 11.4 0 0.0 1 11.4 0 0.0 0 0.0 95 0 0.0
71.9 220 71.9 0 0.0 0 0.0 0 0.0 116 72.5 110 75.3 226 73.9 115 71.9 106 72.6 221 72.2 140 87.5 120 82.2 260 85.0 140 87.5 118 80.8 259 84.6 452 466 918 78 17.3 77 16.5 155 16.9 55 12.2 47 10.1 102 11.1 380 69 18.1 65 17.1 54 14.2 6 1.6 47 12.4 3050 19 0.6
77,5 77,5 % 77,5 % 90 90
76,6
%
UMLAH DAN PERSENTASE WUS TIDAK HAMIL DIIMUNISASI JUMLAH TOTAL DAN PERSENTASE WUS (HAMIL+TIDAK HAMIL) DIIMUNIS TT2+ BUMIL
TT2 TT3 TT4 TT5 TT1 TT2 TT3 TT4 TT5 TT2+
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 0.0 0.0 1 0.2 2 0.5 0 0.0 0 0.0 2 0.5 4 10.1
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
0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 5.1
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
0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 1 0.4 2 6.3
0.0 0.0 0.0 0.0 1 0.3 1 0.3 1 0.3 0 0.0 1 0.3 3 7.3
0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 0.5 1 5.3
0.0 0.0 0.0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 0 0.0 1 5.7
0.0 0.0 0.0 0.0 2 0.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 1.7 3 27.3
0.0 0.0 0.0 0.0 1 0.4 1 0.4 1 0.4 0 0.0 0 0.0 2 5.9
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 1 5.1
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 0.0 0 0.0 0 0.0 0 0.0 8 0.2 7 0.2 2 0.1 0 0.0 9 0.3 18 4.7
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 0.0 0.0 3 0.7 1 0.2 0 0.0 0 0.0 0 0.0 1 2.5
0.0 0.0 0.0 0.0 0 0.0 1 0.6 2 1.2 0 0.0 1 0.6 4 20.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 1 3.3
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 1 0.7 1 0.7 0 0.0 0 0.0 2 11.8
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 1 0.4 1 0.4 3 1.1 0 0.0 0 0.0 4 12.5
0.0 0.0 0.0 0.0 3 0.9 1 0.3 2 0.6 0 0.0 2 0.6 5 12.2
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1 9.1
0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 3 1.1 4 11.8
0.0 0.0 0.0 0.0 2 1.1 1 0.5 0 0.0 0 0.0 0 0.0 1 5.1
0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 #REF! 0 #REF! 0 #REF! 0 #REF! 10 #REF! 7 #REF! 9 #REF! 0 #REF! 7 #REF! 23 6.0
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 0.0 0.0 2 0.5 1 0.2 1 0.2 0 0.0 2 0.5 4 10.1
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 1 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 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 1 3.1
0.0 0.0 0.0 0.0 2 0.6 1 0.3 1 0.3 1 0.3 0 0.0 3 7.3
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 2 1.3 0 0.0 0 0.0 0 0.0 2 11.4
0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1 3.4
0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1 2.9
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 1 5.1
0.0 0.0 0.0 0.0 1 0.6 0 0.0 2 1.2 0 0.0 1 0.6 3 13.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 8 0.2 6 0.2 4 0.1 2 0.1 4 0.1 16 4.2
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 0.0 0.0 6 1.4 3 0.7 0 0.0 0 0.0 0 0.0 3 7.6
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 2 0.8 1 0.4 1 0.4 0 0.0 0 0.0 2 6.7
0.0 0.0 0.0 0.0 6 3.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1 5.3
0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1 3.1
0.0 0.0 0.0 0.0 2 0.6 1 0.3 0 0.0 0 0.0 0 0.0 1 2.4
0.0 0.0 0.0 0.0 0 0.0 2 1.0 2 1.0 0 0.0 0 0.0 4 21.4
0.0 0.0 0.0 0.0 2 1.3 0 0.0 0 0.0 0 0.0 1 0.6 1 5.7
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 2 18.2
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 1 2.9
0.0 0.0 0.0 0.0 0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 2 10.1
0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 4.3
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 19 0.6 11 0.3 6 0.2 0 0.0 2 0.1 19 5.0
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 0.0 0.0 1 0.2 2 0.5 0 0.0 0 0.0 1 0.2 3 7.6
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 1 0.4 2 0.8 0 0.0 0 0.0 3 10.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.7 0 0.0 0 0.0 1 5.9
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 1 5.3
0.0 0.0 0.0 0.0 3 1.1 1 0.4 0 0.0 0 0.0 0 0.0 1 3.1
0.0 0.0 0.0 0.0 2 0.6 2 0.6 0 0.0 0 0.0 0 0.0 2 4.9
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 1 0.4 1 0.4 1 0.4 0 0.0 0 0.0 2 6.9
0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1 0.4 1 2.9
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 9 0.3 7 0.2 4 0.1 0 0.0 3 0.1 14 3.7
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 0.0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 1 0.2 1 2.5
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 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.7 0 0.0 0 0.0 1 5.9
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 2 6.3
0.0 0.0 0.0 0.0 2 0.6 1 0.3 1 0.3 0 0.0 0 0.0 2 4.9
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 1 3.4
0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 9.1
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
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 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 0.1 3 0.1 4 0.1 0 0.0 1 0.0 8 2.1
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 0.0 0.0 1 0.2 2 0.5 0 0.0 0 0.0 0 0.0 2 5.1
0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1 5.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 1 3.3
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 1 0.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 1 5.3
0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1 3.1
0.0 0.0 0.0 0.0 0 0.0 1 0.3 0 0.0 0 0.0 0 0.0 1 2.4
0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 0.5 1 5.3
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 1 2.9
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1 4.3
0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 1.0 0 0.0 0 0.0 1 11.4
0 0.0 0 0.0 0 0.0 0 0.0 4 0.1 4 0.1 5 0.1 1 0.0 1 0.0 11 2.9
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 0.0 0.0 5 1.2 3 0.7 0 0.0 0 0.0 1 0.2 4 10.1
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 1 0.4 1 0.4 2 0.8 0 0.0 0 0.0 3 10.0
0.0 0.0 0.0 0.0 3 1.8 0 0.0 0 0.0 0 0.0 1 0.6 1 5.1
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
0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1 3.1
0.0 0.0 0.0 0.0 2 0.6 0 0.0 2 0.6 0 0.0 1 0.3 3 7.3
0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 0.5 1 5.3
0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 0.6 1 5.7
0.0 0.0 0.0 0.0 1 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 1 0.6 0 0.0 0 0.0 1 0.6 2 18.2
0.0 0.0 0.0 0.0 0 0.0 2 0.7 1 0.4 0 0.0 0 0.0 3 8.8
0.0 0.0 0.0 0.0 0 0.0 2 1.1 3 1.6 0 0.0 1 0.5 6 30.3
0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 1 0.6 2 8.7
0.0 0.0 0.0 0.0 1 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 15 0.4 10 0.3 9 0.3 0 0.0 8 0.2 27 7.1
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 0.0 0.0 2 0.5 1 0.2 0 0.0 0 0.0 0 0.0 1 2.5
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 1 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 3 1.8 0 0.0 0 0.0 0 0.0 3 15.2
0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 1.4 0 0.0 1 0.7 3 17.6
0.0 0.0 0.0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 0 0.0 1 5.3
0.0 0.0 0.0 0.0 1 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 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 1 0.4 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 1 0.5 0 0.0 1 0.5 2 10.1
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 0.0 0 0.0 0 0.0 0 0.0 5 0.1 5 0.1 3 0.1 1 0.0 2 0.1 11 2.9
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 0.0 0.0 0 0.0 2 0.5 0 0.0 0 0.0 1 0.2 3 7.6
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 2 6.7
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.7 1 5.9
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 0.7 0 0.0 0 0.0 2 6.3
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 0.6 2 4.9
0.0 0.0 0.0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 0 0.0 1 5.3
0.0 0.0 0.0 0.0 1 0.6 0 0.0 1 0.6 0 0.0 2 1.3 3 17.0
0.0 0.0 0.0 0.0 2 0.8 1 0.4 4 1.7 2 0.8 1 0.4 8 27.6
0.0 0.0 0.0 0.0 2 1.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 3 1.1 3 8.8
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 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 0.2 5 0.1 8 0.2 2 0.1 10 0.3 25 6.6
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
# % # % # % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 0 0.0 22 5.1 17 3.9 1 0.2 0 0.0 8 1.8 26 65.7
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 3 1.8 1 0.6 1 0.6 6 30.0
0 0.0 0 0.0 0 0.0 0 0.0 4 1.6 4 1.6 7 2.8 0 0.0 1 0.4 12 40.0
0 0.0 0 0.0 0 0.0 0 0.0 10 6.0 4 2.4 0 0.0 0 0.0 1 0.6 5 25.3
0 0.0 0 0.0 0 0.0 0 0.0 1 0.7 1 0.7 5 3.5 0 0.0 2 1.4 8 47.1
0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 1 0.6 1 0.6 1 0.6 1 0.6 4 21.1
0 0.0 0 0.0 0 0.0 0 0.0 8 3.0 7 2.6 6 2.2 0 0.0 2 0.7 15 46.9
0 0.0 0 0.0 0 0.0 0 0.0 14 4.1 8 2.4 7 2.1 1 0.3 6 1.8 22 53.7
0 0.0 0 0.0 0 0.0 0 0.0 4 2.0 3 1.5 2 1.0 0 0.0 3 1.5 8 42.8
0 0.0 0 0.0 0 0.0 0 0.0 5 3.2 3 1.9 1 0.6 0 0.0 4 2.5 8 45.5
0 0.0 0 0.0 0 0.0 0 0.0 6 2.5 3 1.3 6 2.5 2 0.8 1 0.4 12 41.4
0 0.0 0 0.0 0 0.0 0 0.0 4 2.3 3 1.7 2 1.2 0 0.0 4 2.3 9 81.8
0 0.0 0 0.0 0 0.0 0 0.0 4 1.4 5 1.8 3 1.1 0 0.0 8 2.8 16 47.1
0 0.0 0 0.0 0 0.0 0 0.0 2 1.1 4 2.2 5 2.7 1 0.5 3 1.6 13 65.7
0 0.0 0 0.0 0 0.0 0 0.0 2 1.2 1 0.6 4 2.4 0 0.0 2 1.2 7 30.3
0 0.0 0 0.0 0 0.0 0 0.0 1 1.0 0 0.0 1 1.0 0 0.0 0 0.0 1 11.4
0 0.0 0 0.0 0 0.0 0 0.0 88 2.6 65 1.9 54 1.6 6 0.2 47 1.4 172 45.2
80
JUMLAH
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR (0 - 11 HB0 (0<7 HARI) BCG POLIO1
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L % #P % # JML % #L % #P % # JML % #L % #P %
2017
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 1 4.8 0 0.0 1 2.8 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 1 11.1 2 18.0 3 15.0 1 11.1 2 18.2
4 ALAKAYA 669 10 8 18 10 8 18 1 10.0 0 0.0 1 5.6 1 10.0 2 20.0 3 16.7 1 10.0 2 25.0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 1 20.0 1 1.0 2 15.4 1 20.0 1 12.5
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 1 16.7 2 12.0 3 21.4 1 16.7 2 25.0
8 MEKAR SARI 1,367 16 10 26 16 10 26 2 12.5 0 0.0 2 7.7 1 6.3 1 16.0 2 7.7 1 6.3 1 10.0
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 1 8.3 1 5.9 0 0.0 1 #DIV/0! 1 5.9 0 0.0 1 8.3
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 1 14.3 1 #REF! 2 12.5 1 14.3 1 11.1
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 2 25.0 2 11.1 1 10.0 2 20.0 3 16.7 1 10.0 2 25.0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 20.0 0 0.0 2 33.3
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 0 0.0 0 0.0 1 4.3 2 46.0 3 7.5 1 4.3 2 11.8
14 WAWONGGURA 740 10 8 18 10 8 18 1 10.0 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0 0.0 0 0.0 0 0.0 1 7.1 1 14.0 2 9.5 1 7.1 1 14.3
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 160 146 306 160 146 306 5 3.1 3 2.1 8 2.6 10 6.3 17 272.0 27 8.8 10 6.3 17 11.6
Jenis Vaksin / Alat Stock Bln Penerimaan Pemakaian

No. Jumlah Sisa Bln ini Permintaan No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai
Suntik & Safety Box Lalu Bln ini Bln ini
I. VAKSIN 1 BCG 27 dosis 9 Ampul

1 Vak. BCG 16 10 26 9 17 (8) 2 DPT-HB 61 dosis - Vial
2 Vak. DPT-HB - - - - - - 3 DPT-HB-Hib 85 dosis 24 Vial
3 Vak. DPT-HB-Hib 18 30 48 24 24 - 4 POLIO 104 dosis 19 Vial
4 Vak. POLIO 33 10 43 19 24 (5) 5 CAMPAK 7 dosis 11 Vial
5 Vak. CAMPAK 18 10 28 11 17 (6) 6 HB. UNIJECT 8 dosis 8 Buah
6 Vak. HB. UNIJECT 120 - 120 8 112 (104) 7 TT 24 dosis 10 Vial
7 Vak. TT 15 10 25 10 15 (5)
II. ALAT SUNTIK
1 ADS 5 ml 21 - 21 15 6 9
2 ADS 0,5 ml 563 200 763 142 621 (479)
3 ADS 0,0 5 ml 77 - 77 21 56 (35)

JUMLAH
DESA / PDDK
NO
KELURAHAN
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
2017
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 0 0.0 0 0.0 0 0.0 4 19.0 3 15.8 7 19.4 4 1.0 3 20.0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 1 16.7 1 5.9 0 0.0 3 #DIV/0! 3 17.6 0 0.0 3 50.0
3 AOSOLE 1,018 9 11 20 9 11 20 2 22.2 0 0.0 2 10.0 2 22.2 1 4.5 3 15.0 2 22.2 1 9.1
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 11.1 0 0.0 2 25.0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 2 20.0 2 7.7 2 12.5 0 0.0 2 7.7 2 12.5 0 0.0
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 1 8.3 1 5.9 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 5.6 0 0.0 1 12.5
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 1 25.0 1 4.0 2 20.0 1 25.0 1 16.7
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 12.5 0 0.0 1 14.3
PALANGGA 13,929 160 146 306 160 146 306 2 1.3 4 2.7 6 2.0 9 5.6 12 213.3 21 6.9 9 5.6 12 8.2


1 Vak. BCG 17 - 17 7 10 (3) 2 DPT-HB 56 dosis - Vial
2 Vak. Polio IPV - - - - - - 3 DPT-HB-Hib 93 dosis 21 Vial
3 Vak. DPT-HB-Hib 24 - 24 21 3 18 4 POLIO 95 dosis 14 Vial
4 Vak. POLIO 24 - 24 14 10 4 5 CAMPAK 41 dosis 7 Vial
5 Vak. CAMPAK 17 - 17 7 10 (3) 6 HB. UNIJECT 6 dosis 6 Buah
7 Vak. TT 15 - 15 7 8 (1)
II. ALAT SUNTIK
1 ADS 5 ml 6 20 26 14 12 2
2 ADS 0,5 ml 621 - 621 193 428 (235)
3 ADS 0,0 5 ml 56 - 56 21 35 (14)
4 Safety Box 5 liter - - - - - s
5 Safety Box 0,25 liter - - - - -
BULAN : MARET 2018
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
2017
1 2 3 4 5 6 7 8 9 10 0 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 2 9.5 0 0.0 2 5.6 1 4.8 2 42.0 3 8.3 1 4.8 2 13.3
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 5.9 0 0.0 1 16.7
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 1 9.1 1 5.0 2 22.2 1 4.5 3 15.0 2 22.2 1 9.1
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 2 25.0 2 15.4 0 0.0 1 #DIV/0! 1 7.7 0 0.0 1 12.5
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 1 12.5 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0
8 MEKAR SARI 1,367 16 10 26 16 10 26 2 12.5 0 0.0 2 7.7 1 6.3 0 0.0 1 3.8 1 6.3 0 0.0
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 1 8.3 1 5.9 1 20.0 3 15.0 4 23.5 1 20.0 3 25.0
10 EEWA 636 7 9 16 7 9 16 1 14.3 0 0.0 1 6.3 2 28.6 1 3.5 3 18.8 2 28.6 1 11.1
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 1 12.5 1 5.6 1 10.0 3 30.0 4 22.2 1 0,0 3 37.5
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 2 8.7 0 0.0 2 5.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
14 WAWONGGURA 740 10 8 18 10 8 18 1 10.0 0 0.0 1 5.6 3 30.0 2 6.7 5 27.8 3 30.0 2 25.0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 160 146 306 160 146 306 8 5.0 6 4.1 14 4.6 13 8.1 14 172.3 27 8.8 13 8.1 14 9.6


2 Vak. Polio IPV - - - - - - 3 DPT-HB-Hib 65 dosis 25 Vial
3 Vak. DPT-HB-HIB 3 30 33 25 8 17 4 POLIO 78 dosis 16 Vial
5 Vak. CAMPAK 10 - 10 7 3 4 6 HB. UNIJECT 14 dosis 14 Buah
7 Vak. TT 8 - 8 4 4 -
II. ALAT SUNTIK
1 ADS 5 ml 12 - 12 12 - 12
2 ADS 0,5 ml 428 200 628 148 480 (332)
3 ADS 0,0 5 ml 35 - 35 14 21 (7)
4 Safety Box 5 liter - - - - -
BULAN : APRIL 2018
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
2017
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 0 0.0 0 0.0 0 0.0 1 4.8 1 21.0 2 5.6 1 4.8 1 6.7
2 WATUDEMBA 665 11 6 17 11 6 17 0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 10.0 2 22.2 0 0.0
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 1 12.5 1 7.7 0 0.0 2 #DIV/0! 2 15.4 0 0.0 2 25.0
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 1 10.0 1 3.8 0 0.0 3 #DIV/0! 3 11.5 0 0.0 3 30.0
9 WATUMEREMBE 814 5 12 17 5 12 17 1 20.0 0 0.0 1 5.9 0 0.0 1 #DIV/0! 1 5.9 0 0.0 1 8.3
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 1 12.5 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 10.0 0 0.0 1 16.7
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 1 5.9 1 2.5 1 4.3 1 23.0 2 5.0 1 4.3 1 5.9
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 160 146 306 160 146 306 1 0.6 4 2.7 5 1.6 6 3.8 10 266.7 16 5.2 6 3.8 10 6.8


3 Vak. DPT-HB-Hib 8 30 38 16 22 (6) 4 POLIO 72 dosis 15 Vial
5 Vak. CAMPAK 3 - 3 3 - 3 6 HB. UNIJECT 5 dosis 5 Buah
7 Vak. TT 4 - 4 4 - 4
II. ALAT SUNTIK
1 ADS 5 ml - 30 30 15 15 -
2 ADS 0,5 ml 480 200 680 144 536 (392)
3 ADS 0,0 5 ml 21 100 121 18 103 (85)
BULAN : MEI 2018
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
2017
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 0 0.0 0 0.0 0 0.0 2 9.5 0 0.0 2 5.6 2 9.5 0 0.0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 0 0.0 4 #DIV/0! 4 20.0 0 0.0 4 36.4
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 0 0.0 3 #DIV/0! 3 23.1 0 0.0 3 37.5
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 1 16.7 1 14.3 2 14.3 1 16.7 1 12.5
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 0 0.0 0 0.0 1 6.3 2 32.0 3 11.5 1 6.3 2 20.0
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 2 40.0 0 0.0 2 11.8 2 40.0 0 0.0
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 0 0.0 0 2.0 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 11.1 0 0.0 2 25.0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 0 0.0 0 0.0 2 8.7 0 0.0 2 5.0 2 8.7 0 0.0
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 160 146 306 160 146 306 8 5.0 5 3.4 13 4.2 9 5.6 12 213.3 21 6.9 9 5.6 12 8.2

No. Jumlah Sisa Bln ini Permintaan 8 5 13 No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai

1 Vak. BCG 14 10 24 9 15 (6) 2 IPV 69 dosis - Vial
2 IPV - - - - - - 3 DPT-HB-Hib 55 dosis 24 Vial
5 Vak. CAMPAK - 10 10 8 2 6 6 HB. UNIJECT 13 dosis - Buah
6 Vak. HB. UNIJECT 88 - - - - - 7 TT 25 dosis 8 Vial
7 Vak. TT - 20 20 8 12 (4)
II. ALAT SUNTIK
1 ADS 5 ml 15 20 35 20 15 5
2 ADS 0,5 ml 536 200 736 195 541 (346)
3 ADS 0,0 5 ml 103 - 103 23 80 (57)
BULAN : JUNI 2018
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
2017
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 1 4.8 0 0.0 1 2.8 2 9.5 1 10.5 3 8.3 2 9.5 1 6.7
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 2 18.2 0 0.0 2 11.8 2 18.2 0 0.0
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 2 18.2 2 10.0 0 0.0 1 #DIV/0! 1 5.0 0 0.0 1 9.1
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 5.6 0 0.0 1 12.5
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 1 12.5 1 7.7 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
7 WAWOURU 1,072 6 8 14 6 8 14 1 16.7 1 12.5 2 14.3 1 16.7 1 6.0 2 14.3 1 16.7 1 12.5
8 MEKAR SARI 1,367 16 10 26 16 10 26 2 12.5 0 0.0 2 7.7 1 6.3 1 16.0 2 7.7 1 6.3 1 10.0
9 WATUMEREMBE 814 5 12 17 5 12 17 1 20.0 0 0.0 1 5.9 4 80.0 2 2.5 6 35.3 4 80.0 2 16.7
10 EEWA 636 7 9 16 7 9 16 0 0.0 1 11.1 1 6.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 960 10 8 18 10 8 18 1 10.0 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
12 ANGGONDARA 741 4 6 10 4 6 10 1 25.0 0 0.0 1 10.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1 4.3 2 11.8 3 7.5 1 4.3 1 23.0 2 5.0 1 4.3 1 5.9
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 1 12.5 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 160 146 306 160 146 306 8 5.0 8 5.5 16 5.2 11 6.9 8 116.4 19 6.2 11 6.9 8 5.5


4 Vak. POLIO 31 - 31 12 19 (7) 5 CAMPAK 12 dosis 2 Vial
5 Vak. CAMPAK 2 - 2 2 - 2 6 HB. UNIJECT 16 dosis 8 Buah
6 Vak. HB. UNIJECT - - - 8 - 8 7 TT 13 dosis 3 Vial
7 Vak. TT 12 - 12 3 9 (6)
II. ALAT SUNTIK
1 ADS 5 ml 15 - 15 9 6 3
2 ADS 0,5 ml 541 - 541 98 443 (345)
3 ADS 0,0 5 ml 80 - 80 19 61 (42)
BULAN : JULI 2018
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
2017
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 0 0.0 2 13.3 2 5.6 0 0.0 1 #DIV/0! 1 2.8 0 0.0 0 0.0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 10.0 0 0.0 2 18.2
4 ALAKAYA 669 10 8 18 10 8 18 1 10.0 1 12.5 2 11.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 2 40.0 0 0.0 2 15.4 2 40.0 0 0.0
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 0 0.0 0 0.0 3 18.8 2 10.7 5 19.2 3 18.8 2 20.0
9 WATUMEREMBE 814 5 12 17 5 12 17 2 40.0 0 0.0 2 11.8 1 20.0 0 0.0 1 5.9 1 20.0 0 0.0
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 1 14.3 1 7.0 2 12.5 1 14.3 1 11.1
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 2 20.0 5 25.0 7 38.9 2 20.0 5 62.5
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 1 25.0 2 8.0 3 30.0 1 25.0 2 33.3
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1 4.3 0 0.0 1 2.5 3 13.0 1 7.7 4 10.0 3 13.0 1 5.9
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 436 1 7 8 1 7 8 1 100.0 0 0.0 1 12.5 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 160 146 306 160 146 306 5 3.1 3 2.1 8 2.6 13 8.1 14 172.3 27 8.8 13 8.1 13 8.9


3 Vak. DPT-HB-Hib 13 30 43 25 18 7 4 POLIO 69 dosis 15 Vial
4 Vak. POLIO 19 20 39 15 24 (9) 5 CAMPAK 23 dosis - Vial
5 Vak. CAMPAK - - - - - - 6 HB. UNIJECT 8 dosis 8 Buah
6 Vak. HB. UNIJECT - - - 8 - 8 7 TT 22 dosis 8 Vial
7 Vak. TT 9 20 29 8 21 (13)
II. ALAT SUNTIK
1 ADS 5 ml 6 20 26 5 21 (16)
2 ADS 0,5 ml 443 200 643 118 525 (407)
3 ADS 0,0 5 ml 61 - 61 27 40 (13)
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
2017
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 0 0.0 1 6.7 1 2.8 1 4.8 3 63.0 4 11.1 1 4.8 3 20.0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 0 0.0 0 0.0 2 18.2 2 11.0 4 23.5 2 18.2 2 33.3
3 AOSOLE 1,018 9 11 20 9 11 20 1 11.1 0 0.0 1 5.0 2 22.2 1 4.5 3 15.0 2 22.2 1 9.1
4 ALAKAYA 669 10 8 18 10 8 18 1 10.0 0 0.0 1 5.6 0 0.0 1 #DIV/0! 1 5.6 0 0.0 1 12.5
5 WAWORAHA 583 5 8 13 5 8 13 2 40.0 0 0.0 2 15.4 0 0.0 1 #DIV/0! 1 7.7 0 0.0 1 12.5
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 7.1 0 0.0 1 16.7
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 3 50.0 1 2.0 4 28.6 3 50.0 1 12.5
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 5.9 1 20.0 0 0.0
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 1 14.3 1 7.0 2 12.5 1 14.3 1 11.1
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 1 12.5 1 5.6 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 0 0.0 0 0.0 2 50.0 0 0.0 2 20.0 2 50.0 0 0.0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1 4.3 0 0.0 1 2.5 4 17.4 3 17.3 7 17.5 4 17.4 3 17.6
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 5.6 0 0.0 1 12.5
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 160 146 306 160 146 306 6 3.8 2 1.4 8 2.6 18 11.3 16 142.2 34 11.1 18 11.3 16 11.0


5 Vak. CAMPAK - 10 10 10 - 10 6 HB. UNIJECT 8 dosis 8 Buah
6 Vak. HB. UNIJECT - 100 100 8 92 (84) 7 TT 21 dosis 8 Vial
7 Vak. Td 21 10 31 8 23 (15)
II. ALAT SUNTIK
1 ADS 5 ml 21 20 41 20 21 (1)
2 ADS 0,5 ml 525 200 725 185 540 (355)
3 ADS 0,0 5 ml 40 - 40 34 6 28
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
2017
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 2 1.0 1 6.7 3 8.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
2 WATUDEMBA 665 11 6 17 11 6 17 1 9.1 0 0.0 1 5.9 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
3 AOSOLE 1,018 9 11 20 9 11 20 1 11.1 1 9.1 2 10.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 1 10.0 2 0,0 3 16.7 1 10.0 2 25.0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 2 33.3 2 14.3 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 0 0.0 0 0.0 1 16.7 1 0,0 2 14.3 1 16.7 1 12.5
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 0 0.0 0 0.0 0 0.0 1 0,0 1 3.8 0 0.0 1 10.0
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0
10 EEWA 636 7 9 16 7 9 16 1 14.3 1 0.0 2 12.5 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 960 10 8 18 10 8 18 1 10.0 1 12.5 2 11.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 2 33.3 2 20.0 0 0.0 1 #DIV/0! 1 10.0 0 0.0 1 16.7
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 0 0.0 0 0.0 4 17.4 1 5.8 5 12.5 4 17.4 1 5.9
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 1 0,0 1 5.6 0 0.0 1 12.5
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0 0.0 0 0.0 0 0.0 1 7.1 1 14.0 2 9.5 1 7.1 1 14.3
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 1 100.0 0 0,0 1 12.5 1 100.0 0 0.0
PALANGGA 13,929 160 146 306 160 146 306 6 3.8 8 5.5 14 4.6 8 5.0 8 160.0 16 5.2 8 5.0 8 5.5


7 Vak. Td 23 - 23 6 17 (11)
II. ALAT SUNTIK
1 ADS 5 ml 21 20 41 21 20 1
2 ADS 0,5 ml 540 200 740 185 555 (370)
3 ADS 0,0 5 ml 6 100 106 16 90 (74)
lkkmmmm

JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
2017
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 0 0.0 1 6.7 1 2.8 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0
2 WATUDEMBA 665 11 6 17 11 6 17 1 9.1 1 16.7 2 11.8 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 10.0 2 22.2 0 0.0
4 ALAKAYA 669 10 8 18 10 8 18 2 20.0 1 12.5 3 16.7 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 1 20.0 1 5.0 2 15.4 1 20.0 1 12.5
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 0 0.0 2 0.0 2 14.3 0 0.0 2 33.3
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 2 25.0 2 14.3 1 16.7 1 6.0 2 14.3 1 16.7 1 12.5
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 2 20.0 2 7.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
9 WATUMEREMBE 814 5 12 17 5 12 17 1 20.0 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 1 14.3 1 7.0 2 12.5 1 14.3 1 11.1
11 ONEMBUTE 960 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 1 10.0 1 10.0 2 11.1 1 10.0 1 12.5
12 ANGGONDARA 741 4 6 10 4 6 10 0 0.0 4 66.7 4 40.0 1 25.0 1 4.0 2 20.0 1 25.0 1 16.7
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1 4.3 0 0.0 1 2.5 1 4.3 0 0.0 1 2.5 1 4.3 0 0.0
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 1 12.5 1 5.6 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0
15 Sanggi - Sanggi 666 14 7 21 14 7 21 0 0.0 0 0.0 0 0.0 3 21.4 0 0.0 3 14.3 3 21.4 0 0.0
16 UPT.TOLIHE 436 1 7 8 1 7 8 1 100.0 0 0.0 1 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 160 146 306 160 146 306 6 3.8 12 8.2 18 5.9 12 7.5 7 93.3 19 6.2 12 7.5 7 4.8


4 Vak. POLIO 29 - 29 17 12 5 5 CAMPAK 63 dosis 11 Vial
7 Vak. TT 17 - 17 3 14 (11)
II. ALAT SUNTIK
1 ADS 5 ml 20 - 20 20 - 20
2 ADS 0,5 ml 555 - 555 200 355 (155)
3 ADS 0,0 5 ml 90 - 90 22 68 (46)
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
2017
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 1 4.8 0 0.0 1 2.8 0 0.0 2 0.0 2 5.6 0 0.0 2 13.3
2 WATUDEMBA 665 11 6 17 11 6 17 1 9.1 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
3 AOSOLE 1,018 9 11 20 9 11 20 1 0.0 0 0.0 1 5.0 1 11.1 1 9.0 2 10.0 1 11.1 1 9.1
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 620 8 6 14 8 6 14 1 12.5 0 0.0 1 7.1 0 0.0 1 0.0 1 7.1 0 0.0 1 16.7
7 WAWOURU 1,072 6 8 14 6 8 14 0 0.0 1 12.5 1 7.1 0 0.0 2 0.0 2 14.3 0 0.0 2 25.0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0 0.0 0 0.0 0 0.0 3 18.8 0 0.0 3 11.5 3 18.8 0 0.0
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 5.9 1 20.0 0 0.0
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 960 10 8 18 10 8 18 1 10.0 1 12.5 2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
12 ANGGONDARA 741 4 6 10 4 6 10 1 25.0 0 0.0 1 10.0 0 0.0 4 0.0 4 40.0 0 0.0 4 66.7
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0 0.0 1 5.9 1 2.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 0 0.0 1 0.0 1 5.6 0 0.0 1 12.5
15 SANGGI-SANGGI 666 14 7 21 14 7 21 1 7.1 0 0.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 436 1 7 8 1 7 8 1 100.0 0 0.0 1 12.5 2 200.0 0 0.0 2 25.0 2 200.0 0 0.0
PALANGGA 13,929 160 146 306 160 146 306 8 5.0 3 2.1 11 3.6 7 4.4 11 251.4 18 5.9 7 4.4 11 7.5
1


1 Vak. BCG 6 10 16 11 5 6 2 DPT-HB 66 dosis - Vial
4 Vak. POLIO 12 20 32 18 14 4 5 CAMPAK 3 dosis 9 Vial
5 Vak. CAMPAK 3 20 23 9 14 (5) 6 HB. UNIJECT 1 dosis 11 Buah
7 Vak. TT 14 10 24 8 16 (8)
II. ALAT SUNTIK
1 ADS 5 ml - - 20 20 - 20
2 ADS 0,5 ml 355 - 355 157 198 (41)
3 ADS 0,0 5 ml 68 - 68 19 49 (30)
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
2017
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 1 4.8 0 0.0 1 2.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 WATUDEMBA 665 11 6 17 11 6 17 0 0.0 1 16.7 1 5.9 1 9.1 2 33.3 3 17.6 1 9.1 2 33.3
3 AOSOLE 1,018 9 11 20 9 11 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 ALAKAYA 669 10 8 18 10 8 18 0 0.0 0 0.0 0 0.0 3 30.0 1 12.5 4 22.2 3 30.0 1 12.5
5 WAWORAHA 583 5 8 13 5 8 13 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 7.7 1 20.0 0 0.0
6 KAPUJAYA 620 8 6 14 8 6 14 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0
7 WAWOURU 1,072 6 8 14 6 8 14 1 16.7 1 12.5 2 14.3 0 0.0 1 12.5 1 7.1 0 0.0 1 12.5
8 MEKAR SARI 1,367 16 10 26 16 10 26 1 6.3 0 0.0 1 3.8 2 12.5 2 20.0 4 15.4 2 12.5 2 20.0
9 WATUMEREMBE 814 5 12 17 5 12 17 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 5.9 1 20.0 0 0.0
10 EEWA 636 7 9 16 7 9 16 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0
11 ONEMBUTE 960 10 8 18 10 8 18 1 10.0 1 12.5 2 11.1 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0
12 ANGGONDARA 741 4 6 10 4 6 10 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1 4.3 0 0.0 1 2.5 1 4.3 5 29.4 6 15.0 1 4.3 5 29.4
14 WAWONGGURA 740 10 8 18 10 8 18 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 13,929 160 146 306 160 146 306 6 3.8 4 2.7 10 3.3 14 8.8 11 7.5 25 8.2 14 8.8 11 7.5


7 Vak. TT 16 10 26 8 18 (10)
II. ALAT SUNTIK
1 ADS 5 ml - 20 20 16 4 12
2 ADS 0,5 ml 198 200 398 175 223 (48)
3 ADS 0,0 5 ml 49 100 149 29 120 (91)
BULAN : JANUARI S/D. desember 2018
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
2017
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
1 KIAEA 1,794 21 15 36 21 15 36 8 38.1 5 33.3 13 36.1 11 52.4 13 24.8 24 66.7 11 52.4 13 86.7
2 WATUDEMBA 665 11 6 17 11 6 17 3 27.3 3 50.0 6 35.3 5 45.5 8 17.6 13 76.5 5 45.5 8 133.3
3 AOSOLE 1,018 9 11 20 9 11 20 5 55.6 4 36.4 9 45.0 12 133.3 13 9.8 25 125.0 12 133.3 13 118.2
4 ALAKAYA 669 10 8 18 10 8 18 5 50.0 2 25.0 7 38.9 5 50.0 9 18.0 14 77.8 5 50.0 9 112.5
5 WAWORAHA 583 5 8 13 5 8 13 2 40.0 4 50.0 6 46.2 5 100.0 9 9.0 14 107.7 5 100.0 9 112.5
6 KAPUJAYA 620 8 6 14 8 6 14 1 12.5 2 33.3 3 21.4 3 37.5 4 10.7 7 50.0 3 37.5 4 66.7
7 WAWOURU 1,072 6 8 14 6 8 14 2 33.3 6 75.0 8 57.1 9 150.0 10 6.7 19 135.7 9 150.0 10 125.0
8 MEKAR SARI 1,367 16 10 26 16 10 26 7 43.8 5 50.0 12 46.2 14 87.5 12 13.7 26 100.0 14 87.5 12 120.0
9 WATUMEREMBE 814 5 12 17 5 12 17 5 100.0 3 25.0 8 47.1 11 220.0 7 3.2 18 105.9 11 220.0 7 58.3
10 EEWA 636 7 9 16 7 9 16 2 28.6 2 22.2 4 25.0 8 114.3 5 4.4 13 81.3 8 114.3 5 55.6
11 ONEMBUTE 960 10 8 18 10 8 18 4 40.0 8 100.0 12 66.7 9 90.0 14 15.6 23 127.8 9 90.0 14 175.0
12 ANGGONDARA 741 4 6 10 4 6 10 3 75.0 6 100.0 9 90.0 6 150.0 12 8.0 18 180.0 6 150.0 12 200.0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 7 30.4 4 23.5 11 27.5 18 78.3 14 17.9 32 80.0 18 78.3 14 82.4
14 WAWONGGURA 740 10 8 18 10 8 18 2 20.0 3 37.5 5 27.8 5 50.0 5 10.0 10 55.6 5 50.0 5 62.5
15 SANGGI-SANGGI 666 14 7 21 14 7 21 2 14.3 0 0.0 2 9.5 6 42.9 4 9.3 10 47.6 6 42.9 4 57.1
16 UPT.TOLIHE 436 1 7 8 1 7 8 3 300.0 0 0.0 3 37.5 3 300.0 1 0.3 4 50.0 3 300.0 1 14.3
PALANGGA 13,929 160 146 306 160 146 306 61 38.1 57 39.0 118 38.6 130 81.3 140 172.3 270 88.2 130 81.3 140 95.9
47%


1 Vak. BCG 8 90 98 88 10 78 2 DPT-HB 576 dosis - Vial
4 Vak. POLIO 21 180 201 192 9 183 5 CAMPAK 337 dosis 100 Vial
5 Vak. CAMPAK 5 50 55 100 (45) 145 6 HB. UNIJECT 118 dosis 210 Buah
6 Vak. HB. UNIJECT 20 100 120 210 (90) 300 7 TT 270 dosis 77 Vial
7 Vak. TT 18 80 98 77 21 56
II. ALAT SUNTIK
1 ADS 5 ml 4 150 154 187 (33) 220
2 ADS 0,5 ml 223 1,600 1,823 1,940 (117) 2,057
3 ADS 0,0 5 ml 122 300 422 318 104 214
DPT/HB-Hib (1) POLIO 2 DPT-HB-HIB 2 POLIO 3
# JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML %
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
0 0.0 2 9.5 0 0.0 2 5.6 2 9.5 0 0.0 2 5.6 0 0.0 2 13.3 2 5.6 0 0.0 2 13.3 2 5.6
0 0.0 0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
3 15.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.0 1 11.1 0 0.0 1 5.0
3 16.7 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 15.4 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
1 7.1 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
3 21.4 1 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1
2 7.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8
1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 40.0 1 8.3 3 17.6 2 40.0 1 8.3 3 17.6
2 12.5 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 0 0.0 1 11.1 1 6.3 0 0.0 1 11.1 1 6.3
3 16.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6
2 20.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0
3 7.5 1 4.3 0 0.0 1 2.5 1 4.3 0 0.0 1 2.5 3 13.0 2 11.8 5 12.5 3 13.0 2 11.8 5 12.5
0 0.0 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1
2 9.5 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 1 100.0 0 0.0 1 12.5 1 100.0 0 0.0 1 12.5
27 8.8 8 5.0 4 2.7 12 3.9 8 5.0 4 2.7 12 3.9 11 6.9 8 5.5 19 6.2 11 6.9 8 5.5 19 6.2
LAPORAN COLD CHAIN
akai I.P Jumlah Keadaan

No. Jenis Cold Chain
(buah)
3 Baik Rusak
#DIV/0! 1 Lemari ES
3.54166667 2 M. Freezer
5.47368421 3 V. Crrier
0.63636364 4 Thermos
1
2.4 MENGETAHUI :
Kepala Puskesmas Palangga.Kab.Konawe selatan..
Amrin,S.Kep
Nip.196506021987031017

DPT/HB-Hib (1) POLIO 2 DPT-HB-HIB 2 POLIO 3
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
7 19.4 1 4.8 0 0.0 1 2.8 1 4.8 0 0.0 1 2.8 2 9.5 2 13.3 4 11.1 2 9.5 2 13.3 4 11.1
3 17.6 0 0.0 0 0.0 0 0.0 0 0.0 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 15.0 1 11.1 0 0.0 1 5.0 1 11.1 0 0.0 1 5.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 11.1 1 10.0 2 25.0 3 16.7 1 10.0 2 25.0 3 16.7 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1
0 0.0 1 20.0 1 12.5 2 15.4 1 20.0 1 12.5 2 15.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3 2 33.3 0 0.0 2 14.3 2 33.3 0 0.0 2 14.3
2 7.7 1 6.3 1 10.0 2 7.7 1 6.3 1 10.0 2 7.7 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 8.3 1 5.9 0 0.0 1 8.3 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3
1 5.6 0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1 1 10.0 2 25.0 3 16.7 1 10.0 2 25.0 3 16.7
2 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0
0 0.0 0 0.0 1 5.9 1 2.5 0 0.0 1 5.9 1 2.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8
1 12.5 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
21 6.9 8 5.0 10 6.8 18 5.9 8 5.0 10 6.8 18 5.9 9 5.6 7 4.8 16 5.2 9 5.6 7 4.8 16 5.2
LAPORAN COLD CHAIN

(buah)
3 Baik Rusak
#DIV/0! 1 Lemari ES
4.42857143 2 M. Freezer
6.78571429 3 V. Crrier
5.85714286 4 Thermos
1
4.57142857
MENGETAHUI :
Amrin,S.Kep
Nip.196506021987031017
DPT/HB -Hib (1) Polio 2 DPT/HB-Hib (2) POLIO3
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
3 8.3 2 9.5 3 20.0 5 13.9 2 9.5 3 20.0 5 13.9 2 6,3 0 0.0 2 5.6 2 9.5 0 0.0 2 5.6
1 5.9 0 0.0 2 33.3 2 11.8 0 0.0 2 33.3 2 11.8 0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9
3 15.0 2 22.2 2 18.2 4 20.0 2 22.2 2 18.2 4 20.0 1 11.1 0 0.0 1 5.0 1 11.1 0 0.0 1 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
1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 1 12.5 2 15.4 1 20.0 1 12.5 2 15.4
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0 1 7.1
1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3
1 3.8 1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8 1 6.3 1 10.0 2 7.7 1 6.3 1 10.0 2 7.7
4 23.5 0 0.0 1 8.3 1 5.9 0 0.0 1 8.3 1 5.9 0 0.0 1 8.3 1 5.9 0 0.0 1 8.3 1 5.9
3 18.8 0 0.0 1 11.1 1 6.3 0 0.0 1 11.1 1 6.3 2 28.6 0 0.0 2 12.5 2 28.6 0 0.0 2 12.5
4 22.2 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 1 10.0 1 12.5 2 11.1 0 0.0 1 12.5 1 5.6
0 0.0 1 25.0 4 66.7 5 50.0 1 25.0 4 66.7 5 50.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0
0 0.0 1 4.3 1 5.9 2 5.0 1 4.3 1 5.9 2 5.0 1 4.3 2 11.8 3 7.5 1 4.3 1 5.9 2 5.0
5 1.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 4.8 1 1.0 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 1 14.3 1 12.5 0 0.0 1 14.3 1 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
27 8.8 10 6.3 17 11.6 27 8.8 10 6.3 17 11.6 27 8.8 11 6.9 9 6.2 20 6.5 10 6.3 8 5.5 18 5.9
LAPORAN COLD CHAIN

(buah)
3 Baik Rusak
#DIV/0! 1 Lemari ES
2.6 2 M. Freezer
4.875 3 V. Crrier
6.71428571 4 Thermos
1
5
MENGETAHUI :
Kepala Puskesmas .Palangga.Kab.Konsel
Amrin,S.Kep
Nip.196506021987031017
DPT/HB-Hib (1) POLIO2 DPT/HB-Hib (2) POLIO3
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
2 5.6 1 4.8 2 13.3 3 8.3 1 4.8 2 13.3 3 8.3 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 16.7 1 5.9 0 0.0 1 16.7 1 5.9 0 0.0 2 33.3 2 11.8 0 0.0 2 33.3 2 11.8
2 10.0 2 22.2 2 18.2 4 20.0 2 22.2 2 18.2 4 20.0 1 11.1 0 0.0 1 5.0 1 11.1 0 0.0 1 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
2 15.4 0 0.0 1 12.5 1 7.7 0 0.0 1 12.5 1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 7.1 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 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
3 11.5 1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8
1 5.9 1 20.0 3 25.0 4 23.5 1 20.0 3 25.0 4 23.5 0 0.0 1 8.3 1 5.9 0 0.0 1 8.3 1 5.9
1 6.3 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 0 0.0 1 11.1 1 6.3 0 0.0 1 11.1 1 6.3
0 0.0 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1
1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 50.0 3 30.0 0 0.0 3 50.0 3 30.0
2 5.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 4.3 0 0.0 1 2.5 1 4.3 0 0.0 1 2.5
0 0.0 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1
1 4.8 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8 1 7.1 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 12.5 0 0.0 1 14.3 1 12.5
16 5.2 9 5.6 11 7.5 20 6.5 9 5.6 11 7.5 20 6.5 6 3.8 11 7.5 17 5.6 6 3.8 11 7.5 17 5.6
LAPORAN COLD CHAIN

(buah)
2.28571429 Baik Rusak
#DIV/0! 1 Lemari ES
4.4375 2 M. Freezer
4.8 3 V. Crrier
15.6666667 4 Thermos
1
4
MENGETAHUI :
Kepala Puskesmas Palangga .Kab.Konsel
Amrin,S.Kep
Nip.196506021987031017
DPT/HB -HIB(1) POLIO2 DPT/HB -HIB(2) POLIO3
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
2 5.6 2 9.5 1 6.7 3 8.3 2 9.5 1 6.7 3 8.3 3 14.3 4 26.7 7 19.4 3 14.3 4 26.7 7 19.4
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9
4 20.0 3 33.3 1 9.1 4 20.0 3 33.3 1 9.1 4 20.0 1 11.1 2 18.2 3 15.0 1 11.1 2 18.2 3 15.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 23.1 0 0.0 2 25.0 2 15.4 0 0.0 2 25.0 2 15.4 0 0.0 1 12.5 1 7.7 0 0.0 1 12.5 1 7.7
0 0.0 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 0 0.0 2 14.3 2 33.3 0 0.0 2 14.3
3 11.5 1 6.3 2 20.0 3 11.5 1 6.3 2 20.0 3 11.5 1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8
2 11.8 0 0.0 1 8.3 1 5.9 0 0.0 1 8.3 1 5.9 0 0.0 3 25.0 3 17.6 0 0.0 3 25.0 3 17.6
0 0.0 2 28.6 1 11.1 3 18.8 2 28.6 1 11.1 3 18.8 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3
2 11.1 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6
0 0.0 1 25.0 1 16.7 2 20.0 1 25.0 1 16.7 2 20.0 1 25.0 2 33.3 3 30.0 1 25.0 2 33.3 3 30.0
2 5.0 1 4.3 1 5.9 2 5.0 1 4.3 1 5.9 2 5.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 5.6 2 20.0 3 37.5 5 27.8 2 20.0 3 37.5 5 27.8 1 10.0 0 0.0 3 16.7 1 10.0 0 0.0 1 5.6
0 0.0 0 0.0 1 14.3 1 4.8 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
21 6.9 14 8.8 14 9.6 28 9.2 15 9.4 14 9.6 0 0.0 11 6.9 14 9.6 25 8.2 11 6.9 14 9.6 25 8.2
LAPORAN COLD CHAIN

(buah)
#DIV/0! 1 Lemari ES
2.29166667 2 M. Freezer
4.77777778 3 V. Crrier
4 4 Thermos
#DIV/0!
3.125
MENGETAHUI :
Kepala Puskesmas Palangga Kab. Konsel
Amrin,S.Kep.Ns
Nip. 196506021987031017
DPT/HB-Hib (1) POLIO2 DPT/HB-Hib (2) POLIO3
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
3 8.3 1 4.8 0 0.0 1 2.8 1 4.8 0 0.0 1 2.8 3 14.3 1 6.7 4 11.1 3 14.3 1 6.7 4 11.1
2 11.8 0 0.0 0 0.0 0 0.0 0 0.0 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 5.0 1 11.1 1 9.1 2 10.0 1 11.1 1 9.1 2 10.0 4 44.4 2 18.2 6 30.0 4 44.4 2 18.2 6 30.0
1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6
0 0.0 0 0.0 3 37.5 3 23.1 0 0.0 3 37.5 3 23.1 0 0.0 1 12.5 1 7.7 0 0.0 1 12.5 1 7.7
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0 1 7.1
2 14.3 1 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 7.7 1 6.3 1 10.0 2 7.7 1 6.3 1 10.0 2 7.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 35.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 5.0 2 8.7 0 0.0 2 5.0 2 8.7 0 0.0 2 5.0 1 4.3 1 5.9 2 5.0 1 4.3 1 5.9 2 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 3 37.5 3 16.7 0 0.0 3 37.5 3 16.7
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
19 6.2 6 3.8 7 4.8 13 4.2 6 3.8 7 4.8 13 4.2 9 5.6 9 6.2 18 5.9 9 5.6 9 6.2 18 5.9
LAPORAN COLD CHAIN

(buah)
#DIV/0! 1 Lemari ES
3.13333333 2 M. Freezer
5.25 3 V. Crrier
6 4 Thermos
2
4.33333333
MENGETAHUI :
Kepala Puskesmas .Palangga Kab.Konsel
Amrin,S.Kep
Nip.196506021987031017
DPT/HB-Hib (1) Polio 2 DPT/HB-Hib (2) Polio 3
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
0 0.0 1 4.8 0 0.0 1 2.8 1 4.8 0 0.0 1 2.8 0 0.0 0 0.0 0 0.0 1 4.8 0 0.0 1 2.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 10.0 0 0.0 4 36.4 4 20.0 0 0.0 4 36.4 4 20.0 0 0.0 1 9.1 1 5.0 0 0.0 1 9.1 1 5.0
0 0.0 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6
2 15.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 7.7 0 0.0 1 12.5 1 7.7
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3
5 19.2 1 6.3 1 10.0 2 7.7 1 6.3 1 10.0 2 7.7 2 12.5 3 30.0 5 19.2 2 12.5 3 30.0 5 19.2
1 5.9 4 80.0 1 8.3 5 29.4 4 80.0 1 8.3 5 29.4 1 20.0 1 8.3 2 11.8 1 20.0 1 8.3 2 11.8
2 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 1 11.1 3 18.8 2 28.6 1 11.1 3 18.8
7 38.9 0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6
3 30.0 1 25.0 1 16.7 2 20.0 1 25.0 1 16.7 2 20.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0
4 10.0 2 8.7 0 0.0 2 5.0 2 8.7 0 0.0 2 5.0 3 13.0 0 0.0 3 7.5 3 13.0 0 0.0 3 7.5
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6
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 14.3 1 4.8 0 0.0 1 14.3 1 4.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
26 8.5 10 6.3 10 6.8 20 6.5 10 6.3 10 6.8 20 6.5 12 7.5 10 6.8 22 7.2 13 8.1 10 6.8 23 7.5
LAPORAN COLD CHAIN

(buah)
5.4 Baik Rusak
#DIV/0! 1 Lemari ES
2.08 2 M. Freezer
4.6 3 V. Crrier
#DIV/0! 4 Thermos
1
2.75
MENGETAHUI :
Kepala Puskesmas Palangga .Kab.Konawe selatan.
Amrin,S.Kep.
Nip.196506021987031017
DPT/HB-Hib (1) POLIO2 DPT/HB-Hib (2) POLIO 3
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
4 11.1 2 9.5 2 13.3 4 11.1 2 9.5 2 13.3 4 11.1 2 9.5 0 0.0 2 5.6 2 9.5 0 0.0 2 5.6
4 23.5 2 18.2 0 0.0 2 11.8 2 18.2 0 0.0 2 11.8 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9
3 15.0 0 0.0 1 9.1 1 5.0 0 0.0 1 9.1 1 5.0 2 22.2 2 18.2 4 20.0 2 22.2 2 18.2 4 20.0
1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6
1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 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 7.1 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
4 28.6 0 0.0 1 12.5 1 7.1 0 0.0 1 12.5 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1
0 0.0 2 12.5 2 20.0 4 15.4 2 12.5 2 20.0 4 15.4 1 6.3 1 10.0 2 7.7 1 6.3 1 10.0 2 7.7
1 5.9 3 60.0 1 8.3 4 23.5 3 60.0 1 8.3 4 23.5 3 60.0 0 0.0 3 17.6 3 60.0 0 0.0 3 17.6
2 12.5 1 14.3 1 11.1 2 12.5 1 14.3 1 11.1 2 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 11.1 1 10.0 5 62.5 6 33.3 1 10.0 5 62.5 6 33.3 0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1
2 20.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0
7 17.5 3 13.0 2 11.8 5 12.5 3 13.0 2 11.8 5 12.5 2 8.7 0 0.0 2 5.0 2 8.7 0 0.0 2 5.0
1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 4.8 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
34 11.1 15 9.4 17 11.6 32 10.5 15 9.4 17 11.6 32 10.5 12 7.5 7 4.8 19 6.2 12 7.5 7 4.8 19 6.2
LAPORAN COLD CHAIN

(buah)
4.25 Baik Rusak
#DIV/0! 1 Lemari ES
4.07692308 2 M. Freezer
5.55 3 V. Crrier
2.9 4 Thermos
1
2.625
MENGETAHUI :
Amrin,S.Kep.Ns
Nip.196506021987031017
DPT/HB-Hib (1) POLIO 2 DPT/HB-Hib (2) POLIO 3
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
0 0.0 1 4.8 4 26.7 5 13.9 1 4.8 4 26.7 5 13.9 1 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6
0 0.0 0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9
0 0.0 2 22.2 1 9.1 3 15.0 2 22.2 1 9.1 3 15.0 2 22.2 4 36.4 6 30.0 2 22.2 4 36.4 6 30.0
3 16.7 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 40.0 1 12.5 3 23.1 2 40.0 1 12.5 3 23.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 1 16.7 1 7.1 0 0.0 1 16.7 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 14.3 3 50.0 1 12.5 4 28.6 3 50.0 1 12.5 4 28.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 3.8 1 6.3 2 20.0 3 11.5 1 6.3 2 20.0 3 11.5 2 12.5 2 20.0 4 15.4 2 12.5 2 20.0 4 15.4
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 60.0 1 8.3 4 23.5 3 60.0 1 8.3 4 23.5
0 0.0 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 0 0.0 1 11.1 1 6.3 0 0.0 1 11.1 1 6.3
0 0.0 2 20.0 2 25.0 4 22.2 2 20.0 2 25.0 4 22.2 1 10.0 5 62.5 6 33.3 1 10.0 5 62.5 6 33.3
1 10.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 1 25.0 1 16.7 2 20.0 1 0.0 1 16.7 2 20.0
5 12.5 2 8.7 3 17.6 5 12.5 2 8.7 3 17.6 5 12.5 4 17.4 2 11.8 6 15.0 4 17.4 2 11.8 6 15.0
1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 9.5 0 0.0 2 28.6 2 9.5 0 0.0 2 28.6 2 9.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 12.5 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
16 5.2 15 9.4 19 13.0 34 11.1 15 9.4 19 13.0 34 11.1 15 9.4 17 11.6 32 10.5 15 9.4 17 11.6 32 10.5
LAPORAN COLD CHAIN

(buah)
3.2 Baik Rusak
#DIV/0! 1 Lemari ES
3.95833333 2 M. Freezer
7.26666667 3 V. Crrier
1.4375 4 Thermos
1
5.16666667
MENGETAHUI :
Amrin,S.Kep
Nip.196506021987031017
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
0 0.0 0 0.0 1 6.7 1 2.8 0 0.0 1 6.7 1 2.8 1 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6
0 0.0 1 9.1 1 16.7 2 11.8 1 9.1 1 16.7 2 11.8 0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9
2 10.0 0 0.0 1 9.1 1 5.0 0 0.0 1 9.1 1 5.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 10.0 2 25.0 3 16.7 1 10.0 2 25.0 3 16.7 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6
2 15.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 40.0 1 12.5 3 23.1 2 40.0 1 12.5 3 23.1
2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 14.3 2 33.3 1 12.5 3 21.4 2 33.3 1 12.5 3 21.4 3 50.0 2 25.0 5 35.7 3 50.0 2 25.0 5 35.7
0 0.0 0 0.0 1 10.0 1 3.8 0 0.0 1 10.0 1 3.8 1 6.3 3 30.0 4 15.4 1 6.3 3 30.0 4 15.4
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 5.9 1 20.0 0 0.0 1 5.9
2 12.5 0 0.0 1 11.1 1 6.3 0 0.0 1 11.1 1 6.3 2 28.6 0 0.0 2 12.5 2 28.6 0 0.0 2 12.5
2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 30.0 0 0.0 3 16.7 2 20.0 0 0.0 2 11.1
2 20.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0
1 2.5 4 17.4 0 0.0 4 10.0 4 17.4 0 0.0 4 10.0 0 0.0 3 17.6 3 7.5 0 0.0 3 17.6 3 7.5
1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
3 14.3 2 14.3 0 0.0 2 9.5 2 14.3 0 0.0 2 9.5 1 7.1 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5
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
19 6.2 11 6.9 9 6.2 20 6.5 11 6.9 9 6.2 20 6.5 15 9.4 13 8.9 28 9.2 14 8.8 13 8.9 27 8.8
LAPORAN COLD CHAIN

(buah)
4.75 Baik Rusak
#DIV/0! 1 Lemari ES
3.11111111 2 M. Freezer
6.23529412 3 V. Crrier
5.72727273 4 Thermos
1
7
MENGETAHUI :
Kepala Puskesmas .Palangga.Kab./Kota.Konsel.
Amrin,S.Kep
Nip.196506021987031017
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
2 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 4.8 2 13.3 3 8.3 1 4.8 2 13.3 3 8.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 22.2 2 18.2 4 20.0 2 22.2 2 18.2 4 20.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1
0 0.0 0 0.0 2 25.0 2 15.4 0 0.0 2 25.0 2 15.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 7.1 0 0.0 1 16.7 1 7.1 0 0.0 1 16.7 1 7.1 0 0.0 1 16.7 1 7.1 0 0.0 1 16.7 1 7.1
2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 1 12.5 3 21.4 2 33.3 1 12.5 3 21.4
3 11.5 1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8 0 0.0 1 10.0 1 3.8 0 0.0 1 10.0 1 3.8
1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 5.9 1 20.0 0 0.0 1 5.9
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 11.1 1 6.3 0 0.0 1 11.1 1 6.3
0 0.0 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 40.0 1 25.0 3 50.0 4 40.0 1 25.0 3 50.0 4 40.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 4.3 0 0.0 1 2.5 1 4.3 0 0.0 1 2.5 4 17.4 0 0.0 4 10.0 4 17.4 0 0.0 4 10.0
1 5.6 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6
0 0.0 2 14.3 0 0.0 2 9.5 2 14.3 0 0.0 2 9.5 1 7.1 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5
2 25.0 1 100.0 0 0.0 1 12.5 1 100.0 0 0.0 1 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
18 5.9 7 4.4 7 4.8 14 4.6 7 4.4 7 4.8 14 4.6 12 7.5 11 7.5 23 7.5 12 7.5 11 7.5 23 7.5
LAPORAN COLD CHAIN

(buah)
#DIV/0! 1 Lemari ES
3.22727273 2 M. Freezer
5.11111111 3 V. Crrier
0.33333333 4 Thermos
0.09090909
3
MENGETAHUI :
Kepala Puskesmas .Palangga Kab. Konsel
Amrin,S.Kep
Nip.196506021987031017
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
0 0.0 3 14.3 1 6.7 4 11.1 3 14.3 1 6.7 4 11.1 1 4.8 2 13.3 3 8.3 1 4.8 2 13.3 3 8.3
3 17.6 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9
0 0.0 3 33.3 1 9.1 4 20.0 3 33.3 1 9.1 4 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 22.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1
1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 1 12.5 2 15.4 1 20.0 1 12.5 2 15.4
1 7.1 0 0.0 2 33.3 2 14.3 0 0.0 2 33.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 7.1 0 0.0 2 25.0 2 14.3 0 0.0 2 25.0 2 14.3 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1
4 15.4 2 12.5 0 0.0 2 7.7 2 12.5 0 0.0 2 7.7 1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8
1 5.9 1 20.0 0 0.0 1 5.9 1 20.0 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 11.1 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
1 10.0 2 50.0 3 50.0 5 50.0 2 50.0 3 50.0 5 50.0 1 25.0 2 33.3 3 30.0 1 25.0 2 33.3 3 30.0
6 15.0 1 4.3 2 11.8 3 7.5 1 4.3 2 11.8 3 7.5 2 8.7 0 0.0 2 5.0 2 8.7 0 0.0 2 5.0
0 0.0 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6
0 0.0 1 7.1 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5 1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
25 8.2 14 8.8 13 8.9 27 8.8 14 8.8 13 8.9 27 8.8 10 6.3 7 4.8 17 5.6 10 6.3 7 4.8 17 5.6
LAPORAN COLD CHAIN

(buah)
#DIV/0! 1 Lemari ES
4.43478261 2 M. Freezer
7.23076923 3 V. Crrier
0 4 Thermos
1
2.75
MENGETAHUI :
Kepala Puskesmas Palangga.Kab. Konsel
Amrin,S.Kep
Nip.196506021987031017
DPT/HB-HIB(1) POLIO2 DPT-HB-HIB2 POLIO3
25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
24 66.7 16 76.2 14 93.3 30 83.3 16 76.2 14 93.3 30 83.3 16 76.2 15 100.0 31 52.8 17 81.0 15 100.0 32 88.9
13 76.5 4 36.4 6 100.0 10 58.8 4 36.4 6 100.0 10 58.8 3 27.3 5 83.3 8 47.1 3 27.3 5 83.3 8 47.1
25 125.0 14 155.6 14 127.3 28 140.0 14 155.6 14 127.3 28 140.0 14 155.6 13 118.2 27 135.0 14 155.6 13 118.2 27 135.0
14 77.8 3 30.0 8 100.0 11 61.1 3 30.0 8 100.0 11 61.1 2 20.0 8 100.0 10 55.6 2 20.0 8 100.0 10 55.6
14 107.7 3 60.0 10 125.0 13 100.0 3 60.0 10 125.0 13 100.0 4 80.0 6 75.0 10 76.9 4 80.0 6 75.0 10 76.9
7 50.0 2 25.0 4 66.7 6 42.9 2 25.0 4 66.7 6 42.9 2 25.0 1 16.7 3 21.4 2 25.0 1 16.7 3 21.4
19 135.7 11 183.3 8 100.0 19 135.7 11 183.3 8 100.0 19 135.7 14 233.3 5 62.5 19 135.7 14 233.3 5 62.5 19 135.7
26 100.0 12 75.0 10 100.0 22 84.6 12 75.0 10 100.0 22 84.6 11 68.8 11 110.0 22 84.6 11 68.8 11 110.0 22 84.6
18 105.9 9 180.0 8 66.7 17 100.0 9 180.0 8 66.7 17 100.0 11 220.0 8 66.7 19 111.8 11 220.0 8 66.7 19 111.8
13 81.3 7 100.0 4 44.4 11 68.8 7 100.0 4 44.4 11 68.8 8 114.3 5 55.6 13 81.3 8 114.3 5 55.6 13 81.3
23 127.8 4 40.0 14 175.0 18 100.0 4 40.0 14 175.0 18 100.0 9 90.0 12 150.0 21 116.7 7 70.0 12 150.0 19 105.6
18 180.0 8 200.0 14 233.3 22 220.0 8 200.0 14 233.3 22 220.0 6 150.0 11 183.3 17 170.0 6 150.0 11 183.3 17 170.0
32 80.0 18 78.3 10 58.8 28 70.0 18 78.3 10 58.8 28 70.0 21 91.3 10 58.8 31 77.5 21 91.3 9 52.9 30 75.0
10 55.6 7 70.0 8 100.0 15 83.3 7 70.0 8 100.0 15 83.3 5 50.0 8 100.0 13 72.2 5 50.0 8 100.0 13 72.2
10 47.6 8 57.1 5 71.4 14 66.7 9 64.3 5 71.4 14 66.7 6 42.9 4 57.1 10 47.6 6 42.9 4 57.1 10 47.6
4 50.0 1 100.0 1 14.3 2 25.0 1 100.0 1 14.3 2 25.0 1 100.0 1 14.3 2 25.0 1 100.0 1 14.3 2 25.0
270 88.2 127 79.4 138 94.5 266 86.9 128 80.0 138 94.5 266 86.9 133 83.1 123 84.2 256 83.7 132 82.5 122 83.6 72 23.5
47% 46.5
LAPORAN COLD CHAIN

(buah)
#DIV/0! 1 Lemari ES
3.54044118 2 M. Freezer
5.625 3 V. Crrier
3.37 4 Thermos
0.56190476
3.50649351
MENGETAHUI :
Amrin,S.Kep
Nip.196506021987031017
DPT/HB-Hib (3) POLIO4 IPV CAMPAK IMUNI
#L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L %
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
1 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6 2 9.5 1 6.7 3 8.3 2 9.5
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 2 18.2 0 0.0 2 11.8 2 18.2
0 0.0 2 18.2 2 10.0 0 0.0 2 18.2 2 10.0 0 0.0 2 18.2 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0
1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 3 30.0 0 0.0 3 16.7 3 30.0
0 0.0 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 20.0 0 0.0 1 7.7 1 20.0
0 0.0 1 16.7 1 7.1 0 0.0 1 16.7 1 7.1 0 0.0 1 16.7 1 7.1 2 25.0 0 0.0 2 14.3 2 25.0
1 16.7 5 62.5 6 42.9 1 16.7 5 62.5 6 42.9 1 16.7 5 62.5 6 42.9 0 0.0 2 25.0 2 14.3 0 0.0
1 6.3 5 50.0 6 23.1 1 6.3 5 50.0 6 23.1 1 6.3 5 50.0 6 23.1 3 18.8 1 10.0 4 15.4 3 18.8
2 40.0 0 0.0 2 11.8 2 40.0 0 0.0 2 11.8 2 40.0 0 0.0 2 11.8 2 40.0 0 0.0 2 11.8 2 40.0
0 0.0 1 11.1 1 6.3 0 0.0 1 11.1 1 6.3 0 0.0 1 11.1 1 6.3 0 0.0 1 11.1 1 6.3 0 0.0
0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1 1 10.0 1 12.5 2 11.1 1 10.0
2 50.0 1 16.7 3 30.0 2 50.0 1 16.7 3 30.0 2 50.0 1 16.7 3 30.0 0 0.0 1 16.7 1 10.0 0 0.0
0 0.0 2 11.8 2 5.0 0 0.0 2 11.8 2 5.0 0 0.0 2 11.8 2 5.0 2 8.7 0 0.0 2 5.0 2 8.7
0 0.0 0 0.0 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 12.5 1 5.6 0 0.0
1 7.1 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5 2 14.3 0 0.0 2 9.5 2 14.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
9 5.6 21 14.4 30 9.8 9 5.6 21 14.4 30 9.8 9 5.6 21 14.4 30 9.8 20 12.5 8 5.5 28 9.2 20 12.5
Palangga ...................................................2018
IDENTITAS DIDUGA KIPI (1) IMUNISASI
Koordinator Jurim Puskesmas Palangga 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari im
2 Kelamin :
Imunisasi (Vaksin) Tgl Jam
3 Tggl / Lahir :
4 Umur :
Iwan Setiawan.SKM 5 Nama ayah :
Nip. 19730720 199502 1001 6 Nama ibu :
7 Alamat :
a. Jalan ………………………… Nomor …. RT/RW ………………. Reaksi timbul pada tgl ....................................
b. Dusun/Kampung…………….. Desa/Kelurahan ………………… Gejala & Waktu timbulnya gejala .................
c. Kecamatan ………………….. Kabupaten …………………………
d. Provinsi Sulawesi Tenggara
8 Jumlah saudara kandung :
DPT/HB-Hib (3) POLIO4 IPV CAMPAK IMUNI
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
1 4.8 4 26.7 5 13.9 1 4.8 4 26.7 5 13.9 1 4.8 4 26.7 5 13.9 6 28.6 1 6.7 7 19.4 6 28.6
0 0.0 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 9.1 0 0.0 1 5.9 1 9.1
1 11.1 0 0.0 1 5.0 1 11.1 0 0.0 1 5.0 1 11.1 0 0.0 1 5.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 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 20.0 0 0.0 1 7.7 1 20.0 0 0.0 1 7.7 1 20.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 1 16.7 3 21.4 2 25.0
1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 2 25.0 3 21.4 1 16.7
1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8 2 12.5 2 20.0 4 15.4 2 12.5
2 40.0 0 0.0 2 11.8 2 40.0 0 0.0 2 11.8 2 40.0 0 0.0 2 11.8 0 0.0 3 25.0 3 17.6 0 0.0
1 14.3 1 11.1 2 12.5 1 14.3 1 11.1 2 12.5 1 14.3 1 11.1 2 12.5 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 1 10.0 1 12.5 2 11.1 1 10.0
2 50.0 1 16.7 3 30.0 2 50.0 1 16.7 3 30.0 2 50.0 1 16.7 3 30.0 2 50.0 0 0.0 2 20.0 2 50.0
1 4.3 2 11.8 3 7.5 1 4.3 2 11.8 3 7.5 1 4.3 2 11.8 3 7.5 4 17.4 0 0.0 4 10.0 4 17.4
0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1 0 0.0 2 25.0 2 11.1 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 3 21.4 1 14.3 4 19.0 3 21.4
1 100.0 0 0.0 1 12.5 1 100.0 0 0.0 1 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 6.9 11 7.5 22 7.2 11 6.9 11 7.5 22 7.2 11 6.9 11 7.5 22 7.2 23 14.4 13 8.9 36 11.8 23 14.4

2 Kelamin :
3 Tggl / Lahir :
4 Umur :
Iwan Setiawan,SKM 5 Nama ayah :
Nip. 19730720 199502 1 001 6 Nama ibu :
7 Alamat :
DPT/HB-Hib (3) POLIO4 IPV CAMPAK
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
1 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6 3 14.3 0 0.0 3 8.3 3 14.3
0 0.0 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 9.1 1 16.7 2 11.8 1 9.1
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 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 12.5 1 7.7 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3 1 16.7 0 0.0 1 7.1 1 16.7
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 7.7 0 0.0
1 20.0 0 0.0 1 5.9 1 20.0 0 0.0 1 5.9 1 20.0 0 0.0 1 5.9 1 20.0 1 8.3 2 11.8 1 20.0
1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0
1 10.0 2 25.0 3 16.7 1 10.0 2 25.0 3 16.7 1 10.0 3 37.5 4 22.2 1 10.0 0 0.0 1 5.6 1 10.0
1 25.0 1 16.7 2 20.0 1 25.0 1 16.7 2 20.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 1 25.0
0 0.0 1 5.9 1 2.5 0 0.0 1 5.9 1 2.5 0 0.0 1 5.9 1 2.5 1 4.3 1 5.9 2 5.0 1 4.3
1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 1 10.0 0 0.0 1 5.6 1 10.0
0 0.0 0 0.0 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 14.3 1 4.8 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 4.4 7 4.8 14 4.6 7 4.4 7 4.8 14 4.6 7 4.4 7 4.8 14 4.6 10 6.3 7 4.8 17 5.6 10 6.3
Palangga, ………………….2016
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
Nip. 19730720 199502 1 001 6 Nama ibu :
7 Alamat :
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
1 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9 1 9.1 1 16.7 2 11.8 1 9.1
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 1 11.1 1 9.1 2 10.0 1 11.1
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
1 20.0 1 12.5 2 15.4 1 20.0 1 12.5 2 15.4 1 20.0 1 12.5 2 15.4 0 0.0 0 0.0 0 0.0 0 0.0
1 12.5 0 0.0 1 7.1 1 12.5 0 0.0 1 7.1 1 12.5 0 0.0 1 7.1 0 0.0 1 16.7 1 7.1 0 0.0
1 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3 2 33.3 2 25.0 4 28.6 2 33.3
1 6.3 0 0.0 1 3.8 1 21.4 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8 2 12.5 0 0.0 2 7.7 2 12.5
0 0.0 1 8.3 1 5.9 0 0.0 1 8.3 1 5.9 0 0.0 1 8.3 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0
2 20.0 1 12.5 3 16.7 2 20.0 1 12.5 3 16.7 2 20.0 1 12.5 3 16.7 1 10.0 3 37.5 4 22.2 1 10.0
0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0 0 0.0 1 16.7 1 10.0 1 25.0 0 0.0 1 10.0 1 25.0
3 13.0 2 11.8 5 #REF! 3 13.0 2 11.8 5 12.5 3 13.0 2 11.8 5 12.5 0 0.0 2 11.8 2 5.0 0 0.0
0 0.0 2 25.0 2 11.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 5.6 1 10.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 6.9 11 7.5 22 7.2 11 6.9 9 6.2 20 6.5 11 6.9 9 6.2 20 6.5 9 5.6 10 6.8 19 6.2 9 5.6

2 Kelamin :
3 Tggl / Lahir :
4 Umur :
Nip. 19730720 199502 1 001 6 Nama ibu :
7 Alamat :
DPT-HB-HIB3 POLIO4 IPV CAMPAK
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 9.5 3 20.0 5 13.9 2 9.5
0 0.0 2 33.3 2 11.8 0 0.0 2 33.3 2 11.8 0 0.0 2 33.3 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0
2 22.2 0 0.0 2 10.0 2 22.2 0 0.0 2 10.0 2 22.2 0 0.0 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 12.5 1 7.7 0 0.0
0 0.0 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 12.5 0 0.0 1 7.1 1 12.5
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 2 25.0 2 14.3 0 0.0
1 6.3 1 10.0 2 7.7 1 6.3 1 10.0 2 7.7 1 6.3 1 10.0 2 7.7 0 0.0 1 10.0 1 3.8 0 0.0
0 0.0 2 16.7 2 11.8 0 0.0 2 16.7 2 11.8 0 0.0 2 16.7 2 11.8 2 40.0 0 0.0 2 11.8 2 0.0
0 0.0 0 0.0 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 11.1 1 6.3 0 0.0
0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 33.3 2 20.0 0 0.0 2 2.0 2 20.0 0 0.0 2 33.3 2 20.0 2 50.0 1 16.7 3 30.0 2 50.0
1 4.3 0 0.0 1 2.5 1 4.3 0 0.0 1 2.5 1 4.3 0 0.0 1 2.5 1 4.3 1 5.9 2 5.0 1 4.3
0 0.0 0 0.0 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 12.5 1 5.6 0 0.0
1 7.1 2 28.6 3 14.3 1 7.1 2 28.6 3 14.3 1 7.1 2 28.6 3 14.3 3 21.4 2 28.6 5 23.8 3 21.4
0 0.0 1 14.3 1 12.5 0 0.0 1 14.3 1 12.5 0 0.0 1 14.3 1 12.5 0 0.0 0 0.0 0 0.0 0 0.0
5 3.1 11 7.5 16 5.2 5 3.1 11 7.5 16 5.2 5 3.1 11 7.5 16 5.2 11 6.9 13 8.9 24 7.8 11 6.9

2 Kelamin :
3 Tggl / Lahir :
4 Umur :
Nip. ........................... 6 Nama ibu :
7 Alamat :
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
1 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6 0 0.0 0 0.0 0 0.0 0 0.0 2 13.3 2 5.6 0 0.0
0 0.0 1 16.7 1 5.9 0 0.0 1 16.7 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 11.1 1 9.1 2 10.0 1 11.1 1 9.1 2 10.0 1 11.1 1 9.1 2 10.0 0 0.0 1 9.1 1 5.0 0 0.0
1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 1 10.0 1 12.5 2 11.1 2 20.0 2 25.0 4 22.2 2 20.0
0 0.0 1 12.5 1 7.7 0 0.0 1 12.5 1 7.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 1 16.7 1 12.5 2 14.3 1 16.7
0 0.0 0 0.0 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 30.0 3 11.5 0 0.0
0 0.0 2 16.7 2 11.8 0 0.0 2 16.7 2 11.8 0 0.0 2 16.7 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0
1 14.3 1 11.1 2 12.5 1 14.3 1 11.1 2 12.5 1 14.3 1 11.1 2 12.5 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 0.0 0 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 14.3 1 12.5 0 0.0 1 14.3 1 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 3.1 9 6.2 14 4.6 5 3.1 9 6.2 14 4.6 3 1.9 5 3.4 8 2.6 3 1.9 9 6.2 12 3.9 3 1.9
Palangga, ………………….2018
Koordinator Jurim Puskesmas .Palangga 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari im
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
Nip. 19730720 199502 1 001 6 Nama ibu :
7 Alamat :
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
2 9.5 1 6.7 3 8.3 2 9.5 1 6.7 3 8.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 22.2 0 0.0 2 10.0 2 22.2 0 0.0 2 10.0 2 22.2 0 0.0 2 10.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 12.5 0 0.0 1 7.1 1 12.5 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 6.3 0 0.0 1 3.8 1 6.3 0 0.0 1 3.8 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 8.3 1 5.9 0 0.0 1 8.3 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 6.3 1 14.3 0 0.0 1 6.3 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 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 25.0 3 50.0 4 40.0 1 25.0 3 50.0 4 40.0 1 25.0 2 33.3 3 30.0 0 0.0 0 0.0 0 0.0 0 0.0
1 4.3 0 0.0 1 2.5 1 4.3 0 0.0 1 2.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 3 37.5 3 16.7 0 0.0 3 37.5 3 16.7 0 0.0 3 37.5 3 16.7 0 0.0 0 0.0 0 0.0 0 0.0
1 7.1 0 0.0 1 4.8 1 7.1 0 0.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 6.9 10 6.8 21 6.9 11 6.9 10 6.8 21 6.9 3 1.9 5 3.4 8 2.6 0 0.0 0 0.0 0 0.0 0 0.0
Palangga ..................................................2018
Koordinator Jurim Puskesmas Palangga. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari im
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
Iwan Setiawan 5 Nama ayah :
Nip. 19730720 199502 1 001 6 Nama ibu :
7 Alamat :
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
2 9.5 3 20.0 5 13.9 2 9.5 3 20.0 5 13.9 2 9.5 3 20.0 5 13.9 2 9.5 1 6.7 3 8.3 2 9.5
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 1 16.7 1 5.9 0 0.0
1 11.1 1 9.1 2 10.0 1 11.1 1 9.1 2 10.0 1 11.1 1 9.1 2 10.0 3 33.3 0 0.0 3 15.0 3 33.3
0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 1 10.0 1 12.5 2 11.1 1 10.0
0 0.0 3 37.5 3 23.1 0 0.0 3 37.5 3 23.1 0 0.0 3 37.5 3 23.1 1 20.0 1 12.5 2 15.4 1 20.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3 1 16.7 1 12.5 2 14.3 3 50.0 1 12.5 4 28.6 3 50.0
0 0.0 1 10.0 1 3.8 0 0.0 1 10.0 1 3.8 0 0.0 1 10.0 1 3.8 1 6.3 1 10.0 2 7.7 1 6.3
1 20.0 1 8.3 2 11.8 1 20.0 1 8.3 2 11.8 1 20.0 1 8.3 2 11.8 2 40.0 2 16.7 4 23.5 2 40.0
2 28.6 1 11.1 3 18.8 2 28.6 1 11.1 3 18.8 2 28.6 1 11.1 3 18.8 1 14.3 1 11.1 2 12.5 1 14.3
2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 0 0.0 2 25.0 2 11.1 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 2 33.3 2 20.0 0 0.0
1 21.4 3 17.6 4 10.0 1 4.3 3 17.6 4 10.0 1 4.3 3 17.6 4 10.0 1 4.3 2 11.8 3 7.5 1 4.3
1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 1 10.0 0 0.0 1 5.6 1 10.0 1 12.5 2 11.1 1 10.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 6.9 15 10.3 26 8.5 11 6.9 15 10.3 26 8.5 11 6.9 15 10.3 26 8.5 16 10.0 16 11.0 32 10.5 16 10.0

Koordinator Jurim Puskesmas .Palangga 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari im
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
Nip. 19730720 199502 1 001 6 Nama ibu :
7 Alamat :
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
1 4.8 1 6.7 2 5.6 1 4.8 1 6.7 2 5.6 0 0.0 0 0.0 0 0.0 4 19.0 2 13.3 6 16.7 4 19.0
1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 3 27.3 3 15.0 0 0.0 3 27.3 3 15.0 0 0.0 3 27.3 3 15.0 0 0.0 3 27.3 3 15.0 0 0.0
0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 5.6 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 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 12.5 0 0.0 1 7.1 1 12.5
1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 1 16.7 1 12.5 2 14.3 1 16.7
3 18.8 2 20.0 5 19.2 3 18.8 2 20.0 5 19.2 3 18.8 2 20.0 5 19.2 1 6.3 1 10.0 2 7.7 1 6.3
3 60.0 1 8.3 4 23.5 3 60.0 1 8.3 4 23.5 3 60.0 1 8.3 4 23.5 0 0.0 1 8.3 1 5.9 0 0.0
0 0.0 0 0.0 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 11.1 1 6.3 0 0.0
0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 2 20.0 2 25.0 4 22.2 2 20.0
1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 2 20.0 0 0.0
2 8.7 0 0.0 2 5.0 2 8.7 0 0.0 2 5.0 2 8.7 0 0.0 2 5.0 5 21.7 5 29.4 10 25.0 5 21.7
0 0.0 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 10.0 2 25.0 3 16.7 1 10.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 14.3 1 14.3 3 14.3 2 14.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 100.0 0 0.0 1 12.5 1 100.0
12 7.5 9 6.2 21 6.9 12 7.5 9 6.2 21 6.9 9 5.6 7 4.8 16 5.2 18 11.3 22 15.1 40 13.1 18 11.3
Palangga, ………………….2016
Koordinator Jurim Puskesmas .palangga 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari im
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
Nip. 19730720 199502 1 001. 6 Nama ibu :
7 Alamat :
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
0 0.0 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 14.3 5 33.3 8 22.2 3 14.3
1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 1 9.1 0 0.0 1 5.9 0 0.0 2 33.3 2 11.8 0 0.0
2 22.2 2 18.2 4 20.0 2 22.2 2 18.2 4 20.0 2 22.2 2 18.2 4 20.0 4 44.4 3 27.3 7 35.0 4 44.4
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 1 12.5 1 5.6 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 12.5 3 30.0 5 19.2 2 12.5 3 30.0 5 19.2 2 12.5 0 0.0 2 7.7 2 12.5 0 0.0 2 7.7 2 12.5
3 60.0 0 0.0 3 17.6 3 60.0 0 0.0 3 17.6 3 60.0 0 0.0 3 17.6 0 0.0 3 25.0 3 17.6 0 0.0
0 0.0 1 11.1 1 6.3 0 0.0 1 11.1 1 6.3 0 0.0 1 11.1 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0
1 10.0 5 62.5 6 33.3 1 10.0 5 62.5 6 33.3 1 10.0 5 62.5 6 33.3 2 20.0 2 25.0 4 22.2 2 20.0
1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 1 25.0 0 0.0 1 10.0 1 25.0 4 66.7 5 50.0 0 0.0
2 8.7 3 17.6 5 12.5 2 8.7 3 17.6 5 12.5 2 8.7 3 17.6 5 12.5 1 4.3 0 0.0 1 2.5 1 4.3
0 0.0 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 10.0 1 12.5 2 11.1 1 10.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 100.0 0 0.0 1 12.5 1 100.0
12 7.5 14 9.6 26 8.5 12 7.5 14 9.6 26 8.5 12 7.5 11 7.5 23 7.5 15 9.4 21 14.4 36 11.8 14 8.8

Koordinator Jurim Puskesmas Palangga. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari im
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
Nip. .19730720 199502 1 oo1. 6 Nama ibu :
7 Alamat :
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
0 0.0 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 4.8 0 0.0 1 2.8 1 4.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 11.1 3 27.3 4 20.0 1 11.1 3 27.3 4 20.0 1 11.1 3 27.3 4 20.0 2 22.2 0 0.0 2 10.0 2 22.2
0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 11.1 0 0.0
2 40.0 1 12.5 3 23.1 2 40.0 1 12.5 3 23.1 2 40.0 1 12.5 3 23.1 0 0.0 1 12.5 1 7.7 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 50.0 2 25.0 5 35.7 3 50.0 2 25.0 5 35.7 3 50.0 2 25.0 5 35.7 2 33.3 0 0.0 2 14.3 2 33.3
0 0.0 2 20.0 2 7.7 0 0.0 2 20.0 2 7.7 0 0.0 2 20.0 2 7.7 0 0.0 2 20.0 2 7.7 0 0.0
1 20.0 1 8.3 2 11.8 1 20.0 1 8.3 2 11.8 1 20.0 1 8.3 2 11.8 1 20.0 1 8.3 2 11.8 1 20.0
0 0.0 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 14.3 1 11.1 2 12.5 1 14.3
2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 2 20.0 0 0.0 2 11.1 0 0.0 2 25.0 2 11.1 0 0.0
1 25.0 1 16.7 2 20.0 1 25.0 1 16.7 2 20.0 1 25.0 1 16.7 2 20.0 1 25.0 2 33.3 3 30.0 1 25.0
2 8.7 4 23.5 6 15.0 2 8.7 4 23.5 6 15.0 2 8.7 4 23.5 6 15.0 0 0.0 1 5.9 1 2.5 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 1 12.5 1 5.6 0 0.0
1 7.1 2 28.6 3 14.3 1 7.1 2 28.6 3 14.3 1 7.1 2 28.6 3 14.3 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
13 8.1 17 11.6 30 9.8 13 8.1 17 11.6 30 9.8 13 8.1 16 11.0 29 9.5 8 5.0 13 8.9 21 6.9 8 5.0
Palangga, ………………….2016
Koordinator Jurim Puskesmas .Palangga. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari im
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
Nip. 19730720 199502 1 001 6 Nama ibu :
7 Alamat :
DPT/HB-Hib (3) POLIO 4 IPV CAMPAK
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
2 9.5 3 20.0 5 13.9 2 9.5 3 20.0 5 13.9 2 9.5 3 20.0 5 13.9 2 9.5 0 0.0 2 5.6 2 9.5
1 9.1 1 16.7 2 11.8 1 9.1 1 16.7 2 11.8 1 9.1 1 16.7 2 11.8 0 0.0 0 0.0 0 0.0 0 0.0
2 22.2 2 18.2 4 20.0 2 22.2 2 18.2 4 20.0 2 22.2 2 18.2 4 20.0 0 0.0 2 18.2 2 10.0 0 0.0
0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 1 12.5 1 5.6 0 0.0 2 25.0 2 11.1 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 3 37.5 3 23.1 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 1 12.5 0 0.0 1 7.1 1 12.5
2 33.3 1 12.5 3 21.4 2 33.3 1 12.5 3 21.4 2 33.3 1 12.5 3 21.4 0 0.0 1 12.5 1 7.1 0 0.0
1 6.3 1 10.0 2 7.7 1 6.3 1 10.0 2 7.7 1 6.3 1 10.0 2 7.7 2 12.5 2 20.0 4 15.4 2 12.5
1 20.0 0 0.0 1 5.9 1 20.0 0 0.0 1 5.9 1 20.0 0 0.0 1 5.9 0 0.0 1 8.3 1 5.9 0 0.0
2 28.6 1 11.1 3 18.8 2 28.6 1 11.1 3 18.8 2 28.6 1 11.1 3 18.8 2 28.6 0 0.0 2 12.5 2 28.6
0 0.0 0 0.0 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 12.5 1 5.6 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 50.0 1 16.7 3 30.0 2 50.0
2 8.7 1 5.9 3 7.5 2 8.7 1 5.9 3 7.5 2 8.7 1 5.9 3 7.5 1 4.3 0 0.0 1 2.5 1 4.3
0 0.0 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 10.0 1 12.5 2 11.1 1 10.0
1 7.1 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5 1 7.1 1 14.3 2 9.5 0 0.0 1 14.3 1 4.8 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
14 8.8 12 8.2 26 8.5 14 8.8 12 8.2 26 8.5 14 8.8 12 8.2 26 8.5 11 6.9 15 10.3 26 8.5 11 6.9
Palangga, ………………….2016
Koordinator Jurim Puskesmas ................. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari im
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
Iwan Setiawan. 5 Nama ayah :
Nip. 19730720 199502 1 001. 6 Nama ibu :
7 Alamat :
51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76
12 57.1 16 106.7 28 77.8 12 57.1 16 106.7 28 77.8 8 38.1 13 86.7 21 58.3 24 114.3 15 100.0 39 108.3 25 119.0
3 27.3 5 83.3 8 47.1 3 27.3 5 83.3 8 47.1 3 27.3 4 66.7 7 41.2 5 45.5 5 83.3 10 58.8 5 45.5
12 133.3 14 127.3 26 130.0 12 133.3 14 127.3 26 130.0 12 133.3 14 127.3 26 130.0 10 111.1 11 100.0 21 105.0 10 111.1
2 20.0 7 87.5 9 50.0 2 20.0 7 87.5 9 50.0 2 20.0 4 50.0 6 33.3 6 60.0 9 112.5 15 83.3 6 60.0
3 60.0 6 75.0 9 69.2 3 60.0 6 75.0 9 69.2 4 80.0 5 62.5 9 69.2 3 60.0 7 87.5 10 76.9 3 60.0
2 25.0 1 16.7 3 21.4 2 25.0 1 16.7 3 21.4 1 12.5 1 16.7 2 14.3 7 87.5 2 33.3 9 64.3 7 87.5
13 216.7 11 137.5 24 171.4 13 216.7 11 137.5 24 171.4 10 166.7 11 137.5 21 150.0 11 183.3 12 150.0 23 164.3 11 183.3
11 68.8 15 150.0 26 100.0 11 68.8 15 150.0 26 100.0 10 62.5 12 120.0 22 84.6 13 81.3 15 150.0 28 107.7 13 81.3
14 280.0 9 75.0 23 135.3 14 280.0 9 75.0 23 135.3 14 280.0 8 66.7 22 129.4 8 160.0 12 100.0 20 117.6 8 160.0
9 128.6 6 66.7 15 93.8 9 128.6 6 66.7 15 93.8 8 114.3 6 66.7 14 87.5 6 85.7 5 55.6 11 68.8 6 85.7
8 80.0 13 162.5 21 116.7 8 80.0 13 162.5 21 116.7 8 80.0 13 162.5 21 116.7 8 80.0 14 175.0 22 122.2 8 80.0
9 225.0 10 166.7 19 190.0 9 225.0 10 166.7 19 190.0 8 200.0 8 133.3 16 160.0 9 225.0 11 183.3 20 200.0 9 225.0
15 65.2 18 105.9 33 82.5 15 65.2 18 105.9 33 82.5 14 60.9 18 105.9 32 80.0 15 65.2 12 70.6 27 67.5 15 65.2
2 20.0 6 75.0 8 44.4 2 20.0 6 75.0 8 44.4 2 20.0 6 75.0 8 44.4 6 60.0 10 125.0 16 88.9 6 60.0
5 35.7 6 85.7 11 52.4 5 35.7 6 85.7 11 52.4 4 28.6 6 85.7 10 47.6 10 71.4 5 71.4 15 71.4 10 71.4
1 100.0 2 28.6 3 37.5 1 100.0 2 28.6 3 37.5 0 0.0 1 14.3 1 12.5 2 200.0 0 0.0 2 25.0 2 200.0
121 75.6 145 99.3 266 86.9 121 75.6 145 99.3 266 86.9 108 67.5 130 89.0 238 77.8 134 83.8 131 89.7 288 94.1 134 83.8
77,5
Iwan Setiawan,SKM
Nip. 19730720 199502 1 001
HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAM
SASARA
NISASI DASAR LENGKAP SASARAN BATITA DPT/HB/Hib CAMPAK TT1 TT2 TT3
N BUMIL
#P % # JML % #L L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
1 6.7 3 ###
8.3 37 56 93 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 40 0 0.0 0 0.0 0 0.0
0 0.0 2 11.8
### 23 27 50 0 0.0 1 3.7 1 2.0 0 0.0 0 0.0 0 0.0 20 1 5.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 31 38 69 0 0.0 2 5.3 2 2.9 1 3.2 0 0.0 1 1.4 30 0 0.0 1 3.3 0 0.0
0 0.0 3 16.7
### 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 1 5.3 1 2.4 20 0 0.0 1 5.1 0 0.0
0 0.0 1 ###
7.7 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 1 5.9 0 0.0
0 0.0 2 14.3
### 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0
2 25.0 2 14.3
### 33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0
1 10.0 4 15.4
### 38 36 74 0 0.0 1 2.8 1 1.4 2 5.3 0 0.0 2 2.7 41 0 0.0 0 0.0 1 2.4
0 0.0 2 11.8
### 32 27 59 0 0.0 1 3.7 1 1.7 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 3 16.0
1 11.1 1 ###
6.3 25 19 44 0 0.0 1 5.3 1 2.3 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0
1 12.5 2 11.1
### 35 38 73 3 8.6 1 2.6 4 5.5 0 0.0 1 2.6 1 1.4 29 1 3.4 1 3.4 0 0.0
1 16.7 1 10.0
### 31 18 49 1 3.2 0 0.0 1 2.0 1 3.2 1 5.6 2 4.1 11 1 9.1 0 0.0 1 9.1
0 0.0 2 ###
5.0 56 60 116 1 1.8 0 0.0 1 0.9 0 0.0 0 0.0 0 0.0 34 2 5.9 3 8.8 0 0.0
1 12.5 1 ###
5.6 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 2 10.1
0 0.0 2 ###
9.5 16 30 46 1 6.3 1 3.3 2 4.3 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 9 13 22 0 0.0 1 7.7 1 4.5 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 1 11.4
8 5.5 28 ###
9.2 452 466 918 6 1.3 9 1.9 15 1.6 4 0.9 3 0.6 7 0.8 380 5 1.3 7 1.8 8 2.1
IMUNISASI
imunisasi terakhir) Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir)
Kelamin : Cara Pemberian (Intra kutan, Su
No. Batch Tgl. Kadaluarsa VVM Imunisasi (Vaksin) Tgl Jam No. Batch Tgl. Kadaluarsa VVM
Tggl / Lahi : IM, tetes)
Umur :
Nama ayah :
Nama ibu :
Alamat :
.......... Jalan ………………………… Nomor …. RT/RW ………………. Reaksi timbul pada tgl ..........................................
............................................ Dusun/Kampung…………….. Desa/Kelurahan ………………… Gejala & Waktu timbulnya gejala .........................................................

SASARA
N BUMIL
SASARA
NISASI DASAR LENGKAP CAMPAK SASARAN BATITA DPT/HB/Hib CAMPAK TT1 TT2 TT3
N BUMIL
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
1 6.7 7 19.4
### 37 56 93 2 5.4 0 0.0 2 2.2 1 2.7 1 1.8 2 2.2 40 0 0.0 1 2.5 1 2.5
0 0.0 1 ###
5.9 23 27 50 1 4.3 2 7.4 3 6.0 0 0.0 0 0.0 0 0.0 20 5 25.0 0 0.0 1 5.0
0 0.0 0 ###
0.0 31 38 69 0 0.0 1 2.6 1 1.4 0 0.0 0 0.0 0 0.0 30 0 0.0 1 3.3 0 0.0
0 0.0 0 ###
0.0 23 19 42 0 0.0 2 10.5 2 4.8 0 0.0 0 0.0 0 0.0 20 2 10.1 0 0.0 0 0.0
0 0.0 1 ###
7.7 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0
1 16.7 3 21.4
### 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0
2 25.0 3 21.4
### 33 35 68 0 0.0 1 2.9 1 1.5 1 3.0 0 0.0 1 1.5 32 1 3.1 0 0.0 1 3.1
2 20.0 4 15.4
### 38 36 74 2 5.3 0 0.0 2 2.7 1 2.6 0 0.0 1 1.4 41 2 4.9 1 2.4 0 0.0
3 25.0 3 17.6
### 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 1 3.7 1 1.7 19 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 25 19 44 1 4.0 0 0.0 1 2.3 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0
1 12.5 2 11.1
### 35 38 73 0 0.0 1 2.6 1 1.4 0 0.0 2 5.3 2 2.7 29 1 3.4 1 3.4 1 3.4
0 0.0 2 20.0
### 31 18 49 1 3.2 1 5.6 2 4.1 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 1 9.1
0 0.0 4 10.0
### 56 60 116 0 0.0 2 3.3 2 1.7 2 3.6 1 1.7 3 2.6 34 4 11.8 0 0.0 0 0.0
2 25.0 2 11.1
### 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 2 10.1
1 14.3 4 19.0
### 16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 1 11.4
13 8.9 36 11.8
### 452 466 918 7 1.5 10 2.1 17 1.9 5 1.1 5 1.1 10 1.1 380 15 3.9 4 1.1 8 2.1
IMUNISASI
Umur :
Nama ayah :
Nama ibu :
Alamat :
SASARA
IDL CAMPAK SASARAN BATITA DPT/HB/Hib CAMPAK TT1 TT2 TT3
N BUMIL
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
0 0.0 3 ###
8.3 37 56 93 4 10.8 0 0.0 4 4.3 1 2.7 0 0.0 1 1.1 40 0 0.0 5 12.6 0 0.0
1 16.7 2 11.8
### 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.0 1 5.0
0 0.0 0 ###
0.0 31 38 69 1 3.2 1 2.6 2 2.9 0 0.0 1 2.6 1 1.4 30 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
1 12.5 1 ###
7.7 22 13 35 1 4.5 0 0.0 1 2.9 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0
0 0.0 1 ###
7.1 33 35 68 0 0.0 1 2.9 1 1.5 2 6.1 1 2.9 3 4.4 32 0 0.0 0 0.0 0 0.0
2 20.0 2 ###
7.7 38 36 74 0 0.0 1 2.8 1 1.4 0 0.0 0 0.0 0 0.0 41 0 0.0 1 2.4 1 2.4
1 8.3 2 11.8
### 32 27 59 3 9.4 1 3.7 4 6.8 1 3.1 0 0.0 1 1.7 19 1 5.3 1 5.3 0 0.0
0 0.0 0 ###
0.0 25 19 44 1 4.0 0 0.0 1 2.3 0 0.0 0 0.0 0 0.0 18 0 0.0 1 5.7 0 0.0
0 0.0 1 ###
5.6 35 38 73 0 0.0 0 0.0 0 0.0 1 2.9 0 0.0 1 1.4 29 1 3.4 1 3.4 0 0.0
0 0.0 1 10.0
### 31 18 49 1 3.2 1 5.6 2 4.1 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0
1 5.9 2 ###
5.0 56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 0 0.0 1 2.9 0 0.0
0 0.0 1 ###
5.6 22 21 43 0 0.0 0 0.0 0 0.0 1 4.5 0 0.0 1 2.3 20 0 0.0 0 0.0 2 10.1
1 14.3 1 ###
4.8 16 30 46 2 12.5 2 6.7 4 8.7 0 0.0 1 3.3 1 2.2 23 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 1 11.4
7 4.8 17 ###
5.6 452 466 918 0 0.0 7 1.5 7 0.8 6 1.3 3 0.6 9 1.0 380 2 0.5 11 2.9 5 1.3
IMUNISASI
Umur :
Nama ayah :
Nama ibu :
Alamat :
SASARA
N BUMIL
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
0 0.0 0 ###
0.0 37 56 93 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 40 0 0.0 0 0.0 0 0.0
1 16.7 2 11.8
### 23 27 50 0 0.0 0 0.0 0 0.0 1 4.3 0 0.0 1 2.0 20 0 0.0 0 0.0 0 0.0
1 9.1 2 10.0
### 31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 22 13 35 0 0.0 2 15.4 2 5.7 0 0.0 0 0.0 0 0.0 17 1 5.9 1 5.9 0 0.0
1 16.7 1 ###
7.1 19 16 35 0 0.0 0 0.0 0 0.0 2 10.5 1 6.3 3 8.6 19 0 0.0 0 0.0 0 0.0
2 25.0 4 28.6
### 33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0
0 0.0 2 ###
7.7 38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 1 3.7 1 1.7 19 1 5.3 1 5.3 0 0.0
0 0.0 0 ###
0.0 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 1 5.7
3 37.5 4 22.2
### 35 38 73 0 0.0 0 0.0 0 0.0 1 2.9 0 0.0 1 1.4 29 0 0.0 2 6.9 0 0.0
0 0.0 1 10.0
### 31 18 49 0 0.0 2 11.1 2 4.1 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0
2 11.8 2 ###
5.0 56 60 116 1 1.8 1 1.7 2 1.7 1 1.8 3 5.0 4 3.4 34 2 5.9 0 0.0 0 0.0
0 0.0 1 ###
5.6 22 21 43 1 4.5 0 0.0 1 2.3 0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.1 2 10.1
0 0.0 0 ###
0.0 16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 0 0.0 1 4.3 0 0.0
0 0.0 0 ###
0.0 9 13 22 2 22.2 1 7.7 3 13.6 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0
10 6.8 19 ###
6.2 452 466 918 4 0.9 6 1.3 10 1.1 5 1.1 5 1.1 10 1.1 380 4 1.1 6 1.6 3 0.8
IMUNISASI
Umur :
Nama ayah :
Nama ibu :
Alamat :
SASARA
N BUMIL
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
3 20.0 5 13.9
### 37 56 93 2 5.4 1 1.8 3 3.2 0 0.0 3 5.4 3 3.2 40 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
1 12.5 1 ###
7.7 22 13 35 1 4.5 1 7.7 2 5.7 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0
0 0.0 1 ###
7.1 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 1 6.3 1 2.9 19 0 0.0 0 0.0 2 10.5
2 25.0 2 14.3
### 33 35 68 0 0.0 1 2.9 1 1.5 2 6.1 0 0.0 2 2.9 32 1 3.1 1 3.1 0 0.0
1 10.0 1 ###
3.8 38 36 74 4 10.5 1 2.8 5 6.8 0 0.0 0 0.0 0 0.0 41 1 2.4 0 0.0 2 4.9
0 0.0 2 11.8
### 32 27 59 0 0.0 0 0.0 0 0.0 1 3.1 0 0.0 1 1.7 19 0 0.0 1 5.3 0 0.0
1 11.1 1 ###
6.3 25 19 44 0 0.0 1 5.3 1 2.3 0 0.0 1 5.3 1 2.3 18 1 5.7 0 0.0 0 0.0
0 0.0 0 ###
0.0 35 38 73 0 0.0 1 2.6 1 1.4 0 0.0 0 0.0 0 0.0 29 1 3.4 0 0.0 0 0.0
1 16.7 3 30.0
### 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 2 18.2 2 18.2 0 0.0
1 5.9 2 ###
5.0 56 60 116 0 0.0 2 3.3 2 1.7 1 1.8 1 1.7 2 1.7 34 0 0.0 3 8.8 2 5.9
1 12.5 1 ###
5.6 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
2 28.6 5 23.8
### 16 30 46 0 0.0 0 0.0 0 0.0 1 6.3 1 3.3 2 4.3 23 0 0.0 1 4.3 0 0.0
0 0.0 0 ###
0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0
13 8.9 24 ###
7.8 452 466 918 7 1.5 8 1.7 15 1.6 5 1.1 7 1.5 12 1.3 380 6 1.6 8 2.1 6 1.6
IMUNISASI
Umur :
Nama ayah :
Nama ibu :
Alamat :
SASARA
N BUMIL
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
2 13.3 2 ###
5.6 37 56 93 0 0.0 0 0.0 0 0.0 2 5.4 1 1.8 3 3.2 40 1 2.5 0 0.0 0 0.0
0 0.0 0 ###
0.0 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 1 5.0 2 10.0 1 5.0
1 9.1 1 ###
5.0 31 38 69 1 3.2 0 0.0 1 1.4 1 3.2 0 0.0 1 1.4 30 0 0.0 0 0.0 0 0.0
2 25.0 4 22.2
### 23 19 42 1 4.3 1 5.3 2 4.8 1 4.3 1 5.3 2 4.8 20 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 22 13 35 0 0.0 2 15.4 2 5.7 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 19 16 35 1 5.3 1 6.3 2 5.7 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 1 5.3
1 12.5 2 14.3
### 33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 1 3.1
3 30.0 3 11.5
### 38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 1 2.4 2 4.9 0 0.0
0 0.0 0 ###
0.0 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 1 5.3
0 0.0 0 ###
0.0 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 22 21 43 1 4.5 0 0.0 1 2.3 0 0.0 0 0.0 0 0.0 20 1 5.1 0 0.0 0 0.0
0 0.0 0 ###
0.0 16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0
9 6.2 12 ###
3.9 452 466 918 4 0.9 4 0.9 8 0.9 4 0.9 2 0.4 6 0.7 380 4 1.1 4 1.1 4 1.1
IMUNISASI
Umur :
Nama ayah :
Nama ibu :
Alamat :
SASARA
N BUMIL
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
0 0.0 0 ###
0.0 37 56 93 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 40 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 31 38 69 0 0.0 1 2.6 1 1.4 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 1 2.4 0 0.0 0 0.0
0 0.0 0 ###
0.0 32 27 59 1 3.1 0 0.0 1 1.7 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 25 19 44 0 0.0 1 5.3 1 2.3 0 0.0 0 0.0 0 0.0 18 0 0.0 1 5.7 1 5.7
0 0.0 0 ###
0.0 35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 1 3.4 1 3.4 0 0.0
0 0.0 0 ###
0.0 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 0 0.0 2 18.2 5 45.5
0 0.0 0 ###
0.0 56 60 116 1 1.8 0 0.0 1 0.9 0 0.0 0 0.0 0 0.0 34 0 0.0 1 2.9 2 5.9
0 0.0 0 ###
0.0 22 21 43 1 4.5 2 9.5 3 7.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 16 30 46 3 18.8 1 3.3 4 8.7 0 0.0 0 0.0 0 0.0 23 0 0.0 1 4.3 1 4.3
0 0.0 0 ###
0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 452 466 918 6 1.3 5 1.1 11 1.2 0 0.0 0 0.0 0 0.0 380 2 0.5 6 1.6 9 2.4
IMUNISASI
Umur :
Nama ayah :
Nama ibu :
Alamat :
SASARA
N BUMIL
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
1 6.7 3 ###
8.3 37 56 93 1 2.7 1 1.8 2 2.2 0 0.0 0 0.0 0 0.0 40 2 5.1 2 5.1 0 0.0
1 16.7 1 ###
5.9 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 2 10.0 1 5.0 0 0.0
0 0.0 3 15.0
### 31 38 69 0 0.0 1 2.6 1 1.4 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0
1 12.5 2 11.1
### 23 19 42 2 8.7 1 5.3 3 7.1 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
1 12.5 2 15.4
### 22 13 35 0 0.0 1 7.7 1 2.9 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0
1 12.5 4 28.6
### 33 35 68 0 0.0 2 5.7 2 2.9 0 0.0 0 0.0 0 0.0 32 1 3.1 2 6.3 0 0.0
1 10.0 2 ###
7.7 38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 1 2.4 1 2.4 1 2.4
2 16.7 4 23.5
### 32 27 59 0 0.0 3 11.1 3 5.1 0 0.0 0 0.0 0 0.0 19 1 5.3 0 0.0 0 0.0
1 11.1 2 12.5
### 25 19 44 1 4.0 2 10.5 3 6.8 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0
2 25.0 2 11.1
### 35 38 73 1 2.9 0 0.0 1 1.4 0 0.0 0 0.0 0 0.0 29 1 3.4 1 3.4 0 0.0
2 33.3 2 20.0
### 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0
2 11.8 3 ###
7.5 56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0
1 12.5 2 11.1
### 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.1 0 0.0
0 0.0 0 ###
0.0 16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0
16 11.0 32 10.5
### 452 466 918 5 1.1 11 2.4 16 1.7 0 0.0 0 0.0 0 0.0 380 8 2.1 8 2.1 1 0.3
IMUNISASI
Umur :
Nama ayah :
Nama ibu :
Alamat :
SASARA
N BUMIL
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
2 13.3 6 16.7
### 37 56 93 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 40 1 2.5 0 0.0 0 0.0
0 0.0 0 ###
0.0 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 2 10.0 1 5.0
3 27.3 3 15.0
### 31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 1 3.3 0 0.0 3 10.0
1 12.5 1 ###
5.6 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 1 5.1 0 0.0 0 0.0
0 0.0 0 ###
0.0 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 1 5.9
0 0.0 1 ###
7.1 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0
1 12.5 2 14.3
### 33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 1 3.1 1 3.1 0 0.0
1 10.0 2 ###
7.7 38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0
1 8.3 1 ###
5.9 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 1 5.3 1 5.3 0 0.0
1 11.1 1 ###
6.3 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 2 11.4
2 25.0 4 22.2
### 35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 1 3.4 0 0.0 1 3.4
2 33.3 2 20.0
### 31 18 49 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 1 9.1 2 18.2 0 0.0
5 29.4 10 25.0
### 56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 4 11.8 0 0.0 0 0.0
2 25.0 3 16.7
### 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
1 14.3 3 14.3
### 16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0
0 0.0 1 12.5
### 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 1 11.4 1 11.4 0 0.0
22 15.1 40 13.1
### 452 466 918 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 380 12 3.2 7 1.8 8 2.1
IMUNISASI
Umur :
Nama ayah :
Nama ibu :
Alamat :
SASARA
N BUMIL
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
5 33.3 8 22.2
### 37 56 93 0 0.0 0 0.0 0 0.0 3 8.1 1 1.8 4 4.3 40 0 0.0 0 0.0 0 0.0
2 33.3 2 11.8
### 23 27 50 0 0.0 0 0.0 0 0.0 2 8.7 3 11.1 5 10.0 20 0 0.0 0 0.0 0 0.0
3 27.3 7 35.0
### 31 38 69 0 0.0 0 0.0 0 0.0 1 3.2 3 7.9 4 5.8 30 1 3.3 0 0.0 0 0.0
1 12.5 1 ###
5.6 23 19 42 0 0.0 0 0.0 0 0.0 3 13.0 0 0.0 3 7.1 20 0 0.0 1 5.1 0 0.0
0 0.0 0 ###
0.0 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 3 23.1 3 8.6 17 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 1 5.3 1 5.3
0 0.0 0 ###
0.0 33 35 68 0 0.0 1 2.9 1 1.5 0 0.0 2 5.7 2 2.9 32 1 3.1 2 6.3 2 6.3
0 0.0 2 ###
7.7 38 36 74 0 0.0 1 2.8 1 1.4 2 5.3 3 8.3 5 6.8 41 0 0.0 1 2.4 0 0.0
3 25.0 3 17.6
### 32 27 59 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 1 5.3 1 5.3
0 0.0 0 ###
0.0 25 19 44 0 0.0 0 0.0 0 0.0 1 4.0 2 10.5 3 6.8 18 0 0.0 0 0.0 0 0.0
2 25.0 4 22.2
### 35 38 73 0 0.0 0 0.0 0 0.0 1 2.9 2 5.3 3 4.1 29 0 0.0 0 0.0 0 0.0
2 33.3 2 20.0
### 31 18 49 0 0.0 0 0.0 0 0.0 1 3.2 2 11.1 3 6.1 11 0 0.0 0 0.0 0 0.0
0 0.0 1 ###
2.5 56 60 116 0 0.0 0 0.0 0 0.0 2 3.6 5 8.3 7 6.0 34 0 0.0 2 5.9 1 2.9
1 12.5 2 11.1
### 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 16 30 46 0 0.0 0 0.0 0 0.0 2 12.5 0 0.0 2 4.3 23 0 0.0 2 8.7 0 0.0
0 0.0 1 12.5
### 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0
19 13.0 33 10.8
### 452 466 918 0 0.0 2 0.4 2 0.2 18 4.0 26 5.6 44 4.8 380 2 0.5 10 2.6 5 1.3
IMUNISASI
Umur :
Nama ayah :
Nama ibu :
Alamat :
SASARA
N BUMIL
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
0 0.0 1 ###
2.8 37 56 93 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 40 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 23 27 50 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
0 0.0 2 10.0
### 31 38 69 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 30 0 0.0 1 3.3 1 3.3
2 25.0 2 11.1
### 23 19 42 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
1 12.5 1 ###
7.7 22 13 35 0 0.0 1 7.7 1 2.9 0 0.0 0 0.0 0 0.0 17 0 0.0 1 5.9 0 0.0
0 0.0 0 ###
0.0 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 1 5.3 0 0.0 1 5.3
0 0.0 2 14.3
### 33 35 68 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 1 3.1 2 6.3 1 3.1
2 20.0 2 ###
7.7 38 36 74 1 2.6 0 0.0 1 1.4 0 0.0 0 0.0 0 0.0 41 1 2.4 2 4.9 1 2.4
1 8.3 2 11.8
### 32 27 59 0 0.0 2 7.4 2 3.4 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0
1 11.1 2 12.5
### 25 19 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0
2 25.0 2 11.1
### 35 38 73 1 2.9 0 0.0 1 1.4 0 0.0 0 0.0 0 0.0 29 1 3.4 0 0.0 0 0.0
2 33.3 3 30.0
### 31 18 49 0 0.0 1 5.6 1 2.0 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 3 27.3
1 5.9 1 ###
2.5 56 60 116 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 34 1 2.9 0 0.0 0 0.0
1 12.5 1 ###
5.6 22 21 43 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 1 11.4 0 0.0
13 8.9 21 ###
6.9 452 466 918 2 0.4 4 0.9 6 0.7 0 0.0 0 0.0 0 0.0 380 5 1.3 7 1.8 7 1.8
IMUNISASI
Umur :
Nama ayah :
Nama ibu :
Alamat :
SASARA
N BUMIL
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
0 0.0 2 ###
5.6 37 56 93 1 2.7 2 3.6 3 3.2 0 0.0 0 0.0 0 0.0 40 2 5.1 0 0.0 0 0.0
0 0.0 0 ###
0.0 23 27 50 1 4.3 1 3.7 2 4.0 0 0.0 0 0.0 0 0.0 20 0 0.0 3 15.0 3 15.0
2 18.2 2 10.0
### 31 38 69 1 3.2 1 2.6 2 2.9 0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0
2 25.0 2 11.1
### 23 19 42 1 4.3 1 5.3 2 4.8 0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 1 5.1
3 37.5 3 23.1
### 22 13 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 17 1 5.9 0 0.0 1 5.9
0 0.0 1 ###
7.1 19 16 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 0 0.0 1 5.3 0 0.0
1 12.5 1 ###
7.1 33 35 68 2 6.1 1 2.9 0 0.0 0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0
2 20.0 4 15.4
### 38 36 74 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0
1 8.3 1 ###
5.9 32 27 59 0 0.0 1 3.7 1 1.7 0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0
0 0.0 2 12.5
### 25 19 44 1 4.0 1 5.3 2 4.5 0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0
1 12.5 1 ###
5.6 35 38 73 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 29 0 0.0 1 3.4 0 0.0
1 16.7 3 30.0
### 31 18 49 2 6.5 1 5.6 3 6.1 0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 1 9.1
0 0.0 0 ###
0.0 56 60 116 2 3.6 2 3.3 4 3.4 0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0
1 12.5 2 11.1
### 22 21 43 1 4.5 0 0.0 1 2.3 0 0.0 0 0.0 0 0.0 20 1 5.1 0 0.0 0 0.0
1 14.3 1 ###
4.8 16 30 46 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 0 0.0 0 0.0 0 0.0
0 0.0 0 ###
0.0 9 13 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0 0.0 0 0.0 0 0.0
15 10.3 26 ###
8.5 452 466 918 12 2.7 11 2.4 23 2.5 0 0.0 0 0.0 0 0.0 380 4 1.1 5 1.3 6 1.6
IMUNISASI
Umur :
Nama ayah :
Nama ibu :
Alamat :
SASARA
N BUMIL
77 78 79 80 ### 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114
15 100.0 39 108.3
### 37 56 93 10 27.0 4 7.1 14 15.1 7 18.9 6 10.7 13 14.0 40 6 15.2 8 20.2 1 18,3
5 83.3 10 58.8
### 23 27 50 2 8.7 4 14.8 6 12.0 3 13.0 3 11.1 6 12.0 20 9 45.0 9 45.0 7 35.0
11 100.0 21 105.0
### 31 38 69 3 9.7 7 18.4 10 14.5 3 9.7 4 10.5 7 10.1 30 2 6.7 3 10.0 4 13.3
9 112.5 15 83.3
### 23 19 42 4 17.4 5 26.3 9 21.4 4 17.4 2 10.5 6 14.3 20 3 15.2 2 10.1 1 5.1
7 87.5 10 76.9
### 22 13 35 2 9.1 7 53.8 9 25.7 0 0.0 3 23.1 3 8.6 17 2 11.8 3 17.6 2 11.8
2 33.3 9 64.3
### 19 16 35 1 5.3 1 6.3 2 5.7 2 10.5 2 12.5 4 11.4 19 1 5.3 2 10.5 5 26.3
12 150.0 23 164.3
### 33 35 68 2 6.1 7 20.0 9 13.2 5 15.2 3 8.6 8 11.8 32 6 18.8 8 25.0 5 15.6
15 150.0 28 107.7
### 38 36 74 7 18.4 4 11.1 11 14.9 5 13.2 3 8.3 8 10.8 41 7 17.1 8 19.5 6 14.6
12 100.0 20 117.6
### 32 27 59 4 12.5 8 29.6 12 20.3 2 6.3 2 7.4 4 6.8 19 4 21.4 5 26.7 5 26.7
5 55.6 11 68.8
### 25 19 44 4 16.0 6 31.6 10 22.7 1 4.0 3 15.8 4 9.1 18 1 5.7 2 11.4 4 22.7
14 175.0 22 122.2
### 35 38 73 5 14.3 3 7.9 8 11.0 3 8.6 5 13.2 8 11.0 29 8 27.6 8 27.6 2 6.9
11 183.3 20 200.0
### 31 18 49 5 16.1 6 33.3 11 22.4 2 6.5 3 16.7 5 10.2 11 4 36.4 6 54.5 11 100.0
12 70.6 27 67.5
### 56 60 116 5 8.9 7 11.7 12 10.3 6 10.7 10 16.7 16 13.8 34 13 38.2 10 29.4 5 14.7
10 125.0 16 88.9
### 22 21 43 4 18.2 2 9.5 6 14.0 1 4.5 0 0.0 1 2.3 20 2 10.1 2 10.1 8 40.4
5 71.4 15 71.4
### 16 30 46 6 37.5 4 13.3 10 21.7 3 18.8 2 6.7 5 10.9 23 0 0.0 5 21.6 1 4.3
0 0.0 2 16.6
### 9 13 22 2 22.2 2 15.4 4 18.2 0 0.0 0 0.0 0 0.0 9 1 11.4 2 22.7 3 34.1
131 89.7 288 94.1
### 452 466 918 66 14.6 77 16.5 143 15.6 47 10.4 51 10.9 98 10.7 380 69 18.1 83 21.8 70 18.4
90 90
46,25
PERSEN
MIL DIIMUNISASI TASE JUMLAH DAN PERSENTASE WUS TIDAK HAMIL DIIMUNISASI JUMLAH TOTAL DAN PERSENTASE WUS (HAMIL+TIDAK HAMIL) DIIMUNISASI TT TT2+ BU
WUS
TT4 TT5 TT1 TT2 TT3 TT4 TT5 TT1 TT2 TT3 TT4 TT5 TT2+
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
115 116 117 118 DIIMUNI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 128 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.7 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 235 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 1 2.4 299 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.3 0 0.0 1 0.3 2
1 5.3 1 5.3 178 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 3 1.5 1 0.5 1 0.5 5
0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 1 0.6 0 0.0 0 0.0 1
0 0.0 1 2.9 251 0.0 0.0 0.0 0.0 0.0 2 0.7 3 1.1 0 0.0 0 0.0 1 0.4 4
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 1.1 0 0.0 0 0.0 2
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 1.0 0 0.0 0 0.0 1
1 0.3 3 0.8 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 0.1 7 0.2 8 0.2 1 0.0 3 0.1 19
ub-kutan, Jumlah dosis

Lokasi penyuntikan
vaksin (ml / tetes)
PERSEN
WUS
WUS
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
115 116 117 118 DIIMUNI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.2 1 0.2 0 0.0 0 0.0 2
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 5 3.0 0 0.0 1 0.6 0 0.0 0 0.0 1
0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 2 1.2 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 235 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 1 0.4 0 0.0 0 0.0 1
0 0.0 0 0.0 299 0 0.0 0.0 0.0 0.0 0.0 2 0.6 1 0.3 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 1 0.4 0 0.0 0 0.0 2
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1
1 2.9 4 0.0 251 0.0 0.0 0.0 0.0 0.0 4 1.4 0 0.0 0 0.0 1 0.4 4 1.4 5
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 1.1 0 0.0 0 0.0 2
0 0.0 0 0.0 146 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 1.0 0 0.0 0 0.0 1
1 0.3 4 1.1 #REF! 0 #REF! 0 #REF! 0 #REF! 0 #REF! 0 #REF! 15 #REF! 4 #REF! 8 #REF! 1 #REF! 4 #REF! 17

Lokasi penyuntikan
vaksin (ml / tetes)
PERSEN
WUS
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
115 116 117 118 DIIMUNI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 0.0 0.0 0.0 0.0 0.0 0 0.0 5 1.2 0 0.0 0 0.0 0 0.0 5
0 0.0 1 5.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 1 0.6 0 0.0 1 0.6 3
0 0.0 1 3.3 223 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 1
0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 128 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 235 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 299 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.3 1 0.3 0 0.0 0 0.0 2
0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 251 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 1.1 0 0.0 0 0.0 2
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 1.0 0 0.0 0 0.0 1
0 0.0 2 0.5 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 0.1 11 0.3 5 0.1 0 0.0 2 0.1 18

Lokasi penyuntikan
vaksin (ml / tetes)
PERSEN
WUS
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
115 116 117 118 DIIMUNI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 223 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 147 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 128 0 0.0 0.0 0.0 0.0 0.0 1 0.7 1 0.7 0 0.0 0 0.0 0 0.0 1
0 0.0 1 5.3 136 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 1
0 0.0 1 3.1 235 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 1
0 0.0 0 0.0 299 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 178 0 0.0 0.0 0.0 0.0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 139 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1
0 0.0 0 0.0 210 0 0.0 0.0 0.0 0.0 0.0 0 0.0 2 0.8 0 0.0 0 0.0 0 0.0 2
0 0.0 0 0.0 162 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 1 2.9 251 0 0.0 0.0 0.0 0.0 0.0 2 0.7 0 0.0 0 0.0 0 0.0 1 0.4 1
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 2 1.1 0 0.0 0 0.0 3
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 3 0.8 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 0.1 6 0.2 3 0.1 0 0.0 3 0.1 12

Lokasi penyuntikan
vaksin (ml / tetes)
PERSEN
WUS
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
DIIMUNI
115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 1.3 0 0.0 0 0.0 2
0 0.0 0 0.0 235 0 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 299 0 0.0 0.0 0.0 0.0 0.0 1 0.3 0 0.0 2 0.6 0 0.0 0 0.0 2
0 0.0 1 5.3 178 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 1 0.5 2
0 0.0 0 0.0 139 0 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 1 3.4 210 0 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1 0.4 1
0 0.0 2 18.2 162 0 0.0 0.0 0.0 0.0 0.0 2 1.2 2 1.2 0 0.0 0 0.0 2 1.2 4
0 0.0 1 2.9 251 0.0 0.0 0.0 0.0 0.0 0 0.0 3 1.1 2 0.7 0 0.0 1 0.4 6
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 5 1.3 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 0.2 8 0.2 6 0.2 0 0.0 5 0.1 19

Lokasi penyuntikan
vaksin (ml / tetes)
PERSEN
WUS
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
115 116 117 118 DIIMUNI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 0.0 0.0 0.0 0.0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 1 0.6 2 1.2 1 0.6 0 0.0 0 0.0 3
0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1
0 0.0 1 3.1 235 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.4 0 0.0 1 0.4 2
0 0.0 0 0.0 299 0 0.0 0.0 0.0 0.0 0.0 1 0.3 2 0.6 0 0.0 0 0.0 0 0.0 2
0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 1
0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 251 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 95 0.0 0.0 0.0 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 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 0.1 4 0.1 4 0.1 0 0.0 1 0.0 9

Lokasi penyuntikan
vaksin (ml / tetes)
PERSEN
WUS
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
115 116 117 118 DIIMUNI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 1 5.9 128 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.7 1
0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 235 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 1 2.4 299 0.0 0.0 0.0 0.0 0.0 1 0.3 0 0.0 0 0.0 0 0.0 1 0.3 1
0 0.0 0 0.0 178 0.0 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 5.7 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 1 0.6 1 0.6 0 0.0 3
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.2 5 2.9 0 0.0 0 0.0 7
0 0.0 2 5.9 251 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 2 0.7 0 0.0 2 0.7 5
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 2
0 0.0 0 0.0 95 0.0 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 4 1.1 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 0.1 6 0.2 9 0.3 1 0.0 4 0.1 20
Lokasi penyuntikan
vaksin (ml / tetes)
PERSEN
WUS
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
115 116 117 118 DIIMUNI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 1 0.3 0.0 0.0 0.0 0.0 3 0.7 2 0.5 0 0.0 0 0.0 0 0.0 2
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 2 1.2 1 0.6 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 235 0.0 0.0 0.0 0.0 0.0 1 0.4 2 0.7 0 0.0 0 0.0 0 0.0 2
0 0.0 0 0.0 299 0 0.0 0.0 0.0 0.0 0.0 1 0.3 1 0.3 1 0.3 0 0.0 0 0.0 2
0 0.0 1 5.3 178 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 0.5 1
0 0.0 0 0.0 139 0.0 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 3.4 1 3.4 210 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 1 0.4 1 0.4 3
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 251 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 95 0.0 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 2 0.5 3050 1 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0.3 8 0.2 1 0.0 1 0.0 2 0.1 12

Lokasi penyuntikan
vaksin (ml / tetes)
PERSEN
WUS
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
115 116 117 118 DIIMUNI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 0.0 0.0 0.0 0.0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.2 1 0.6 0 0.0 0 0.0 3
0 0.0 1 3.3 223 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 3 1.2 0 0.0 1 0.4 4
0 0.0 2 10.1 147 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 2 1.2 2
0 0.0 1 5.9 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.7 0 0.0 1 0.7 2
0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 235 0 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 299 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 1.3 0 0.0 0 0.0 2
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 1 0.4 0 0.0 0 0.0 1
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 1 0.6 2 1.2 0 0.0 0 0.0 0 0.0 2
0 0.0 0 0.0 251 0 0.0 0.0 0.0 0.0 0.0 4 1.4 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 1 1.0 1 1.0 0 0.0 0 0.0 0 0.0 1
0 0.0 4 1.1 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 12 0.3 7 0.2 8 0.2 0 0.0 4 0.1 19

Lokasi penyuntikan
vaksin (ml / tetes)
PERSEN
WUS
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
115 116 117 118 DIIMUNI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
2 10.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 2 1.2 0 0.0 2
0 0.0 0 0.0 223 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 147 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 136 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 2
0 0.0 1 3.1 235 0 0.0 0.0 0.0 0.0 0.0 1 0.4 2 0.7 2 0.7 0 0.0 1 0.4 5
0 0.0 0 0.0 299 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.3 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 2
0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 1 2.9 251 0.0 0.0 0.0 0.0 0.0 0 0.0 2 0.7 1 0.4 0 0.0 1 0.4 4
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.2 0 0.0 0 0.0 0 0.0 2
0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
2 0.5 2 0.5 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 0.1 10 0.3 5 0.1 2 0.1 2 0.1 19

Lokasi penyuntikan
vaksin (ml / tetes)
PERSEN
WUS
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
115 116 117 118 DIIMUNI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 1 3.3 223 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 1 0.4 0 0.0 1 0.4 3
0 0.0 0 0.0 147 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.7 0 0.0 0 0.0 0 0.0 1
0 0.0 1 5.3 136 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 1 0.6 0 0.0 1 0.6 2
0 0.0 0 0.0 235 0 0.0 0.0 0.0 0.0 0.0 1 0.4 2 0.7 1 0.4 0 0.0 0 0.0 3
3 7.3 0 0.0 299 0.0 0.0 0.0 0.0 0.0 1 0.3 2 0.6 1 0.3 3 0.9 0 0.0 6
0 0.0 0 0.0 178 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 3 1.7 0 0.0 0 0.0 3
0 0.0 0 0.0 251 0 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 162 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 1 1.0 0 0.0 0 0.0 0 0.0 1
3 0.8 2 0.5 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 0.1 7 0.2 7 0.2 3 0.1 2 0.1 19

Lokasi penyuntikan
vaksin (ml / tetes)
PERSEN
WUS
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
115 116 117 118 DIIMUNI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 0 0.0 0.0 0.0 0.0 0.0 2 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 3 1.8 3 1.8 0 0.0 0 0.0 6
0 0.0 0 0.0 223 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 147 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1
0 0.0 0 0.0 128 0.0 0.0 0.0 0.0 0.0 1 0.7 0 0.0 1 0.7 0 0.0 0 0.0 1
1 5.3 1 5.3 136 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 1 0.6 1 0.6 3
0 0.0 0 0.0 235 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 299 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 1 5.3 178 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 1
0 0.0 1 5.7 139 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 1
0 0.0 0 0.0 210 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1
1 2.9 2 5.9 251 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 2 0.7 3
0 0.0 0 0.0 162 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0 0.0 0 0.0 95 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
2 0.5 5 1.3 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 0.1 5 0.1 6 0.2 2 0.1 5 0.1 18

Lokasi penyuntikan
vaksin (ml / tetes)
PERSEN
WUS
TDK
# % # % HAMIL # % # % # % # % # % # % # % # % # % # % #
115 116 117 118 DIIMUNI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
0 0.0 0 0.0 393 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 1.4 8 1.8 1 0.2 0 0.0 0 0.0 9
2 10.0 1 5.0 146 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 5.4 9 5.4 7 4.2 2 1.2 1 0.6 19
0 0.0 3 10.0 223 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 0.8 3 1.2 4 1.6 0 0.0 3 1.2 10
0 0.0 2 10.1 147 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 1.8 2 1.2 1 0.6 0 0.0 2 1.2 5
0 0.0 2 11.8 128 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 1.4 3 2.1 2 1.4 0 0.0 2 1.4 7
1 5.3 3 15.8 136 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 2 1.3 5 3.2 1 0.6 3 1.9 11
0 0.0 3 9.4 235 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 2.2 8 3.0 5 1.9 0 0.0 3 1.1 16
3 7.3 2 4.9 299 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 2.1 8 2.4 6 1.8 3 0.9 2 0.6 19
1 5.3 4 21.4 178 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 2.0 5 2.5 5 2.5 1 0.5 4 2.0 15
1 5.7 1 5.7 139 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 2 1.3 4 2.5 1 0.6 1 0.6 8
1 3.4 2 6.9 210 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 3.3 8 3.3 2 0.8 1 0.4 2 0.8 13
0 0.0 2 18.2 162 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 2.3 6 3.5 11 6.3 0 0.0 2 1.2 19
2 5.9 12 35.3 251 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 13 4.6 10 3.5 5 1.8 2 0.7 12 4.2 29
0 0.0 0 0.0 162 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 1.1 2 1.1 8 4.4 0 0.0 0 0.0 10
0 0.0 0 0.0 146 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 3.0 1 0.6 0 0.0 0 0.0 6
0 0.0 0 0.0 95 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 1.0 2 1.9 3 2.9 0 0.0 0 0.0 5
11 2.9 37 9.7 3050 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 69 2.0 83 2.4 70 2.0 11 0.3 37 1.1 201
BUMIL
T2+
%
141
0.0
0.0
3.3
5.1
5.9
0.0
0.0
4.9
26.7
0.0
3.4
9.1
11.8
10.1
0.0
11.4
5.0
BUMIL
T2+
%
141
5.1
5.0
3.3
0.0
0.0
0.0
3.1
2.4
0.0
0.0
6.9
9.1
14.7
10.1
0.0
11.4
4.5
BUMIL
T2+
%
141
12.6
15.0
3.3
0.0
0.0
0.0
0.0
4.9
5.3
5.7
3.4
0.0
2.9
10.1
0.0
11.4
4.7
BUMIL
T2+
%
141
0.0
0.0
0.0
0.0
5.9
5.3
3.1
0.0
5.3
5.7
6.9
0.0
2.9
15.2
4.3
0.0
3.2
BUMIL
T2+
%
141
0.0
0.0
0.0
0.0
0.0
10.5
3.1
4.9
10.7
0.0
3.4
36.4
17.6
0.0
4.3
0.0
5.0
BUMIL
T2+
%
141
0.0
15.0
0.0
0.0
0.0
5.3
6.3
4.9
5.3
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.4
BUMIL
T2+
%
141
0.0
0.0
0.0
0.0
5.9
0.0
0.0
2.4
0.0
17.0
3.4
63.6
14.7
0.0
8.7
0.0
5.3
BUMIL
T2+
%
141
5.1
5.0
0.0
0.0
0.0
0.0
6.3
4.9
5.3
0.0
10.3
0.0
0.0
5.1
0.0
0.0
3.2
BUMIL
T2+
%
141
0.0
15.0
13.3
10.1
11.8
0.0
3.1
0.0
5.3
11.4
3.4
18.2
0.0
0.0
0.0
11.4
5.0
BUMIL
T2+
%
141
0.0
10.0
0.0
5.1
0.0
10.5
15.6
2.4
10.7
0.0
0.0
0.0
11.8
0.0
8.7
0.0
5.0
BUMIL
T2+
%
141
0.0
0.0
10.0
0.0
5.9
10.5
9.4
14.6
0.0
0.0
0.0
27.3
0.0
0.0
0.0
11.4
5.0
BUMIL
T2+
%
141
0.0
30.0
0.0
5.1
5.9
15.8
0.0
0.0
5.3
5.7
3.4
9.1
8.8
0.0
0.0
0.0
4.7
BUMIL
T2+
%
141
22.7
95.0
33.3
25.3
41.2
57.9
50.0
46.3
80.2
45.5
44.8
172.7
85.3
50.5
26.0
56.8
52.8
80
HASIL CAKUPAN IMUNISASI PER DESA/KELURAHAN PUSKESMAS PALANGGA KABUPATEN / KO
JUMLAH
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR (0 - 11
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 0
2 WATUDEMBA 665 11 6 17 11 6 17 0
3 AOSOLE 1,018 9 11 20 9 11 20 0
4 ALAKAYA 669 10 8 18 10 8 18 0
5 WAWORAHA 583 5 8 13 5 8 13 0
6 KAPUJAYA 620 8 6 14 8 6 14 0
7 WAWOURU 1,072 6 8 14 6 8 14 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0
9 WATUMEREMBE 814 5 12 17 5 12 17 0
10 EEWA 636 7 9 16 7 9 16 0
11 ONEMBUTE 960 10 8 18 10 8 18 0
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0
14 WAWONGGURA 740 10 8 18 10 8 18 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 0
LAPORAN VAKSIN, ALAT SUNTIK DAN SAFETY BOX

No. Jumlah Sisa Bln ini Permintaan
I. VAKSIN
1 Vak. BCG 23 - 23 5 18 (13)
2 Vak. DPT-HB - - - - - -
3 Vak. DPT-HB-Hib 10 30 40 24 16 8
4 Vak. POLIO 28 10 38 15 23 (8)
5 Vak. CAMPAK 22 10 32 10 22 (12)
6 Vak. HB. UNIJECT 130 - 130 17 113 (96)
7 Vak. TT 16 10 26 9 17 (8)
II. ALAT SUNTIK
1 ADS 5 ml 42 - 42 15 27 (12)
2 ADS 0,5 ml 410 200 610 142 468 (326)
3 ADS 0,0 5 ml 50 - 50 21 29 (8)
JUMLAH
DESA / PDDK
NO
KELURAHAN
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 0
2 WATUDEMBA 665 11 6 17 11 6 17 0
3 AOSOLE 1,018 9 11 20 9 11 20 0
4 ALAKAYA 669 10 8 18 10 8 18 0
5 WAWORAHA 583 5 8 13 5 8 13 0
6 KAPUJAYA 620 8 6 14 8 6 14 0
7 WAWOURU 1,072 6 8 14 6 8 14 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0
9 WATUMEREMBE 814 5 12 17 5 12 17 0
10 EEWA 636 7 9 16 7 9 16 0
11 ONEMBUTE 960 10 8 18 10 8 18 0
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0
14 WAWONGGURA 740 10 8 18 10 8 18 1
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 1

I. VAKSIN
1 Vak. BCG 18 10 28 10 18 (8)
2 Vak. Polio IPV - 5 5 - 5 (5)
3 Vak. DPT-HB-Hib 16 30 46 28 18 10
4 Vak. POLIO 23 - 23 21 2 19
5 Vak. CAMPAK 22 10 32 11 21 (10)
6 Vak. HB. UNIJECT 113 - 113 4 109 (105)
7 Vak. TT 17 10 27 11 16 (5)
II. ALAT SUNTIK
1 ADS 5 ml 27 20 47 21 26 (5)
2 ADS 0,5 ml 468 200 668 150 518 (368)
3 ADS 0,0 5 ml 29 100 129 25 104 (79)
BULAN : MARET 2017
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 1
2 WATUDEMBA 665 11 6 17 11 6 17 0
3 AOSOLE 1,018 9 11 20 9 11 20 0
4 ALAKAYA 669 10 8 18 10 8 18 1
5 WAWORAHA 583 5 8 13 5 8 13 0
6 KAPUJAYA 620 8 6 14 8 6 14 0
7 WAWOURU 1,072 6 8 14 6 8 14 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0
9 WATUMEREMBE 814 5 12 17 5 12 17 0
10 EEWA 636 7 9 16 7 9 16 0
11 ONEMBUTE 960 10 8 18 10 8 18 0
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0
14 WAWONGGURA 740 10 8 18 10 8 18 1
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 3

I. VAKSIN
1 Vak. BCG 18 - 18 7 11 (4)
2 Vak. Polio IPV 5 - 5 5 - 5
3 Vak. DPT-HB-HIB 18 - 18 18 - 18
4 Vak. POLIO 2 - 2 2 - 2
5 Vak. CAMPAK 21 - 21 12 9 3
6 Vak. HB. UNIJECT 109 - 109 9 100 (91)
7 Vak. TT 16 - 16 8 8 -
II. ALAT SUNTIK
1 ADS 5 ml 26 - 26 20 6 14
2 ADS 0,5 ml 518 - 518 130 388 (258)
3 ADS 0,0 5 ml 104 - 104 27 77 (50)
BULAN : APRIL 2017
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 2
2 WATUDEMBA 665 11 6 17 11 6 17 1
3 AOSOLE 1,018 9 11 20 9 11 20 0
4 ALAKAYA 669 10 8 18 10 8 18 2
5 WAWORAHA 583 5 8 13 5 8 13 1
6 KAPUJAYA 620 8 6 14 8 6 14 1
7 WAWOURU 1,072 6 8 14 6 8 14 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 1
9 WATUMEREMBE 814 5 12 17 5 12 17 0
10 EEWA 636 7 9 16 7 9 16 0
11 ONEMBUTE 960 10 8 18 10 8 18 1
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1
14 WAWONGGURA 740 10 8 18 10 8 18 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 1
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 11

I. VAKSIN
1 Vak. BCG 11 10 21 7 14 (7)
2 Vak. DPT-HB - - - - - -
3 Vak. DPT-HB-Hib - 30 30 26 4 22
4 Vak. POLIO 2 30 32 19 13 6
5 Vak. CAMPAK 9 10 19 10 9 1
6 Vak. HB. UNIJECT 100 - 100 14 86 (72)
7 Vak. TT 8 10 18 8 10 (2)
II. ALAT SUNTIK
1 ADS 5 ml 6 20 26 17 9 8
2 ADS 0,5 ml 388 20 408 180 228 (48)
3 ADS 0,0 5 ml 77 - 77 22 55 (33)
BULAN : MEI 2017
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 2
2 WATUDEMBA 665 11 6 17 11 6 17 0
3 AOSOLE 1,018 9 11 20 9 11 20 0
4 ALAKAYA 669 10 8 18 10 8 18 0
5 WAWORAHA 583 5 8 13 5 8 13 1
6 KAPUJAYA 620 8 6 14 8 6 14 0
7 WAWOURU 1,072 6 8 14 6 8 14 1
8 MEKAR SARI 1,367 16 10 26 16 10 26 2
9 WATUMEREMBE 814 5 12 17 5 12 17 0
10 EEWA 636 7 9 16 7 9 16 0
11 ONEMBUTE 960 10 8 18 10 8 18 0
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1
14 WAWONGGURA 740 10 8 18 10 8 18 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 7

I. VAKSIN
1 Vak. BCG 14 10 24 6 18 (12)
2 IPV - 5 5 2 3 (1)
3 Vak. DPT-HB-Hib 4 30 34 22 12 10
4 Vak. POLIO 13 20 33 15 18 (3)
5 Vak. CAMPAK 9 10 19 11 8 3
6 Vak. HB. UNIJECT 86 - 86 9 77 (68)
7 Vak. TT 10 - 10 7 3 4
II. ALAT SUNTIK
1 ADS 5 ml 9 20 29 17 12 5
2 ADS 0,5 ml 228 200 428 130 298 (168)
3 ADS 0,0 5 ml 55 100 155 25 130 (105)
BULAN : JUNI 2017
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 0
2 WATUDEMBA 665 11 6 17 11 6 17 0
3 AOSOLE 1,018 9 11 20 9 11 20 1
4 ALAKAYA 669 10 8 18 10 8 18 0
5 WAWORAHA 583 5 8 13 5 8 13 0
6 KAPUJAYA 620 8 6 14 8 6 14 0
7 WAWOURU 1,072 6 8 14 6 8 14 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0
9 WATUMEREMBE 814 5 12 17 5 12 17 0
10 EEWA 636 7 9 16 7 9 16 0
11 ONEMBUTE 960 10 8 18 10 8 18 1
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1
14 WAWONGGURA 740 10 8 18 10 8 18 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 3

I. VAKSIN
1 Vak. BCG 18 10 28 6 22 (16)
2 Vak. DPT-HB - - - -
3 Vak. DPT-HB-Hib 12 30 42 14 28 (14)
4 Vak. POLIO 18 30 48 11 37 (26)
5 Vak. CAMPAK 8 10 18 7 11 (4)
6 Vak. HB. UNIJECT 77 77 5 72 (67)
7 Vak. TT 3 20 23 3 20 (17)
II. ALAT SUNTIK
1 ADS 5 ml 12 20 32 13 19 (6)
2 ADS 0,5 ml 298 200 498 112 386 (274)
3 ADS 0,0 5 ml 130 - 130 21 109 (88)
BULAN : JULI 2017
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 1
2 WATUDEMBA 665 11 6 17 11 6 17 0
3 AOSOLE 1,018 9 11 20 9 11 20 0
4 ALAKAYA 669 10 8 18 10 8 18 0
5 WAWORAHA 583 5 8 13 5 8 13 0
6 KAPUJAYA 620 8 6 14 8 6 14 0
7 WAWOURU 1,072 6 8 14 6 8 14 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 1
9 WATUMEREMBE 814 5 12 17 5 12 17 0
10 EEWA 636 7 9 16 7 9 16 0
11 ONEMBUTE 960 10 8 18 10 8 18 0
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0
14 WAWONGGURA 740 10 8 18 10 8 18 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 2

I. VAKSIN
1 Vak. BCG 22 10 32 11 21 (10)
2 Vak. DPT-HB - - - - -
3 Vak. DPT-HB-Hib 28 30 58 25 33 (8)
4 Vak. POLIO 37 30 67 16 51 (35)
5 Vak. CAMPAK 11 10 21 8 13 (5)
6 Vak. HB. UNIJECT 72 72 6 66 (60)
7 Vak. TT 20 10 30 8 22 (14)
II. ALAT SUNTIK
1 ADS 5 ml 19 20 39 19 20 (1)
2 ADS 0,5 ml 386 200 586 146 440 (294)
3 ADS 0,0 5 ml 109 - 109 35 74 (39)
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 2
2 WATUDEMBA 665 11 6 17 11 6 17 0
3 AOSOLE 1,018 9 11 20 9 11 20 0
4 ALAKAYA 669 10 8 18 10 8 18 1
5 WAWORAHA 583 5 8 13 5 8 13 0
6 KAPUJAYA 620 8 6 14 8 6 14 0
7 WAWOURU 1,072 6 8 14 6 8 14 1
8 MEKAR SARI 1,367 16 10 26 16 10 26 0
9 WATUMEREMBE 814 5 12 17 5 12 17 0
10 EEWA 636 7 9 16 7 9 16 0
11 ONEMBUTE 960 10 8 18 10 8 18 0
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0
14 WAWONGGURA 740 10 8 18 10 8 18 1
15 SANGGI-SANGGI 666 14 7 21 14 7 21 1
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 6

I. VAKSIN
1 Vak. BCG 5 10 15 6 9 (3)
2 Vak. DPT-HB - - - - - -
3 Vak. DPT-HB-Hib 3 30 33 29 4 25
4 Vak. POLIO 21 30 51 20 31 (11)
5 Vak. CAMPAK 13 10 23 13 10 3
6 Vak. HB. UNIJECT 66 66 11 55 (44)
7 Vak. Td 12 10 22 11 11 -
II. ALAT SUNTIK
1 ADS 5 ml 20 20 40 19 21 (2)
2 ADS 0,5 ml 440 200 640 218 422 (204)
3 ADS 0,0 5 ml 74 - 74 24 50 (26)
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 0
2 WATUDEMBA 665 11 6 17 11 6 17 0
3 AOSOLE 1,018 9 11 20 9 11 20 0
4 ALAKAYA 669 10 8 18 10 8 18 0
5 WAWORAHA 583 5 8 13 5 8 13 0
6 KAPUJAYA 620 8 6 14 8 6 14 0
7 WAWOURU 1,072 6 8 14 6 8 14 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 1
9 WATUMEREMBE 814 5 12 17 5 12 17 1
10 EEWA 636 7 9 16 7 9 16 1
11 ONEMBUTE 960 10 8 18 10 8 18 0
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 1
14 WAWONGGURA 740 10 8 18 10 8 18 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 4

I. VAKSIN
1 Vak. BCG 9 10 19 3 16 (13)
2 Vak. DPT-HB - - - - - -
3 Vak. DPT-HB-Hib 4 30 34 14 20 (6)
4 Vak. POLIO 31 20 51 10 41 (31)
5 Vak. CAMPAK 10 10 20 6 14 (8)
6 Vak. HB. UNIJECT 55 - 55 10 45 (35)
7 Vak. Td 11 20 31 5 26 (21)
II. ALAT SUNTIK
1 ADS 5 ml 21 20 41 9 32 (23)
2 ADS 0,5 ml 422 200 622 112 510 (398)
3 ADS 0,0 5 ml 50 100 150 11 139 (128)
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 0
2 WATUDEMBA 665 11 6 17 11 6 17 0
3 AOSOLE 1,018 9 11 20 9 11 20 0
4 ALAKAYA 669 10 8 18 10 8 18 0
5 WAWORAHA 583 5 8 13 5 8 13 0
6 KAPUJAYA 620 8 6 14 8 6 14 0
7 WAWOURU 1,072 6 8 14 6 8 14 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0
9 WATUMEREMBE 814 5 12 17 5 12 17 0
10 EEWA 636 7 9 16 7 9 16 0
11 ONEMBUTE 960 10 8 18 10 8 18 0
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0
14 WAWONGGURA 740 10 8 18 10 8 18 0
15 Sanggi - Sanggi 666 14 7 21 14 7 21 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 0

I. VAKSIN
1 Vak. BCG 16 - 16 - - -
2 Vak. DPT-HB - - - - - -
3 Vak. DPT-HB-Hib 20 - - - - -
4 Vak. POLIO 41 - 41 - 41 (41)
5 Vak. CAMPAK 14 - 14 - 14 (14)
6 Vak. HB. UNIJECT 45 - 45 - 45 (45)
7 Vak. TT 26 - 26 - 26 (26)
II. ALAT SUNTIK
1 ADS 5 ml 32 - 32 - 32 (32)
2 ADS 0,5 ml 510 - 510 - 510 (510)
3 ADS 0,0 5 ml 139 - - - - -
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 0
2 WATUDEMBA 665 11 6 17 11 6 17 0
3 AOSOLE 1,018 9 11 20 9 11 20 0
4 ALAKAYA 669 10 8 18 10 8 18 0
5 WAWORAHA 583 5 8 13 5 8 13 0
6 KAPUJAYA 620 8 6 14 8 6 14 0
7 WAWOURU 1,072 6 8 14 6 8 14 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0
9 WATUMEREMBE 814 5 12 17 5 12 17 0
10 EEWA 636 7 9 16 7 9 16 0
11 ONEMBUTE 960 10 8 18 10 8 18 0
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0
14 WAWONGGURA 740 10 8 18 10 8 18 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 0
1

I. VAKSIN
1 Vak. BCG - - - - - -
2 Vak. DPT-HB - - - - - -
3 Vak. DPT-HB-Hib - - - - - -
4 Vak. POLIO 41 - 41 - 41 (41)
5 Vak. CAMPAK 14 - 14 - 14 (14)
6 Vak. HB. UNIJECT - - - - - -
7 Vak. TT 26 - 26 - 26 (26)
II. ALAT SUNTIK
1 ADS 5 ml 32 - 32 - 32 (32)
2 ADS 0,5 ml 510 - 510 - 510 (510)
3 ADS 0,0 5 ml - - - - - -
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 0
2 WATUDEMBA 665 11 6 17 11 6 17 0
3 AOSOLE 1,018 9 11 20 9 11 20 0
4 ALAKAYA 669 10 8 18 10 8 18 0
5 WAWORAHA 583 5 8 13 5 8 13 0
6 KAPUJAYA 620 8 6 14 8 6 14 0
7 WAWOURU 1,072 6 8 14 6 8 14 0
8 MEKAR SARI 1,367 16 10 26 16 10 26 0
9 WATUMEREMBE 814 5 12 17 5 12 17 0
10 EEWA 636 7 9 16 7 9 16 0
11 ONEMBUTE 960 10 8 18 10 8 18 0
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 0
14 WAWONGGURA 740 10 8 18 10 8 18 0
15 SANGGI-SANGGI 666 14 7 21 14 7 21 0
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 0

I. VAKSIN
1 Vak. BCG - - - - - -
2 Vak. DPT-HB - - - - - -
3 Vak. DPT-HB-Hib - - - - - -
4 Vak. POLIO 41 - 41 - 41 (41)
5 Vak. CAMPAK 14 - 14 - 14 (14)
6 Vak. HB. UNIJECT - - - - - -
7 Vak. TT 26 - 26 - 26 (26)
II. ALAT SUNTIK
1 ADS 5 ml 32 - 32 - 32 (32)
2 ADS 0,5 ml 510 - 510 - 510 (510)
3 ADS 0,0 5 ml - - - - - -
BULAN : JANUARI S/D.DESEMBER 2017
JUMLAH
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
L P JLH L BLN
P JLH #L
2017
1 2 3 4 5 6 7 8 9
1 KIAEA 1,794 21 15 36 21 15 36 8
2 WATUDEMBA 665 11 6 17 11 6 17 1
3 AOSOLE 1,018 9 11 20 9 11 20 1
4 ALAKAYA 669 10 8 18 10 8 18 4
5 WAWORAHA 583 5 8 13 5 8 13 2
6 KAPUJAYA 620 8 6 14 8 6 14 1
7 WAWOURU 1,072 6 8 14 6 8 14 2
8 MEKAR SARI 1,367 16 10 26 16 10 26 5
9 WATUMEREMBE 814 5 12 17 5 12 17 1
10 EEWA 636 7 9 16 7 9 16 1
11 ONEMBUTE 960 10 8 18 10 8 18 2
12 ANGGONDARA 741 4 6 10 4 6 10 0
13 KEL.PALANGGA 1,148 23 17 40 23 17 40 4
14 WAWONGGURA 740 10 8 18 10 8 18 3
15 SANGGI-SANGGI 666 14 7 21 14 7 21 2
16 UPT.TOLIHE 436 1 7 8 1 7 8 0
PALANGGA 13,929 160 146 306 160 146 306 43

I. VAKSIN
1 Vak. BCG - 70 70 61 9 52
2 Vak. DPT-HB - 10 10 7 3 4
3 Vak. DPT-HB-Hib - 240 240 200 40 160
4 Vak. POLIO 41 170 211 129 82 47
5 Vak. CAMPAK 14 80 94 100 (6) 106
6 Vak. HB. UNIJECT 20 - 20 210 (190) 400
7 Vak. TT 26 90 116 70 46 24
II. ALAT SUNTIK
1 ADS 5 ml 32 140 172 150 22 128
2 ADS 0,5 ml 510 1,420 1,930 1,320 610 710
3 ADS 0,0 5 ml 122 300 422 318 104 214
A KABUPATEN / KOTA KONAWE SELATAN TAHUN 2017.
HB0 (0<7 HARI) BCG

% #P % # JML % #L % #P % # JML
10 11 12 13 14 15 16 17 18 19
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 1 7.1 1 14.0 2
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 1 0.6 1 160.0 2
INDEK PEMAKAIAN VAKSIN (IPK)
No. Jenis Vaksin
1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
HB0 (0<7 HARI) BCG
% #P % # JML % #L % #P % # JML
10 11 12 13 14 15 16 17 18 19
0.0 0 0.0 0 0.0 1 4.8 3 63.0 4
0.0 1 16.7 1 5.9 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 2 22.2 0 0.0 2
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 1 12.5 1 7.7 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 1 12.5 1 8.0 2
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 1 10.0 1 3.8 2 12.5 0 0.0 2
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1
0.0 0 0.0 0 0.0 1 25.0 0 0.0 1
0.0 0 0.0 0 0.0 1 4.3 1 23.0 2
10.0 0 0.0 1 5.6 1 10.0 1 10.0 2
0.0 0 0.0 0 0.0 4 28.6 1 3.5 5
0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2
0.6 3 2.1 4 1.3 13 8.1 10 123.1 23
No. Jenis Vaksin
1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
HB0 (0<7 HARI) BCG
% #P % # JML % #L % #P % # JML
10 0 12 13 14 15 16 17 18 19
4.8 2 13.3 3 8.3 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 1 9.1 1 11.0 2
0.0 0 0.0 0 0.0 1 11.1 3 27.0 4
10.0 1 12.5 2 11.1 3 30.0 3 10.0 6
0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1
0.0 0 0.0 0 0.0 1 12.5 1 8.0 2
0.0 0 0.0 0 0.0 1 16.7 2 12.0 3
0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1
0.0 2 16.7 2 11.8 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1
0.0 0 0.0 0 0.0 1 10.0 1 10.0 2
0.0 1 16.7 1 10.0 1 25.0 1 4.0 2
0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1
10.0 1 12.5 2 11.1 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 2 14.3 0 0.0 2
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
1.9 7 4.8 10 3.3 11 6.9 16 232.7 27
No. Jenis Vaksin
1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
HB0 (0<7 HARI) BCG
% #P % # JML % #L % #P % # JML
10 11 12 13 14 15 16 17 18 19
9.5 1 6.7 3 8.3 0 0.0 0 #DIV/0! 0
0 0.0 1 5.9 1 9.1 0 0.0 1
0.0 0 0.0 0 0.0 1 11.1 1 9.0 2
20.0 0 0.0 2 11.1 0 0.0 0 #DIV/0! 0
20.0 0 0.0 1 7.7 0 0.0 0 #DIV/0! 0
12.5 0 0.0 1 7.1 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2
6.3 0 0.0 1 3.8 0 0.0 4 #DIV/0! 4
0.0 1 8.3 1 5.9 1 20.0 4 20.0 5
0.0 0 0.0 0 0.0 1 14.3 0 0.0 1
10.0 1 12.5 2 11.1 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
4.3 0 0.0 1 2.5 0 0.0 0 #DIV/0! 0
0.0 1 12.5 1 5.6 3 30.0 0 0.0 3
7.1 0 0.0 1 4.8 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 1 100.0 0 0.0 1
6.9 4 2.7 15 4.9 8 5.0 11 220.0 19
No. Jenis Vaksin
1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
HB0 (0<7 HARI) BCG
% #P % # JML % #L % #P % # JML
10 11 12 13 14 15 16 17 18 19
9.5 1 6.7 3 8.3 3 14.3 1 7.0 4
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 3 30.0 2 6.7 5
20.0 0 0.0 1 7.7 1 20.0 1 5.0 2
0.0 0 0.0 0 0.0 3 37.5 0 0.0 3
16.7 0 0.0 1 7.1 0 0.0 2 14.3 2
12.5 0 0.0 2 7.7 2 12.5 0 0.0 2
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 2.0 0
0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1
0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1
4.3 1 5.9 2 5.0 4 17.4 0 0.0 4
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
4.4 2 1.4 9 2.9 16 10.0 8 80.0 24
No. Jenis Vaksin
1 BCG
2 IPV
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
HB0 (0<7 HARI) BCG
% #P % # JML % #L % #P % # JML
10 11 12 13 14 15 16 17 18 19
0.0 0 0.0 0 0.0 5 23.8 0.0 5
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
11.1 0 0.0 1 5.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 1 20.0 0 0.0 1
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 1 10.0 1 3.8 2 12.5 3 24.0 5
0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1
0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1
10.0 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 2 50.0 1 2.0 3
4.3 0 0.0 1 2.5 0 0.0 0 #DIV/0! 0
0.0 0.0 0 0.0 0 0.0 3 #DIV/0! 3
0.0 1 14.3 1 4.8 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
1.9 2 1.4 5 1.6 10 6.3 9 144.0 19
No. Jenis Vaksin
1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
HB0 (0<7 HARI) BCG
% #P % # JML % #L % #P % # JML
10 11 12 13 14 15 16 17 18 19
4.8 0 0.0 1 2.8 3 14.3 2 14.0 5
0.0 0 0.0 0 0.0 1 9.1 2 22.0 3
0.0 0 0.0 0 0.0 1 11.1 1 9.0 2
0.0 0 0.0 0 0.0 3 30.0 0 0.0 3
0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1
0.0 0 0.0 0 0.0 1 12.5 1 8.0 2
0.0 1 12.5 1 7.1 2 33.3 1 3.0 3
6.3 1 10.0 2 7.7 2 12.5 0 0.0 2
0.0 0 0.0 0 0.0 1 20.0 2 10.0 3
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 2 11.8 2 5.0 3 13.0 1 7.7 4
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 3 21.4 1 4.7 4
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
1.3 4 2.7 6 2.0 20 12.5 12 96.0 32
No. Jenis Vaksin
1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
HB0 (0<7 HARI) BCG
% #P % # JML % #L % #P % # JML
10 11 12 13 14 15 16 17 18 19
9.5 0 0.0 2 5.6 1 4.8 2 42.0 3
0.0 0 0.0 0 0.0 1 9.1 1 11.0 2
0.0 0 0.0 0 0.0 1 11.1 1 9.0 2
10.0 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0
0.0 1 12.5 1 7.7 0 0.0 0 #DIV/0! 0
0.0 1 16.7 1 7.1 0 0.0 0 #DIV/0! 0
16.7 2 25.0 3 21.4 2 33.3 1 3.0 3
0.0 0 0.0 0 0.0 1 6.3 2 32.0 3
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 3 30.0 4 13.3 7
0.0 1 16.7 1 10.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
10.0 0 0.0 1 5.6 2 20.0 0 0.0 2
7.1 0 0.0 1 4.8 2 14.3 0 0.0 2
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
3.8 5 3.4 11 3.6 13 8.1 11 135.4 24
No. Jenis Vaksin
1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
HB0 (0<7 HARI) BCG
% #P % # JML % #L % #P % # JML
10 11 12 13 14 15 16 17 18 19
1.0 0 0.0 0 0.0 3 14.3 1 7.0 4
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 1 9.1 1 5.0 0 0.0 0 #DIV/0! 0
0.0 1 12.5 1 5.6 0 0.0 0 0,0 0
0.0 0 0.0 0 0.0 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 12.5 1 7.1 0 0.0 0 0,0 0
6.3 0 0.0 1 3.8 0 0.0 0 0,0 0
20.0 0 0.0 1 5.9 0 0.0 0 0,0 0
14.3 0 0.0 1 6.3 0 0.0 0 0,0 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 1 16.7 1 10.0 0 0.0 0 #DIV/0! 0
4.3 1 5.9 2 5.0 2 8.7 1 11.5 3
0.0 1 12.5 1 5.6 0 0.0 0 0,0 0
0.0 0 0.0 0 0.0 2 14.3 2 14.0 4
0.0 0 0.0 0 0.0 0 0.0 0 0,0 0
2.5 6 4.1 10 3.3 7 4.4 4 91.4 11
No. Jenis Vaksin
1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
HB0 (0<7 HARI) BCG
% #P % # JML % #L % #P % # JML
10 11 12 13 14 15 16 17 18 19
0.0 0 0.0 0 0.0 1 4.8 5 105.0 6
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 1 11.1 2 18.0 3
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1
0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1
0.0 0 0.0 0 0.0 1 16.7 5 30.0 6
0.0 0 0.0 0 0.0 1 6.3 5 80.0 6
0.0 0 0.0 0 0.0 4 80.0 0 0.0 4
0.0 0 0.0 0 0.0 1 14.3 0 0.0 1
0.0 0 0.0 0 0.0 1 10.0 2 20.0 3
0.0 0 0.0 0 0.0 3 75.0 1 1.3 4
0.0 0 0.0 0 0.0 0 0.0 4 #DIV/0! 4
0.0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 13 8.1 28 344.6 41
No. Jenis Vaksin

1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
HB0 (0<7 HARI) BCG
% #P % # JML % #L % #P % # JML
10 11 12 13 14 15 16 17 18 19
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0
No. Jenis Vaksin
1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
HB0 (0<7 HARI) BCG
% #P % # JML % #L % #P % # JML
10 11 12 13 14 15 16 17 18 19
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
No. Jenis Vaksin

1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
HB0 (0<7 HARI) BCG
% #P % # JML % #L % #P % # JML
10 11 12 13 14 15 16 17 18 19
38.1 4 26.7 12 33.3 17 81.0 14 17.3 31
9.1 1 16.7 2 11.8 4 36.4 4 11.0 8
11.1 1 9.1 2 10.0 7 77.8 8 10.3 15
40.0 2 25.0 6 33.3 9 90.0 5 5.6 14
40.0 2 25.0 4 30.8 2 40.0 4 10.0 6
12.5 1 16.7 2 14.3 6 75.0 4 5.3 10
33.3 4 50.0 6 42.9 6 100.0 13 13.0 19
31.3 3 30.0 8 30.8 10 62.5 15 24.0 25
20.0 3 25.0 4 23.5 6 120.0 7 5.8 13
14.3 0 0.0 1 6.3 2 28.6 2 7.0 4
20.0 1 12.5 3 16.7 5 50.0 9 18.0 14
0.0 3 50.0 3 30.0 7 175.0 4 2.3 11
17.4 4 23.5 8 20.0 10 43.5 8 18.4 18
30.0 3 37.5 6 33.3 6 60.0 6 10.0 12
14.3 1 14.3 3 14.3 14 100.0 5 5.0 19
0.0 0 0.0 0 0.0 1 100.0 2 2.0 3
26.9 33 22.6 76 24.8 112 70.0 110 157.1 222
No. Jenis Vaksin
1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
POLIO1 DPT/HB-Hib (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
9.5 1 7.1 1 14.3 2 9.5 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.7 1 0.6 1 0.7 2 0.7 0 0.0 0
LAPORAN COLD CHAIN
Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P

No.
2 dosis 5 Ampul 0.4
2 dosis - Vial #DIV/0! 1
6 dosis 24 Vial 0.25 2
0 dosis 10 Vial 0 4
0 dosis 17 Buah 0
0 dosis 9 Vial 0
POLIO1 DPT/HB (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
11.1 1 1.0 3 20.0 4 11.1 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
10.0 2 22.2 0 0.0 2 10.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
14.3 1 12.5 1 16.7 2 14.3 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
7.7 2 12.5 0 0.0 2 7.7 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
5.6 0 0.0 1 12.5 1 5.6 0 0.0 0
10.0 1 25.0 0 0.0 1 10.0 0 0.0 0
5.0 1 4.3 1 5.9 2 5.0 0 0.0 0
11.1 1 10.0 1 12.5 2 11.1 0 0.0 0
23.8 4 28.6 1 14.3 5 23.8 0 0.0 0
25.0 0 0.0 2 28.6 2 25.0 0 0.0 0
7.5 13 8.1 10 6.8 23 7.5 0 0.0 0
LAPORAN COLD CHAIN

No.
23 dosis 10 Ampul 2.3
76 dosis 28 Vial 2.71428571 2
88 dosis 21 Vial 4.19047619 3
37 dosis 11 Vial 3.36363636 4
4 dosis 4 Buah 1
33 dosis 11 Vial 3
POLIO1 DPT/HB (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
11.8 1 9.1 1 16.7 2 11.8 0 0.0 0
20.0 1 11.1 3 27.3 4 20.0 0 0.0 0
33.3 3 30.0 3 37.5 6 33.3 0 0.0 0
7.7 0 0.0 1 12.5 1 7.7 0 0.0 0
14.3 1 12.5 1 16.7 2 14.3 0 0.0 0
21.4 1 16.7 2 25.0 3 21.4 0 0.0 0
3.8 0 0.0 1 10.0 1 3.8 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
6.3 0 0.0 1 11.1 1 6.3 0 0.0 0
11.1 1 0,0 1 12.5 2 11.1 0 0.0 0
20.0 1 25.0 1 16.7 2 20.0 0 0.0 0
2.5 0 0.0 1 5.9 1 2.5 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
9.5 2 14.3 0 0.0 2 9.5 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
8.8 11 6.9 16 11.0 27 8.8 0 0.0 0
LAPORAN COLD CHAIN

No.
27 dosis 7 Ampul 3.85714286
0 dosis 5 Vial 0 1
46 dosis 12 Vial 3.83333333 4
10 dosis 9 Buah 1.11111111
24 dosis 8 Vial 3
POLIO1 DPT/HB (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
5.9 1 9.1 0 0.0 1 5.9 0 0.0 0
10.0 1 11.1 1 9.1 2 10.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
14.3 0 0.0 2 25.0 2 14.3 0 0.0 0
15.4 0 0.0 4 40.0 4 15.4 0 0.0 0
29.4 1 20.0 4 33.3 5 29.4 0 0.0 0
6.3 1 14.3 0 0.0 1 6.3 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 2 50.0 2
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
16.7 3 30.0 0 0.0 3 16.7 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
12.5 1 100.0 0 0.0 1 12.5 0 0.0 0
6.2 8 5.0 11 7.5 19 6.2 2 1.3 2
LAPORAN COLD CHAIN

No.
19 dosis 7 Ampul 2.71428571
99 dosis 26 Vial 3.80769231 2
97 dosis 19 Vial 5.10526316 3
15 dosis 14 Buah 1.07142857
38 dosis 8 Vial 4.75
POLIO1 DPT/HB (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
11.1 3 14.3 1 6.7 4 11.1 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
27.8 3 30.0 2 25.0 5 27.8 0 0.0 0
15.4 1 20.0 1 12.5 2 15.4 0 0.0 0
21.4 3 37.5 0 0.0 3 21.4 0 0.0 0
14.3 0 0.0 2 25.0 2 14.3 0 0.0 0
7.7 2 12.5 0 0.0 2 7.7 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
5.6 0 0.0 1 12.5 1 5.6 0 0.0 0
10.0 0 0.0 1 16.7 1 10.0 0 0.0 0
10.0 4 17.4 0 0.0 4 10.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
7.8 16 10.0 8 5.5 24 7.8 0 0.0 0
LAPORAN COLD CHAIN

No.
24 dosis 6 Ampul 4
0 dosis 2 Vial 0 1
75 dosis 22 Vial 3.40909091 2
89 dosis 15 Vial 5.93333333 3
34 dosis 11 Vial 3.09090909 4
9 dosis 9 Buah 1
23 dosis 7 Vial 3.28571429
POLIO1 DPT/HB (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
13.9 5 23.8 0 0.0 5 13.9 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
7.7 1 20.0 0 0.0 1 7.7 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
19.2 2 12.5 3 30.0 5 19.2 0 0.0 0
5.9 0 0.0 1 8.3 1 5.9 0 0.0 0
6.3 0 0.0 1 11.1 1 6.3 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
30.0 2 50.0 1 16.7 3 30.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
16.7 0 0.0 3 37.5 3 16.7 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
6.2 10 6.3 9 6.2 19 6.2 0 0.0 0
LAPORAN COLD CHAIN

No.
19 dosis 6 Ampul 3.16666667
64 dosis 14 Vial 4.57142857 2
74 dosis 11 Vial 6.72727273 3
31 dosis 7 Vial 4.42857143 4
5 dosis 5 Buah 1
11 dosis 3 Vial 3.66666667
POLIO1 DPT/HB (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
13.9 3 14.3 2 13.3 5 13.9 0 0.0 0
17.6 1 9.1 2 33.3 3 17.6 0 0.0 0
10.0 1 11.1 1 9.1 2 10.0 0 0.0 0
16.7 3 30.0 0 0.0 3 16.7 0 0.0 0
7.7 0 0.0 1 12.5 1 7.7 0 0.0 0
14.3 1 12.5 1 16.7 2 14.3 0 0.0 0
21.4 2 33.3 1 12.5 3 21.4 0 0.0 0
7.7 2 12.5 0 0.0 2 7.7 0 0.0 0
17.6 1 20.0 2 16.7 3 17.6 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
10.0 3 13.0 1 5.9 4 10.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
19.0 3 21.4 1 14.3 4 19.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
10.5 20 12.5 12 8.2 32 10.5 0 0.0 0
LAPORAN COLD CHAIN

No.
32 dosis 11 Ampul 2.90909091
89 dosis 25 Vial 3.56 2
105 dosis 16 Vial 6.5625 3
6 dosis 6 Buah 1
POLIO1 DPT/HB (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
8.3 1 4.8 2 13.3 3 8.3 0 0.0 0
11.8 1 9.1 1 16.7 2 11.8 0 0.0 0
10.0 1 11.1 1 9.1 2 10.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
21.4 2 33.3 1 12.5 3 21.4 0 0.0 0
11.5 1 6.3 2 20.0 3 11.5 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
38.9 3 30.0 4 50.0 7 38.9 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
11.1 2 20.0 0 0.0 2 11.1 0 0.0 0
9.5 2 14.3 0 0.0 2 9.5 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
7.8 13 8.1 11 7.5 24 7.8 0 0.0 0
LAPORAN COLD CHAIN

No.
24 dosis 6 Ampul 4
108 dosis 29 Vial 3.72413793 2
109 dosis 20 Vial 5.45 3
46 dosis 13 Vial 3.53846154 4
11 dosis 11 Buah 1
42 dosis 11 Vial 3.81818182
POLIO1 DPT/HB (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
11.1 3 14.3 1 6.7 4 11.1 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 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
7.5 2 8.7 1 5.9 3 7.5 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
19.0 2 14.3 2 28.6 4 19.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
3.6 7 4.4 4 2.7 11 3.6 0 0.0 0
LAPORAN COLD CHAIN

No.
11 dosis 3 Ampul 3.66666667
76 dosis 14 Vial 5.42857143 2
24 dosis 6 Vial 4 4
10 dosis 10 Buah 1
16 dosis 5 Vial 3.2
POLIO1 DPT/HB (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
16.7 1 4.8 5 33.3 6 16.7 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
15.0 1 11.1 2 18.2 3 15.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
7.7 0 0.0 1 12.5 1 7.7 0 0.0 0
7.1 0 0.0 1 16.7 1 7.1 0 0.0 0
42.9 1 16.7 5 62.5 6 42.9 0 0.0 0
23.1 1 6.3 5 50.0 6 23.1 0 0.0 0
23.5 4 80.0 0 0.0 4 23.5 0 0.0 0
6.3 1 14.3 0 0.0 1 6.3 0 0.0 0
16.7 1 10.0 2 25.0 3 16.7 0 0.0 0
40.0 3 75.0 1 16.7 4 40.0 0 0.0 0
10.0 0 0.0 4 23.5 4 10.0 0 0.0 0
11.1 0 0.0 2 25.0 2 11.1 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
13.4 13 8.1 28 19.2 41 13.4 0 0.0 0
LAPORAN COLD CHAIN

No.
No.
41 dosis - Ampul #DIV/0!
0 dosis - Buah #DIV/0!
32 dosis - Vial #DIV/0!
POLIO1 DPT/HB (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
LAPORAN COLD CHAIN

No.
POLIO1 DPT/HB (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
LAPORAN COLD CHAIN

No.
No.
POLIO1 DPT/HB (1)
% #L % #P % # JML % #L % #P
20 21 22 23 24 25 26 27 28 29
86.1 17 81.0 14 93.3 31 86.1 0 0.0 0
47.1 4 36.4 4 66.7 8 47.1 0 0.0 0
75.0 7 77.8 8 72.7 15 75.0 0 0.0 0
77.8 9 90.0 5 62.5 14 77.8 0 0.0 0
46.2 2 40.0 4 50.0 6 46.2 0 0.0 0
71.4 6 75.0 4 66.7 10 71.4 0 0.0 0
135.7 6 100.0 13 162.5 19 135.7 0 0.0 0
96.2 10 62.5 15 150.0 25 96.2 0 0.0 0
76.5 6 120.0 7 58.3 13 76.5 0 0.0 0
25.0 2 28.6 2 22.2 4 25.0 0 0.0 0
77.8 5 50.0 9 112.5 14 77.8 0 0.0 0
110.0 7 175.0 4 66.7 11 110.0 2 50.0 2
45.0 10 43.5 8 47.1 18 45.0 0 0.0 0
66.7 6 60.0 6 75.0 12 66.7 0 0.0 0
90.5 14 100.0 5 71.4 19 90.5 0 0.0 0
37.5 1 100.0 2 28.6 3 37.5 0 0.0 0
72.5 112 70.0 110 75.3 222 72.5 2 1.3 2
79% 79%
LAPORAN COLD CHAIN

No.
222 dosis 61 Ampul 3.63934426
7 dosis 7 Vial 1 1
761 dosis 200 Vial 3.805 2
835 dosis 129 Vial 6.47286822 3
329 dosis 100 Vial 3.29 4
76 dosis 210 Buah 0.36190476
234 dosis 70 Vial 3.34285714
DPT/HB-Hib (1) POLIO 2 DPT-HB-HIB 2
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Kepala Puskesmas Palangga.Kab.Konawe selatan..
Amrin,S.Kep
Nip.196506021987031017
DPT/HB (1) DPT/HB-Hib (1) POLIO2
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 1 16.7 1 5.9 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 12.5 1 7.7 0
0.0 0 0.0 1 12.5 1 16.7 2 14.3 1
0.0 0 0.0 0 0.0 1 12.5 1 7.1 0
0.0 0 0.0 4 25.0 1 10.0 5 19.2 4
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 1 14.3 2 22.2 3 18.8 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 3 13.0 2 11.8 5 12.5 3
0.0 0 0.0 1 10.0 0 0.0 1 5.6 1
0.0 0 0.0 0 0.0 1 14.3 1 4.8 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 10 6.3 10 6.8 20 6.5 10
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Amrin,S.Kep
Nip.196506021987031017
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 1 4.8 1 6.7 2 5.6 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 1 12.5 1 5.6 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 1 12.5 1 16.7 2 14.3 1
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 2 12.5 0 0.0 2 7.7 2
0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 12.5 1 5.6 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 1 4.3 0 0.0 1 2.5 1
0.0 0 0.0 1 10.0 2 25.0 3 16.7 1
0.0 0 0.0 3 21.4 0 0.0 3 14.3 3
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 9 5.6 6 4.1 15 4.9 9
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Kepala Puskesmas .Palangga.Kab.Konsel
Amrin,S.Kep
Nip.196506021987031017
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 0 0.0 1 6.7 1 2.8 0
0.0 0 0.0 2 18.2 0 0.0 2 11.8 2
0.0 0 0.0 1 11.1 1 9.1 2 10.0 1
0.0 0 0.0 2 20.0 2 25.0 4 22.2 2
0.0 0 0.0 0 0.0 1 12.5 1 7.7 0
0.0 0 0.0 1 12.5 1 16.7 2 14.3 1
0.0 0 0.0 1 16.7 1 12.5 2 14.3 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 1 10.0 1 12.5 2 11.1 1
33.3 4 40.0 2 50.0 2 33.3 4 40.0 0
0.0 0 0.0 3 13.0 1 5.9 4 10.0 3
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 2 14.3 1 14.3 3 14.3 2
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
1.4 4 1.3 15 9.4 12 8.2 27 8.8 13
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Kepala Puskesmas Palangga .Kab.Konsel
Amrin,S.Kep
Nip.196506021987031017
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 1 4.8 3 20.0 4 11.1 1
0.0 0 0.0 1 9.1 1 16.7 2 11.8 1
0.0 0 0.0 1 11.1 2 18.2 3 15.0 1
0.0 0 0.0 1 10.0 0 0.0 1 5.6 1
0.0 0 0.0 0 0.0 1 12.5 1 7.7 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 37.5 3 21.4 0
0.0 0 0.0 0 0.0 4 40.0 4 15.4 0
0.0 0 0.0 0 0.0 2 16.7 2 11.8 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 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 30.0 0 0.0 3 16.7 3
0.0 0 0.0 1 7.1 0 0.0 1 4.8 1
0.0 0 0.0 0 0.0 1 14.3 1 12.5 0
0.0 0 0.0 8 5.0 17 11.6 25 8.2 8
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Kepala Puskesmas Palangga Kab. Konsel
Amrin,S.Kep.Ns
Nip. 196506021987031017
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 0 0.0 1 6.7 1 2.8 0
0.0 0 0.0 1 9.1 0 0.0 1 5.9 1
0.0 0 0.0 1 11.1 1 9.1 2 10.0 1
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 1 20.0 1 12.5 2 15.4 1
0.0 0 0.0 2 25.0 0 0.0 2 14.3 2
0.0 0 0.0 0 0.0 2 25.0 2 14.3 0
0.0 0 0.0 0 0.0 1 10.0 1 3.8 0
0.0 0 0.0 1 20.0 1 8.3 2 11.8 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 2 8.7 0 0.0 2 5.0 2
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 8 5.0 7 4.8 15 4.9 8
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Kepala Puskesmas .Palangga Kab.Konsel
Amrin,S.Kep
Nip.196506021987031017
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 3 14.3 0 0.0 3 8.3 3
0.0 0 0.0 0 0.0 1 16.7 1 5.9 0
0.0 0 0.0 1 11.1 0 0.0 1 5.0 1
0.0 0 0.0 3 30.0 2 25.0 5 27.8 3
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 1 12.5 0 0.0 1 7.1 1
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 3 18.8 2 20.0 5 19.2 3
0.0 0 0.0 0 0.0 2 16.7 2 11.8 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 1 10.0 1 12.5 2 11.1 1
0.0 0 0.0 0 0.0 2 33.3 2 20.0 0
0.0 0 0.0 4 17.4 0 0.0 4 10.0 4
0.0 0 0.0 0 0.0 3 37.5 3 16.7 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 16 10.0 13 8.9 29 9.5 16
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Kepala Puskesmas Palangga .Kab.Konawe selatan.
Amrin,S.Kep.Ns.
Nip.196506021987031017
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 3 14.3 2 13.3 5 13.9 3
0.0 0 0.0 1 9.1 2 33.3 3 17.6 1
0.0 0 0.0 0 0.0 1 9.1 1 5.0 0
0.0 0 0.0 3 30.0 0 0.0 3 16.7 3
0.0 0 0.0 1 20.0 1 12.5 2 15.4 1
0.0 0 0.0 1 12.5 1 16.7 2 14.3 1
0.0 0 0.0 2 33.3 0 0.0 2 14.3 2
0.0 0 0.0 3 18.8 1 10.0 4 15.4 3
0.0 0 0.0 1 20.0 2 16.7 3 17.6 1
0.0 0 0.0 1 14.3 1 11.1 2 12.5 1
0.0 0 0.0 1 10.0 1 12.5 2 11.1 1
0.0 0 0.0 2 50.0 0 0.0 2 20.0 2
0.0 0 0.0 2 8.7 1 5.9 3 7.5 2
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 5 35.7 1 14.3 6 28.6 5
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 26 16.3 14 9.6 40 13.1 26
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Amrin,S.Kep.Ns
Nip.196506021987031017
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 2 9.5 1 6.7 3 8.3 2
0.0 0 0.0 1 9.1 1 16.7 2 11.8 1
0.0 0 0.0 1 11.1 0 0.0 1 5.0 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 2 25.0 2 14.3 0
0.0 0 0.0 0 0.0 2 20.0 2 7.7 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 1 14.3 0 0.0 1 6.3 0
0.0 0 0.0 2 20.0 1 12.5 3 16.7 2
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 1 4.3 0 0.0 1 2.5 1
0.0 0 0.0 2 20.0 0 0.0 2 11.1 2
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 10 6.3 7 4.8 17 5.6 9
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Amrin,S.Kep
Nip.196506021987031017
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 4 19.0 2 13.3 6 16.7 4
0.0 0 0.0 1 9.1 0 0.0 1 5.9 1
0.0 0 0.0 2 22.2 1 9.1 3 15.0 2
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 2 33.3 0 0.0 2 14.3 2
0.0 0 0.0 1 6.3 0 0.0 1 3.8 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 1 10.0 1 12.5 2 11.1 1
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 2 8.7 1 5.9 3 7.5 2
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 2 14.3 2 28.6 4 19.0 2
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 15 9.4 7 4.8 22 7.2 15
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Jumlah
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Kepala Puskesmas .Palangga.Kab./Kota.Konsel.
Amrin,S.Kep
Nip.196506021987031017
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Amrin,S.Kep
Nip.196506021987031017
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Jumlah
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Kepala Puskesmas Palangga.Kab. Konsel
Amrin,S.Kep
Nip.196506021987031017
% # JML % #L % #P % # JML % #L
30 31 32 33 34 35 36 37 38 39
0.0 0 0.0 14 66.7 11 73.3 25 69.4 14
0.0 0 0.0 7 63.6 6 100.0 13 76.5 7
0.0 0 0.0 7 77.8 6 54.5 13 65.0 7
0.0 0 0.0 9 90.0 5 62.5 14 77.8 9
0.0 0 0.0 2 40.0 5 62.5 7 53.8 2
0.0 0 0.0 7 87.5 4 66.7 11 78.6 7
0.0 0 0.0 5 83.3 9 112.5 14 100.0 5
0.0 0 0.0 13 81.3 11 110.0 24 92.3 13
0.0 0 0.0 2 40.0 7 58.3 9 52.9 2
0.0 0 0.0 3 42.9 3 33.3 6 37.5 2
0.0 0 0.0 6 60.0 6 75.0 12 66.7 6
33.3 4 40.0 4 100.0 4 66.7 8 80.0 2
0.0 0 0.0 18 78.3 5 29.4 23 57.5 18
0.0 0 0.0 7 70.0 5 62.5 12 66.7 7
0.0 0 0.0 13 92.9 5 71.4 18 85.7 13
0.0 0 0.0 0 0.0 1 14.3 1 12.5 0
1.4 4 1.3 117 73.1 93 63.7 210 68.6 114
79%
LAPORAN COLD CHAIN
Jumlah Keadaan
Jenis Cold Chain
(buah)
Baik Rusak
Lemari ES
M. Freezer
V. Crrier
Thermos
MENGETAHUI :
Amrin,S.Kep
Nip.196506021987031017
DPT-HB-HIB 2 POLIO 3
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
POLIO2 DPT/HB (2)
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 1 16.7 1 5.9 0 0.0 0 0.0
0.0 0 0.0 0 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 12.5 1 7.7 0 0.0 0 0.0
12.5 1 16.7 2 14.3 0 0.0 0 0.0
0.0 1 12.5 1 7.1 0 0.0 0 0.0
25.0 1 10.0 5 19.2 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
14.3 2 22.2 3 18.8 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
13.0 2 11.8 5 12.5 0 0.0 0 0.0
10.0 0 0.0 1 5.6 0 0.0 0 0.0
0.0 1 14.3 1 4.8 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
6.3 10 6.8 20 6.5 0 0.0 0 0.0
POLIO2 DPT/HB (2)
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
6,3 1 6.7 2 5.6 0 0.0 0 0.0
0.0 0 0.0 0 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 12.5 1 5.6 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
12.5 1 16.7 2 14.3 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
12.5 0 0.0 2 7.7 0 0.0 0 0.0
0.0 0 0.0 0 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 12.5 1 5.6 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
4.3 0 0.0 1 2.5 0 0.0 0 0.0
10.0 2 25.0 3 16.7 0 0.0 0 0.0
21.4 0 0.0 3 14.3 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
5.6 6 4.1 15 4.9 0 0.0 0 0.0
POLIO2 DPT/HB (2)
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
0.0 1 6.7 1 2.8 0 0.0 0 0.0
18.2 0 0.0 2 11.8 0 0.0 0 0.0
11.1 1 9.1 2 10.0 0 0.0 0 0.0
20.0 2 25.0 4 22.2 0 0.0 0 0.0
0.0 1 12.5 1 7.7 0 0.0 0 0.0
12.5 1 16.7 2 14.3 0 0.0 0 0.0
16.7 1 12.5 2 14.3 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
10.0 1 12.5 2 11.1 0 0.0 0 0.0
0.0 0 0.0 0 0.0 1 25.0 0 0.0
13.0 1 5.9 4 10.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
14.3 1 14.3 3 14.3 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
8.1 10 6.8 23 7.5 1 0.6 0 0.0
POLIO2 DPT/HB (2)
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
4.8 3 20.0 4 11.1 0 0.0 0 0.0
9.1 1 16.7 2 11.8 0 0.0 0 0.0
11.1 2 18.2 3 15.0 0 0.0 0 0.0
10.0 0 0.0 1 5.6 0 0.0 0 0.0
0.0 1 12.5 1 7.7 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 3 37.5 3 21.4 0 0.0 0 0.0
0.0 4 40.0 4 15.4 0 0.0 0 0.0
0.0 2 16.7 2 11.8 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
30.0 1 12.5 3 16.7 0 0.0 0 0.0
7.1 0 0.0 1 4.8 0 0.0 0 0.0
0.0 1 14.3 1 12.5 0 0.0 0 0.0
5.0 18 12.3 25 8.2 0 0.0 0 0.0
POLIO2 DPT/HB (2)
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
0.0 1 6.7 1 2.8 0 0.0 0 0.0
9.1 0 0.0 1 5.9 0 0.0 0 0.0
11.1 1 9.1 2 10.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
20.0 1 12.5 2 15.4 0 0.0 0 0.0
25.0 0 0.0 2 14.3 0 0.0 0 0.0
0.0 2 25.0 2 14.3 0 0.0 0 0.0
0.0 1 10.0 1 3.8 0 0.0 0 0.0
20.0 1 8.3 2 11.8 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
8.7 0 0.0 2 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
5.0 7 4.8 15 4.9 0 0.0 0 0.0
POLIO2 DPT/HB (2)
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
14.3 0 0.0 3 8.3 0 0.0 0 0.0
0.0 1 16.7 1 5.9 0 0.0 0 0.0
11.1 0 0.0 1 5.0 0 0.0 0 0.0
30.0 2 25.0 5 27.8 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
12.5 0 0.0 1 7.1 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
18.8 2 20.0 5 19.2 0 0.0 0 0.0
0.0 2 16.7 2 11.8 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
10.0 1 12.5 2 11.1 0 0.0 0 0.0
0.0 2 33.3 2 20.0 0 0.0 0 0.0
17.4 0 0.0 4 10.0 0 0.0 0 0.0
0.0 3 37.5 3 16.7 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
10.0 13 8.9 29 9.5 0 0.0 0 0.0
POLIO2 DPT/HB (2)
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
14.3 2 13.3 5 13.9 0 0.0 0 0.0
9.1 2 33.3 3 17.6 0 0.0 0 0.0
0.0 1 9.1 1 5.0 0 0.0 0 0.0
30.0 0 0.0 3 16.7 0 0.0 0 0.0
20.0 1 12.5 2 15.4 0 0.0 0 0.0
12.5 1 16.7 2 14.3 0 0.0 0 0.0
33.3 0 0.0 2 14.3 0 0.0 0 0.0
18.8 1 10.0 4 15.4 0 0.0 0 0.0
20.0 2 16.7 3 17.6 0 0.0 0 0.0
14.3 1 11.1 2 12.5 0 0.0 0 0.0
10.0 1 12.5 2 11.1 0 0.0 0 0.0
50.0 0 0.0 2 20.0 0 0.0 0 0.0
8.7 1 5.9 3 7.5 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
35.7 1 14.3 6 28.6 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
16.3 14 9.6 40 13.1 0 0.0 0 0.0
POLIO2 DPT/HB (2)
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
9.5 1 6.7 3 8.3 0 0.0 0 0.0
9.1 1 16.7 2 11.8 0 0.0 0 0.0
11.1 0 0.0 1 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 0.0 0 0.0
0.0 2 20.0 2 7.7 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
20.0 1 12.5 3 16.7 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
4.3 0 0.0 1 2.5 0.0 0 0.0
20.0 0 0.0 2 11.1 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
5.6 5 3.4 14 4.6 0 0.0 0 0.0
POLIO2 DPT/HB (2)
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
19.0 2 13.3 6 16.7 0 0.0 0 0.0
9.1 0 0.0 1 5.9 0 0.0 0 0.0
22.2 1 9.1 3 15.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
33.3 0 0.0 2 14.3 0 0.0 0 0.0
6.3 0 0.0 1 3.8 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
10.0 1 12.5 2 11.1 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
8.7 1 5.9 3 7.5 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
14.3 2 28.6 4 19.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
9.4 7 4.8 22 7.2 0 0.0 0 0.0
POLIO2 DPT/HB (2)
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
POLIO2 DPT/HB (2)
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
POLIO2 DPT/HB (2)
% #P % # JML % #L % #P %
40 41 42 43 44 45 46 47 48
66.7 11 73.3 25 69.4 0 0.0 0 0.0
63.6 6 100.0 13 76.5 0 0.0 0 0.0
77.8 6 54.5 13 65.0 0 0.0 0 0.0
90.0 5 62.5 14 77.8 0 0.0 0 0.0
40.0 5 62.5 7 53.8 0 0.0 0 0.0
87.5 4 66.7 11 78.6 0 0.0 0 0.0
83.3 7 87.5 12 85.7 0 0.0 0 0.0
81.3 11 110.0 24 92.3 0 0.0 0 0.0
40.0 7 58.3 9 52.9 0 0.0 0 0.0
28.6 3 33.3 5 31.3 0 0.0 0 0.0
60.0 6 75.0 12 66.7 0 0.0 0 0.0
50.0 2 33.3 4 40.0 1 25.0 0 0.0
78.3 5 29.4 23 57.5 0 0.0 0 0.0
70.0 6 75.0 13 72.2 0 0.0 0 0.0
92.9 5 71.4 18 85.7 0 0.0 0 0.0
0.0 1 14.3 1 12.5 0 0.0 0 0.0
71.3 90 61.6 204 66.7 1 0.6 0 0.0
79%
NISASI BAYI
LIO 3 DPT/HB-Hib (3) POLIO4
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 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 7.1 1 14.3 2 9.5 1 7.1
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 0.6 1 0.7 2 0.7 1 0.6
Palangga ...................................................2017
Iwan Setiawan.SKM
Nip. 19730720 199502 1001
NISASI BAYI
HB (2) DPT/HB-Hib (2) POLIO3
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 2 9.5 0 0.0 2 5.6 2 9.5
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 22.2 1 9.1 3 15.0 2 22.2
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 2 25.0 2 15.4 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 1 10.0 1 3.8 0 0.0
0 0.0 1 20.0 0 0.0 1 5.9 1 20.0
0 0.0 0 0.0 2 22.2 2 12.5 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 2 8.7 2 11.8 4 10.0 2 8.7
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 7.1 1 14.3 2 9.5 1 7.1
0 0.0 0 0.0 1 14.3 1 12.5 0 0.0
0 0.0 8 5.0 10 6.8 18 5.9 8 5.0
Iwan Setiawan,SKM
Nip. 19730720 199502 1 001
NISASI BAYI
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 0 0.0 1 6.7 1 2.8 0 0.0
0 0.0 0 0.0 1 16.7 1 5.9 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 20.0 2 25.0 4 22.2 2 20.0
0 0.0 1 20.0 1 12.5 2 15.4 1 20.0
0 0.0 1 12.5 2 33.3 3 21.4 1 12.5
0 0.0 0 0.0 1 12.5 1 7.1 0 0.0
0 0.0 4 25.0 1 10.0 5 19.2 4 25.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 2 22.2 2 12.5 0 0.0
0 0.0 1 10.0 0 0.0 1 5.6 1 10.0
0 0.0 0 0.0 1 16.7 1 10.0 0 0.0
0 0.0 2 8.7 3 17.6 5 12.5 2 8.7
0 0.0 1 10.0 0 0.0 1 5.6 1 10.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 12 7.5 15 10.3 27 8.8 12 7.5
Palangga, ………………….2016
Iwan Setiawan,SKM
Nip. 19730720 199502 1 001
NISASI BAYI
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 1 4.8 2 13.3 3 8.3 1 4.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 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 12.5 1 16.7 2 14.3 1 12.5
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 12.5 1 10.0 3 11.5 2 21.4
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 1 11.1 1 6.3 0 0.0
0 0.0 0 0.0 1 12.5 1 5.6 0 0.0
1 10.0 1 25.0 0 0.0 1 10.0 0 0.0
0 0.0 2 8.7 1 5.9 3 7.5 2 8.7
0 0.0 1 10.0 2 25.0 3 16.7 1 10.0
0 0.0 3 21.4 0 0.0 3 14.3 3 21.4
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 0.3 11 6.9 9 6.2 20 6.5 10 6.3
Iwan Setiawan,SKM
Nip. 19730720 199502 1 001
NISASI BAYI
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 0 0.0 0 0.0 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 11.1 1 9.1 2 10.0 1 11.1
0 0.0 2 20.0 1 12.5 3 16.7 2 20.0
0 0.0 0 0.0 1 12.5 1 7.7 0 0.0
0 0.0 0 0.0 2 33.3 2 14.3 0 0.0
0 0.0 1 16.7 1 12.5 2 14.3 1 16.7
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 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 10.0 1 12.5 2 11.1 1 10.0
0 0.0 2 50.0 1 16.7 3 30.0 2 50.0
0 0.0 4 17.4 2 11.8 6 15.0 4 17.4
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 7.1 1 14.3 2 9.5 1 7.1
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 12 7.5 11 7.5 23 7.5 12 7.5
Iwan Setiawan,SKM
Nip. ...........................
NISASI BAYI
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 9.1 0 0.0 1 5.9 1 9.1
0 0.0 1 11.1 2 18.2 3 15.0 1 11.1
0 0.0 0 0.0 2 25.0 2 11.1 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 3 37.5 3 21.4 0 0.0
0 0.0 0 0.0 4 40.0 4 15.4 0 0.0
0 0.0 0 0.0 1 8.3 1 5.9 0 0.0
0 0.0 1 14.3 0 0.0 1 6.3 1 14.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 20.0
0 0.0 1 4.3 0 0.0 1 2.5 1 4.3
0 0.0 1 10.0 0 0.0 1 5.6 1 10.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 2 28.6 2 25.0 0 0.0
0 0.0 5 3.1 14 9.6 19 6.2 5 3.1
Palangga, ………………….2017
Koordinator Jurim Puskesmas .Palangga
Iwan Setiawan,SKM
Nip. 19730720 199502 1 001
NISASI BAYI
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 1 4.8 2 13.3 3 8.3 1 4.8
0 0.0 2 18.2 0 0.0 2 11.8 2 18.2
0 0.0 1 11.1 0 0.0 1 5.0 1 11.1
0 0.0 1 10.0 0 0.0 1 5.6 1 10.0
0 0.0 1 20.0 1 12.5 2 15.4 1 20.0
0 0.0 2 25.0 0 0.0 2 14.3 2 25.0
0 0.0 0 0.0 2 25.0 2 14.3 0 0.0
0 0.0 0 0.0 1 10.0 1 3.8 0 0.0
0 0.0 1 20.0 2 16.7 3 17.6 1 20.0
0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 1 10.0 0 0.0
0 0.0 1 4.3 0 0.0 1 2.5 1 4.3
0 0.0 1 10.0 0 0.0 1 5.6 1 10.0
0 0.0 2 14.3 1 14.3 3 14.3 2 14.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 13 8.1 10 6.8 23 7.5 13 8.1
Palangga ..................................................2016
Koordinator Jurim Puskesmas Palangga.
Iwan Setiawan
Nip. 19730720 199502 1 001
NISASI BAYI
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 2 9.5 0 0.0 2 5.6 2 9.5
0 0.0 0 0.0 1 16.7 1 5.9 0 0.0
0 0.0 1 11.1 1 9.1 2 10.0 1 11.1
0 0.0 3 30.0 2 25.0 5 27.8 3 30.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 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 18.8 2 20.0 5 19.2 3 18.8
0 0.0 0 0.0 2 16.7 2 11.8 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 1 10.0 0 0.0
0 0.0 4 21.4 0 0.0 4 10.0 4 17.4
0 0.0 0 0.0 2 25.0 2 11.1 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 13 8.1 11 7.5 24 7.8 13 8.1
Koordinator Jurim Puskesmas .Palangga
Iwan Setiawan,SKM
Nip. 19730720 199502 1 001
NISASI BAYI
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 4 19.0 0 0.0 4 11.1 4 19.0
0 0.0 1 9.1 2 33.3 3 17.6 1 9.1
0 0.0 0 0.0 1 9.1 1 5.0 0 0.0
0 0.0 2 20.0 0 0.0 2 11.1 2 20.0
0 0.0 1 20.0 1 12.5 2 15.4 1 20.0
0 0.0 1 12.5 1 16.7 2 14.3 1 12.5
0 0.0 1 16.7 0 0.0 1 7.1 1 16.7
0 0.0 2 12.5 0 0.0 2 7.7 2 12.5
0 0.0 1 20.0 1 8.3 2 11.8 1 20.0
0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 1 10.0 0 0.0
0 0.0 1 4.3 0 0.0 1 2.5 1 4.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 4 28.6 1 14.3 5 23.8 4 28.6
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 18 11.3 8 5.5 26 8.5 18 11.3
Palangga, ………………….2016
Koordinator Jurim Puskesmas .palangga
Iwan Setiawan.SKM
Nip. 19730720 199502 1 001.
NISASI BAYI
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 3 14.3 3 20.0 6 16.7 3 14.3
0 0.0 1 9.1 0 0.0 1 5.9 1 9.1
0 0.0 1 11.1 0 0.0 1 5.0 1 11.1
0 0.0 1 10.0 0 0.0 1 5.6 1 10.0
0 0.0 0 0.0 0 0.0 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 16.7 2 25.0 3 21.4 1 16.7
0 0.0 1 6.3 1 10.0 2 7.7 1 6.3
0 0.0 0 0.0 1 8.3 1 5.9 0 0.0
0 0.0 0 0.0 1 11.1 1 6.3 0 0.0
0 0.0 1 10.0 1 12.5 2 11.1 1 10.0
0 0.0 2 50.0 0 0.0 2 20.0 2 50.0
0 0.0 1 4.3 0 0.0 1 2.5 1 4.3
0 0.0 2 20.0 0 0.0 2 11.1 2 20.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 14 8.8 9 6.2 23 7.5 14 8.8

Koordinator Jurim Puskesmas Palangga.
Iwan Setiawan,SKM
Nip. .19730720 199502 1 oo1.
NISASI BAYI
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Palangga, ………………….2016
Koordinator Jurim Puskesmas .Palangga.

Iwan Setiawan,SKM
Nip. 19730720 199502 1 001
NISASI BAYI
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Palangga, ………………….2016
Koordinator Jurim Puskesmas .................
Iwan Setiawan.
Nip. 19730720 199502 1 001.
NISASI BAYI
# JML % #L % #P % # JML % #L %
49 50 51 52 53 54 55 56 57 58
0 0.0 13 61.9 8 53.3 21 58.3 13 61.9
0 0.0 5 45.5 1 16.7 6 35.3 5 45.5
0 0.0 7 77.8 6 54.5 13 65.0 7 77.8
0 0.0 11 110.0 7 87.5 18 100.0 11 110.0
0 0.0 3 60.0 6 75.0 9 69.2 3 60.0
0 0.0 5 62.5 6 100.0 11 78.6 5 62.5
0 0.0 3 50.0 9 112.5 12 85.7 3 50.0
0 0.0 12 75.0 11 110.0 23 88.5 12 75.0
0 0.0 3 60.0 7 58.3 10 58.8 3 60.0
0 0.0 1 14.3 6 66.7 7 43.8 1 14.3
0 0.0 3 30.0 3 37.5 6 33.3 3 30.0
1 10.0 5 125.0 5 83.3 10 100.0 4 100.0
0 0.0 18 78.3 8 47.1 26 65.0 18 78.3
0 0.0 6 60.0 4 50.0 10 55.6 6 60.0
0 0.0 12 85.7 5 71.4 17 81.0 12 85.7
0 0.0 0 0.0 3 42.9 3 37.5 0 0.0
1 0.3 107 66.9 95 65.1 202 66.0 106 66.3
79%

Iwan Setiawan,SKM
Nip. 19730720 199502 1 001
POLIO4 IPV
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 14.3 2 9.5 1 7.1 1 14.3 2 9.5
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 0.7 2 0.7 1 0.6 1 0.7 2 0.7
IDENTITAS DIDUGA KIPI (1)

1 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
a. Jalan ………………………… Nomor …. RT/RW ……………….
b. Dusun/Kampung…………….. Desa/Kelurahan …………………
POLIO3 DPT/HB (3)
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
0 0.0 2 5.6 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 9.1 3 15.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 25.0 2 15.4 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
1 10.0 1 3.8 0 0.0 0 0.0 0 0.0
0 0.0 1 5.9 0 0.0 0 0.0 0 0.0
2 22.2 2 12.5 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
2 11.8 4 10.0 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 14.3 2 9.5 0 0.0 0 0.0 0 0.0
1 14.3 1 12.5 0 0.0 0 0.0 0 0.0
10 6.8 18 5.9 0 0.0 0 0.0 0 0.0

1 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
POLIO3 DPT/HB (3)
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
1 6.7 1 2.8 0 0.0 0 0.0 0 0.0
1 16.7 1 5.9 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 25.0 4 22.2 0 0.0 0 0.0 0 0.0
1 12.5 2 15.4 0 0.0 0 0.0 0 0.0
2 33.3 3 21.4 0 0.0 0 0.0 0 0.0
1 12.5 1 7.1 0 0.0 0 0.0 0 0.0
1 10.0 5 19.2 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 22.2 2 12.5 0 0.0 0 0.0 0 0.0
0 0.0 1 5.6 0 0.0 0 0.0 0 0.0
1 16.7 1 10.0 0 0.0 0 0.0 0 0.0
3 17.6 5 12.5 0 0.0 0 0.0 0 0.0
0 0.0 1 5.6 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
15 10.3 27 8.8 0 0.0 0 0.0 0 0.0

1 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
POLIO3 DPT/HB (3)
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
2 13.3 3 8.3 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 16.7 2 14.3 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 10.0 3 11.5 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 11.1 1 6.3 0 0.0 0 0.0 0 0.0
1 12.5 1 5.6 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 5.9 3 7.5 0 0.0 0 0.0 0 0.0
2 25.0 3 16.7 0 0.0 0 0.0 0 0.0
0 0.0 3 14.3 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
9 6.2 19 6.2 0 0.0 0 0.0 0 0.0

1 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
POLIO3 DPT/HB (3)
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
0 0.0 0 0.0 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 9.1 2 10.0 0 0.0 0 0.0 0 0.0
1 12.5 3 16.7 0 0.0 0 0.0 0 0.0
1 12.5 1 7.7 0 0.0 0 0.0 0 0.0
2 33.3 2 14.3 0 0.0 0 0.0 0 0.0
1 12.5 2 14.3 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 12.5 2 11.1 0 0.0 0 0.0 0 0.0
1 16.7 3 30.0 0 0.0 0 0.0 0 0.0
2 11.8 6 15.0 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 14.3 2 9.5 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 7.5 23 7.5 0 0.0 0 0.0 0 0.0

1 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
POLIO3 DPT/HB (3)
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 5.9 0 0.0 0 0.0 0 0.0
2 18.2 3 15.0 0 0.0 0 0.0 0 0.0
2 25.0 2 11.1 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
3 37.5 3 21.4 0 0.0 0 0.0 0 0.0
4 40.0 4 15.4 0 0.0 0 0.0 0 0.0
1 8.3 1 5.9 0 0.0 0 0.0 0 0.0
0 0.0 1 6.3 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 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 2.5 0 0.0 0 0.0 0 0.0
0 0.0 1 5.6 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 28.6 2 25.0 0 0.0 0 0.0 0 0.0
14 9.6 19 6.2 0 0.0 0 0.0 0 0.0

1 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
POLIO3 DPT/HB (3)
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
2 13.3 3 8.3 0 0.0 0 0.0 0 0.0
0 0.0 2 11.8 0 0.0 0 0.0 0 0.0
0 0.0 1 5.0 0 0.0 0 0.0 0 0.0
0 0.0 1 5.6 0 0.0 0 0.0 0 0.0
1 12.5 2 15.4 0 0.0 0 0.0 0 0.0
0 0.0 2 14.3 0 0.0 0 0.0 0 0.0
2 25.0 2 14.3 0 0.0 0 0.0 0 0.0
1 10.0 1 3.8 0 0.0 0 0.0 0 0.0
2 16.7 3 17.6 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 16.7 1 10.0 0 0.0 0 0.0 0 0.0
0 0.0 1 2.5 0 0.0 0 0.0 0 0.0
0 0.0 1 5.6 0 0.0 0 0.0 0 0.0
1 14.3 3 14.3 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 6.8 23 7.5 0 0.0 0 0.0 0 0.0

1 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
POLIO3 DPT/HB (3)
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
0 0.0 2 5.6 0 0.0 0 0.0 0 0.0
1 16.7 1 5.9 0 0.0 0 0.0 0 0.0
1 9.1 2 10.0 0 0.0 0 0.0 0 0.0
2 25.0 5 27.8 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 20.0 5 19.2 0 0.0 0 0.0 0 0.0
2 16.7 2 11.8 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 16.7 1 10.0 0 0.0 0 0.0 0 0.0
0 0.0 4 10.0 0 0.0 0 0.0 0 0.0
2 25.0 2 11.1 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
11 7.5 24 7.8 0 0.0 0 0.0 0 0.0

1 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
POLIO3 DPT/HB (3)
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
0 0.0 4 11.1 0 0.0 0 0.0 0 0.0
2 33.3 3 17.6 0 0.0 0 0.0 0 0.0
1 9.1 1 5.0 0 0.0 0 0.0 0 0.0
0 0.0 2 11.1 0 0.0 0 0.0 0 0.0
1 12.5 2 15.4 0 0.0 0 0.0 0 0.0
1 16.7 2 14.3 0 0.0 0 0.0 0 0.0
0 0.0 1 7.1 0 0.0 0 0.0 0 0.0
0 0.0 2 7.7 0 0.0 0 0.0 0 0.0
1 8.3 2 11.8 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 16.7 1 10.0 0 0.0 0 0.0 0 0.0
0 0.0 1 2.5 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 14.3 5 23.8 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
8 5.5 26 8.5 0 0.0 0 0.0 0 0.0
1 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
POLIO3 DPT/HB (3)
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
3 20.0 6 16.7 0 0.0 0 0.0 0 0.0
0 0.0 1 5.9 0 0.0 0 0.0 0 0.0
0 0.0 1 5.0 0 0.0 0 0.0 0 0.0
0 0.0 1 5.6 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 25.0 3 21.4 0 0.0 0 0.0 0 0.0
1 10.0 2 7.7 0 0.0 0 0.0 0 0.0
1 8.3 1 5.9 0 0.0 0 0.0 0 0.0
1 11.1 1 6.3 0 0.0 0 0.0 0 0.0
1 12.5 2 11.1 0 0.0 0 0.0 0 0.0
0 0.0 2 20.0 0 0.0 0 0.0 0 0.0
0 0.0 1 2.5 0 0.0 0 0.0 0 0.0
0 0.0 2 11.1 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
9 6.2 23 7.5 0 0.0 0 0.0 0 0.0

1 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
POLIO3 DPT/HB (3)
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
POLIO3 DPT/HB (3)
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
POLIO3 DPT/HB (3)
#P % # JML % #L % #P % # JML %
59 60 61 62 63 64 65 66 67 68
8 53.3 21 58.3 0 0.0 0 0.0 0 0.0
4 66.7 9 52.9 0 0.0 0 0.0 0 0.0
6 54.5 13 65.0 0 0.0 0 0.0 0 0.0
7 87.5 18 100.0 0 0.0 0 0.0 0 0.0
6 75.0 9 69.2 0 0.0 0 0.0 0 0.0
6 100.0 11 78.6 0 0.0 0 0.0 0 0.0
9 112.5 12 85.7 0 0.0 0 0.0 0 0.0
11 110.0 23 88.5 0 0.0 0 0.0 0 0.0
7 58.3 10 58.8 0 0.0 0 0.0 0 0.0
6 66.7 7 43.8 0 0.0 0 0.0 0 0.0
3 37.5 6 33.3 0 0.0 0 0.0 0 0.0
5 83.3 9 90.0 0 0.0 0 0.0 0 0.0
8 47.1 26 65.0 0 0.0 0 0.0 0 0.0
4 50.0 10 55.6 0 0.0 0 0.0 0 0.0
5 71.4 17 81.0 1 7.1 1 14.3 2 9.5
3 42.9 3 37.5 0 0.0 0 0.0 0 0.0
98 67.1 204 66.7 1 0.6 1 0.7 2 0.7
77,5
CAMPAK IMUNISASI DASAR LENGKAP
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 14.3 0 0.0 2 9.5 2 14.3 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 1.3 0 0.0 2 0.7 2 1.3 0 0.0
IMUNISASI
Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir)
Imunisasi (Vaksin) Tgl Jam No. Batch
W ………………. Reaksi timbul pada tgl ..........................................

……………… Gejala & Waktu timbulnya gejala .........................................................
…………………
DPT/HB-Hib (3) POLIO4
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
1 4.8 1 6.7 2 5.6 1 4.8 1 6.7
1 9.1 3 50.0 4 23.5 1 9.1 3 50.0
2 22.2 2 18.2 4 20.0 2 22.2 2 18.2
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 12.5 1 7.7 0 0.0 1 12.5
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 16.7 0 0.0 1 7.1 1 16.7 0 0.0
3 18.8 0 0.0 3 11.5 3 18.8 0 0.0
1 20.0 1 8.3 2 11.8 1 20.0 1 8.3
2 28.6 2 22.2 4 25.0 2 28.6 2 22.2
0 0.0 0 0.0 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 4.3 1 5.9 2 5.0 1 4.3 1 5.9
2 20.0 0 0.0 2 11.1 2 20.0 0 0.0
1 7.1 0 0.0 1 4.8 1 7.1 0 0.0
0 0.0 1 14.3 1 12.5 0 0.0 1 14.3
15 9.4 12 8.2 27 8.8 15 9.4 12 8.2
IMUNISASI

…………………
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
3 14.3 0 0.0 3 8.3 3 14.3 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 22.2 1 9.1 3 15.0 2 22.2 1 9.1
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 12.5 1 7.7 0 0.0 1 12.5
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 1 10.0 1 3.8 0 0.0 1 10.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 25.0 0 0.0 1 10.0 1 25.0 0 0.0
1 4.3 0 0.0 1 2.5 1 4.3 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 7.1 0 0.0 1 4.8 1 7.1 0 0.0
0 0.0 1 14.3 1 12.5 0 0.0 1 14.3
8 5.0 4 2.7 12 3.9 8 5.0 4 2.7
IMUNISASI

…………………
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
1 4.8 1 6.7 2 5.6 1 4.8 1 6.7
1 9.1 0 0.0 1 5.9 1 9.1 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 20.0 2 25.0 4 22.2 2 20.0 2 25.0
1 20.0 2 25.0 3 23.1 1 20.0 2 25.0
1 12.5 2 33.3 3 21.4 1 12.5 2 33.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
3 18.8 1 10.0 4 15.4 3 18.8 1 10.0
1 20.0 0 0.0 1 5.9 1 20.0 0 0.0
0 0.0 4 44.4 4 25.0 0 0.0 4 44.4
1 10.0 0 0.0 1 5.6 1 10.0 0 0.0
0 0.0 1 16.7 1 10.0 0 0.0 1 16.7
3 13.0 6 35.3 9 22.5 3 13.0 6 35.3
1 10.0 0 0.0 1 5.6 1 10.0 0 0.0
2 14.3 0 0.0 2 9.5 2 14.3 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
17 10.6 19 13.0 36 11.8 17 10.6 19 13.0
IMUNISASI

…………………
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
0 0.0 2 13.3 2 5.6 0 0.0 2 13.3
0 0.0 1 16.7 1 5.9 0 0.0 1 16.7
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 12.5 0 0.0 1 7.1 1 12.5 0 0.0
0 0.0 1 12.5 1 7.1 0 0.0 1 12.5
2 12.5 0 0.0 2 7.7 2 12.5 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 1 16.7 1 10.0 0 0.0 1 16.7
2 8.7 2 11.8 4 10.0 2 8.7 2 11.8
1 10.0 2 25.0 3 16.7 1 10.0 2 25.0
2 14.3 0 0.0 2 9.5 2 14.3 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
8 5.0 9 6.2 17 5.6 8 5.0 9 6.2
IMUNISASI

…………………
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
1 4.8 0 0.0 1 2.8 1 4.8 0 0.0
1 9.1 0 0.0 1 5.9 1 9.1 0 0.0
1 11.1 1 9.1 2 10.0 1 11.1 1 9.1
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 12.5 1 7.7 0 0.0 1 12.5
0 0.0 3 50.0 3 21.4 0 0.0 3 50.0
1 16.7 1 12.5 2 14.3 1 16.7 1 12.5
1 6.3 0 0.0 1 3.8 1 6.3 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 11.1 1 6.3 0 0.0 1 11.1
2 20.0 2 25.0 4 22.2 2 20.0 2 25.0
1 25.0 1 16.7 2 20.0 1 25.0 1 16.7
3 13.0 1 5.9 4 10.0 2 8.7 1 5.9
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 6.9 11 7.5 22 7.2 10 6.3 11 7.5
IMUNISASI

…………………
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 9.1 0 0.0 1 5.9 1 9.1 0 0.0
0 0.0 2 18.2 2 10.0 0 0.0 2 18.2
0 0.0 1 12.5 1 5.6 0 0.0 1 12.5
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 3 37.5 3 21.4 0 0.0 3 37.5
0 0.0 3 30.0 3 11.5 0 0.0 3 30.0
0 0.0 1 8.3 1 5.9 0 0.0 1 8.3
1 14.3 0 0.0 1 6.3 1 14.3 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 50.0 0 0.0 2 20.0 2 50.0 0 0.0
1 4.3 0 0.0 1 2.5 1 4.3 0 0.0
1 10.0 0 0.0 1 5.6 1 10.0 0 0.0
1 7.1 2 28.6 3 14.3 1 7.1 2 28.6
0 0.0 2 28.6 2 25.0 0 0.0 2 28.6
7 4.4 14 9.6 21 6.9 7 4.4 14 9.6
IMUNISASI

…………………
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
1 4.8 2 13.3 3 8.3 1 4.8 2 13.3
1 9.1 0 0.0 1 5.9 1 9.1 0 0.0
2 22.2 0 0.0 2 10.0 2 22.2 0 0.0
1 10.0 0 0.0 1 5.6 1 10.0 0 0.0
1 20.0 1 12.5 2 15.4 1 20.0 1 12.5
1 12.5 0 0.0 1 7.1 1 12.5 0 0.0
0 0.0 2 25.0 2 14.3 0 0.0 2 25.0
0 0.0 2 20.0 2 7.7 0 0.0 2 20.0
1 20.0 1 8.3 2 11.8 1 20.0 1 8.3
0 0.0 0 0.0 0 0.0 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 16.7 1 10.0 0 0.0 1 16.7
1 4.3 1 5.9 2 5.0 1 4.3 1 5.9
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 7.1 1 14.3 2 9.5 1 7.1 1 14.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 6.3 11 7.5 21 6.9 10 6.3 11 7.5
IMUNISASI

…………………
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
2 9.5 0 0.0 2 5.6 2 9.5 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 11.1 1 9.1 2 10.0 1 11.1 1 9.1
3 30.0 1 12.5 4 22.2 3 30.0 1 12.5
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 25.0 0 0.0 2 14.3 2 25.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
3 18.8 0 0.0 3 11.5 3 18.8 0 0.0
0 0.0 3 25.0 3 17.6 0 0.0 3 25.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 10.0 1 12.5 2 11.1 1 10.0 1 12.5
0 0.0 1 16.7 1 10.0 0 0.0 1 16.7
3 13.0 0 0.0 3 7.5 3 13.0 0 0.0
0 0.0 2 25.0 2 11.1 0 0.0 2 25.0
2 14.3 0 0.0 2 9.5 2 14.3 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
17 10.6 9 6.2 26 8.5 17 10.6 9 6.2
IMUNISASI

…………………
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
2 9.5 0 0.0 2 5.6 2 9.5 0 0.0
0 0.0 2 33.3 2 11.8 0 0.0 2 33.3
0 0.0 1 9.1 1 5.0 0 0.0 1 9.1
1 10.0 1 12.5 2 11.1 1 10.0 1 12.5
1 20.0 1 12.5 2 15.4 1 20.0 1 12.5
1 12.5 1 16.7 2 14.3 1 12.5 1 16.7
1 16.7 0 0.0 1 7.1 1 16.7 0 0.0
0 0.0 2 20.0 2 7.7 0 0.0 2 20.0
0 0.0 1 8.3 1 5.9 0 0.0 1 8.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 13.0 0 0.0 3 7.5 3 13.0 0 0.0
1 10.0 0 0.0 1 5.6 1 10.0 0 0.0
2 14.3 1 14.3 3 14.3 2 14.3 1 14.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
12 7.5 10 6.8 22 7.2 12 7.5 10 6.8
IMUNISASI

…………………
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI


…………………
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI

…………………
#L % #P % # JML % #L % #P %
69 70 71 72 73 74 75 76 77 78
11 52.4 6 40.0 17 47.2 11 52.4 6 40.0
5 45.5 6 100.0 11 64.7 5 45.5 6 100.0
8 88.9 8 72.7 16 80.0 8 88.9 8 72.7
7 70.0 5 62.5 12 66.7 7 70.0 5 62.5
3 60.0 7 87.5 10 76.9 3 60.0 7 87.5
6 75.0 6 100.0 12 85.7 6 75.0 6 100.0
3 50.0 7 87.5 10 71.4 3 50.0 7 87.5
12 75.0 9 90.0 21 80.8 12 75.0 9 90.0
3 60.0 7 58.3 10 58.8 3 60.0 7 58.3
3 42.9 7 77.8 10 62.5 3 42.9 7 77.8
4 40.0 3 37.5 7 38.9 4 40.0 3 37.5
4 100.0 5 83.3 9 90.0 4 100.0 5 83.3
18 78.3 11 64.7 29 72.5 17 73.9 11 64.7
6 60.0 4 50.0 10 55.6 6 60.0 4 50.0
14 100.0 4 57.1 18 85.7 14 100.0 4 57.1
0 0.0 4 57.1 4 50.0 0 0.0 4 57.1
107 66.9 99 67.8 206 67.3 106 66.3 99 67.8
77,5 %
ASAR LENGKAP
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 9.5 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
2 0.7 0 0.0 0 0.0 0 0.0 0 0.0
Cara Pemberian (Intra kutan, Sub-kutan, Jumlah dosis

Tgl. Kadaluarsa VVM Lokasi penyuntikan
IM, tetes) vaksin (ml / tetes)
............................
LIO4 CAMPAK IMUNISASI DASA
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
2 5.6 0 0.0 3 20.0 3 8.3 0 0.0
4 23.5 3 27.3 1 16.7 4 23.5 3 27.3
4 20.0 3 33.3 1 9.1 4 20.0 3 33.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 7.7 0 0.0 1 12.5 1 7.7 0 0.0
0 0.0 0 0.0 2 33.3 2 14.3 0 0.0
1 7.1 2 33.3 0 0.0 2 14.3 2 33.3
3 11.5 0 0.0 2 20.0 2 7.7 0 0.0
2 11.8 1 20.0 3 25.0 4 23.5 1 20.0
4 25.0 1 14.3 0 0.0 1 6.3 1 14.3
0 0.0 1 10.0 1 12.5 2 11.1 1 10.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 5.0 2 8.7 2 11.8 4 10.0 2 8.7
2 11.1 0 0.0 0 0.0 0 0.0 0 0.0
1 4.8 0 0.0 1 14.3 1 4.8 0 0.0
1 12.5 0 0.0 1 14.3 1 12.5 0 0.0
27 8.8 13 8.1 18 12.3 31 10.1 13 8.1

............................
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
3 8.3 1 4.8 2 13.3 3 8.3 1 4.8
0 0.0 0 0.0 2 33.3 2 11.8 0 0.0
3 15.0 2 22.2 3 27.3 5 25.0 2 22.2
0 0.0 2 20.0 0 0.0 2 11.1 2 20.0
1 7.7 2 40.0 1 12.5 3 23.1 2 40.0
0 0.0 2 25.0 1 16.7 3 21.4 2 25.0
0 0.0 2 33.3 1 12.5 3 21.4 2 33.3
1 3.8 3 18.8 0 0.0 3 11.5 3 18.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 14.3 1 11.1 2 12.5 1 14.3
0 0.0 2 20.0 1 12.5 3 16.7 2 20.0
1 10.0 0 0.0 0 0.0 0 0.0 0 0.0
1 2.5 0 0.0 2 11.8 2 5.0 0 0.0
0 0.0 0 0.0 3 37.5 3 16.7 0 0.0
1 4.8 1 7.1 1 14.3 2 9.5 1 7.1
1 12.5 0 0.0 2 28.6 2 25.0 0 0.0
12 3.9 18 11.3 20 13.7 38 12.4 18 11.3

............................
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
2 5.6 6 28.6 0 0.0 6 16.7 6 28.6
1 5.9 1 9.1 1 16.7 2 11.8 1 9.1
0 0.0 1 11.1 2 18.2 3 15.0 1 11.1
4 22.2 0 0.0 0 0.0 0 0.0 0 0.0
3 23.1 0 0.0 0 0.0 0 0.0 0 0.0
3 21.4 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 2 25.0 2 14.3 0 0.0
4 15.4 4 25.0 2 20.0 6 23.1 4 25.0
1 5.9 1 20.0 1 8.3 2 11.8 1 20.0
4 25.0 1 14.3 0 0.0 1 6.3 1 14.3
1 5.6 1 10.0 3 37.5 4 22.2 1 10.0
1 10.0 1 25.0 2 33.3 3 30.0 1 25.0
9 22.5 4 17.4 1 5.9 5 12.5 4 17.4
1 5.6 0 0.0 0 0.0 0 0.0 0 0.0
2 9.5 1 7.1 1 14.3 2 9.5 1 7.1
0 0.0 1 100.0 0 0.0 1 12.5 1 100.0
36 11.8 22 13.8 15 10.3 37 12.1 22 13.8

............................
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
2 5.6 3 14.3 1 6.7 4 11.1 3 14.3
1 5.9 0 0.0 1 16.7 1 5.9 0 0.0
0 0.0 1 11.1 1 9.1 2 10.0 1 11.1
0 0.0 0 0.0 1 12.5 1 5.6 0 0.0
0 0.0 1 20.0 1 12.5 2 15.4 1 20.0
1 7.1 0 0.0 0 0.0 0 0.0 0 0.0
1 7.1 1 16.7 0 0.0 1 7.1 1 16.7
2 7.7 2 12.5 0 0.0 2 7.7 2 12.5
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
1 10.0 0 0.0 0 0.0 0 0.0 0 0.0
4 10.0 3 13.0 1 5.9 4 10.0 3 13.0
3 16.7 0 0.0 0 0.0 0 0.0 0 0.0
2 9.5 1 7.1 1 14.3 2 9.5 1 7.1
0 0.0 0 0.0 1 14.3 1 12.5 0 0.0
17 5.6 12 7.5 8 5.5 20 6.5 12 7.5

............................
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
1 2.8 3 14.3 0 0.0 3 8.3 3 14.3
1 5.9 1 9.1 2 33.3 3 17.6 1 9.1
2 10.0 0 0.0 1 9.1 1 5.0 0 0.0
0 0.0 2 20.0 0 0.0 2 11.1 2 20.0
1 7.7 0 0.0 0 0.0 0 0.0 0 0.0
3 21.4 0 0.0 0 0.0 0 0.0 0 0.0
2 14.3 0 0.0 0 0.0 0 0.0 0 0.0
1 3.8 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 20.0 2 16.7 3 17.6 1 20.0
1 6.3 1 14.3 2 22.2 3 18.8 1 14.3
4 22.2 1 10.0 0 0.0 1 5.6 1 10.0
2 20.0 0 0.0 1 16.7 1 10.0 0 0.0
3 7.5 2 8.7 1 5.9 3 7.5 2 8.7
0 0.0 2 20.0 0 0.0 2 11.1 2 20.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
21 6.9 13 8.1 9 6.2 22 7.2 13 8.1

............................
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
0 0.0 1 4.8 1 6.7 2 5.6 1 4.8
1 5.9 0 0.0 1 16.7 1 5.9 0 0.0
2 10.0 1 11.1 0 0.0 1 5.0 1 11.1
1 5.6 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 1 12.5 1 7.7 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
3 21.4 0 0.0 0 0.0 0 0.0 0 0.0
3 11.5 0 0.0 0 0.0 0 0.0 0 0.0
1 5.9 0 0.0 0 0.0 0 0.0 0 0.0
1 6.3 1 14.3 2 22.2 3 18.8 1 14.3
0 0.0 2 20.0 0 0.0 2 11.1 2 20.0
2 20.0 1 25.0 0 0.0 1 10.0 1 25.0
1 2.5 2 8.7 4 23.5 6 15.0 2 8.7
1 5.6 2 20.0 0 0.0 2 11.1 2 20.0
3 14.3 2 14.3 1 14.3 3 14.3 2 14.3
2 25.0 0 0.0 1 14.3 1 12.5 0 0.0
21 6.9 12 7.5 11 7.5 23 7.5 12 7.5

............................
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
3 8.3 0 0.0 1 6.7 1 2.8 0 0.0
1 5.9 0 0.0 0 0.0 0 0.0 0 0.0
2 10.0 0 0.0 0 0.0 0 0.0 0 0.0
1 5.6 1 10.0 2 25.0 3 16.7 1 10.0
2 15.4 0 0.0 2 25.0 2 15.4 0 0.0
1 7.1 0 0.0 2 33.3 2 14.3 0 0.0
2 14.3 0 0.0 1 12.5 1 7.1 0 0.0
2 7.7 3 18.8 3 30.0 6 23.1 3 18.8
2 11.8 1 20.0 0 0.0 1 5.9 1 20.0
0 0.0 1 14.3 2 22.2 3 18.8 1 14.3
0 0.0 0 0.0 2 25.0 2 11.1 0 0.0
1 10.0 1 25.0 0 0.0 1 10.0 1 25.0
2 5.0 3 13.0 2 11.8 5 12.5 3 13.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 9.5 1 7.1 0 0.0 1 4.8 1 7.1
0 0.0 0 0.0 1 14.3 1 12.5 0 0.0
21 6.9 11 6.9 18 12.3 29 9.5 11 6.9

............................
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
2 5.6 1 4.8 2 13.3 3 8.3 1 4.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 10.0 1 11.1 0 0.0 1 5.0 1 11.1
4 22.2 2 20.0 1 12.5 3 16.7 2 20.0
0 0.0 1 20.0 1 12.5 2 15.4 1 20.0
2 14.3 1 12.5 0 0.0 1 7.1 1 12.5
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
3 11.5 0 0.0 0 0.0 0 0.0 0 0.0
3 17.6 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 1 11.1 1 6.3 0 0.0
2 11.1 0 0.0 0 0.0 0 0.0 0 0.0
1 10.0 0 0.0 1 16.7 1 10.0 0 0.0
3 7.5 4 17.4 2 11.8 6 15.0 4 17.4
2 11.1 2 20.0 0 0.0 2 11.1 2 20.0
2 9.5 2 14.3 1 14.3 3 14.3 2 14.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
26 8.5 14 8.8 9 6.2 23 7.5 14 8.8
............................
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
2 5.6 0 0.0 1 6.7 1 2.8 0 0.0
2 11.8 1 9.1 0 0.0 1 5.9 1 9.1
1 5.0 2 22.2 2 18.2 4 20.0 2 22.2
2 11.1 0 0.0 0 0.0 0 0.0 0 0.0
2 15.4 0 0.0 0 0.0 0 0.0 0 0.0
2 14.3 2 25.0 1 16.7 3 21.4 2 25.0
1 7.1 1 16.7 1 12.5 2 14.3 1 16.7
2 7.7 2 12.5 0 0.0 2 7.7 2 12.5
1 5.9 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 50.0 0 0.0 2 20.0 2 50.0
3 7.5 0 0.0 0 0.0 0 0.0 0 0.0
1 5.6 0 0.0 2 25.0 2 11.1 0 0.0
3 14.3 2 14.3 0 0.0 2 9.5 2 14.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
22 7.2 12 7.5 7 4.8 19 6.2 12 7.5
............................
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
0 0.0 0 0.0 3 20.0 3 8.3 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 2.1 3 1.0 0 0.0

............................
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
............................
# JML % #L % #P % # JML % #L %
79 80 81 82 83 84 85 86 87 88
17 47.2 15 71.4 8 53.3 23 63.9 15 71.4
11 64.7 6 54.5 8 133.3 14 82.4 6 54.5
16 80.0 11 122.2 10 90.9 21 105.0 11 122.2
12 66.7 7 70.0 4 50.0 11 61.1 7 70.0
10 76.9 4 80.0 7 87.5 11 84.6 4 80.0
12 85.7 5 62.5 6 100.0 11 78.6 5 62.5
10 71.4 6 100.0 5 62.5 11 78.6 6 100.0
21 80.8 14 87.5 7 70.0 21 80.8 14 87.5
10 58.8 4 80.0 6 50.0 10 58.8 4 80.0
10 62.5 6 85.7 8 88.9 14 87.5 6 85.7
7 38.9 7 70.0 7 87.5 14 77.8 7 70.0
9 90.0 5 125.0 4 66.7 9 90.0 5 125.0
28 70.0 20 87.0 15 88.2 35 87.5 20 87.0
10 55.6 6 60.0 5 62.5 11 61.1 6 60.0
18 85.7 10 71.4 6 85.7 16 76.2 10 71.4
4 16.6 1 100.0 6 85.7 7 87.5 1 100.0
205 67.0 127 79.4 112 76.7 239 78.1 127 79.4
77,5 %
HASI
SASARAN BATITA DPT/HB/Hib
#P % # JML % L P JLH #L %
89 90 91 92 93 94 95 96 97
0 0.0 0 0.0 37 56 93 0 0.0
0 0.0 0 0.0 23 27 50 0 0.0
0 0.0 0 0.0 31 38 69 0 0.0
0 0.0 0 0.0 23 19 42 0 0.0
0 0.0 0 0.0 22 13 35 0 0.0
0 0.0 0 0.0 19 16 35 0 0.0
0 0.0 0 0.0 33 35 68 0 0.0
0 0.0 0 0.0 38 36 74 0 0.0
0 0.0 0 0.0 32 27 59 0 0.0
0 0.0 0 0.0 25 19 44 0 0.0
0 0.0 0 0.0 35 38 73 0 0.0
0 0.0 0 0.0 31 18 49 0 0.0
0 0.0 0 0.0 56 60 116 0 0.0
0 0.0 0 0.0 22 21 43 0 0.0
0 0.0 0 0.0 16 30 46 1 6.3
0 0.0 0 0.0 9 13 22 0 0.0
0 0.0 0 0.0 452 466 918 1 0.2

1 Nama :
2 Kelamin :
Lokasi penyuntikan
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
HASI
IMUNISASI DASAR LENGKAP SASARAN BATITA DPT/HB/Hib
89 90 91 92 93 94 95 96 97
3 20.0 3 8.3 37 56 93 0 0.0
1 16.7 4 23.5 23 27 50 0 0.0
1 9.1 4 20.0 31 38 69 1 3.2
0 0.0 0 0.0 23 19 42 0 0.0
1 12.5 1 7.7 22 13 35 0 0.0
2 33.3 2 14.3 19 16 35 0 0.0
0 0.0 2 14.3 33 35 68 0 0.0
2 20.0 2 7.7 38 36 74 2 5.3
3 25.0 4 23.5 32 27 59 2 6.3
0 0.0 1 6.3 25 19 44 0 0.0
1 12.5 2 11.1 35 38 73 0 0.0
0 0.0 0 0.0 31 18 49 0 0.0
2 11.8 4 10.0 56 60 116 0 0.0
0 0.0 0 0.0 22 21 43 0 0.0
1 14.3 1 4.8 16 30 46 0 0.0
1 14.3 1 12.5 9 13 22 0 0.0
18 12.3 31 10.1 452 466 918 5 1.1

1 Nama :
2 Kelamin :
Lokasi penyuntikan
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
HASI
89 90 91 92 93 94 95 96 97
2 13.3 3 8.3 37 56 93 0 0.0
2 33.3 2 11.8 23 27 50 0 0.0
3 27.3 5 25.0 31 38 69 1 3.2
0 0.0 2 11.1 23 19 42 0 0.0
1 12.5 3 23.1 22 13 35 0 0.0
1 16.7 3 21.4 19 16 35 0 0.0
1 12.5 3 21.4 33 35 68 1 3.0
0 0.0 3 11.5 38 36 74 0 0.0
0 0.0 0 0.0 32 27 59 0 0.0
1 11.1 2 12.5 25 19 44 0 0.0
1 12.5 3 16.7 35 38 73 0 0.0
0 0.0 0 0.0 31 18 49 2 6.5
2 11.8 2 5.0 56 60 116 2 3.6
3 37.5 3 16.7 22 21 43 0 0.0
1 14.3 2 9.5 16 30 46 2 12.5
2 28.6 2 25.0 9 13 22 2 22.2
20 13.7 38 12.4 452 466 918 0 0.0

1 Nama :
2 Kelamin :
Lokasi penyuntikan
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
HASI
89 90 91 92 93 94 95 96 97
0 0.0 6 16.7 37 56 93 0 0.0
1 16.7 2 11.8 23 27 50 0 0.0
2 18.2 3 15.0 31 38 69 0 0.0
0 0.0 0 0.0 23 19 42 1 4.3
0 0.0 0 0.0 22 13 35 0 0.0
0 0.0 0 0.0 19 16 35 1 5.3
2 25.0 2 14.3 33 35 68 1 3.0
2 20.0 6 23.1 38 36 74 2 5.3
1 8.3 2 11.8 32 27 59 0 0.0
0 0.0 1 6.3 25 19 44 0 0.0
3 37.5 4 22.2 35 38 73 0 0.0
2 33.3 3 30.0 31 18 49 0 0.0
1 5.9 5 12.5 56 60 116 0 0.0
0 0.0 0 0.0 22 21 43 1 4.5
1 14.3 2 9.5 16 30 46 1 6.3
0 0.0 1 12.5 9 13 22 0 0.0
15 10.3 37 12.1 452 466 918 7 1.5

1 Nama :
2 Kelamin :
Lokasi penyuntikan
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
HASI
89 90 91 92 93 94 95 96 97
1 6.7 4 11.1 37 56 93 0 0.0
1 16.7 1 5.9 23 27 50 0 0.0
1 9.1 2 10.0 31 38 69 1 3.2
1 12.5 1 5.6 23 19 42 0 0.0
1 12.5 2 15.4 22 13 35 0 0.0
0 0.0 0 0.0 19 16 35 0 0.0
0 0.0 1 7.1 33 35 68 0 0.0
0 0.0 2 7.7 38 36 74 0 0.0
0 0.0 0 0.0 32 27 59 0 0.0
0 0.0 0 0.0 25 19 44 0 0.0
0 0.0 0 0.0 35 38 73 1 2.9
0 0.0 0 0.0 31 18 49 0 0.0
1 5.9 4 10.0 56 60 116 0 0.0
0 0.0 0 0.0 22 21 43 0 0.0
1 14.3 2 9.5 16 30 46 0 0.0
1 14.3 1 12.5 9 13 22 0 0.0
8 5.5 20 6.5 452 466 918 2 0.4

1 Nama :
2 Kelamin :
Lokasi penyuntikan
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
HASI
89 90 91 92 93 94 95 96 97
0 0.0 3 8.3 37 56 93 1 2.7
2 33.3 3 17.6 23 27 50 0 0.0
1 9.1 1 5.0 31 38 69 0 0.0
0 0.0 2 11.1 23 19 42 0 0.0
0 0.0 0 0.0 22 13 35 0 0.0
0 0.0 0 0.0 19 16 35 0 0.0
0 0.0 0 0.0 33 35 68 0 0.0
0 0.0 0 0.0 38 36 74 1 2.6
2 16.7 3 17.6 32 27 59 0 0.0
2 22.2 3 18.8 25 19 44 0 0.0
0 0.0 1 5.6 35 38 73 0 0.0
1 16.7 1 10.0 31 18 49 2 6.5
1 5.9 3 7.5 56 60 116 0 0.0
0 0.0 2 11.1 22 21 43 0 0.0
0 0.0 0 0.0 16 30 46 0 0.0
0 0.0 0 0.0 9 13 22 0 0.0
9 6.2 22 7.2 452 466 918 4 0.9

1 Nama :
2 Kelamin :
Lokasi penyuntikan
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
HASI
89 90 91 92 93 94 95 96 97
1 6.7 2 5.6 37 56 93 5 13.5
1 16.7 1 5.9 23 27 50 0 0.0
0 0.0 1 5.0 31 38 69 0 0.0
0 0.0 0 0.0 23 19 42 1 4.3
1 12.5 1 7.7 22 13 35 0 0.0
0 0.0 0 0.0 19 16 35 0 0.0
0 0.0 0 0.0 33 35 68 1 3.0
0 0.0 0 0.0 38 36 74 2 5.3
0 0.0 0 0.0 32 27 59 0 0.0
2 22.2 3 18.8 25 19 44 0 0.0
0 0.0 2 11.1 35 38 73 0 0.0
0 0.0 1 10.0 31 18 49 0 0.0
4 23.5 6 15.0 56 60 116 1 1.8
0 0.0 2 11.1 22 21 43 1 4.5
1 14.3 3 14.3 16 30 46 0 0.0
1 14.3 1 12.5 9 13 22 0 0.0
11 7.5 23 7.5 452 466 918 11 2.4

1 Nama :
2 Kelamin :
Lokasi penyuntikan
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
HASI
89 90 91 92 93 94 95 96 97
1 6.7 1 2.8 37 56 93 1 2.7
0 0.0 0 0.0 23 27 50 2 8.7
0 0.0 0 0.0 31 38 69 1 3.2
2 25.0 3 16.7 23 19 42 0 0.0
2 25.0 2 15.4 22 13 35 0 0.0
2 33.3 2 14.3 19 16 35 1 5.3
1 12.5 1 7.1 33 35 68 1 3.0
3 30.0 6 23.1 38 36 74 2 5.3
0 0.0 1 5.9 32 27 59 1 3.1
2 22.2 3 18.8 25 19 44 2 8.0
2 25.0 2 11.1 35 38 73 0 0.0
0 0.0 1 10.0 31 18 49 0 0.0
2 11.8 5 12.5 56 60 116 2 3.6
0 0.0 0 0.0 22 21 43 0 0.0
0 0.0 1 4.8 16 30 46 0 0.0
1 14.3 1 12.5 9 13 22 0 0.0
18 12.3 29 9.5 452 466 918 13 2.9

1 Nama :
2 Kelamin :
Lokasi penyuntikan
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
HASI
89 90 91 92 93 94 95 96 97
2 13.3 3 8.3 37 56 93 1 2.7
0 0.0 0 0.0 23 27 50 0 0.0
0 0.0 1 5.0 31 38 69 0 0.0
1 12.5 3 16.7 23 19 42 0 0.0
1 12.5 2 15.4 22 13 35 0 0.0
0 0.0 1 7.1 19 16 35 2 10.5
0 0.0 0 0.0 33 35 68 0 0.0
0 0.0 0 0.0 38 36 74 0 0.0
0 0.0 0 0.0 32 27 59 0 0.0
1 11.1 1 6.3 25 19 44 0 0.0
0 0.0 0 0.0 35 38 73 0 0.0
1 16.7 1 10.0 31 18 49 0 0.0
2 11.8 6 15.0 56 60 116 0 0.0
0 0.0 2 11.1 22 21 43 0 0.0
1 14.3 3 14.3 16 30 46 0 0.0
0 0.0 0 0.0 9 13 22 0 0.0
9 6.2 23 7.5 452 466 918 3 0.7
1 Nama :
2 Kelamin :
Lokasi penyuntikan
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
HASI
89 90 91 92 93 94 95 96 97
1 6.7 1 0.0 37 56 93 1 2.7
0 0.0 1 5.9 23 27 50 2 8.7
2 18.2 4 20.0 31 38 69 0 0.0
0 0.0 0 0.0 23 19 42 0 0.0
0 0.0 0 0.0 22 13 35 0 0.0
1 16.7 3 21.4 19 16 35 1 5.3
1 12.5 2 14.3 33 35 68 4 12.1
0 0.0 2 7.7 38 36 74 1 2.6
0 0.0 0 0.0 32 27 59 2 6.3
0 0.0 0 0.0 25 19 44 0 0.0
0 0.0 0 0.0 35 38 73 1 2.9
0 0.0 2 20.0 31 18 49 0 0.0
0 0.0 0 0.0 56 60 116 1 1.8
2 25.0 2 11.1 22 21 43 2 9.1
0 0.0 2 9.5 16 30 46 2 12.5
0 0.0 0 0.0 9 13 22 0 0.0
7 4.8 19 6.2 452 466 918 17 3.8

1 Nama :
2 Kelamin :
Lokasi penyuntikan
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
HASI
89 90 91 92 93 94 95 96 97
0 0.0 0 0.0 37 56 93 0 0.0
0 0.0 0 0.0 23 27 50 0 0.0
0 0.0 0 0.0 31 38 69 0 0.0
0 0.0 0 0.0 23 19 42 0 0.0
0 0.0 0 0.0 22 13 35 0 0.0
0 0.0 0 0.0 19 16 35 0 0.0
0 0.0 0 0.0 33 35 68 0 0.0
0 0.0 0 0.0 38 36 74 0 0.0
0 0.0 0 0.0 32 27 59 0 0.0
0 0.0 0 0.0 25 19 44 0 0.0
0 0.0 0 0.0 35 38 73 0 0.0
0 0.0 0 0.0 31 18 49 0 0.0
0 0.0 0 0.0 56 60 116 0 0.0
0 0.0 0 0.0 22 21 43 0 0.0
0 0.0 0 0.0 16 30 46 0 0.0
0 0.0 0 0.0 9 13 22 0 0.0
0 0.0 0 0.0 452 466 918 0 0.0

1 Nama :
2 Kelamin :
Lokasi penyuntikan
Lokasi penyuntikan
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
HASI
89 90 91 92 93 94 95 96 97
0 0.0 0 0.0 37 56 93 0 0.0
0 0.0 0 0.0 23 27 50 0 0.0
0 0.0 0 0.0 31 38 69 0 0.0
0 0.0 0 0.0 23 19 42 0 0.0
0 0.0 0 0.0 22 13 35 0 0.0
0 0.0 0 0.0 19 16 35 0 0.0
0 0.0 0 0.0 33 35 68 0 0.0
0 0.0 0 0.0 38 36 74 0 0.0
0 0.0 0 0.0 32 27 59 0 0.0
0 0.0 0 0.0 25 19 44 0 0.0
0 0.0 0 0.0 35 38 73 0 0.0
0 0.0 0 0.0 31 18 49 0 0.0
0 0.0 0 0.0 56 60 116 0 0.0
0 0.0 0 0.0 22 21 43 0 0.0
0 0.0 0 0.0 16 30 46 0 0.0
0 0.0 0 0.0 9 13 22 0 0.0
0 0.0 0 0.0 452 466 918 0 0.0

1 Nama :
2 Kelamin :
Lokasi penyuntikan
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
6 Nama ibu :
7 Alamat :
HASI
89 90 91 92 93 94 95 96 97
8 53.3 23 63.9 37 56 93 9 24.3
8 133.3 14 82.4 23 27 50 4 17.4
10 90.9 21 105.0 31 38 69 4 12.9
4 50.0 11 61.1 23 19 42 2 8.7
7 87.5 11 84.6 22 13 35 0 0.0
6 100.0 11 78.6 19 16 35 5 26.3
5 62.5 11 78.6 33 35 68 8 24.2
7 70.0 21 80.8 38 36 74 10 26.3
6 50.0 10 58.8 32 27 59 5 15.6
8 88.9 14 87.5 25 19 44 2 8.0
7 87.5 14 77.8 35 38 73 2 5.7
4 66.7 9 90.0 31 18 49 4 12.9
15 88.2 35 87.5 56 60 116 6 10.7
5 62.5 11 61.1 22 21 43 4 18.2
6 85.7 16 76.2 16 30 46 6 37.5
4 57.1 6 75.0 9 13 22 2 22.2
110 75.3 238 77.8 452 466 918 73 16.2
76,6
%
HASIL IMUNISASI BATITA
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 3.3 2 4.3 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 0.2 2 0.2 0 0.0 0 0.0 0 0.0
IMUNISASI
…. RT/RW ………………. Reaksi timbul pada tgl ..........................................

urahan ………………… Gejala & Waktu timbulnya gejala .........................................................
n …………………………
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
0 0.0 0 0.0 1 2.7 1 1.8 2 2.2
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 5.3 3 4.3 0 0.0 1 2.6 1 1.4
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 7.7 1 2.9 0 0.0 0 0.0 0 0.0
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 2.9 1 1.5
0 0.0 2 2.7 0 0.0 2 5.6 2 2.7
0 0.0 2 3.4 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 0.0 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 10.0 3 6.5 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 1.3 11 1.2 1 0.2 5 1.1 6 0.7
IMUNISASI

n …………………………
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
0 0.0 0 0.0 1 2.7 0 0.0 1 1.1
1 3.7 1 2.0 0 0.0 1 3.7 1 2.0
0 0.0 1 1.4 1 3.2 0 0.0 1 1.4
1 5.3 1 2.4 0 0.0 0 0.0 0 0.0
2 15.4 2 5.7 0 0.0 0 0.0 0 0.0
1 6.3 1 2.9 0 0.0 0 0.0 0 0.0
1 2.9 2 2.9 1 3.0 0 0.0 1 1.5
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 0.0
1 5.6 3 6.1 0 0.0 0 0.0 0 0.0
2 3.3 4 3.4 3 5.4 0 0.0 3 2.6
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 4.3 1 6.3 0 0.0 1 2.2
0 0.0 2 9.1 0 0.0 0 0.0 0 0.0
9 1.9 9 1.0 7 1.5 1 0.2 8 0.9
IMUNISASI

n …………………………
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
0 0.0 0 0.0 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 7.9 3 4.3 0 0.0 0 0.0 0 0.0
0 0.0 1 2.4 1 4.3 0 0.0 1 2.4
0 0.0 0 0.0 1 4.5 0 0.0 1 2.9
0 0.0 1 2.9 0 0.0 0 0.0 0 0.0
1 2.9 2 2.9 3 9.1 0 0.0 3 4.4
1 2.8 3 4.1 1 2.6 0 0.0 1 1.4
2 7.4 2 3.4 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 1 2.9 0 0.0 1 1.4
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 1.7 1 0.9 0 0.0 3 5.0 3 2.6
0 0.0 1 2.3 0 0.0 0 0.0 0 0.0
0 0.0 1 2.2 0 0.0 0 0.0 0 0.0
1 7.7 1 4.5 0 0.0 1 7.7 1 4.5
9 1.9 16 1.7 7 1.5 4 0.9 11 1.2
IMUNISASI

n …………………………
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
1 1.8 1 1.1 1 2.7 1 1.8 2 2.2
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 1.4 0 0.0 0 0.0 0 0.0
1 5.3 1 2.4 0 0.0 2 10.5 2 4.8
0 0.0 0 0.0 1 4.5 1 7.7 2 5.7
1 6.3 1 2.9 1 5.3 0 0.0 1 2.9
1 2.9 1 1.5 4 12.1 0 0.0 4 5.9
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 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 1.4 1 2.9 0 0.0 1 1.4
1 5.6 1 2.0 0 0.0 0 0.0 0 0.0
1 1.7 1 0.9 0 0.0 2 3.3 2 1.7
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 3.3 1 2.2 0 0.0 0 0.0 0 0.0
1 7.7 1 4.5 0 0.0 0 0.0 0 0.0
8 1.7 10 1.1 8 1.8 6 1.3 14 1.5
IMUNISASI

n …………………………
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
1 1.8 2 2.2 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 4 14.8 4 8.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 3.0 0 0.0 1 1.5
0 0.0 1 1.4 2 5.3 1 2.8 3 4.1
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 1 2.9 0 0.0 1 1.4
3 16.7 5 10.2 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 0.9 8 0.9 4 0.9 5 1.1 9 1.0
IMUNISASI

n …………………………
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
1 1.8 6 6.5 0 0.0 2 3.6 2 2.2
0 0.0 0 0.0 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 5.3 2 4.8 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 2.9 2 2.9 0 0.0 0 0.0 0 0.0
1 2.8 3 4.1 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 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 1.7 2 1.7 2 3.6 1 1.7 3 2.6
0 0.0 1 2.3 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 1.1 16 1.7 2 0.4 3 0.6 5 0.5
IMUNISASI

n …………………………
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
1 1.8 2 2.2 0 0.0 0 0.0 0 0.0
0 0.0 2 4.0 0 0.0 0 0.0 0 0.0
0 0.0 1 1.4 1 3.2 0 0.0 1 1.4
1 5.3 1 2.4 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 1 2.9 1 5.3 1 6.3 2 5.7
0 0.0 1 1.5 0 0.0 0 0.0 0 0.0
0 0.0 2 2.7 2 5.3 0 0.0 2 2.7
0 0.0 1 1.7 0 0.0 1 3.7 1 1.7
0 0.0 2 4.5 0 0.0 0 0.0 0 0.0
1 2.6 1 1.4 1 2.9 1 2.6 2 2.7
1 5.6 1 2.0 1 3.2 1 5.6 2 4.1
3 5.0 5 4.3 3 5.4 2 3.3 5 4.3
2 9.5 2 4.7 0 0.0 0 0.0 0 0.0
1 3.3 1 2.2 1 6.3 1 3.3 2 4.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 2.1 23 2.5 10 2.2 7 1.5 17 1.9
IMUNISASI

n …………………………
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
1 1.8 2 2.2 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 5.3 2 2.9 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 5.3 1 2.4
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 5.7 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 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 3.3 1 2.2 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 0.9 7 0.8 0 0.0 1 0.2 1 0.1
IMUNISASI

n …………………………
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
2 3.6 3 3.2 0 0.0 1 1.8 1 1.1
0 0.0 2 4.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 2.6 1 1.4
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 7.7 1 2.9
1 6.3 2 5.7 1 5.3 0 0.0 1 2.9
1 2.9 5 7.4 2 6.1 0 0.0 2 2.9
0 0.0 1 1.4 2 5.3 1 2.8 3 4.1
3 11.1 5 8.5 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 5.3 3 4.1 1 2.9 1 2.6 2 2.7
2 11.1 2 4.1 1 3.2 1 5.6 2 4.1
2 3.3 3 2.6 0 0.0 0 0.0 0 0.0
1 4.8 3 7.0 3 13.6 0 0.0 3 7.0
0 0.0 2 4.3 1 6.3 2 6.7 3 6.5
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
14 3.0 31 3.4 11 2.4 8 1.7 19 2.1
IMUNISASI

n …………………………
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI


n …………………………
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI

n …………………………
DPT/HB/Hib CAMPAK
#P % # JML % #L % #P % # JML %
98 99 100 101 102 103 104 105 106 107
7 12.5 16 17.2 3 8.1 5 8.9 8 8.6
1 3.7 5 10.0 0 0.0 5 18.5 5 10.0
7 18.4 11 15.9 2 6.5 2 5.3 4 5.8
4 21.1 6 14.3 1 4.3 3 15.8 4 9.5
3 23.1 3 8.6 2 9.1 2 15.4 4 11.4
3 18.8 8 22.9 3 15.8 1 6.3 4 11.4
5 14.3 13 19.1 11 33.3 1 2.9 12 17.6
2 5.6 12 16.2 7 18.4 4 11.1 11 14.9
5 18.5 10 16.9 0 0.0 1 3.7 1 1.7
0 0.0 2 4.5 0 0.0 0 0.0 0 0.0
3 7.9 5 6.8 5 14.3 2 5.3 7 9.6
8 44.4 12 24.5 2 6.5 2 11.1 4 8.2
10 16.7 16 13.8 8 14.3 8 13.3 16 13.8
3 14.3 7 16.3 3 13.6 0 0.0 3 7.0
7 23.3 13 28.3 3 18.8 3 10.0 6 13.0
2 15.4 4 18.2 0 0.0 1 7.7 1 4.5
70 15.0 143 15.6 50 11.1 40 8.6 90 9.8
90 90
JUMLAH DAN PERSENTASE IBU HAMIL DIIMUNISASI
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
30 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
17 0 0.0 0 0.0 0 0.0 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
32 0 0.0 0 0.0 0 0.0 0 0.0 0
41 0 0.0 0 0.0 0 0.0 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
18 0 0.0 0 0.0 0 0.0 0 0.0 0
29 0 0.0 0 0.0 0 0.0 0 0.0 0
11 0 0.0 0 0.0 0 0.0 0 0.0 0
34 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
23 0 0.0 0 0.0 0 0.0 0 0.0 0
9 0 0.0 0 0.0 0 0.0 0 0.0 0
380 0 0.0 0 0.0 0 0.0 0 0.0 0
i imunisasi terakhir)
No. Batch Tgl. Kadaluarsa VVM
.............................................
SASARA
N BUMIL
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 1 2.5 1 2.5 0 0.0 0 0.0 0
20 0 0.0 1 5.0 2 10.0 0 0.0 1
30 0 0.0 0 0.0 0 0.0 0 0.0 1
20 0 0.0 0 0.0 0 0.0 0 0.0 0
17 0 0.0 1 5.9 1 5.9 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
32 1 3.1 1 3.1 3 9.4 0 0.0 0
41 1 2.4 1 2.4 2 4.9 0 0.0 2
19 0 0.0 0 0.0 0 0.0 0 0.0 0
18 0 0.0 0 0.0 0 0.0 0 0.0 0
29 0 0.0 0 0.0 0 0.0 0 0.0 0
11 0 0.0 0 0.0 1 9.1 0 0.0 0
34 0 0.0 1 2.9 0 0.0 0 0.0 3
20 2 10.1 1 5.1 0 0.0 0 0.0 0
23 0 0.0 0 0.0 0 0.0 0 0.0 0
9 0 0.0 0 0.0 0 0.0 0 0.0 0
380 5 1.3 7 1.8 9 2.4 0 0.0 7
.............................................
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 2 5.1 1 2.5 1 2.5 0 0.0 2
20 0 0.0 0 0.0 0 0.0 0 0.0 0
30 1 3.3 0 0.0 0 0.0 0 0.0 0
20 1 5.1 0 0.0 0 0.0 0 0.0 0
17 0 0.0 0 0.0 0 0.0 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
32 0 0.0 0 0.0 0 0.0 0 0.0 1
41 2 4.9 1 2.4 1 2.4 1 2.4 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
18 0 0.0 2 11.4 0 0.0 0 0.0 0
29 0 0.0 1 3.4 0 0.0 0 0.0 0
11 1 9.1 0 0.0 0 0.0 0 0.0 0
34 0 0.0 1 2.9 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 1 5.1 0
23 1 4.3 0 0.0 2 8.7 0 0.0 1
9 0 0.0 0 0.0 0 0.0 0 0.0 0
380 8 2.1 6 1.6 4 1.1 2 0.5 4
.............................................
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 5 12.6 3 7.6 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
30 1 3.3 1 3.3 1 3.3 0 0.0 0
20 5 25.3 0 0.0 0 0.0 0 0.0 0
17 0 0.0 0 0.0 0 0.0 0 0.0 0
19 0 0.0 0 0.0 1 5.3 0 0.0 0
32 1 3.1 1 3.1 0 0.0 0 0.0 0
41 2 4.9 1 2.4 0 0.0 0 0.0 0
19 0 0.0 2 10.7 2 10.7 0 0.0 0
18 1 5.7 0 0.0 0 0.0 0 0.0 1
29 0 0.0 0 0.0 0 0.0 0 0.0 0
11 0 0.0 1 9.1 1 9.1 0 0.0 0
34 0 0.0 0 0.0 0 0.0 0 0.0 1
20 0 0.0 1 5.1 1 5.1 0 0.0 0
23 0 0.0 1 4.3 0 0.0 0 0.0 0
9 0 0.0 0 0.0 0 0.0 0 0.0 0
380 15 3.9 11 2.9 6 1.6 0 0.0 2
.............................................
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 1 2.5 2 5.1 0 0.0 0 0.0 1
20 0 0.0 0 0.0 0 0.0 0 0.0 0
30 0 0.0 1 3.3 2 6.7 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
17 0 0.0 0 0.0 1 5.9 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 1
32 1 3.1 1 3.1 0 0.0 0 0.0 0
41 1 2.4 2 4.9 0 0.0 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
18 0 0.0 0 0.0 0 0.0 0 0.0 0
29 1 3.4 1 3.4 1 3.4 0 0.0 0
11 0 0.0 0 0.0 0 0.0 0 0.0 0
34 1 2.9 0 0.0 0 0.0 0 0.0 1
20 0 0.0 0 0.0 0 0.0 0 0.0 0
23 0 0.0 0 0.0 0 0.0 0 0.0 0
9 0 0.0 0 0.0 0 0.0 0 0.0 0
380 5 1.3 7 1.8 4 1.1 0 0.0 3
.............................................
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 1 2.5 0 0.0 0 0.0 0 0.0 1
20 0 0.0 0 0.0 0 0.0 0 0.0 0
30 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
17 0 0.0 0 0.0 1 5.9 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
32 0 0.0 1 3.1 1 3.1 0 0.0 0
41 1 2.4 1 2.4 1 2.4 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
18 0 0.0 0 0.0 0 0.0 0 0.0 0
29 0 0.0 0 0.0 1 3.4 0 0.0 0
11 0 0.0 1 9.1 0 0.0 0 0.0 0
34 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
23 0 0.0 0 0.0 0 0.0 0 0.0 0
9 0 0.0 0 0.0 0 0.0 0 0.0 0
380 2 0.5 3 0.8 4 1.1 0 0.0 1
.............................................
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 1 2.5 2 5.1 0 0.0 0 0.0 0
20 0 0.0 0 0.0 1 5.0 0 0.0 0
30 0 0.0 0 0.0 1 3.3 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
17 0 0.0 0 0.0 0 0.0 0 0.0 0
19 0 0.0 0 0.0 0 0.0 1 5.3 0
32 1 3.1 1 3.1 0 0.0 0 0.0 0
41 0 0.0 1 2.4 0 0.0 0 0.0 0
19 1 5.3 0 0.0 0 0.0 0 0.0 1
18 0 0.0 0 0.0 0 0.0 0 0.0 0
29 0 0.0 0 0.0 0 0.0 0 0.0 0
11 0 0.0 0 0.0 0 0.0 0 0.0 0
34 0 0.0 0 0.0 1 2.9 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
23 0 0.0 0 0.0 1 4.3 0 0.0 0
9 0 0.0 0 0.0 1 11.4 0 0.0 0
380 3 0.8 4 1.1 5 1.3 1 0.3 1
.............................................
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 4 10.1 3 7.6 0 0.0 0 0.0 1
20 0 0.0 0 0.0 0 0.0 0 0.0 0
30 1 3.3 1 3.3 2 6.7 0 0.0 0
20 3 15.2 0 0.0 0 0.0 0 0.0 1
17 0 0.0 0 0.0 0 0.0 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
32 0 0.0 1 3.1 0 0.0 0 0.0 0
41 1 2.4 0 0.0 2 4.9 0 0.0 1
19 1 5.3 0 0.0 0 0.0 0 0.0 1
18 1 5.7 0 0.0 0 0.0 0 0.0 1
29 1 3.4 0 0.0 0 0.0 0 0.0 0
11 0 0.0 1 9.1 0 0.0 0 0.0 1
34 0 0.0 2 5.9 1 2.9 0 0.0 0
20 0 0.0 2 10.1 3 15.2 0 0.0 1
23 0 0.0 0 0.0 1 4.3 0 0.0 1
9 1 11.4 0 0.0 0 0.0 0 0.0 0
380 13 3.4 10 2.6 9 2.4 0 0.0 8
.............................................
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 2 5.1 1 2.5 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 1 5.0 0
30 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 3 15.2 0 0.0 0 0.0 0
17 0 0.0 0 0.0 2 11.8 0 0.0 1
19 1 5.3 1 5.3 0 0.0 0 0.0 0
32 0 0.0 0 0.0 0 0.0 0 0.0 0
41 0 0.0 0 0.0 0 0.0 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
18 0 0.0 0 0.0 0 0.0 0 0.0 0
29 0 0.0 0 0.0 0 0.0 0 0.0 0
11 0 0.0 0 0.0 0 0.0 0 0.0 0
34 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 0 0.0 1 5.1 0 0.0 1
23 0 0.0 0 0.0 0 0.0 0 0.0 0
9 0 0.0 0 0.0 0 0.0 0 0.0 0
380 3 0.8 5 1.3 3 0.8 1 0.3 2
.............................................
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 0 0.0 2 5.1 0 0.0 0 0.0 1
20 0 0.0 0 0.0 0 0.0 0 0.0 0
30 0 0.0 1 3.3 1 3.3 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
17 0 0.0 0 0.0 0 0.0 0 0.0 1
19 0 0.0 0 0.0 0 0.0 0 0.0 0
32 0 0.0 0 0.0 2 6.3 0 0.0 0
41 0 0.0 0 0.0 0 0.0 0 0.0 2
19 1 5.3 1 5.3 0 0.0 0 0.0 0
18 1 5.7 0 0.0 1 5.7 0 0.0 2
29 2 6.9 1 3.4 4 13.8 2 6.9 1
11 2 18.2 0 0.0 0 0.0 0 0.0 0
34 1 2.9 0 0.0 0 0.0 0 0.0 3
20 0 0.0 0 0.0 0 0.0 0 0.0 0
23 0 0.0 0 0.0 0 0.0 0 0.0 0
9 0 0.0 0 0.0 0 0.0 0 0.0 0
380 7 1.8 5 1.3 8 2.1 2 0.5 10
.............................................
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
30 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
17 0 0.0 0 0.0 0 0.0 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
32 0 0.0 0 0.0 0 0.0 0 0.0 0
41 0 0.0 0 0.0 0 0.0 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
18 0 0.0 0 0.0 0 0.0 0 0.0 0
29 0 0.0 0 0.0 0 0.0 0 0.0 0
11 0 0.0 0 0.0 0 0.0 0 0.0 0
34 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
23 0 0.0 0 0.0 0 0.0 0 0.0 0
9 0 0.0 0 0.0 0 0.0 0 0.0 0
380 0 0.0 0 0.0 0 0.0 0 0.0 0
.............................................
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
30 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
17 0 0.0 0 0.0 0 0.0 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
32 0 0.0 0 0.0 0 0.0 0 0.0 0
41 0 0.0 0 0.0 0 0.0 0 0.0 0
19 0 0.0 0 0.0 0 0.0 0 0.0 0
18 0 0.0 0 0.0 0 0.0 0 0.0 0
29 0 0.0 0 0.0 0 0.0 0 0.0 0
11 0 0.0 0 0.0 0 0.0 0 0.0 0
34 0 0.0 0 0.0 0 0.0 0 0.0 0
20 0 0.0 0 0.0 0 0.0 0 0.0 0
23 0 0.0 0 0.0 0 0.0 0 0.0 0
9 0 0.0 0 0.0 0 0.0 0 0.0 0
380 0 0.0 0 0.0 0 0.0 0 0.0 0
.............................................
SASARA
TT1 TT2 TT3 TT4 TT5
N BUMIL
# % # % # % # % #
108 109 110 111 112 113 114 115 116 117
40 17 42.9 15 37.9 1 18,3 0 0.0 6
20 0 0.0 1 5.0 3 15.0 1 5.0 1
30 3 10.0 4 13.3 7 23.3 0 0.0 1
20 9 45.5 3 15.2 0 0.0 0 0.0 1
17 0 0.0 1 5.9 5 29.4 0 0.0 2
19 1 5.3 1 5.3 1 5.3 1 5.3 1
32 4 12.5 6 18.8 6 18.8 0 0.0 1
41 8 19.5 7 17.1 6 14.6 1 2.4 5
19 3 16.0 3 16.0 2 10.7 0 0.0 2
18 3 17.0 2 11.4 1 5.7 0 0.0 4
29 4 13.8 3 10.3 6 20.7 2 6.9 1
11 3 27.3 3 27.3 2 18.2 0 0.0 1
34 2 5.9 4 11.8 2 5.9 0 0.0 8
20 2 10.1 4 20.2 5 25.3 1 5.1 2
23 1 4.3 1 4.3 4 17.3 0 0.0 2
9 1 11.4 0 0.0 1 11.4 0 0.0 0
380 61 16.0 58 15.2 52 13.7 6 1.6 38
PERSEN
TASE JUMLAH DAN PERSENTASE WUS TIDAK HAMIL DIIMUNISASI
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
0.0 393 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 223 0.0 0.0 0.0 0.0
0.0 147 0.0 0.0 0.0 0.0
0.0 128 0 0.0 0.0 0.0 0.0
0.0 136 0.0 0.0 0.0 0.0
0.0 235 0.0 0.0 0.0 0.0
0.0 299 0.0 0.0 0.0 0.0
0.0 178 0.0 0.0 0.0 0.0
0.0 139 0.0 0.0 0.0 0.0
0.0 210 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 251 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 95 0.0 0.0 0.0 0.0
0.0 3050 0 0.0 0 0.0 0 0.0 0 0.0
Lokasi penyuntikan
PERSEN
WUS
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
0.0 393 2 0.5 0.0 0.0 0.0
5.0 146 0.0 0.0 0.0 0.0
3.3 223 0.0 0.0 0.0 0.0
0.0 147 0.0 0.0 0.0 0.0
0.0 128 0.0 0.0 0.0 0.0
0.0 136 0.0 0.0 0.0 0.0
0.0 235 0.0 0.0 0.0 0.0
4.9 299 2 0.7 0.0 0.0 0.0
0.0 178 0.0 0.0 0.0 0.0
0.0 139 0.0 0.0 0.0 0.0
0.0 210 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 251 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 146 1 0.7 0.0 0.0 0.0
0.0 95 0.0 0.0 0.0 0.0
1.8 #REF! 5 #REF! 0 #REF! 0 #REF! 0 #REF!
Lokasi penyuntikan
PERSEN
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
5.1 393 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 223 0.0 0.0 0.0 0.0
0.0 147 0.0 0.0 0.0 0.0
0.0 128 0 0.0 0.0 0.0 0.0
0.0 136 0.0 0.0 0.0 0.0
3.1 235 0.0 0.0 0.0 0.0
0.0 299 0.0 0.0 0.0 0.0
0.0 178 0.0 0.0 0.0 0.0
0.0 139 0.0 0.0 0.0 0.0
0.0 210 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 251 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
4.3 146 0.0 0.0 0.0 0.0
0.0 95 0.0 0.0 0.0 0.0
1.1 3050 0 0.0 0 0.0 0 0.0 0 0.0
Lokasi penyuntikan
PERSEN
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
0.0 393 1 0.3 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 223 1 0.4 0.0 0.0 0.0
0.0 147 1 0.7 0.0 0.0 0.0
0.0 128 0.0 0.0 0.0 0.0
0.0 136 0.0 0.0 0.0 0.0
0.0 235 0.0 0.0 0.0 0.0
0.0 299 0 0.0 0.0 0.0 0.0
0.0 178 0.0 0.0 0.0 0.0
5.7 139 1 0.7 0.0 0.0 0.0
0.0 210 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
2.9 251 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 95 0.0 0.0 0.0 0.0
0.5 3050 4 0.1 0 0.0 0 0.0 0 0.0
Lokasi penyuntikan
PERSEN
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
2.5 393 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 223 0.0 0.0 0.0 0.0
0.0 147 0.0 0.0 0.0 0.0
0.0 128 0.0 0.0 0.0 0.0
5.3 136 0.0 0.0 0.0 0.0
0.0 235 2 0.9 0.0 0.0 0.0
0.0 299 1 0.3 0.0 0.0 0.0
0.0 178 0.0 0.0 0.0 0.0
0.0 139 0 0.0 0.0 0.0 0.0
0.0 210 0.0 0.0 0.0 0.0
0.0 162 1 0.6 0.0 0.0 0.0
2.9 251 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 95 0.0 0.0 0.0 0.0
0.8 3050 4 0.1 0 0.0 0 0.0 0 0.0
Lokasi penyuntikan
PERSEN
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
2.5 393 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 223 0.0 0.0 0.0 0.0
0.0 147 0.0 0.0 0.0 0.0
0.0 128 0.0 0.0 0.0 0.0
0.0 136 0.0 0.0 0.0 0.0
0.0 235 0.0 0.0 0.0 0.0
0.0 299 1 0.3 0.0 0.0 0.0
0.0 178 0.0 0.0 0.0 0.0
0.0 139 0.0 0.0 0.0 0.0
0.0 210 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 251 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 95 0.0 0.0 0.0 0.0
0.3 3050 1 0.0 0 0.0 0 0.0 0 0.0
Lokasi penyuntikan
PERSEN
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
0.0 393 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 223 0.0 0.0 0.0 0.0
0.0 147 0.0 0.0 0.0 0.0
0.0 128 1 0.8 0.0 0.0 0.0
0.0 136 0.0 0.0 0.0 0.0
0.0 235 0.0 0.0 0.0 0.0
0.0 299 0.0 0.0 0.0 0.0
5.3 178 0.0 0.0 0.0 0.0
0.0 139 0.0 0.0 0.0 0.0
0.0 210 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 251 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 95 0.0 0.0 0.0 0.0
0.3 3050 1 0.0 0 0.0 0 0.0 0 0.0
Lokasi penyuntikan
PERSEN
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
2.5 393 1 0.3 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 223 0.0 0.0 0.0 0.0
5.1 147 0.0 0.0 0.0 0.0
0.0 128 0.0 0.0 0.0 0.0
0.0 136 0.0 0.0 0.0 0.0
0.0 235 0.0 0.0 0.0 0.0
2.4 299 1 0.3 0.0 0.0 0.0
5.3 178 0.0 0.0 0.0 0.0
5.7 139 0.0 0.0 0.0 0.0
0.0 210 0.0 0.0 0.0 0.0
9.1 162 0.0 0.0 0.0 0.0
0.0 251 0.0 0.0 0.0 0.0
5.1 162 0.0 0.0 0.0 0.0
4.3 146 0.0 0.0 0.0 0.0
0.0 95 0.0 0.0 0.0 0.0
2.1 3050 2 0.1 0 0.0 0 0.0 0 0.0
Lokasi penyuntikan
PERSEN
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
0.0 393 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 223 0.0 0.0 0.0 0.0
0.0 147 0.0 0.0 0.0 0.0
5.9 128 0.0 0.0 0.0 0.0
0.0 136 0.0 0.0 0.0 0.0
0.0 235 1 0.4 0.0 0.0 0.0
0.0 299 0.0 0.0 0.0 0.0
0.0 178 0.0 0.0 0.0 0.0
0.0 139 0.0 0.0 0.0 0.0
0.0 210 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 251 1 0.4 0.0 0.0 0.0
5.1 162 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 95 0.0 0.0 0.0 0.0
0.5 3050 2 0.1 0 0.0 0 0.0 0 0.0
Lokasi penyuntikan
PERSEN
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
2.5 393 0 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 223 0.0 0.0 0.0 0.0
0.0 147 0 0.0 0.0 0.0 0.0
5.9 128 0.0 0.0 0.0 0.0
0.0 136 0.0 0.0 0.0 0.0
0.0 235 0 0.0 0.0 0.0 0.0
4.9 299 0.0 0.0 0.0 0.0
0.0 178 0.0 0.0 0.0 0.0
11.4 139 0.0 0.0 0.0 0.0
3.4 210 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
8.8 251 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 95 0.0 0.0 0.0 0.0
2.6 3050 0 0.0 0 0.0 0 0.0 0 0.0
Lokasi penyuntikan
PERSEN
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
0.0 393 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 223 0 0.0 0.0 0.0 0.0
0.0 147 0.0 0.0 0.0 0.0
0.0 128 0.0 0.0 0.0 0.0
0.0 136 0.0 0.0 0.0 0.0
0.0 235 0 0.0 0.0 0.0 0.0
0.0 299 0.0 0.0 0.0 0.0
0.0 178 0.0 0.0 0.0 0.0
0.0 139 0.0 0.0 0.0 0.0
0.0 210 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 251 0 0.0 0.0 0.0 0.0
0.0 162 0 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 95 0.0 0.0 0.0 0.0
0.0 3050 0 0.0 0 0.0 0 0.0 0 0.0
Lokasi penyuntikan
Lokasi penyuntikan
PERSEN
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
0.0 393 0 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 223 0 0.0 0.0 0.0 0.0
0.0 147 0 0.0 0.0 0.0 0.0
0.0 128 0.0 0.0 0.0 0.0
0.0 136 0.0 0.0 0.0 0.0
0.0 235 0.0 0.0 0.0 0.0
0.0 299 0.0 0.0 0.0 0.0
0.0 178 0.0 0.0 0.0 0.0
0.0 139 0.0 0.0 0.0 0.0
0.0 210 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 251 0.0 0.0 0.0 0.0
0.0 162 0.0 0.0 0.0 0.0
0.0 146 0.0 0.0 0.0 0.0
0.0 95 0.0 0.0 0.0 0.0
0.0 3050 0 0.0 0 0.0 0 0.0 0 0.0
Lokasi penyuntikan
PERSEN
WUS
TT5 TT1 TT2 TT3 TT4
TDK
% HAMIL # % # % # % # %
118 DIIMUNI
119 120 121 122 123 124 125 126 127
15.2 393 4 1.0 0 0.0 0 0.0 0 0.0
5.0 146 0 0.0 0 0.0 0 0.0 0 0.0
3.3 223 1 0.4 0 0.0 0 0.0 0 0.0
5.1 147 1 0.7 0 0.0 0 0.0 0 0.0
11.8 128 1 0.8 0 0.0 0 0.0 0 0.0
5.3 136 0 0.0 0 0.0 0 0.0 0 0.0
3.1 235 3 1.3 0 0.0 0 0.0 0 0.0
12.2 299 5 1.7 0 0.0 0 0.0 0 0.0
10.7 178 0 0.0 0 0.0 0 0.0 0 0.0
22.7 139 1 0.7 0 0.0 0 0.0 0 0.0
3.4 210 0 0.0 0 0.0 0 0.0 0 0.0
9.1 162 1 0.6 0 0.0 0 0.0 0 0.0
23.5 251 1 0.4 0 0.0 0 0.0 0 0.0
10.1 162 0 0.0 0 0.0 0 0.0 0 0.0
8.7 146 1 0.7 0 0.0 0 0.0 0 0.0
0.0 95 0 0.0 0 0.0 0 0.0 0 0.0
10.0 3050 19 0.6 0 0.0 0 0.0 0 0.0
IIMUNISASI JUMLAH TOTAL DAN PERSENTASE WUS (HAMIL+TIDAK HAMIL) DIIMUNISASI TT
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0.0 3 0.7 1 0.2 0 0.0 0 0.0
0.0 0 0.0 1 0.6 2 1.2 0 0.0
0.0 0 0.0 0 0.0 0 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 0.7 1 0.7 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 1 0.4 1 0.4 3 1.1 0 0.0
0.0 3 0.9 1 0.3 2 0.6 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 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 0.6 0 0.0
0.0 0 0.0 1 0.4 0 0.0 0 0.0
0.0 2 1.1 1 0.5 0 0.0 0 0.0
0.0 1 0.6 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 #REF! 10 #REF! 7 #REF! 9 #REF! 0 #REF!
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0.0 2 0.5 1 0.2 1 0.2 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 1 0.4 0 0.0 0 0.0 0 0.0
0.0 1 0.6 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 2 0.6 1 0.3 1 0.3 1 0.3
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 2 1.3 0 0.0 0 0.0
0.0 0 0.0 1 0.4 0 0.0 0 0.0
0.0 1 0.6 0 0.0 0 0.0 0 0.0
0.0 0 0.0 1 0.4 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 1 0.5
0.0 1 0.6 0 0.0 2 1.2 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 8 0.2 6 0.2 4 0.1 2 0.1
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0.0 6 1.4 3 0.7 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 2 0.8 1 0.4 1 0.4 0 0.0
0.0 6 3.6 0 0.0 0 0.0 0 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 0.6 0 0.0
0.0 1 0.4 1 0.4 0 0.0 0 0.0
0.0 2 0.6 1 0.3 0 0.0 0 0.0
0.0 0 0.0 2 1.0 2 1.0 0 0.0
0.0 2 1.3 0 0.0 0 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 0.6 1 0.6 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 1 0.5 1 0.5 0 0.0
0.0 0 0.0 1 0.6 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 19 0.6 11 0.3 6 0.2 0 0.0
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0.0 1 0.2 2 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 1 0.4 2 0.8 0 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 0.7 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 3 1.1 1 0.4 0 0.0 0 0.0
0.0 2 0.6 2 0.6 0 0.0 0 0.0
0.0 0 0.0 0 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 0.4 1 0.4 1 0.4 0 0.0
0.0 1 0.6 0 0.0 0 0.0 0 0.0
0.0 1 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 9 0.3 7 0.2 4 0.1 0 0.0
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0.0 1 0.2 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 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 0.7 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 1 0.4 1 0.4 0 0.0
0.0 2 0.6 1 0.3 1 0.3 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 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 0.4 0 0.0
0.0 0 0.0 1 0.6 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 3 0.1 3 0.1 4 0.1 0 0.0
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0.0 1 0.2 2 0.5 0 0.0 0 0.0
0.0 0 0.0 0 0.0 1 0.6 0 0.0
0.0 0 0.0 0 0.0 1 0.4 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 1 0.7 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 1 0.6
0.0 1 0.4 1 0.4 0 0.0 0 0.0
0.0 0 0.0 1 0.3 0 0.0 0 0.0
0.0 1 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 0.0 1 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 1 0.6 0 0.0
0.0 0 0.0 0 0.0 1 1.0 0 0.0
0 0.0 4 0.1 4 0.1 5 0.1 1 0.0
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0.0 5 1.2 3 0.7 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 1 0.4 1 0.4 2 0.8 0 0.0
0.0 3 1.8 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 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 0.4 0 0.0 0 0.0
0.0 2 0.6 0 0.0 2 0.6 0 0.0
0.0 1 0.5 0 0.0 0 0.0 0 0.0
0.0 1 0.6 0 0.0 0 0.0 0 0.0
0.0 1 0.4 0 0.0 0 0.0 0 0.0
0.0 0 0.0 1 0.6 0 0.0 0 0.0
0.0 0 0.0 2 0.7 1 0.4 0 0.0
0.0 0 0.0 2 1.1 3 1.6 0 0.0
0.0 0 0.0 0 0.0 1 0.6 0 0.0
0.0 1 1.0 0 0.0 0 0.0 0 0.0
0 0.0 15 0.4 10 0.3 9 0.3 0 0.0
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0.0 2 0.5 1 0.2 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 1 0.6
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 3 1.8 0 0.0 0 0.0
0.0 0 0.0 0 0.0 2 1.4 0 0.0
0.0 1 0.6 1 0.6 0 0.0 0 0.0
0.0 1 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 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 1 0.4 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 1 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 5 0.1 5 0.1 3 0.1 1 0.0
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0.0 0 0.0 2 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 1 0.4 1 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 2 0.7 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 1 0.5 1 0.5 0 0.0 0 0.0
0.0 1 0.6 0 0.0 1 0.6 0 0.0
0.0 2 0.8 1 0.4 4 1.7 2 0.8
0.0 2 1.2 0 0.0 0 0.0 0 0.0
0.0 1 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 7 0.2 5 0.1 8 0.2 2 0.1
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
TT5 TT1 TT2 TT3 TT4
# % # % # % # % # %
128 129 130 131 132 133 134 135 136 137
0 0.0 21 4.9 15 3.5 1 0.2 0 0.0
0 0.0 0 0.0 1 0.6 3 1.8 1 0.6
0 0.0 4 1.6 4 1.6 7 2.8 0 0.0
0 0.0 10 6.0 3 1.8 0 0.0 0 0.0
0 0.0 1 0.7 1 0.7 5 3.5 0 0.0
0 0.0 1 0.6 1 0.6 1 0.6 1 0.6
0 0.0 7 2.6 6 2.2 6 2.2 0 0.0
0 0.0 13 3.8 7 2.1 6 1.8 1 0.3
0 0.0 3 1.5 3 1.5 2 1.0 0 0.0
0 0.0 4 2.5 2 1.3 1 0.6 0 0.0
0 0.0 4 1.7 3 1.3 6 2.5 2 0.8
0 0.0 4 2.3 3 1.7 2 1.2 0 0.0
0 0.0 3 1.1 4 1.4 2 0.7 0 0.0
0 0.0 2 1.1 4 2.2 5 2.7 1 0.5
0 0.0 2 1.2 1 0.6 4 2.4 0 0.0
0 0.0 1 1.0 0 0.0 1 1.0 0 0.0
0 0.0 80 2.3 58 1.7 52 1.5 6 0.2
IMUNISASI TT TT2+ BUMIL
TT5 TT2+
# % # %
138 139 140 141
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
TT5 TT2+
# % # %
138 139 140 141
0 0.0 1 2.5
1 0.6 4 20.0
1 0.4 1 3.3
0 0.0 0 0.0
0 0.0 2 11.8
0 0.0 0 0.0
0 0.0 4 12.5
2 0.6 5 12.2
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 1 9.1
3 1.1 4 11.8
0 0.0 1 5.1
0 0.0 0 0.0
0 0.0 0 0.0
7 #REF! 23 6.0
TT5 TT2+
# % # %
138 139 140 141
2 0.5 4 10.1
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
1 0.4 1 3.1
0 0.0 3 7.3
0 0.0 0 0.0
0 0.0 2 11.4
0 0.0 1 3.4
0 0.0 0 0.0
0 0.0 1 2.9
0 0.0 1 5.1
1 0.6 3 13.0
0 0.0 0 0.0
4 0.1 16 4.2
TT5 TT2+
# % # %
138 139 140 141
0 0.0 3 7.6
0 0.0 0 0.0
0 0.0 2 6.7
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 1 5.3
0 0.0 1 3.1
0 0.0 1 2.4
0 0.0 4 21.4
1 0.6 1 5.7
0 0.0 0 0.0
0 0.0 2 18.2
1 0.4 1 2.9
0 0.0 2 10.1
0 0.0 1 4.3
0 0.0 0 0.0
2 0.1 19 5.0
TT5 TT2+
# % # %
138 139 140 141
1 0.2 3 7.6
0 0.0 0 0.0
0 0.0 3 10.0
0 0.0 0 0.0
0 0.0 1 5.9
1 0.6 1 5.3
0 0.0 1 3.1
0 0.0 2 4.9
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 2 6.9
0 0.0 0 0.0
1 0.4 1 2.9
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
3 0.1 14 3.7
TT5 TT2+
# % # %
138 139 140 141
1 0.2 1 2.5
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 1 5.9
0 0.0 0 0.0
0 0.0 2 6.3
0 0.0 2 4.9
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 1 3.4
0 0.0 1 9.1
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
1 0.0 8 2.1
TT5 TT2+
# % # %
138 139 140 141
0 0.0 2 5.1
0 0.0 1 5.0
0 0.0 1 3.3
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 1 5.3
0 0.0 1 3.1
0 0.0 1 2.4
1 0.5 1 5.3
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 1 2.9
0 0.0 0 0.0
0 0.0 1 4.3
0 0.0 1 11.4
1 0.0 11 2.9
TT5 TT2+
# % # %
138 139 140 141
1 0.2 4 10.1
0 0.0 0 0.0
0 0.0 3 10.0
1 0.6 1 5.1
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 1 3.1
1 0.3 3 7.3
1 0.5 1 5.3
1 0.6 1 5.7
0 0.0 0 0.0
1 0.6 2 18.2
0 0.0 3 8.8
1 0.5 6 30.3
1 0.6 2 8.7
0 0.0 0 0.0
8 0.2 27 7.1
TT5 TT2+
# % # %
138 139 140 141
0 0.0 1 2.5
0 0.0 1 5.0
0 0.0 0 0.0
0 0.0 3 15.2
1 0.7 3 17.6
0 0.0 1 5.3
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
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 0.5 2 10.1
0 0.0 0 0.0
0 0.0 0 0.0
2 0.1 11 2.9
TT5 TT2+
# % # %
138 139 140 141
1 0.2 3 7.6
0 0.0 0 0.0
0 0.0 2 6.7
0 0.0 0 0.0
1 0.7 1 5.9
0 0.0 0 0.0
0 0.0 2 6.3
2 0.6 2 4.9
0 0.0 1 5.3
2 1.3 3 17.0
1 0.4 8 27.6
0 0.0 0 0.0
3 1.1 3 8.8
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
10 0.3 25 6.6
TT5 TT2+
# % # %
138 139 140 141
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
TT5 TT2+
# % # %
138 139 140 141
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
0 0.0 0 0.0
TT5 TT2+
# % # %
138 139 140 141
6 1.4 22 55.6
1 0.6 6 30.0
1 0.4 12 40.0
1 0.6 4 20.2
2 1.4 8 47.1
1 0.6 4 21.1
1 0.4 13 40.6
5 1.5 19 46.3
2 1.0 7 37.4
4 2.5 7 39.8
1 0.4 12 41.4
1 0.6 6 54.5
8 2.8 14 41.2
2 1.1 12 60.6
2 1.2 7 30.3
0 0.0 1 11.4
38 1.1 154 40.5
80
JUMLAH HASIL IMUNISASI BAYI INFANT
SURVIVING
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI)
(0 - 11
KELURAHAN TAHUN
L P JLH L BLN
P JLH # L
2017
1 2 3 4 5 6 7 ###
8
1 KIAEA 1,794 21 15 36 21 15 ###
36
2 WATUDEMBA 665 11 6 17 11 6 ###
17
3 AOSOLE 1,018 9 11 20 9 11 ###
20
4 ALAKAYA 669 10 8 18 10 8 ###
18
5 WAWORAHA 583 5 8 13 5 8 ###
13
6 KAPUJAYA 620 8 6 14 8 6 ###
14
7 WAWOURU 1,072 6 8 14 6 8 ###
14
8 MEKAR SARI 1,367 16 10 26 16 10 ###
26
9 WATUMEREMBE 814 5 12 17 5 12 ###
17
10 EEWA 636 7 9 16 7 9 ###
16
11 ONEMBUTE 960 10 8 18 10 8 ###
18
12 ANGGONDARA 741 4 6 10 4 6 ###
10
13 KEL.PALANGGA 1,148 23 17 40 23 17 ###
40
14 WAWONGGURA 740 10 8 18 10 8 ###
18
15 SANGGI-SANGGI 666 14 7 21 14 7 ###
21
16 UPT.TOLIHE 436 1 7 8 1 7 ###
8
PUSKESMAS 13,929 160 146 306 160 146 306
###
PUSKESMAS
PALANGGA Warna Kuning yang diisi
:
BULAN JANUARI 2020
SURVIVING INFANT
BAYI BARU LAHIR HB0 <24 JAM BCG POLIO1 DPT/HB-Hib (1) POLIO 2 DPT-HB-HIB 2
JUMLAH
DESA / PDDK
NO
KELURAHAN TAHUN
2019 L P JLH L P JLH #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML %
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 41 20 20 40 1 5.0 0 0.0 1 2.5 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 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 5.0 1 2.5 82.0
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 1 14.3 1 7.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 AOSOLE 1,066 12 12 24 11 11 22 1 9.1 0 0.0 1 4.5 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 9.1 2 18.2 3 13.6 1 9.1 2 18.2 3 13.6 1 9.1 2 18.2 3 13.6
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 12.5 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
5 WAWORAHA 611 7 7 14 6 6 12 0 0.0 0 0.0 0 0.0 0 0.0 3 1.0 3 25.0 0 0.0 3 50.0 3 25.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 8.3
6 KAPU JAYA 650 7 7 14 7 7 14 1 14.3 0 0.0 1 7.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 2 28.6 3 21.4 1 14.3 2 28.6 3 21.4 0 0.0 0 0.0 0 0.0
7 WAWOURU 1,125 13 12 25 12 12 24 0 0.0 0 0.0 0 0.0 2 16.7 0 0.0 2 8.3 2 16.7 0 0.0 2 8.3 2 16.7 1 8.3 3 12.5 2 16.7 1 8.3 3 12.5 0 0.0 0 0.0 0 0.0
8 MEKAR SARI 1,433 16 16 32 15 15 30 2 13.3 1 6.7 3 10.0 0 0.0 1 #DIV/0! 1 3.3 0 0.0 1 6.7 1 3.3 1 6.7 2 13.3 3 10.0 1 6.7 2 13.3 3 10.0 1 6.7 1 6.7 2 6.7
9 WATUMEREMBE 854 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6
10 EEWA 666 8 7 15 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 2 #REF! 3 21.4 1 14.3 2 28.6 3 21.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 14.3 2 14.3
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 0 0.0 0 25.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
12 ANGGONDARA 779 9 8 17 8 8 16 2 25.0 0 0.0 2 12.5 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 3 23.1 0 0.0 3 11.5 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 3 23.1 4 30.8 7 26.9
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 1 20.0 1 10.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 325 153 152 305 13 8.5 3 2.0 16 5.2 6 3.9 7 178.5 13 4.3 6 3.9 7 4.6 13 4.3 8 5.2 9 5.9 17 5.6 8 5.2 9 5.9 17 5.6 9 5.9 9 5.9 18 5.9
Jenis Vaksin / Alat Stock Bln Penerim Pemakai Sisa Bln

No. Jumlah Permint No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P No. Jumlah Keadaan
Suntik & Safety Box Lalu aan Bln an Bln ini Jenis Cold Chain
aan (buah)
ini ini
1 Vak. BCG 10 10 20 13 7 20 2 DPT-HB 35 dosis - Vial #DIV/0! 1 Lemari ES
4 Vak. POLIO 15 20 35 18 17 30 5 CAMPAK #REF! dosis 8 Vial #REF! 4 Thermos
5 Vak. CAMPAK 12 - 12 8 4 10 6 HB. UNIJECT 16 dosis 16 Buah 1
6 Vak. HB. UNIJECT 34 20 54 16 38 10 7 TT 13 dosis 8 Vial 1.625 MENGETAHUI :
7 Vak. TT - 20 20 8 12 10 Kepala Puskesmas Palangga.Kab.Konawe selatan..
II. ALAT SUNTIK
1 ADS 5 ml 10 - 10 8 2 -
2 ADS 0,5 ml 168 200 368 87 281 200
3 ADS 0,0 5 ml 331 - 331 13 318 100 Amrin,S.Kep
PUSKESMAS
:
BULAN FEBRUARI 2020
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB-Hib (1) POLIO 2 DPT-HB-HIB 2
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 41 20 20 40 0 0.0 0 0.0 0 0.0 2 10.0 1 10.0 3 7.5 2 1.0 1 5.0 3 7.5 0 0.0 4 20.0 4 10.0 0 0.0 4 20.0 4 10.0 1 5.0 0 0.0 1 2.5
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1
3 AOSOLE 1,066 12 12 24 11 11 22 0 0.0 2 18.2 2 9.1 1 9.1 1 11.0 2 9.1 1 9.1 1 9.1 2 9.1 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 0 0.0 2 18.2 2 9.1
4 ALAKAYA 704 8 8 16 7 7 14 1 14.3 0 0.0 1 7.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 50.0 3 21.4 0 0.0 3 50.0 3 21.4 0 0.0 0 0.0 0 0.0
6 KAPU JAYA 650 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 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 14.3 2 28.6 3 21.4
7 WAWOURU 1,125 13 12 25 12 12 24 0 0.0 0 0.0 0 0.0 1 8.3 0 0.0 1 4.2 1 8.3 0 0.0 1 4.2 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 3 25.0 0 0.0 3 12.5
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 1 6.7 1 3.3 2 13.3 1 7.5 3 10.0 2 13.3 1 6.7 3 10.0 0 0.0 2 13.3 2 6.7 0 0.0 2 13.3 2 6.7 0 0.0 2 13.3 2 6.7
9 WATUMEREMBE 854 10 9 19 9 9 18 0 0.0 2 22.2 2 11.1 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6
10 EEWA 666 8 7 15 7 7 14 1 14.3 0 0.0 1 7.1 0 0.0 1 #DIV/0! 1 7.1 0 0.0 1 14.3 1 7.1 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 1 10.0 1 4.8 1 9.1 2 22.0 3 14.3 1 9.1 2 20.0 3 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
12 ANGGONDARA 779 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5 2 25.0 1 12.5 3 18.8
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 0 0.0 1 7.7 1 3.8 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 1 12.5 1 6.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 1 12.5 1 6.3
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 325 153 152 307 3 2.0 8 5.3 11 3.6 10 6.5 7 107.1 17 5.5 10 6.5 7 4.6 17 5.5 8 5.2 13 8.6 21 6.8 8 5.2 13 8.6 21 6.8 11 7.2 10 6.6 21 6.8

aan (buah)
ini ini
1 Vak. BCG 7 20 27 9 18 20 2 DPT-HB 31 dosis - Vial #DIV/0! 1 Lemari ES
2 Vak. Polio IPV - - - - - - 3 DPT-HB-Hib 118 dosis 22 Vial 5.363636 2 M. Freezer
5 Vak. CAMPAK 4 10 14 15 (1) 10 6 HB. UNIJECT 11 dosis 11 Buah 1
6 Vak. HB. UNIJECT 38 10 48 11 37 10 7 TT 40 dosis 12 Vial 3.333333
7 Vak. TT 12 10 22 12 10 - MENGETAHUI :
1 ADS 5 ml 2 - 2 22 - 22
2 ADS 0,5 ml 281 200 481 140 349 200
3 ADS 0,0 5 ml 318 100 418 20 398 100
HASIL CAKUPAN IMUNISASI PER DESA/KELURAHAN PUSKESMAS PALANGGA KABUPATEN / KOTA KONAWE SELATAN TAHUN 2020
PUSKESMAS
:
BULAN MARET 2020
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB -Hib (1) Polio 2 DPT/HB-Hib (2)
KELURAHAN TAHUN
(0 - 11 BLN
1 2 3 4 5 6 7 8 9 10 0 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 6,3 0.0 0 0.0
2 WATUDEMBA 697 8 8 16 7 7 14 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 AOSOLE 1,066 12 12 24 11 11 22 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
4 ALAKAYA 704 8 8 16 7 7 14 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
5 WAWORAHA 611 7 7 14 6 6 14 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
6 KAPU JAYA 650 7 7 14 7 7 14 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 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 WAWOURU 1,125 13 12 25 12 12 24 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
8 MEKAR SARI 1,433 16 16 32 15 15 30 1.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
9 WATUMEREMBE 854 10 9 19 9 9 18 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
10 EEWA 666 8 7 15 7 7 14 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
11 ONEMBUTE 1,007 11 11 22 11 10 21 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0,0 0.0 0 0.0 0.0 3.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
12 ANGGONDARA 779 9 8 17 8 8 16 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
14 WAWONGGURA 776 9 8 17 8 8 16 0.0 0.0 0 0.0 0.0 #DIV/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
16 UPT.TOLIHE 457 5 5 10 5 5 10 0.0 0.0 0 0.0 0.0 #DIV/0! 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0
PALANGGA 14,608 166 159 325 153 152 307 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0

aan (buah)
ini ini
I. VAKSIN 1 BCG 0 dosis - Ampul #DIV/0! Baik Rusak
1 Vak. BCG 18 0 18 - 18 (18) 2 DPT-HB 0 dosis - Vial #DIV/0! 1 Lemari ES
2 Vak. Polio IPV - 0 - - - - 3 DPT-HB-Hib 0 dosis - Vial #DIV/0! 2 M. Freezer
3 Vak. DPT-HB-HIB 60 20 80 - 80 (80) 4 POLIO 0 dosis - Vial #DIV/0! 3 V. Crrier
4 Vak. POLIO 25 30 55 - 55 (55) 5 CAMPAK #REF! dosis - Vial #REF! 4 Thermos
5 Vak. CAMPAK (1) 10 11 - 11 (11) 6 HB. UNIJECT 0 dosis - Buah #DIV/0!
6 Vak. HB. UNIJECT 37 10 47 - 47 (47) 7 TT 0 dosis - Vial #DIV/0!
7 Vak. TT 10 - 10 0 - - MENGETAHUI :
1 ADS 5 ml - - - - - -
2 ADS 0,5 ml 349 200 548 - 548 (548)
3 ADS 0,0 5 ml 398 100 498 - 498 (498)
PUSKESMAS
:
BULAN APRIL 2019
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB-Hib (1) POLIO2 DPT/HB-Hib (2)
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 0 0.0 0 0.0 0 0.0 2 10.0 0 0.0 2 5.0 2 10.0 0 0.0 2 5.0 2 10.0 0 0.0 2 5.0 2 10.0 0 0.0 2 5.0 1 5.0 0 0.0 1 2.5
2 WATUDEMBA 697 8 8 16 7 7 14 0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1
3 AOSOLE 1,066 12 12 24 11 11 22 0 0.0 1 9.1 1 4.5 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 3 27.3 1 9.1 4 18.2 3 27.3 1 9.1 4 18.2 5 45.5 0 0.0 5 22.7
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 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 14.3 0 0.0 1 7.1
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 0 0.0 0 0.0 2 33.3 0 0.0 2 14.3 2 33.3 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 KAPU JAYA 650 7 7 14 7 7 14 1 14.3 0 0.0 1 7.1 3 42.9 0 0.0 3 21.4 3 42.9 0 0.0 3 21.4 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
7 WAWOURU 1,125 13 12 25 12 12 24 1 8.3 1 8.3 2 8.3 0 0.0 2 #DIV/0! 2 8.3 0 0.0 2 16.7 2 8.3 2 16.7 1 8.3 3 12.5 2 16.7 1 8.3 3 12.5 1 8.3 2 16.7 3 12.5
8 MEKAR SARI 1,433 16 16 32 15 15 30 1 6.7 1 6.7 2 6.7 1 6.7 1 15.0 2 6.7 1 6.7 1 6.7 2 6.7 3 20.0 2 13.3 5 16.7 3 20.0 2 13.3 5 16.7 2 13.3 1 6.7 3 10.0
9 WATUMEREMBE 854 10 9 19 9 9 18 1 11.1 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 EEWA 666 8 7 15 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 9.5
12 ANGGONDARA 779 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 62.5 0 0.0 5 31.3
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 0 0.0 0 0.0 0 0.0 6 46.2 2 4.3 8 30.8 6 46.2 2 15.4 8 30.8 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 0 0.0 4 30.8 4 15.4
14 WAWONGGURA 776 9 8 17 8 8 16 1 12.5 1 12.5 2 12.5 0 0.0 1 #DIV/0! 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5
16 UPT.TOLIHE 457 5 5 10 5 5 10 1 20.0 0 0.0 1 10.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 325 153 152 307 6 3.9 4 2.6 10 3.3 16 10.5 8 76.5 24 7.8 16 10.5 8 5.3 24 7.8 13 8.5 5 3.3 18 5.9 13 8.5 5 3.3 18 5.9 15 9.8 14 9.2 29 9.4

No. Jumlah Permint No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Keadaan
Suntik & Safety Box Lalu aan Bln an Bln ini No. Jenis Cold Chain Jumlah
aan
ini ini (buah)
2 Vak. DPT-HB - - - 3 DPT-HB-Hib 74 dosis 22 Vial 3.363636 2 M. Freezer
4 Vak. POLIO 20 20 40 12 28 (16) 5 CAMPAK #REF! dosis 6 Vial #REF! 4 Thermos
5 Vak. CAMPAK 19 - 19 6 13 (7) 6 HB. UNIJECT 10 dosis 10 Buah 1
6 Vak. HB. UNIJECT 69 - 69 10 59 (49) 7 TT 0 dosis - Vial #DIV/0!
7 Vak. TT - - - - - - MENGETAHUI :
1 ADS 5 ml 101 - 101 18 83 (65)
2 ADS 0,5 ml 13 200 213 125 88 37
3 ADS 0,0 5 ml 141 - 141 25 116 (91)
PUSKESMAS
:
BULAN MEI 2019
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB -HIB(1) POLIO2 DPT/HB -HIB(2)
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 0 0.0 1 5.0 1 2.5 0 0.0 1 #DIV/0! 1 2.5 0 0.0 1 5.0 1 2.5 2 10.0 1 5.0 3 7.5 2 10.0 1 5.0 3 7.5 2 10.0 1 5.0 3 7.5
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 1 14.3 1 7.1 2 28.6 1 3.5 3 21.4 2 28.6 1 14.3 3 21.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1
3 AOSOLE 1,066 12 12 24 11 11 22 0 0.0 2 18.2 2 9.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 36.4 1 9.1 5 22.7
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 611 7 7 14 6 6 14 1 16.7 0 0.0 1 7.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 0 0.0 2 14.3 2 33.3 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0
6 KAPU JAYA 650 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 2 14.0 3 21.4 1 14.3 2 28.6 3 21.4 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0
7 WAWOURU 1,125 13 12 25 12 12 24 2 16.7 1 8.3 3 12.5 1 8.3 4 14.3 5 20.8 1 8.3 4 4.0 5 20.8 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 2 16.7 1 8.3 3 12.5
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 1 6.7 1 3.3 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 2 13.3 3 10.0
9 WATUMEREMBE 854 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 1 11.1 1 9.0 2 11.1 1 11.1 1 11.1 2 11.1 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 0 0.0 1 11.1 1 5.6
10 EEWA 666 8 7 15 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 0 2.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 4.8 0 0.0 1 10.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 0 0.0 1 10.0 1 4.8
12 ANGGONDARA 779 9 8 17 8 8 16 2 25.0 0 0.0 2 12.5 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 0 0.0 0 0.0 0 0.0 2 15.4 1 6.5 3 11.5 2 15.4 1 7.7 3 11.5 6 46.2 2 15.4 8 30.8 6 46.2 2 15.4 8 30.8 2 15.4 1 7.7 3 11.5
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 37.5 3 18.8 0 0.0 3 37.5 3 18.8 0 0.0 0 0.0 3 18.8
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 10.0
PALANGGA 14,608 166 159 325 153 152 307 5 3.3 6 3.9 11 3.6 11 7.2 12 166.9 23 7.5 11 7.2 12 7.9 23 7.5 16 10.5 8 5.3 24 7.8 16 10.5 8 5.3 0 0.0 12 7.8 13 8.6 25 8.1

aan
ini ini (buah)
1 Vak. BCG 10 15 25 8 17 (9) 2 IPV 76 dosis - Vial #DIV/0! 1 Lemari ES
2 IPV - - - - - - 3 DPT-HB-Hib 56 dosis 22 Vial 2.545455 2 M. Freezer
7 Vak. TT - 15 15 3 12 (9)
1 ADS 5 ml 83 20 103 9 94 (85) Kepala Puskesmas Palangga Kab. Konsel
2 ADS 0,5 ml 88 200 288 155 133 22
3 ADS 0,0 5 ml 116 - 116 25 91 (66)
Nip. 196506021987031017
PUSKESMAS
:
BULAN JUNI 2019
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 1 5.0 0 0.0 1 2.5 1 5.0 2 40.0 3 7.5 1 5.0 2 10.0 3 7.5 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 1 5.0 1 5.0 2 5.0
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 1 14.3 1 7.1 3 42.9 1 2.3 4 28.6 3 42.9 1 14.3 4 28.6 0 0.0 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 AOSOLE 1,066 12 12 24 11 11 22 0 0.0 0 0.0 0 0.0 0 0.0 3 #DIV/0! 3 13.6 0 0.0 3 27.3 3 13.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 ALAKAYA 704 8 8 16 7 7 14 1 14.3 1 14.3 2 14.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 611 7 7 14 6 6 14 1 16.7 1 16.7 2 14.3 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 0 0.0 2 14.3
6 KAPU JAYA 650 7 7 14 7 7 14 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 2 28.6 0 0.0 2 14.3
7 WAWOURU 1,125 13 12 25 12 12 24 1 8.3 0 0.0 1 4.2 3 25.0 0 0.0 3 12.5 3 25.0 0 0.0 3 12.5 1 8.3 4 33.3 5 20.8 1 8.3 4 33.3 5 20.8 0 0.0 1 8.3 1 4.2
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 2 13.3 2 6.7 3 20.0 2 10.0 5 16.7 3 20.0 2 13.3 5 16.7 0 0.0 1 6.7 1 3.3 0 0.0 1 6.7 1 3.3 2 13.3 1 6.7 3 10.0
9 WATUMEREMBE 854 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 1 11.1 1 9.0 2 11.1 1 11.1 1 11.1 2 11.1 1 11.1 1 11.1 2 11.1 1 11.1 1 11.1 2 11.1 2 22.2 0 0.0 2 11.1
10 EEWA 666 8 7 15 7 7 14 0 0.0 1 14.3 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 1,007 11 11 22 11 10 21 1 9.1 0 0.0 1 4.8 1 9.1 2 22.0 3 14.3 1 9.1 2 20.0 3 14.3 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 2 18.2 0 0.0 2 9.5
12 ANGGONDARA 779 9 8 17 8 8 16 1 12.5 0 0.0 1 6.3 4 50.0 2 4.0 6 37.5 4 50.0 2 25.0 6 37.5 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 1 7.7 2 15.4 3 11.5 1 7.7 2 15.4 3 11.5 4 30.8 2 15.4 6 23.1
14 WAWONGGURA 776 9 8 17 8 8 16 1 12.5 0 0.0 1 6.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 326 153 152 307 9 5.9 6 3.9 15 4.9 20 13.1 14 107.1 34 11.1 20 13.1 14 9.2 34 11.1 9 5.9 11 7.2 20 6.5 9 5.9 11 7.2 20 6.5 15 9.8 6 3.9 21 6.8

aan
ini ini (buah)
1 Vak. BCG 17 - 17 10 7 3 2 DPT-HB 58 dosis - Vial #DIV/0! 1 Lemari ES
3 Vak. DPT-HB-Hib 49 - 49 21 28 (7) 4 POLIO 98 dosis 17 Vial 5.764706 3 V. Crrier
4 Vak. POLIO 45 - 45 17 28 (11) 5 CAMPAK 12 dosis 9 Vial 1.333333 4 Thermos
7 Vak. TT 12 - 12 8 4 4
1 ADS 5 ml 94 - 94 21 73 (52) Kepala Puskesmas .Palangga Kab.Konsel
2 ADS 0,5 ml 133 200 333 155 178 (23)
3 ADS 0,0 5 ml 91 - 91 32 59 (27)
5 Safety Box 0,25 liter - - - - - Amrin,S.Kep
Nip.196506021987031017
PUSKESMAS
:
BULAN JULI 2019
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB-Hib (1) Polio 2 DPT/HB-Hib (2)
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 1 5.0 2 10.0 3 7.5 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 0 0.0 0 0.0 0 0.0
2 WATUDEMBA 697 8 8 16 7 7 14 1 14.3 0 0.0 1 7.1 0 0.0 3 42,9 3 21.4 0 0.0 3 42.9 3 21.4 5 71.4 3 42.9 8 57.1 5 71.4 3 42.9 8 57.1 0 0.0 1 14.3 1 7.1
3 AOSOLE 1,066 12 12 24 11 11 22 1 9.1 0 0.0 1 4.5 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 27.3 3 13.6 0 0.0 3 27.3 3 13.6 0 0.0 0 0.0 0 0.0
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0
6 KAPU JAYA 650 7 7 14 7 7 14 0 0.0 1 14.3 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 1 14,3 2 14.3 1 14.3 1 14.3 2 14.3 2 28.6 1 14.3 3 21.4
7 WAWOURU 1,125 13 12 25 12 12 24 0 0.0 1 8.3 1 4.2 2 16.7 2 12.0 4 16.7 2 16.7 2 16.7 4 16.7 4 33.3 0 0.0 4 16.7 4 33.3 0 0.0 4 16.7 1 8.3 4 33.3 5 20.8
8 MEKAR SARI 1,433 16 16 32 15 15 30 1 6.7 0 0.0 1 3.3 2 13.3 2 15.0 4 13.3 2 13.3 2 13.3 4 13.3 3 20.0 1 6.7 4 13.3 3 20.0 1 6.7 4 13.3 1 6.7 1 6.7 2 6.7
9 WATUMEREMBE 854 10 9 19 9 9 18 1 11.1 0 0.0 1 5.6 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6
10 EEWA 666 8 7 15 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 2 28,6 2 14.3 0 0.0 2 28.6 2 14.3 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 2 18.2 0 0.0 2 9.5 2 18.2 0 0.0 2 9.5 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 1 9.1 1 10.0 2 9.5
12 ANGGONDARA 779 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 6 75.0 2 25.0 8 50.0 6 75.0 2 25.0 8 50.0 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 2 15.4 1 7.7 3 11.5 0 0.0 3 23,1 3 11.5 0 0.0 3 23.1 3 11.5 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 2 15.4 2 15.4 4 15.4
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 1 8.0 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3
15 SANGGI-SANGGI 698 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 2 14.0 3 21.4 1 14.3 2 28.6 3 21.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 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 20.0 0 0.0 1 10.0
PALANGGA 14,608 166 159 326 153 152 307 7 4.6 5 3.3 12 3.9 11 7.2 15 208.6 26 8.5 11 7.2 15 9.9 26 8.5 23 15.0 13 8.6 36 11.7 23 15.0 13 8.6 36 11.7 9 5.9 13 8.6 22 7.2

aan
ini ini (buah)
4 Vak. POLIO 28 - 28 20 8 12 5 CAMPAK #REF! dosis 11 Vial #REF! 4 Thermos
7 Vak. TT 4 10 10 6 4 2
2 ADS 0,5 ml 178 200 378 205 173 32
3 ADS 0,0 5 ml 59 - 59 28 31 (3)
5 Safety Box 0,25 liter - - - - Amrin,S.Kep.
Nip.196506021987031017
PUSKESMAS
:
BULAN AGUSTUS 2019
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 0 0.0 0 0.0 0 0.0 2 10.0 3 30.0 5 12.5 2 10.0 3 15.0 5 12.5 1 5.0 2 10.0 3 7.5 1 5.0 2 10.0 3 7.5 0 0.0 0 0.0 0 0.0
2 WATUDEMBA 697 8 8 16 7 7 14 1 14.3 0 0.0 1 7.1 1 14.3 3 21.0 4 28.6 1 14.3 3 42.9 4 28.6 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 4 57.1 3 42.9 7 50.0
3 AOSOLE 1,066 12 12 24 11 11 22 1 9.1 0 0.0 1 4.5 0 0.0 3 #DIV/0! 3 13.6 0 0.0 3 27.3 3 13.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 27.3 3 13.6
4 ALAKAYA 704 8 8 16 7 7 14 1 14.3 0 0.0 1 7.1 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 0 0.0 0 0.0 1 16.7 1 6.0 2 14.3 1 16.7 1 16.7 2 14.3 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1
6 KAPU JAYA 650 7 7 14 7 7 14 1 14.3 1 14.3 2 14.3 0 0.0 1 #DIV/0! 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 1 14.3 2 14.3
7 WAWOURU 1,125 13 12 25 12 12 24 1 8.3 0 0.0 1 4.2 1 8.3 2 24.0 3 12.5 1 8.3 2 16.7 3 12.5 2 16.7 2 16.7 4 16.7 2 16.7 2 16.7 4 16.7 3 25.0 0 0.0 3 12.5
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 0 0.0 0 0.0 1 6.7 2 30.0 3 10.0 1 6.7 2 13.3 3 10.0 2 13.3 1 6.7 3 10.0 2 13.3 1 6.7 3 10.0 3 20.0 0 0.0 3 10.0
9 WATUMEREMBE 854 10 9 19 9 9 18 1 11.1 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6
10 EEWA 666 8 7 15 7 7 14 0 0.0 1 14.3 1 7.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 0 0.0 1 7.1
11 ONEMBUTE 1,007 11 11 22 11 10 21 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 3 27.3 0 0.0 3 14.3 3 27.3 0 0.0 3 14.3 0 0.0 1 10.0 1 4.8
12 ANGGONDARA 779 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 4 50.0 1 12.5 5 31.3
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 0 0.0 0 0.0 0 0.0 4 30.8 0 0.0 4 15.4 4 30.8 0 0.0 4 15.4 0 0.0 3 23.1 3 11.5 0 0.0 3 23.1 3 11.5 1 7.7 0 0.0 1 3.8
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 1 12.5 1 6.3 0 0.0 3 #DIV/0! 3 18.8 0 0.0 3 37.5 3 18.8 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 1 12.5 1 12.5 2 12.5
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 326 153 152 307 7 4.6 4 2.6 11 3.6 13 8.5 18 211.8 31 10.1 13 8.5 18 11.8 31 10.1 15 9.8 12 7.9 27 8.8 15 9.8 12 7.9 27 8.8 20 13.1 10 6.6 30 9.8

aan
ini ini (buah)
4 Vak. POLIO 8 30 38 19 19 - 5 CAMPAK #REF! dosis 12 Vial #REF! 4 Thermos
5 Vak. CAMPAK 14 - - 12 2 10 6 HB. UNIJECT 11 dosis 11 Buah 1
6 Vak. HB. UNIJECT 41 - - 11 30 (19) 7 TT 4 dosis 4 Vial 1
7 Vak. Td 4 - - 4 - 4
1 ADS 5 ml 73 - 73 25 48 (23) Kepala Puskesmas Palangga Kab.Konsel
2 ADS 0,5 ml 173 200 373 163 210 (47)
3 ADS 0,0 5 ml 31 100 131 11 120 (109)
Nip.196506021987031017
PUSKESMAS
:
BULAN SEPTEMBER 2019
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB-Hib (1) POLIO 2 DPT/HB-Hib (2)
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 1 1.0 1 5.0 2 5.0 0 0.0 1 #DIV/0! 1 2.5 0 0.0 1 5.0 1 2.5 0 0.0 2 10.0 2 5.0 0 0.0 2 10.0 2 5.0 0 0.0 1 5.0 1 2.5
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 5 71.4 6 42.9 1 14.3 5 71.4 6 42.9 1 14.3 0 0.0 1 7.1
3 AOSOLE 1,066 12 12 24 11 11 22 3 27.3 1 9.1 4 18.2 2 18.2 0 0.0 2 9.1 2 18.2 0 0.0 2 9.1 0 0.0 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 0 0.0 0 0.0
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 1 0,0 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 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 16.7 1 16.7 2 14.3 1 16.7 1 16.7 2 14.3 1 16.7 0 0.0 1 7.1
6 KAPU JAYA 650 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 1 0,0 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 0 0.0 1 7.1
7 WAWOURU 1,125 13 12 25 12 12 24 1 8.3 0 0.0 1 4.2 2 16.7 1 0,0 3 12.5 2 16.7 1 8.3 3 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 25.0 2 16.7 5 20.8
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 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 6.7 2 13.3 3 10.0 1 6.7 2 13.3 3 10.0 1 6.7 1 6.7 2 6.7
9 WATUMEREMBE 854 10 9 19 9 9 18 1 11.1 0 0.0 1 5.6 3 33.3 0 0,0 3 16.7 3 33.3 0 0.0 3 16.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 1 11.1 2 11.1
10 EEWA 666 8 7 15 7 7 14 2 28.6 0 0.0 2 14.3 1 14.3 2 0,0 3 21.4 1 14.3 2 28.6 3 21.4 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 1 9.1 1 11.0 2 9.5 1 9.1 1 10.0 2 9.5 1 9.1 2 20.0 3 14.3 1 9.1 2 20.0 3 14.3 3 27.3 0 0.0 3 14.3
12 ANGGONDARA 779 9 8 17 8 8 16 1 12.5 1 12.5 2 12.5 0 0.0 1 #DIV/0! 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 1 12.5 3 18.8
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 0 0.0 0 0.0 0 0.0 0 0.0 3 #DIV/0! 3 11.5 0 0.0 3 23.1 3 11.5 2 15.4 1 7.7 3 11.5 2 15.4 1 7.7 3 11.5 0 0.0 1 7.7 1 3.8
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 1 0,0 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 1 12.5 0 0.0 1 6.3
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 326 153 152 307 9 5.9 3 2.0 12 3.9 11 7.2 15 208.6 26 8.5 11 7.2 15 9.9 26 8.5 7 4.6 18 11.8 25 8.1 7 4.6 18 11.8 25 8.1 14 9.2 10 6.6 24 7.8

aan
ini ini (buah)
6 Vak. HB. UNIJECT 30 50 80 12 68 (56) 7 TT 0 dosis - Vial #DIV/0!
7 Vak. Td - - - - - - MENGETAHUI :
1 ADS 5 ml 48 - 48 22 26 (4)
2 ADS 0,5 ml 210 200 410 262 148 114
3 ADS 0,0 5 ml 120 - 120 26 94 (68)
lkkmmmm
PUSKESMAS
:
BULAN OKTOBER 2019
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 0 0.0 1 5.0 1 2.5 1 5.0 0 0,0 1 2.5 1 5.0 0 0.0 1 2.5 3 15.0 2 10.0 5 12.5 3 15.0 2 10.0 5 12.5 1 5.0 5 25.0 6 15.0
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 0 0,0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 5 71.4 6 42.9
3 AOSOLE 1,066 12 12 24 11 11 22 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 3 27.3 1 9.1 4 18.2 3 27.3 1 9.1 4 18.2 0 0.0 1 9.1 1 4.5
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 3 42.9 0 0,0 3 21.4 3 42.9 0 0.0 3 21.4 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 1 14.3 0 0.0 1 7.1
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 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 16.7 1 16.7 2 14.3
6 KAPU JAYA 650 7 7 14 7 7 14 0 0.0 2 28.6 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1
7 WAWOURU 1,125 13 12 25 12 12 24 0 0.0 1 8.3 1 4.2 1 8.3 0 0.0 1 4.2 1 8.3 0 0.0 1 4.2 3 25.0 2 16.7 5 20.8 3 25.0 2 16.7 5 20.8 0 0.0 0 0.0 0 0.0
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 0 0.0 0 0.0 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 3 20.0 4 13.3
9 WATUMEREMBE 854 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 3 33.3 0 0.0 3 16.7 3 33.3 0 0.0 3 16.7 0 0.0 0 0.0 0 0.0
10 EEWA 666 8 7 15 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 1 14.3 1 7.1
11 ONEMBUTE 1,007 11 11 22 11 10 21 1 9.1 0 0.0 1 4.8 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 9.5
12 ANGGONDARA 779 9 8 17 8 8 16 1 12.5 0 0.0 1 6.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 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 12.5 1 12.5 2 12.5
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 1 7.7 0 0.0 1 3.8 2 15.4 2 13.0 4 15.4 2 15.4 2 15.4 4 15.4 1 7.7 1 7.7 2 7.7 1 7.7 1 7.7 2 7.7 3 23.1 2 15.4 5 19.2
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 1 12.5 3 37.5 4 25.0
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 326 153 152 307 3 2.0 4 2.6 7 2.3 15 9.8 2 20.4 17 5.5 15 9.8 2 1.3 17 5.5 17 11.1 14 9.2 31 10.1 17 11.1 14 9.2 31 10.1 10 6.5 25 16.4 35 11.4

aan
ini ini (buah)
2 Vak. DPT-HB - - - - - - 3 DPT-HB-Hib 96 dosis 24 Vial 4 2 M. Freezer
6 Vak. HB. UNIJECT 68 - 68 7 61 (54) 7 TT 0 dosis - Vial #DIV/0!
7 Vak. TT - 15 15 - 15 (15) MENGETAHUI :
1 ADS 5 ml 26 - 26 16 10 6
2 ADS 0,5 ml 148 200 348 168 180 (12)
3 ADS 0,0 5 ml 94 100 194 18 176 (158)
PUSKESMAS
:
BULAN NOPEMBER 2019
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 1 5.0 1 5.0 2 5.0 0 0.0 1 0.0 1 2.5 0 0.0 1 5.0 1 2.5 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 4 20.0 1 5.0 5 12.5
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 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 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 2 28.6 2 14.3
3 AOSOLE 1,066 12 12 24 11 11 22 2 0.0 1 9.1 3 13.6 2 18.2 4 22.0 6 27.3 2 18.2 4 36.4 6 27.3 1 9.1 1 9.1 2 9.1 1 9.1 1 9.1 2 9.1 1 9.1 0 0.0 1 4.5
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 1 0.0 1 7.1 0 0.0 1 14.3 1 7.1 3 42.9 1 14.3 4 28.6 3 42.9 1 14.3 4 28.6 2 28.6 2 28.6 4 28.6
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 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
6 KAPU JAYA 650 7 7 14 7 7 14 1 14.3 0 0.0 1 7.1 0 0.0 2 0.0 2 14.3 0 0.0 2 28.6 2 14.3 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 1 14.3 0 0.0 1 7.1
7 WAWOURU 1,125 13 12 25 12 12 24 0 0.0 1 8.3 1 4.2 1 8.3 1 0.0 2 8.3 1 8.3 1 8.3 2 8.3 2 16.7 1 8.3 3 12.5 2 16.7 1 8.3 3 12.5 3 25.0 2 16.7 5 20.8
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 3 20.0 3 10.0 1 6.7 1 15.0 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 2 13.3 2 13.3 4 13.3
9 WATUMEREMBE 854 10 9 19 9 9 18 1 11.1 0 0.0 1 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 0.0 3 33.3 0 0.0 3 16.7
10 EEWA 666 8 7 15 7 7 14 1 14.3 1 14.3 2 14.3 1 14.3 1 0.0 2 14.3 1 14.3 1 14.3 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 2 28.6 2 14.3
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 1 10.0 2 9.5
12 ANGGONDARA 779 9 8 17 8 8 16 1 12.5 1 12.5 2 12.5 2 25.0 2 0.0 4 25.0 2 25.0 2 25.0 4 25.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 1 7.7 0 0.0 1 3.8 2 15.4 2 0.0 4 15.4 2 15.4 2 15.4 4 15.4 0 0.0 3 23.1 3 11.5 0 0.0 3 23.1 3 11.5 1 7.7 1 7.7 2 7.7
14 WAWONGGURA 776 9 8 17 8 8 16 1 12.5 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 2 25.0 2 12.5
15 SANGGI-SANGGI 698 8 8 16 7 7 14 1 14.3 1 14.3 2 14.3 1 14.3 1 0.0 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 2 28.6 3 21.4
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 326 153 152 307 10 6.5 9 5.9 19 6.2 12 7.8 16 204.0 28 9.1 12 7.8 16 10.5 28 9.1 16 10.5 11 7.2 27 8.8 16 10.5 11 7.2 27 8.8 19 12.4 17 11.2 36 11.7
1

aan
ini ini (buah)
1 Vak. BCG 18 - 18 10 8 2 2 DPT-HB 63 dosis - Vial #DIV/0! 1 Lemari ES
3 Vak. DPT-HB-Hib 37 - 37 27 10 17 4 POLIO 128 dosis 15 Vial 8.533333 3 V. Crrier
4 Vak. POLIO 32 - 32 15 17 (2) 5 CAMPAK #REF! dosis 12 Vial #REF! 4 Thermos
7 Vak. TT 15 - 15 15 - 15 MENGETAHUI :
1 ADS 5 ml 10 20 30 22 8 14
2 ADS 0,5 ml 180 200 380 233 147 86
3 ADS 0,0 5 ml 176 100 276 22 254 (232)
PUSKESMAS
:
BULAN DESEMBER 2019
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 0 0.0 1 5.0 1 2.5 0 0.0 3 15.0 3 7.5 0 0.0 3 15.0 3 7.5 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
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 1 14.3 1 7.1 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 1 14.3 0 0.0 1 7.1
3 AOSOLE 1,066 12 12 24 11 11 22 0 0.0 0 0.0 0 0.0 2 18.2 1 9.1 3 13.6 2 18.2 1 9.1 3 13.6 2 18.2 4 36.4 6 27.3 2 18.2 4 36.4 6 27.3 1 9.1 1 9.1 2 9.1
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 1 14.3 3 21.4
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 2 33.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0
6 KAPU JAYA 650 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 1 14.3 3 21.4
7 WAWOURU 1,125 13 12 25 12 12 24 0 0.0 0 0.0 0 0.0 3 25.0 1 8.3 4 16.7 3 25.0 1 8.3 4 16.7 1 8.3 1 8.3 2 8.3 1 8.3 1 8.3 2 8.3 2 16.7 1 8.3 3 12.5
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 0 0.0 0 0.0 1 6.7 3 20.0 4 13.3 1 6.7 3 20.0 4 13.3 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7
9 WATUMEREMBE 854 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6
10 EEWA 666 8 7 15 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 2 28.6 0 0.0 2 14.3
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 1 10.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 9.5
12 ANGGONDARA 779 9 8 17 8 8 16 1 12.5 1 12.5 2 12.5 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 0 0.0 0 0.0 0 0.0 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 2 15.4 4 30.8 6 23.1 2 15.4 4 30.8 6 23.1 0 0.0 1 7.7 1 3.8
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 0.0 2 12.5
15 SANGGI-SANGGI 698 8 8 16 7 7 14 0 0.0 1 14.3 1 7.1 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 326 153 152 307 1 0.7 7 4.6 8 2.6 14 9.2 9 5.9 23 7.5 14 9.2 9 5.9 23 7.5 10 6.5 13 8.6 23 7.5 10 6.5 13 8.6 23 7.5 12 7.8 11 7.2 23 7.5

aan
ini ini (buah)
7 Vak. TT - 10 10 10 - 10 MENGETAHUI :
1 ADS 5 ml 8 20 28 18 10 8
2 ADS 0,5 ml 147 200 347 179 168 11
3 ADS 0,0 5 ml 254 100 354 23 331 (308)
PUSKESMAS
:
BULAN JANUARI S/D. desember 2019
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB-HIB(1) POLIO2 DPT-HB-HIB2
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 5 25.0 7 35.0 12 30.0 8 40.0 12 30.0 20 50.0 8 40.0 1 5.0 9 22.5 11 55.0 12 60.0 23 57.5 11 55.0 12 60.0 23 57.5 10 50.0 10 50.0 20 52.8
2 WATUDEMBA 697 8 8 16 7 7 14 2 28.6 4 57.1 6 42.9 7 100.0 12 12.0 19 135.7 7 100.0 12 171.4 19 135.7 7 100.0 10 142.9 17 121.4 7 100.0 10 142.9 17 121.4 7 100.0 14 200.0 21 150.0
3 AOSOLE 1,066 12 12 24 11 11 22 8 72.7 7 63.6 15 68.2 7 63.6 12 18.9 19 86.4 7 63.6 12 109.1 19 86.4 11 100.0 13 118.2 24 109.1 11 100.0 13 118.2 24 109.1 12 109.1 10 90.9 22 100.0
4 ALAKAYA 704 8 8 16 7 7 14 3 42.9 1 14.3 4 28.6 6 85.7 2 2.3 8 57.1 6 85.7 2 28.6 8 57.1 6 85.7 2 28.6 8 57.1 6 85.7 2 28.6 8 57.1 6 85.7 3 42.9 9 64.3
5 WAWORAHA 611 7 7 14 6 6 14 2 33.3 3 50.0 5 35.7 6 100.0 4 4.0 10 71.4 6 100.0 4 66.7 10 71.4 6 100.0 4 66.7 10 71.4 6 100.0 4 66.7 10 71.4 6 100.0 1 16.7 7 50.0
6 KAPU JAYA 650 7 7 14 7 7 14 5 71.4 4 57.1 9 64.3 10 142.9 6 4.2 16 114.3 10 142.9 6 85.7 16 114.3 10 142.9 6 85.7 16 114.3 10 142.9 6 85.7 16 114.3 10 142.9 6 85.7 16 114.3
7 WAWOURU 1,125 13 12 25 12 12 24 6 50.0 5 41.7 11 45.8 17 141.7 13 9.2 30 125.0 17 141.7 13 108.3 30 125.0 17 141.7 14 116.7 31 129.2 17 141.7 14 116.7 31 129.2 18 150.0 13 108.3 31 129.2
8 MEKAR SARI 1,433 16 16 32 15 15 30 4 26.7 9 60.0 13 43.3 13 86.7 13 15.0 26 86.7 13 86.7 13 86.7 26 86.7 14 93.3 15 100.0 29 96.7 14 93.3 15 100.0 29 96.7 15 100.0 15 100.0 30 100.0
9 WATUMEREMBE 854 10 9 19 9 9 18 5 55.6 2 22.2 7 38.9 10 111.1 2 1.8 12 66.7 10 111.1 2 22.2 12 66.7 11 122.2 2 22.2 13 72.2 11 122.2 2 22.2 13 72.2 10 111.1 3 33.3 13 72.2
10 EEWA 666 8 7 15 7 7 14 4 57.1 3 42.9 7 50.0 7 100.0 8 8.0 15 107.1 7 100.0 8 114.3 15 107.1 7 100.0 5 71.4 12 85.7 7 100.0 5 71.4 12 85.7 5 71.4 6 85.7 11 78.6
11 ONEMBUTE 1,007 11 11 22 11 10 21 3 27.3 2 20.0 5 23.8 8 72.7 6 8.3 14 66.7 8 72.7 6 60.0 14 66.7 7 63.6 3 30.0 10 47.6 7 63.6 3 30.0 10 47.6 7 63.6 10 100.0 17 81.0
12 ANGGONDARA 779 9 8 17 8 8 16 9 112.5 3 37.5 12 75.0 11 137.5 5 3.6 16 100.0 11 137.5 5 62.5 16 100.0 8 100.0 6 75.0 14 87.5 8 100.0 6 75.0 14 87.5 14 175.0 8 100.0 22 137.5
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 8 61.5 2 15.4 10 38.5 22 169.2 13 7.7 35 134.6 22 169.2 13 100.0 35 134.6 18 138.5 16 123.1 34 130.8 18 138.5 16 123.1 34 130.8 18 138.5 18 138.5 36 138.5
14 WAWONGGURA 776 9 8 17 8 8 16 3 37.5 3 37.5 6 37.5 3 37.5 6 16.0 9 56.3 3 37.5 6 75.0 9 56.3 4 50.0 10 125.0 14 87.5 4 50.0 10 125.0 14 87.5 3 37.5 12 150.0 15 93.8
15 SANGGI-SANGGI 698 8 8 16 7 7 14 5 71.4 3 42.9 8 57.1 3 42.9 9 21.0 12 85.7 3 42.9 9 128.6 12 85.7 3 42.9 9 128.6 0 0.0 3 42.9 9 128.6 12 85.7 3 42.9 9 128.6 12 85.7
16 UPT.TOLIHE 457 5 5 10 5 5 10 1 20.0 1 20.0 2 20.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 2 40.0 0 0.0 2 20.0 2 40.0 0 0.0 2 20.0 2 40.0 0 0.0 2 20.0
PALANGGA 14,608 166 159 326 153 152 307 73 0.0 59 38.8 132 43.0 139 90.8 123 135.4 262 85.3 139 90.8 112 73.7 239 77.9 142 92.8 127 83.6 251 81.8 142 92.8 127 83.6 269 87.6 146 95.4 138 90.8 284 92.5

aan
ini ini (buah)
6 Vak. HB. UNIJECT - 100 100 12 88 (76) 7 TT 245 dosis 8 Vial 30.625
1 ADS 5 ml 33 20 53 15 38 (23)
2 ADS 0,5 ml 117 200 317 137 180 (43)
3 ADS 0,0 5 ml 104 100 204 19 185 (166)
5 Safety Box 0,25 liter - - - Nip.196506021987031017
POLIO 3 DPT/HB-Hib (3) POLIO4 IPV CAMPAK IMUNISASI DASAR LENGKAP SASARAN BATITA DPT/HB/Hib (18 Bln)
#L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML %
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
0 0.0 1 5.0 1 2.5 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 1 5.0 0 0.0 1 2.5 1 5.0 1 5.0 2 5.0 20 20 40 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 7 14 0 0.0 0 0.0 0 0.0
1 9.1 2 18.2 3 13.6 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 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 11 11 22 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 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 7 7 14 1 14.3 3 42.9 4 28.6
1 16.7 0 0.0 1 8.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 6 12 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 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 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 8.3 0 0.0 1 4.2 0 0.0 2 16.7 2 8.3 12 12 24 2 16.7 0 0.0 2 8.3
1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 0 0.0 0 0.0 0 0.0 0 0.0 1 6.7 1 3.3 1 6.7 0 0.0 1 3.3 15 15 30 0 0.0 0 0.0 0 0.0
1 11.1 0 0.0 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 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 33.3 0 0.0 3 16.7 9 9 18 0 0.0 0 0.0 0 0.0
1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 10 21 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 8 16 0 0.0 0 0.0 0 0.0
3 23.1 4 30.8 7 26.9 1 7.7 1 7.7 2 7.7 1 7.7 1 7.7 2 7.7 0 0.0 0 0.0 0 0.0 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 13 13 26 2 15.4 0 0.0 2 7.7
0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 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 8 8 16 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1 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 1 14.3 1 7.1 1 14.3 0 0.0 1 7.1 7 7 14 0 0.0 1 14.3 1 7.1
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 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 5 5 10 1 20.0 0 0.0 1 10.0
9 5.9 9 5.9 18 5.9 7 4.6 5 3.3 12 3.9 7 4.6 5 3.3 12 3.9 0 0.0 0 0.0 0 0.0 4 2.6 2 1.3 6 2.0 8 5.2 3 2.0 11 3.6 153 152 305 6 3.9 4 2.6 10 3.3
Palangga ...................................................2019
Koordinator Jurim Puskesmas Palangga 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) :
2 Kelamin : Imunisasi Tgl. :
Tgl Jam No. Batch
3 Tggl / Lahir : (Vaksin) Kadaluarsa :
4 Umur : :
Iwan Setiawan.SKM 5 Nama ayah : :
Nip. 19730720 199502 1001 6 Nama ibu : :
7 Alamat : :
a. Jalan ………………………… Nomor …. RT/RW ………………. Reaksi timbul pada tgl .......................................... Jalan ………………………… Nomor …. RT/RW ……………….
b. Dusun/Kampung…………….. Desa/Kelurahan ………………… Gejala & Waktu timbulnya gejala ..................................................Dusun/Kampung…………….. Desa/Kelurahan …………………
c. Kecamatan ………………….. Kabupaten ………………………… Kecamatan ………………….. Kabupaten …………………………
d. Provinsi Sulawesi Tenggara Provinsi Sulawesi Tenggara
POLIO 3 DPT/HB-Hib (3) POLIO4 IPV CAMPAK IMUNISASI DASAR LENGKAP SASARAN BATITA DPT/HB/Hib
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
1 5.0 0 0.0 1 2.5 3 15.0 0 0.0 3 7.5 3 15.0 0 0.0 3 7.5 0 0.0 0 0.0 0 0.0 1 5.0 3 15.0 4 10.0 0 0.0 2 10.0 2 5.0 20 20 40 2 10.0 2 10.0 4 10.0
0 0.0 1 14.3 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 2 28.6 2 28.6 4 28.6 0 0.0 0 0.0 0 0.0 7 7 14 3 42.9 0 0.0 3 21.4
0 0.0 2 18.2 2 9.1 2 18.2 3 27.3 5 22.7 2 18.2 3 27.3 5 22.7 0 0.0 0 0.0 0 0.0 1 9.1 3 27.3 4 18.2 0 0.0 0 0.0 0 0.0 11 11 22 1 9.1 0 0.0 1 4.5
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 1 14.3 1 7.1 7 7 14 2 28.6 2 28.6 4 28.6
0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 0 0.0 1 16.7 1 7.1 6 6 12 1 16.7 0 0.0 1 8.3
1 14.3 2 28.6 3 21.4 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 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 7 7 14 0 0.0 0 0.0 0 0.0
3 25.0 0 0.0 3 12.5 1 8.3 1 8.3 2 8.3 1 8.3 1 8.3 2 8.3 0 0.0 0 0.0 0 0.0 2 16.7 0 0.0 2 8.3 0 0.0 0 0.0 0 0.0 12 12 24 1 8.3 1 8.3 2 8.3
0 0.0 2 13.3 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 0 0.0 0 0.0 0 0.0 3 20.0 1 6.7 4 13.3 0 0.0 0 0.0 0 0.0 15 15 30 0 0.0 0 0.0 0 0.0
1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 1 5.6 0 0.0 2 22.2 2 11.1 9 9 18 1 11.1 0 0.0 1 5.6
0 0.0 0 0.0 0 0.0 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 0 0.0 0 0.0 0 0.0 1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0 7 7 14 1 14.3 0 0.0 1 7.1
0 0.0 0 0.0 0 0.0 2 18.2 2 20.0 4 19.0 2 18.2 2 20.0 4 19.0 0 0.0 0 0.0 0 0.0 1 9.1 2 20.0 3 14.3 1 9.1 2 20.0 3 14.3 11 10 21 1 9.1 1 10.0 2 9.5
2 25.0 1 12.5 3 18.8 1 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 0 0.0 0 0.0 0 0.0 3 37.5 0 0.0 3 18.8 0 0.0 0 0.0 0 0.0 8 8 16 0 0.0 1 12.5 1 6.3
2 15.4 0 0.0 2 7.7 1 7.7 5 38.5 6 23.1 1 7.7 5 38.5 6 23.1 0 0.0 0 0.0 0 0.0 2 15.4 0 0.0 2 7.7 0 0.0 0 0.0 0 0.0 13 13 26 4 30.8 3 23.1 7 26.9
0 0.0 1 12.5 1 6.3 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 1 12.5 2 25.0 3 18.8 0 0.0 0 0.0 0 0.0 8 8 16 0 0.0 0 0.0 0 0.0
1 14.3 1 14.3 2 14.3 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 14.3 2 14.3 7 7 14 3 42.9 0 0.0 3 21.4
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 5 5 10 0 0.0 0 0.0 0 0.0
0.0 10 6.6 10 3.3 18 11.8 15 9.9 33 10.7 18 11.8 15 9.9 33 10.7 0.0 0 0.0 0 0.0 19 12.4 15 9.9 34 11.1 2 1.3 9 5.9 11 3.6 153 152 305 20 13.1 10 6.6 30 9.8

Tgl Jam No. Batch
4 Umur : :
ABBAS,Amd.Kep 5 Nama ayah : :
Nip.19731007 201406 1 002 6 Nama ibu : :
7 Alamat : :
POLIO3 DPT/HB-Hib (3) POLIO4 IPV CAMPAK IDL SASARAN BATITA DPT/HB/Hib
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 20 20 40 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 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 7 14 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 11 11 22 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 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 7 14 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 6 6 12 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 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 7 14 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 12 12 24 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 15 15 30 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 9 9 18 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 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 7 14 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 11 10 21 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 8 16 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 13 13 26 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 8 8 16 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 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 7 14 0.0 0.0 0 0.0
0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 0.0 0.0 0 0.0 5 5 10 0.0 0.0 0 0.0
0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 152 305 0 0.0 0 0.0 0 0.0
Palangga, ………………….2019
Tgl Jam No. Batch
4 Umur : :
Iwan Setiawan,SKM 5 Nama ayah : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 0 0.0 3 15.0 3 7.5 0 0.0 3 15.0 3 7.5 20 20 40 2 10.0 0 0.0 2 5.0
0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 2 28.6 0 0.0 2 0.0 2 28.6 0 0.0 2 14.3 7 7 14 0 0.0 0 0.0 0 0.0
5 45.5 0 0.0 5 22.7 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 2 18.2 0 0.0 2 9.1 2 18.2 0 0.0 2 9.1 11 11 22 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 7 7 14 1 14.3 0 0.0 1 7.1
0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 6 12 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 7 14 0 0.0 0 0.0 0 0.0
1 8.3 2 16.7 3 12.5 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 12 12 24 2 16.7 1 8.3 3 12.5
2 13.3 1 6.7 3 10.0 0 0.0 1 6.7 1 3.3 0 21.4 1 6.7 1 3.3 0 0.0 1 6.7 1 3.3 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 15 15 30 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 9 9 18 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 2 20.0 2 9.5 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 10 21 0 0.0 0 0.0 0 0.0
5 62.5 0 0.0 5 31.3 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 3 37.5 0 0.0 3 18.8 3 37.5 0 0.0 3 18.8 8 8 16 0 0.0 0 0.0 0 0.0
0 0.0 4 30.8 4 15.4 2 15.4 2 15.4 4 #REF! 2 15.4 2 15.4 4 15.4 2 15.4 2 15.4 4 15.4 0 0.0 5 38.5 5 19.2 0 0.0 5 38.5 5 19.2 13 13 26 1 7.7 2 15.4 3 11.5
0 0.0 2 25.0 2 12.5 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 8 8 16 2 25.0 1 12.5 3 18.8
0 0.0 2 28.6 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 7 7 14 0 0.0 1 14.3 1 7.1
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 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 5 5 10 1 20.0 0 0.0 1 10.0
15 9.8 14 9.2 29 9.4 12 7.8 8 5.3 20 6.5 12 7.8 8 5.3 20 6.5 12 7.8 8 5.3 20 6.5 12 7.8 10 6.6 22 7.2 12 7.8 10 6.6 22 7.2 153 152 305 9 5.9 5 3.3 14 4.6

Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
POLIO3 DPT-HB-HIB3 POLIO4 IPV CAMPAK IDL SASARAN BATITA DPT/HB/Hib
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
2 10.0 1 5.0 3 7.5 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 0 0.0 2 10.0 2 5.0 0 0.0 2 10.0 2 5.0 20 20 40 1 5.0 1 5.0 2 5.0
0 0.0 1 14.3 1 7.1 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 7 14 0 0.0 0 0.0 0 0.0
4 36.4 1 9.1 5 22.7 4 36.4 1 9.1 5 22.7 4 36.4 1 9.1 5 22.7 4 36.4 1 9.1 5 22.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 11 22 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 6 6 12 0 0.0 1 16.7 1 8.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 7 14 0 0.0 0 0.0 0 0.0
2 16.7 1 8.3 3 12.5 1 8.3 2 16.7 3 12.5 1 8.3 2 16.7 3 12.5 1 8.3 2 16.7 3 12.5 1 8.3 1 8.3 2 8.3 1 8.3 1 8.3 2 8.3 12 12 24 1 8.3 0 0.0 1 4.2
1 6.7 2 13.3 3 10.0 3 20.0 0 0.0 3 10.0 3 20.0 0 0.0 3 10.0 3 20.0 0 0.0 3 10.0 0 0.0 1 6.7 1 3.3 0 0.0 1 6.7 1 3.3 15 15 30 0 0.0 1 6.7 1 3.3
0 0.0 1 11.1 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 9 18 2 22.2 0 0.0 2 11.1
0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 7 7 14 1 14.3 0 0.0 1 7.1
0 0.0 1 10.0 1 4.8 1 9.1 1 10.0 2 9.5 1 9.1 1 10.0 2 9.5 1 9.1 1 10.0 2 9.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 10 21 1 9.1 0 0.0 1 4.8
0 0.0 2 25.0 2 12.5 1 12.5 1 12.5 2 12.5 1 12.5 1 2.0 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 8 16 0 0.0 1 12.5 1 6.3
2 15.4 1 7.7 3 11.5 3 23.1 2 15.4 5 19.2 3 23.1 2 15.4 5 19.2 3 23.1 2 15.4 5 19.2 3 23.1 0 0.0 3 11.5 3 23.1 0 0.0 3 11.5 13 13 26 2 15.4 1 7.7 3 11.5
0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 8 8 16 1 12.5 0 0.0 1 6.3
0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 3 42.9 0 0.0 3 21.4 3 42.9 0 0.0 3 21.4 7 7 14 0 0.0 0 0.0 0 0.0
1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 5 10 0 0.0 0 0.0 0 0.0
12 7.8 13 8.6 25 8.1 16 10.5 11 7.2 27 8.8 16 10.5 11 7.2 27 8.8 16 10.5 11 7.2 27 8.8 9 5.9 6 3.9 15 4.9 9 5.9 6 3.9 15 4.9 153 152 305 9 5.9 5 3.3 14 4.6

Tgl Jam No. Batch
4 Umur : :
Nip. ........................... 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
1 5.0 1 5.0 2 5.0 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 0 0.0 0 0.0 0 0.0 3 15.0 0 0.0 3 7.5 3 15.0 0 0.0 3 7.5 20 20 40 0 0.0 1 5.0 1 2.5
0 0.0 0 0.0 0 0.0 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 5 45.5 1 9.1 6 27.3 5 45.5 1 9.1 6 27.3 5 45.5 1 9.1 6 27.3 4 36.4 0 0.0 4 18.2 4 36.4 0 0.0 4 18.2 11 11 22 1 9.1 1 9.1 2 9.1
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 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 7 7 14 0 0.0 0 0.0 0 0.0
2 33.3 0 0.0 2 14.3 0 0.0 0 0.0 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 16.7 1 7.1 0 0.0 1 16.7 1 7.1 6 6 12 0 0.0 0 0.0 0 0.0
2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 0 0.0 0 0.0 0 0.0 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 12 12 24 3 25.0 0 0.0 3 12.5
2 13.3 1 6.7 3 10.0 0 0.0 3 20.0 3 10.0 0 0.0 3 20.0 3 10.0 0 0.0 3 20.0 3 10.0 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 15 15 30 0 0.0 0 0.0 0 0.0
2 22.2 0 0.0 2 11.1 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 9 9 18 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 7 7 14 0 0.0 0 0.0 0 0.0
2 18.2 0 0.0 2 9.5 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 10 21 0 0.0 0 0.0 0 0.0
0 0.0 1 12.5 1 6.3 0 0.0 2 25.0 2 12.5 0 20.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5 8 8 16 0 0.0 1 12.5 1 6.3
4 30.8 2 15.4 6 23.1 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 0 0.0 3 23.1 3 11.5 0 0.0 3 23.1 3 11.5 13 13 26 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 8 8 16 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 5 10 0 0.0 0 0.0 0 0.0
15 9.8 6 3.9 21 6.8 10 6.5 11 7.2 21 6.8 10 6.5 11 7.2 21 6.8 8 5.2 9 5.9 17 5.5 12 7.8 10 6.6 22 7.2 12 7.8 10 6.6 22 7.2 153 152 305 4 2.6 3 2.0 7 2.3
Palangga, ………………….2019
Koordinator Jurim Puskesmas .Palangga 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) :
Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
Polio 3 DPT/HB-Hib (3) POLIO4 IPV CAMPAK IDL SASARAN BATITA DPT/HB/Hib
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
0 0.0 0 0.0 0 0.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 20 20 40 0 0.0 1 5.0 1 2.5
0 0.0 1 14.3 1 7.1 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 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 0 0.0 2 18.2 2 9.1 0 0.0 2 18.2 2 9.1 11 11 22 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 7 7 14 1 14.3 3 42.9 4 28.6
0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 6 12 0 0.0 0 0.0 0 0.0
2 28.6 1 14.3 3 21.4 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 7 7 14 1 14.3 0 0.0 1 7.1
1 8.3 4 33.3 5 20.8 1 8.3 1 8.3 2 8.3 1 8.3 1 8.3 2 8.3 1 8.3 1 8.3 2 8.3 0 0.0 2 16.7 2 8.3 0 0.0 2 16.7 2 8.3 12 12 24 1 8.3 2 16.7 3 12.5
1 6.7 1 6.7 2 6.7 3 20.0 1 6.7 4 13.3 3 20.0 1 6.7 4 13.3 3 20.0 1 6.7 4 13.3 2 13.3 0 0.0 2 6.7 2 13.3 0 0.0 2 6.7 15 15 30 2 13.3 0 0.0 2 6.7
0 0.0 1 11.1 1 5.6 2 22.2 1 11.1 3 16.7 2 22.2 1 11.1 3 16.7 2 22.2 1 11.1 3 16.7 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 9 9 18 0 0.0 3 33.3 3 16.7
1 14.3 0 0.0 1 7.1 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 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 7 7 14 0 0.0 0 0.0 0 0.0
1 9.1 1 10.0 2 9.5 2 18.2 1 10.0 3 14.3 2 18.2 1 10.0 3 14.3 2 18.2 1 10.0 3 14.3 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 11 10 21 0 0.0 1 10.0 1 4.8
0 0.0 0 0.0 0 0.0 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8 1 12.5 3 37.5 4 25.0 1 12.5 3 37.5 4 25.0 8 8 16 1 12.5 1 12.5 2 12.5
2 15.4 2 15.4 4 15.4 3 23.1 3 23.1 6 23.1 3 23.1 3 23.1 6 23.1 3 23.1 3 23.1 6 23.1 3 23.1 1 7.7 4 15.4 3 23.1 1 7.7 4 15.4 13 13 26 0 0.0 1 7.7 1 3.8
0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 8 8 16 0 0.0 0 0.0 0 0.0
0 0.0 1 14.3 1 7.1 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 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 7 7 14 0 0.0 0 0.0 0 0.0
1 20.0 0 0.0 1 10.0 0 0.0 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 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 5 5 10 0 0.0 0 0.0 0 0.0
9 5.9 13 8.6 22 7.2 18 11.8 10 6.6 28 9.1 18 11.8 10 6.6 28 9.1 18 11.8 10 6.6 28 9.1 12 7.8 14 9.2 26 8.5 12 7.8 14 9.2 26 8.5 153 152 305 6 3.9 12 7.9 18 5.9
Palangga ..................................................2019
Koordinator Jurim Puskesmas Palangga. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) :
Tgl Jam No. Batch
4 Umur : :
Iwan Setiawan 5 Nama ayah : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
POLIO 3 DPT/HB-Hib (3) POLIO4 IPV CAMPAK IDL SASARAN BATITA DPT/HB/Hib
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
0 0.0 0 0.0 0 0.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 20 20 40 2 10.0 2 10.0 4 10.0
4 57.1 3 42.9 7 50.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 2 28.6 3 21.4 1 14.3 2 28.6 3 21.4 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 3 27.3 3 13.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 18.2 0 0.0 2 9.1 2 18.2 0 0.0 2 9.1 11 11 22 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 7 14 0 0.0 0 0.0 0 0.0
1 16.7 0 0.0 1 7.1 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 2 33.3 0 0.0 2 14.3 2 33.3 0 0.0 2 14.3 6 6 12 0 0.0 0 0.0 0 0.0
1 14.3 1 14.3 2 14.3 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 7 7 14 0 0.0 0 0.0 0 0.0
3 25.0 0 0.0 3 12.5 2 16.7 3 25.0 5 20.8 2 16.7 3 25.0 5 20.8 2 16.7 3 25.0 5 20.8 0 0.0 2 16.7 2 8.3 0 0.0 2 16.7 2 8.3 12 12 24 1 8.3 1 8.3 2 8.3
3 20.0 0 0.0 3 10.0 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 15 15 30 2 13.3 1 6.7 3 10.0
1 11.1 0 0.0 1 5.6 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 9 18 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 1 10.0 1 4.8 1 9.1 1 10.0 2 9.5 1 9.1 1 10.0 2 9.5 1 9.1 1 10.0 2 9.5 3 27.3 0 0.0 3 14.3 3 27.3 0 0.0 3 14.3 11 10 21 0 0.0 0 0.0 0 0.0
4 50.0 1 12.5 5 31.3 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 1 12.5 3 37.5 4 25.0 1 12.5 3 37.5 4 25.0 8 8 16 0 0.0 0 0.0 0 0.0
1 7.7 0 0.0 1 3.8 2 21.4 1 7.7 3 11.5 2 15.4 1 7.7 3 11.5 2 15.4 1 7.7 3 11.5 0 0.0 5 38.5 5 19.2 0 0.0 5 38.5 5 19.2 13 13 26 1 7.7 0 0.0 1 3.8
1 12.5 1 12.5 2 12.5 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 8 8 16 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 5 5 10 0 0.0 0 0.0 0 0.0
20 13.1 10 6.6 30 9.8 13 8.5 11 7.2 24 7.8 13 8.5 11 7.2 24 7.8 13 8.5 11 7.2 24 7.8 14 9.2 14 9.2 28 9.1 14 9.2 14 9.2 28 9.1 153 152 305 6 3.9 4 2.6 10 3.3
Palangga, …………………….. 2019

Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
0 0.0 1 5.0 1 2.5 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 2 10.0 0 0.0 2 5.0 2 10.0 0 0.0 2 5.0 20 20 40 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1 2 28.6 2 28.6 4 28.6 2 28.6 2 28.6 4 28.6 2 28.6 2 28.6 4 28.6 2 28.6 2 28.6 4 28.6 2 28.6 2 28.6 4 28.6 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 3 27.3 3 13.6 0 0.0 3 27.3 3 13.6 0 0.0 3 27.3 3 13.6 2 18.2 0 0.0 2 9.1 2 18.2 0 0.0 2 9.1 11 11 22 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 7 7 14 0 0.0 2 28.6 2 14.3
1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 6 12 1 16.7 3 50.0 4 33.3
1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 7 14 1 14.3 0 0.0 1 7.1
3 25.0 2 16.7 5 20.8 3 25.0 1 8.3 4 16.7 3 25.0 1 8.3 4 16.7 3 25.0 1 8.3 4 16.7 2 16.7 1 8.3 3 12.5 2 16.7 1 8.3 3 12.5 12 12 24 0 0.0 0 0.0 0 0.0
1 6.7 1 6.7 2 6.7 2 13.3 0 0.0 2 6.7 2 13.3 0 0.0 2 6.7 2 13.3 0 0.0 2 6.7 3 20.0 2 13.3 5 16.7 3 20.0 2 13.3 5 16.7 15 15 30 0 0.0 0 0.0 0 0.0
1 11.1 1 11.1 2 11.1 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 9 18 0 0.0 2 22.2 2 11.1
0 0.0 1 14.3 1 7.1 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 7 7 14 0 0.0 0 0.0 0 0.0
3 27.3 0 0.0 3 14.3 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 0 0.0 3 30.0 3 14.3 0 0.0 3 30.0 3 14.3 11 10 21 1 9.1 1 10.0 2 9.5
2 0.0 1 12.5 3 18.8 3 37.5 1 12.5 4 25.0 3 37.5 1 12.5 4 25.0 3 37.5 1 12.5 4 25.0 3 37.5 1 12.5 4 25.0 3 37.5 1 12.5 4 25.0 8 8 16 0 0.0 0 0.0 0 0.0
0 0.0 1 7.7 1 3.8 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 13 13 26 1 7.7 0 0.0 1 3.8
1 12.5 0 0.0 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 8 8 16 0 0.0 1 12.5 1 6.3
0 0.0 2 28.6 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 5 10 0 0.0 0 0.0 0 0.0
14 9.2 10 6.6 24 7.8 13 8.5 10 6.6 23 7.5 13 8.5 10 6.6 23 7.5 13 8.5 10 6.6 23 7.5 17 11.1 11 7.2 28 9.1 17 11.1 11 7.2 28 9.1 153 152 305 4 2.6 9 5.9 13 4.3
Palangga, ………………….2019
Koordinator Jurim Puskesmas .palangga 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) :
Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1 001. 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
1 5.0 5 25.0 6 15.0 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 20 20 40 2 10.0 2 10.0 4 10.0
1 14.3 5 71.4 6 42.9 3 42.9 1 14.3 4 28.6 3 42.9 1 14.3 4 28.6 3 42.9 1 14.3 4 28.6 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 1 9.1 1 4.5 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 2 18.2 1 9.1 3 13.6 2 18.2 1 9.1 3 13.6 11 11 22 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 7 14 0 0.0 0 0.0 0 0.0
1 16.7 1 16.7 2 14.3 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 6 12 0 0.0 1 16.7 1 8.3
0 0.0 1 14.3 1 7.1 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 3 25.0 2 16.7 5 20.8 3 25.0 2 16.7 5 20.8 3 25.0 2 16.7 5 20.8 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 12 12 24 0 0.0 1 8.3 1 4.2
1 6.7 3 20.0 4 13.3 2 13.3 1 6.7 3 10.0 2 13.3 1 6.7 3 10.0 2 13.3 1 6.7 3 10.0 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 15 15 30 2 13.3 3 20.0 5 16.7
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 11.1 1 5.6 0 0.0 1 11.1 1 5.6 9 9 18 0 0.0 1 11.1 1 5.6
0 0.0 1 14.3 1 7.1 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 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 2 20.0 2 9.5 3 27.3 0 0.0 3 14.3 3 27.3 0 0.0 3 14.3 3 27.3 0 0.0 3 14.3 2 18.2 1 10.0 3 14.3 2 18.2 1 10.0 3 14.3 11 10 21 0 0.0 0 0.0 0 0.0
1 12.5 1 12.5 2 12.5 2 25.0 2 25.0 4 25.0 2 25.0 2 25.0 4 25.0 2 25.0 2 25.0 4 25.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 8 16 0 0.0 0 0.0 0 0.0
3 23.1 2 15.4 5 19.2 2 15.4 2 15.4 4 15.4 2 15.4 2 15.4 4 15.4 2 15.4 2 15.4 4 15.4 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 13 13 26 1 7.7 2 15.4 3 11.5
1 12.5 3 37.5 4 25.0 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 8 8 16 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 7 7 14 2 28.6 0 0.0 2 14.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 5 10 0 0.0 0 0.0 0 0.0
10 6.5 25 16.4 35 11.4 20 13.1 12 7.9 32 10.4 20 13.1 12 7.9 32 10.4 20 13.1 12 7.9 32 10.4 6 3.9 10 6.6 16 5.2 6 3.9 10 6.6 16 5.2 153 152 305 7 4.6 10 6.6 17 5.6
Palangga,31 Oktober 2019

Tgl Jam No. Batch
4 Umur : :
Nip. .19730720 199502 1 001. 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
4 20.0 1 5.0 5 12.5 1 5.0 6 30.0 7 17.5 1 5.0 6 30.0 7 17.5 0 0.0 0 0.0 0 0.0 2 10.0 2 10.0 4 10.0 2 10.0 2 10.0 4 10.0 20 20 40 1 5.0 0 0.0 1 2.5
0 0.0 2 28.6 2 14.3 1 14.3 5 71.4 6 42.9 1 14.3 5 71.4 6 42.9 0 0.0 0 0.0 0 0.0 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 7 7 14 0 0.0 0 0.0 0 0.0
1 9.1 0 0.0 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 11 11 22 0 0.0 0 0.0 0 0.0
2 28.6 2 28.6 4 28.6 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 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 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 16.7 1 16.7 2 14.3 1 16.7 1 16.7 2 14.3 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 6 6 12 0 0.0 1 16.7 1 8.3
1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 0 0.0 0 0.0 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 7 7 14 0 0.0 0 0.0 0 0.0
3 25.0 2 16.7 5 20.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 16.7 2 16.7 4 16.7 2 16.7 2 16.7 4 16.7 12 12 24 0 0.0 0 0.0 0 0.0
2 13.3 2 13.3 4 13.3 1 6.7 2 13.3 3 10.0 1 6.7 2 13.3 3 10.0 0 0.0 0 0.0 0 0.0 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 15 15 30 1 6.7 1 6.7 2 6.7
3 33.3 0 0.0 3 16.7 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6 0 0.0 0 0.0 0 0.0 2 22.2 1 11.1 3 16.7 2 22.2 1 11.1 3 16.7 9 9 18 3 33.3 0 0.0 3 16.7
0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 7 7 14 1 14.3 0 0.0 1 7.1
1 9.1 1 10.0 2 9.5 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 10 21 2 18.2 2 20.0 4 19.0
0 0.0 0 0.0 0 0.0 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 8 8 16 0 0.0 0 0.0 0 0.0
1 7.7 1 7.7 2 7.7 2 15.4 2 15.4 4 15.4 2 15.4 2 15.4 4 15.4 0 0.0 0 0.0 0 0.0 4 30.8 0 0.0 4 15.4 4 30.8 0 0.0 4 15.4 13 13 26 1 7.7 0 0.0 1 3.8
0 0.0 2 25.0 2 12.5 1 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 0 0.0 0 0.0 0 0.0 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8 8 8 16 0 0.0 0 0.0 0 0.0
1 14.3 2 28.6 3 21.4 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 7 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 5 5 10 0 0.0 0 0.0 0 0.0
19 12.4 17 11.2 36 11.7 10 6.5 25 16.4 35 11.4 10 6.5 25 16.4 35 11.4 0 0.0 0 0.0 0 0.0 21 13.7 8 5.3 29 9.4 21 13.7 8 5.3 29 9.4 153 152 305 9 5.9 4 2.6 13 4.3
Palangga, ………………….2019
Koordinator Jurim Puskesmas .Palangga. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) :
Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
POLIO 3 DPT/HB-Hib (3) POLIO 4 IPV CAMPAK IDL SASARAN BATITA DPT/HB/Hib
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
0 0.0 0 0.0 0 0.0 2 10.0 1 5.0 3 7.5 2 10.0 1 5.0 3 7.5 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 20 20 40 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 0 0.0 0 0.0 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 7 7 14 0 0.0 2 28.6 2 14.3
1 9.1 1 9.1 2 9.1 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 11 11 22 0 0.0 1 9.1 1 4.5
2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 7 7 14 0 0.0 1 14.3 1 7.1
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 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 6 6 12 2 33.3 0 0.0 2 16.7
2 28.6 1 14.3 3 21.4 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 7 7 14 0 0.0 0 0.0 0 0.0
2 16.7 1 8.3 3 12.5 3 25.0 1 8.3 4 16.7 3 25.0 1 8.3 4 16.7 0 0.0 0 0.0 0 0.0 1 8.3 2 16.7 3 12.5 1 8.3 2 16.7 3 12.5 12 12 24 2 16.7 2 16.7 0 0.0
1 6.7 1 6.7 2 6.7 2 13.3 3 20.0 5 16.7 2 13.3 3 20.0 5 16.7 0 0.0 0 0.0 0 0.0 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 15 15 30 0 0.0 0 0.0 0 0.0
1 11.1 0 0.0 1 5.6 4 44.4 0 0.0 4 22.2 4 44.4 0 0.0 4 22.2 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 9 9 18 4 44.4 1 11.1 5 27.8
2 28.6 0 0.0 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 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 7 14 0 0.0 0 0.0 0 0.0
0 0.0 2 20.0 2 9.5 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 10 21 3 27.3 1 10.0 4 19.0
0 0.0 1 12.5 1 6.3 0 0.0 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 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 8 8 16 0 0.0 0 0.0 0 0.0
0 0.0 1 7.7 1 3.8 0 0.0 1 7.7 1 3.8 0 0.0 1 7.7 1 3.8 0 0.0 0 0.0 0 0.0 2 15.4 3 23.1 5 19.2 2 15.4 3 23.1 0 0.0 13 13 26 0 0.0 1 7.7 1 3.8
0 0.0 2 25.0 2 12.5 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 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 8 8 16 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 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 7 14 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 5 10 0 0.0 0 0.0 0 0.0
12 7.8 11 7.2 23 7.5 15 9.8 12 7.9 27 8.8 15 9.8 12 7.9 27 8.8 0 0.0 0 0.0 0 0.0 10 6.5 11 7.2 21 6.8 10 6.5 11 7.2 21 6.8 153 152 305 11 7.2 9 5.9 20 6.6
Palangga, ………………….2019
Koordinator Jurim Puskesmas ................. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) :
Tgl Jam No. Batch
4 Umur : :
Iwan Setiawan. 5 Nama ayah : :
Nip. 19730720 199502 1 001. 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
10 50.0 10 50.0 20 50.0 11 55.0 10 50.0 21 52.5 11 55.0 10 50.0 21 52.5 4 20.0 3 15.0 7 17.5 3 15.0 12 60.0 15 37.5 3 5.0 2 0.0 5 2.5 20 20 40 10 50.0 9 45.0 19 47.5
7 100.0 14 200.0 21 150.0 10 142.9 1 14.3 11 78.6 10 142.9 1 14.3 11 78.6 8 114.3 1 14.3 9 64.3 10 142.9 9 128.6 19 135.7 3 28.6 1 0.0 4 14.3 7 7 14 3 42.9 2 28.6 5 35.7
12 109.1 10 90.9 22 100.0 14 127.3 9 81.8 23 104.5 14 127.3 9 81.8 23 104.5 11 100.0 5 45.5 16 72.7 14 127.3 8 72.7 22 100.0 0 0.0 8 45.5 8 22.7 11 11 22 2 18.2 2 18.2 4 18.2
6 85.7 3 42.9 9 64.3 6 85.7 4 57.1 10 71.4 6 85.7 4 57.1 10 71.4 1 14.3 2 28.6 3 21.4 5 71.4 3 42.9 8 57.1 0 0.0 1 14.3 1 7.1 7 7 14 5 71.4 11 157.1 16 114.3
6 100.0 1 16.7 7 50.0 6 100.0 1 16.7 7 50.0 6 100.0 1 16.7 7 50.0 4 66.7 0 0.0 4 28.6 6 100.0 1 16.7 7 50.0 2 0.0 4 66.7 6 28.6 6 6 12 4 66.7 6 100.0 10 83.3
10 142.9 6 85.7 16 114.3 10 142.9 3 42.9 13 92.9 10 142.9 3 42.9 13 92.9 7 100.0 2 28.6 9 64.3 4 57.1 4 57.1 8 57.1 0 0.0 1 0.0 1 0.0 7 7 14 2 28.6 0 0.0 2 14.3
18 150.0 13 108.3 31 129.2 14 116.7 13 108.3 27 112.5 14 116.7 13 108.3 27 112.5 10 83.3 10 83.3 20 83.3 6 50.0 12 100.0 18 75.0 6 8.3 2 8.3 8 8.3 12 12 24 13 108.3 8 66.7 21 87.5
15 100.0 15 100.0 30 100.0 16 106.7 14 93.3 30 100.0 16 106.7 14 93.3 30 100.0 11 73.3 7 46.7 18 60.0 14 93.3 7 46.7 21 70.0 3 6.7 5 20.0 8 13.3 15 15 30 7 46.7 6 40.0 13 43.3
10 111.1 3 33.3 13 72.2 9 100.0 3 33.3 12 66.7 9 100.0 3 33.3 12 66.7 1 11.1 2 22.2 1 5.6 7 77.8 3 33.3 10 55.6 7 11.1 2 11.1 9 11.1 9 9 18 10 111.1 7 77.8 17 94.4
5 71.4 6 85.7 11 78.6 5 71.4 7 100.0 12 85.7 5 71.4 7 100.0 12 85.7 3 42.9 2 28.6 5 35.7 1 14.3 4 57.1 5 35.7 1 100.0 1 0.0 2 50.0 7 7 14 3 42.9 0 0.0 3 21.4
7 63.6 10 100.0 17 81.0 11 100.0 8 80.0 19 90.5 11 100.0 8 80.0 19 90.5 8 72.7 4 40.0 12 57.1 6 54.5 7 70.0 13 61.9 4 0.0 6 60.0 10 28.6 11 10 21 8 72.7 6 60.0 14 66.7
14 175.0 8 100.0 22 137.5 12 150.0 12 150.0 24 150.0 12 150.0 12 150.0 24 150.0 9 112.5 9 112.5 18 112.5 0 0.0 2 25.0 2 12.5 0 0.0 2 12.5 2 6.3 8 8 16 1 12.5 4 50.0 5 31.3
18 138.5 18 138.5 36 138.5 19 146.2 19 146.2 38 146.2 19 146.2 19 146.2 38 146.2 15 115.4 10 76.9 25 96.2 7 53.8 17 130.8 24 92.3 7 7.7 5 7.7 12 7.7 13 13 26 13 100.0 10 76.9 23 88.5
3 37.5 12 150.0 15 93.8 4 50.0 8 100.0 12 75.0 4 50.0 8 100.0 12 75.0 2 25.0 4 50.0 6 37.5 2 25.0 10 125.0 12 75.0 2 25.0 0 0.0 2 12.5 8 8 16 3 37.5 2 25.0 5 31.3
3 42.9 9 128.6 12 85.7 3 42.9 7 100.0 10 71.4 3 42.9 7 100.0 10 71.4 2 28.6 5 71.4 7 50.0 5 71.4 1 14.3 6 42.9 1 14.3 1 0.0 2 7.1 7 7 14 5 71.4 2 28.6 7 50.0
2 40.0 0 0.0 2 20.0 2 40.0 0 0.0 2 20.0 2 40.0 0 0.0 2 20.0 1 20.0 0 0.0 1 10.0 5 100.0 0 0.0 5 50.0 0 0.0 0 0.0 0 0.0 5 5 10 2 40.0 0 0.0 2 20.0
146 95.4 138 90.8 284 92.5 152 99.3 119 78.3 236 76.9 152 99.3 119 78.3 236 76.9 97 63.4 66 43.4 163 53.1 95 62.1 100 65.8 235 76.5 39 25.5 41 27.0 235 76.5 153 152 305 91 59.5 75 49.3 166 54.4
37 41 78
Palangga, ………………………. 2019
Iwan Setiawan,SKM
Nip. 19730720 199502 1 001
0 #REF! 0 #REF! 0 #REF! 0 #REF! 0 #REF! 0 #REF! 0 #REF! 0 ### 0 ###

JUMLAH DAN PERSENTASE IBU HAMIL DIIMUNISASI JUMLAH DAN PERSENTASE WUS TIDAK HAMIL DIIMUNISASI JUMLAH TOTAL DAN PERSENTASE WUS (HAMIL+TIDAK HAMIL) T
DT2+ BUMIL
JMLH &
CAMPAK (24 Bln TT1 TT2 TT3 TT4 TT5 PERSEN TT1 TT2 TT3 TT4 TT5 TT1 TT2 TT3 TT4 TT5 TT2+
TASE
SASARA
WUS
N
TDK
BUMIL
#L % #P % # JML % # % # % # % # % # % HAMIL # % # % # % # % # % # % # % # % # % # % # %
DIIMUNI
SASI
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
1 5.0 1 5.0 2 5.0 46 1 2.2 1 2.2 0 0.0 0 0.0 0 0.0 412 0.0 0.0 0.0 0.0 0.0 1 0.2 1 0.2 0 0.0 0 0.0 0 0.0 1 2.2
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 26 2 7.7 0 0.0 0 0.0 0 0.0 1 3.8 233 0.0 0.0 0.0 0.0 0.0 2 0.8 0 0.0 0 0.0 0 0.0 1 0.4 1 3.8
0 0.0 0 0.0 0 0.0 17 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 134 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 16 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 16.7 2 8.3 27 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 246 0.0 0.0 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 6.7 0 0.0 1 3.3 35 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 314 0.0 0.0 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 33.3 0 0.0 3 16.7 21 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 16 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 25 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 171 0.0 0.0 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 7.7 0 0.0 1 3.8 29 1 3.4 2 6.9 0 0.0 0 0.0 0 0.0 264 0.0 0.0 0.0 0.0 0.0 1 0.3 2 0.7 0 0.0 0 0.0 0 0.0 2 6.9
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 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 14.3 0 0.0 1 7.1 17 4 23.5 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 4 2.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 20.0 0 0.0 1 10.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
8 5.2 3 2.0 11 3.6 356 9 2.5 3 0.8 0 0.0 0 0.0 1 0.3 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 0.3 3 0.1 0 0.0 0 0.0 1 0.0 4 1.1
IMUNISASI
Jumlah dosis
Imunisasi Tgl. Cara Pemberian (Intra kutan,
Tgl Jam No. Batch VVM vaksin (ml / Lokasi penyuntikan
(Vaksin) Kadaluarsa Sub-kutan, IM, tetes)
tetes)
Reaksi timbul pada tgl ..........................................

Gejala & Waktu timbulnya gejala .........................................................
PERSENT
JUMLAH DAN PERSENTASE IBU HAMIL DIIMUNISASI JUMLAH DAN PERSENTASE WUS TIDAK HAMIL DIIMUNISASI JUMLAH TOTAL DAN PERSENTASE WUS (HAMIL+TIDAK HAMIL) DIIMUNI
TT2+ BUMIL
ASE WUS
SASARA
CAMPAK TT1 TT2 TT3 TT4 TT5 TDK TT1 TT2 TT3 TT4 TT5 TT1 TT2 TT3 TT4 TT5 TT2+
N BUMIL
HAMIL
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
DIIMUNIS
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 2 10.0 2 5.0 44 0 0.0 3 6.8 3 6.8 2 4.5 1 2.3 412 0 0.0 0.0 0.0 0.0 0.0 0 0.0 3 0.7 3 0.7 2 0.4 1 0.2 9 20.5
0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.0 1 5.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 2 10.0
0 0.0 0 0.0 0 0.0 30 0 0.0 1 3.3 0 0.0 0 0.0 0 0.0 233 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 1 3.3
0 0.0 1 14.3 1 7.1 15 0 0.0 0 0.0 1 6.5 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 1 6.5
0 0.0 1 16.7 1 8.3 17 1 5.9 0 0.0 1 5.9 0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 1 0.7 0 0.0 1 0.7 0 0.0 0 0.0 1 5.9
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 32 1 3.1 0 0.0 0 0.0 0 0.0 0 0.0 246 0.0 0.0 0.0 0.0 0.0 1 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 41 1 2.4 1 2.4 1 2.4 2 4.9 0 0.0 314 0 0.0 0.0 0.0 0.0 0.0 1 0.3 1 0.3 1 0.3 2 0.6 0 0.0 4 9.8
0 0.0 2 22.2 2 11.1 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 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 9.1 2 20.0 3 14.3 29 1 3.4 1 3.4 1 3.4 1 3.4 0 0.0 221 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 1 0.4 1 0.4 0 0.0 3 10.3
0 0.0 0 0.0 0 0.0 18 2 11.4 0 0.0 1 5.7 0 0.0 1 5.7 171 0.0 0.0 0.0 0.0 0.0 2 1.1 0 0.0 1 0.5 0 0.0 1 0.5 2 11.4
0 0.0 0 0.0 0 0.0 34 2 5.9 2 5.9 1 2.9 0 0.0 0 0.0 264 0.0 0.0 0.0 0.0 0.0 2 0.7 2 0.7 1 0.3 0 0.0 0 0.0 3 8.8
0 0.0 0 0.0 0 0.0 18 3 17.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 3 1.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 14.3 1 14.3 2 14.3 15 0 0.0 3 19.5 0 0.0 0 0.0 0 0.0 153 0 0.0 0.0 0.0 0.0 0.0 0 0.0 3 1.8 0 0.0 0 0.0 0 0.0 3 19.5
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 1.3 9 5.9 11 3.6 378 11 2.9 12 3.2 10 2.6 5 1.3 2 0.5 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 11 0.3 12 0.3 10 0.3 5 0.1 2 0.1 29 7.7
IMUNISASI
Jumlah dosis
tetes)

PERSENT
TT2+ BUMIL
ASE WUS
SASARA
N BUMIL
HAMIL
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
DIIMUNIS
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 0.0 0.0 0.0 0.0 0.0 412 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0.0 0.0 0.0 0.0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 30 0.0 0.0 0.0 0.0 0.0 233 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0.0 0.0 0.0 0.0 0.0 154 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 17 0.0 0.0 0.0 0.0 0.0 134 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 19 0.0 0.0 0.0 0.0 0.0 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 32 0.0 0.0 0.0 0.0 0.0 246 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 41 0.0 0.0 0.0 0.0 0.0 314 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0.0 0.0 0.0 0.0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0.0 0.0 0.0 0.0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0.0 0.0 0.0 0.0 0.0 221 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0.0 0.0 0.0 0.0 0.0 171 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 34 0.0 0.0 0.0 0.0 0.0 264 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0.0 0.0 0.0 0.0 0.0 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0.0 0.0 0.0 0.0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 11 0.0 0.0 0.0 0.0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 378 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI
Jumlah dosis
tetes)

PERSENT
TT2+ BUMIL
ASE WUS
SASARA
N BUMIL
HAMIL
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
DIIMUNIS
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 412 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 233 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 154 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 134 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 142 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 246 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 314 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 221 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 171 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 264 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 378 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI
Jumlah dosis
tetes)

PERSENT
TT2+ BUMIL
ASE WUS
SASARA
N BUMIL
HAMIL
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
DIIMUNIS
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 412 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 233 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 246 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 314 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 1 6.5 3 19.5 0 0.0 0 0.0 146 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 3 1.9 0 0.0 0 0.0 4 26.0
0 0.0 0 0.0 0 0.0 29 1 3.4 0 0.0 0 0.0 0 0.0 0 0.0 221 0 0.0 0.0 0.0 0.0 0.0 1 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 18 0 0.0 0 0.0 1 5.7 0 0.0 1 5.7 171 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 1 0.5 2 11.4
0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 264 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 1 6.5 0 0.0 0 0.0 0 0.0 2 13.0 153 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 2 1.2 2 13.0
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 378 2 0.5 1 0.3 4 1.1 0 0.0 3 0.8 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 0.1 1 0.0 4 0.1 0 0.0 3 0.1 8 2.1
IMUNISASI
Jumlah dosis
tetes)

PERSENT
TT2+ BUMIL
ASE WUS
SASARA
N BUMIL
HAMIL
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
DIIMUNIS
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 5 11.4 1 2.3 1 2.3 0 0.0 0 0.0 412 0.0 0.0 0.0 0.0 0.0 5 1.1 1 0.2 1 0.2 0 0.0 0 0.0 2 4.5
0 0.0 0 0.0 0 0.0 20 1 5.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 30 1 3.3 1 3.3 0 0.0 0 0.0 0 0.0 233 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1 3.3
0 0.0 0 0.0 0 0.0 15 1 6.5 0 0.0 2 13.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 2 1.2 0 0.0 0 0.0 2 13.0
0 0.0 0 0.0 0 0.0 17 0 0.0 1 5.9 1 5.9 0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.7 1 0.7 0 0.0 0 0.0 2 11.8
0 0.0 0 0.0 0 0.0 19 1 5.3 2 10.5 0 0.0 0 0.0 0 0.0 142 0.0 0.0 0.0 0.0 0.0 1 0.6 2 1.2 0 0.0 0 0.0 0 0.0 2 10.5
0 0.0 0 0.0 0 0.0 32 1 3.1 0 0.0 1 3.1 0 0.0 0 0.0 246 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 1 0.4 0 0.0 0 0.0 1 3.1
1 6.7 0 0.0 1 3.3 41 0 0.0 1 2.4 1 2.4 0 0.0 0 0.0 314 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.3 1 0.3 0 0.0 0 0.0 2 4.9
0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.1 1 5.1 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 2 10.1
0 0.0 0 0.0 0 0.0 15 1 6.5 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 3 10.3 1 3.4 0 0.0 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 3 1.2 1 0.4 0 0.0 0 0.0 0 0.0 1 3.4
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 1 5.7 0 0.0 0 0.0 171 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 1 5.7
0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 2 5.9 1 2.9 1 2.9 264 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 0.7 1 0.3 1 0.3 4 11.8
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 1 6.5 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 6.5
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 1 9.1 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.9 0 0.0 0 0.0 1 9.1
1 0.7 0 0.0 1 0.3 378 14 3.7 9 2.4 11 2.9 1 0.3 1 0.3 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 14 0.4 9 0.3 11 0.3 1 0.0 1 0.0 22 5.8
IMUNISASI
Jumlah dosis
tetes)

PERSENT
TT2+ BUMIL
ASE WUS
SASARA
N BUMIL
HAMIL
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
DIIMUNIS
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 1 2.3 1 2.3 0 0.0 0 0.0 0 0.0 412 0.0 0.0 0.0 0.0 0.0 1 0.2 1 0.2 0 0.0 0 0.0 0 0.0 1 2.3
0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.0 1 5.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 2 10.0
0 0.0 0 0.0 0 0.0 30 1 3.3 1 3.3 1 3.3 2 6.7 0 0.0 233 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 1 0.4 2 0.8 0 0.0 4 13.3
1 14.3 0 0.0 1 7.1 15 0 0.0 1 6.5 0 0.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 6.5
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 1 5.9 0 0.0 134 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.7 0 0.0 1 5.9
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 1 5.3 0 0.0 1 5.3 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 1 0.6 2 10.5
1 8.3 0 0.0 1 4.2 32 1 3.1 2 6.3 0 0.0 0 0.0 0 0.0 246 0.0 0.0 0.0 0.0 0.0 1 0.4 2 0.7 0 0.0 0 0.0 0 0.0 2 6.3
0 0.0 0 0.0 0 0.0 41 2 4.9 0 0.0 2 4.9 0 0.0 0 0.0 314 0.0 0.0 0.0 0.0 0.0 2 0.6 0 0.0 2 0.6 0 0.0 0 0.0 2 4.9
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0 0.0 1 3.4 2 6.9 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 2 0.8 0 0.0 0 0.0 3 10.3
0 0.0 0 0.0 0 0.0 18 1 5.7 0 0.0 0 0.0 0 0.0 1 5.7 171 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 0.5 1 5.7
0 0.0 1 7.7 1 3.8 34 1 2.9 0 0.0 1 2.9 0 0.0 1 2.9 264 0.0 0.0 0.0 0.0 0.0 1 0.3 0 0.0 1 0.3 0 0.0 1 0.3 2 5.9
1 12.5 0 0.0 1 6.3 18 0 0.0 0 0.0 0 0.0 0 0.0 1 5.7 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 1 5.7
0 0.0 0 0.0 0 0.0 15 1 6.5 1 6.5 2 13.0 0 0.0 2 13.0 153 0.0 0.0 0.0 0.0 0.0 1 0.6 1 0.6 2 1.2 0 0.0 2 1.2 5 32.5
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 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 2.0 1 0.7 4 1.3 378 8 2.1 8 2.1 10 2.6 3 0.8 6 1.6 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 0.2 8 0.2 10 0.3 3 0.1 6 0.2 27 7.1
IMUNISASI
Jumlah dosis
tetes)

PERSENT
TT2+ BUMIL
ASE WUS
SASARA
N BUMIL
HAMIL
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
DIIMUNIS
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 3 6.8 0 0.0 0 0.0 0 0.0 0 0.0 412 1 0.2 0.0 0.0 0.0 0.0 4 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 18.2 0 0.0 2 9.1 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 233 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 3 25.0 3 12.5 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 246 0.0 0.0 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 6.7 0 0.0 1 3.3 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 314 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 171 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 7.7 1 3.8 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 264 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 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 2.0 4 2.6 7 2.3 378 3 0.8 0 0.0 0 0.0 0 0.0 0 0.0 3199 1 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 0.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI
Jumlah dosis
tetes)

PERSENT
TT2+ BUMIL
ASE WUS
SASARA
N BUMIL
HAMIL
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
DIIMUNIS
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 412 0.0 0.0 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 14.3 0 0.0 1 7.1 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 233 0.0 0.0 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 14.3 0 0.0 1 7.1 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 142 0.0 0.0 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 1 4.2 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 246 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 13.3 2 6.7 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 314 0.0 0.0 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 11.1 0 0.0 1 5.6 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 171 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 264 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 2.6 2 1.3 6 2.0 378 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI
Jumlah dosis
tetes)

PERSENT
TT2+ BUMIL
ASE WUS
SASARA
N BUMIL
HAMIL
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
DIIMUNIS
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 412 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 9.1 1 4.5 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 233 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 28.6 1 14.3 3 21.4 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 154 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 16.7 1 8.3 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 134 0.0 0.0 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 14.3 0 0.0 1 7.1 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 142 0.0 0.0 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 25.0 2 16.7 5 20.8 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 246 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 314 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0.0 0.0 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 14.3 0 0.0 1 7.1 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 171 0.0 0.0 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 7.7 0 0.0 1 3.8 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 264 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 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 14.3 0 0.0 1 7.1 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 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 20.0 0 0.0 1 10.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 6.5 5 3.3 15 4.9 378 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI
Jumlah dosis
tetes)

PERSENT
TT2+ BUMIL
ASE WUS
SASARA
N BUMIL
HAMIL
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
DIIMUNIS
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 1 5.0 1 2.5 44 1 2.3 3 6.8 2 4.5 0 0.0 4 9.1 412 0.0 0.0 0.0 0.0 0.0 1 0.2 3 0.7 2 0.4 0 0.0 4 0.9 9 20.5
0 0.0 0 0.0 0 0.0 20 1 5.0 0 0.0 3 15.0 1 5.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 3 1.7 1 0.6 0 0.0 4 20.0
0 0.0 0 0.0 0 0.0 30 2 6.7 0 0.0 0 0.0 0 0.0 3 10.0 233 0 0.0 0.0 0.0 0.0 0.0 2 0.8 0 0.0 0 0.0 0 0.0 3 1.1 3 10.0
1 14.3 1 14.3 2 14.3 15 0 0.0 1 6.5 2 13.0 0 0.0 1 6.5 154 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 2 1.2 0 0.0 1 0.6 4 26.0
1 16.7 2 33.3 3 25.0 17 1 5.9 0 0.0 0 0.0 1 5.9 0 0.0 134 0.0 0.0 0.0 0.0 0.0 1 0.7 0 0.0 0 0.0 1 0.7 0 0.0 1 5.9
0 0.0 3 42.9 3 21.4 19 0 0.0 0 0.0 2 10.5 0 0.0 0 0.0 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 1.2 0 0.0 0 0.0 2 10.5
0 0.0 0 0.0 0 0.0 32 0 0.0 1 3.1 1 3.1 0 0.0 0 0.0 246 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 2 6.3
0 0.0 0 0.0 0 0.0 41 3 7.3 0 0.0 2 4.9 0 0.0 0 0.0 314 0.0 0.0 0.0 0.0 0.0 3 0.8 0 0.0 2 0.6 0 0.0 0 0.0 2 4.9
0 0.0 2 22.2 2 11.1 20 0 0.0 1 5.1 5 25.3 0 0.0 1 5.1 187 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 5 2.4 0 0.0 1 0.5 7 35.4
0 0.0 0 0.0 0 0.0 15 1 6.5 0 0.0 1 6.5 0 0.0 2 13.0 146 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 1 0.6 0 0.0 2 1.2 3 19.5
0 0.0 0 0.0 0 0.0 29 1 3.4 1 3.4 2 6.9 1 3.4 2 6.9 221 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 2 0.8 1 0.4 2 0.8 6 20.7
0 0.0 2 25.0 2 12.5 18 1 5.7 3 17.0 1 5.7 0 0.0 0 0.0 171 0.0 0.0 0.0 0.0 0.0 1 0.5 3 1.6 1 0.5 0 0.0 0 0.0 4 22.7
0 0.0 2 15.4 2 7.7 34 2 5.9 2 5.9 0 0.0 0 0.0 1 2.9 264 0 0.0 0.0 0.0 0.0 0.0 2 0.7 2 0.7 0 0.0 0 0.0 1 0.3 3 8.8
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 1 6.5 1 6.5 0 0.0 0 0.0 1 6.5 153 0.0 0.0 0.0 0.0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 1 0.6 2 13.0
0 0.0 0 0.0 0 0.0 11 0 0.0 1 9.1 1 9.1 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.9 1 0.9 0 0.0 0 0.0 2 18.2
2 1.3 13 8.6 15 4.9 378 14 3.7 14 3.7 22 5.8 3 0.8 15 4.0 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 14 0.4 14 0.4 22 0.6 3 0.1 15 0.4 54 14.3
IMUNISASI
Jumlah dosis
tetes)

PERSENT
TT2+ BUMIL
ASE WUS
SASARA
N BUMIL
HAMIL
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
DIIMUNIS
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 2 4.5 2 4.5 1 2.3 0 0.0 0 0.0 412 0 0.0 0.0 0.0 0.0 0.0 2 0.4 2 0.4 1 0.2 0 0.0 0 0.0 3 6.8
0 0.0 0 0.0 0 0.0 20 1 5.0 0 0.0 1 5.0 1 5.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 1 0.6 1 0.6 0 0.0 2 10.0
0 0.0 1 9.1 1 4.5 30 1 3.3 2 6.7 0 0.0 0 0.0 0 0.0 233 0 0.0 0.0 0.0 0.0 0.0 1 0.4 2 0.8 0 0.0 0 0.0 0 0.0 2 6.7
1 14.3 1 14.3 2 14.3 15 1 6.5 0 0.0 3 19.5 0 0.0 0 0.0 154 0 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 3 1.8 0 0.0 0 0.0 3 19.5
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 1 5.9 0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.7 0 0.0 0 0.0 1 5.9
1 14.3 0 0.0 1 7.1 19 0 0.0 0 0.0 0 0.0 1 5.3 0 0.0 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 1 5.3
1 8.3 0 0.0 1 4.2 32 0 0.0 2 6.3 0 0.0 0 0.0 1 3.1 246 0.0 0.0 0.0 0.0 0.0 0 0.0 2 0.7 0 0.0 0 0.0 1 0.4 3 9.4
1 6.7 0 0.0 1 3.3 41 0 0.0 1 2.4 0 0.0 0 0.0 1 2.4 314 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.3 0 0.0 0 0.0 1 0.3 2 4.9
0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.1 0 0.0 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 5.1
0 0.0 1 14.3 1 7.1 15 2 13.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 2 1.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 20.0 2 9.5 29 1 3.4 0 0.0 1 3.4 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 1 0.4 0 0.0 0 0.0 1 3.4
0 0.0 0 0.0 0 0.0 18 1 5.7 0 0.0 0 0.0 0 0.0 1 5.7 171 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 0.5 1 5.7
0 0.0 0 0.0 0 0.0 34 1 2.9 0 0.0 1 2.9 0 0.0 1 2.9 264 0.0 0.0 0.0 0.0 0.0 1 0.3 0 0.0 1 0.3 0 0.0 1 0.3 2 5.9
0 0.0 0 0.0 0 0.0 18 2 11.4 0 0.0 0 0.0 1 5.7 0 0.0 170 0.0 0.0 0.0 0.0 0.0 2 1.1 0 0.0 0 0.0 1 0.5 0 0.0 1 5.7
0 0.0 0 0.0 0 0.0 15 3 19.5 1 6.5 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 3 1.8 1 0.6 0 0.0 0 0.0 0 0.0 1 6.5
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 2.6 5 3.3 9 3.0 378 15 4.0 9 2.4 8 2.1 3 0.8 4 1.1 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 15 0.4 9 0.3 8 0.2 3 0.1 4 0.1 24 6.3
IMUNISASI
Jumlah dosis
tetes)

PERSENT
TT2+ BUMIL
ASE WUS
SASARA
N BUMIL
HAMIL
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
DIIMUNIS
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
1 5.0 4 20.0 5 12.5 44 13 29.5 11 25.0 7 18,3 2 4.5 5 11.4 412 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 14 3.1 11 2.4 7 1.5 2 0.4 5 1.1 25 56.8
1 14.3 0 0.0 1 7.1 20 3 15.0 2 10.0 6 30.0 2 10.0 0 0.0 153 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 1.7 2 1.2 6 3.5 2 1.2 0 0.0 10 50.0
2 18.2 2 18.2 4 18.2 30 7 23.3 5 16.7 1 3.3 2 6.7 4 13.3 233 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 2.7 5 1.9 1 0.4 2 0.8 4 1.5 12 40.0
6 85.7 4 57.1 10 71.4 15 3 19.5 2 13.0 8 51.9 0 0.0 1 6.5 154 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 1.8 2 1.2 8 4.7 0 0.0 1 0.6 11 71.4
1 16.7 4 66.7 5 41.7 17 2 11.8 1 5.9 3 17.6 2 11.8 0 0.0 134 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 1.3 1 0.7 3 2.0 2 1.3 0 0.0 6 35.3
2 28.6 3 42.9 5 35.7 19 1 5.3 2 10.5 3 15.8 1 5.3 1 5.3 142 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 2 1.2 3 1.9 1 0.6 1 0.6 7 36.8
6 50.0 7 58.3 13 54.2 32 3 9.4 5 15.6 2 6.3 0 0.0 1 3.1 246 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 1.1 5 1.8 2 0.7 0 0.0 1 0.4 8 25.0
4 26.7 2 13.3 6 20.0 41 6 14.6 3 7.3 6 14.6 2 4.9 1 2.4 314 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 1.7 3 0.8 6 1.7 2 0.6 1 0.3 12 29.3
4 44.4 4 44.4 8 44.4 20 0 0.0 3 15.2 6 30.3 0 0.0 1 5.1 187 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 1.5 6 2.9 0 0.0 1 0.5 10 50.5
1 14.3 1 14.3 2 14.3 15 4 26.0 1 6.5 4 26.0 0 0.0 2 13.0 146 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 2.5 1 0.6 4 2.5 0 0.0 2 1.2 7 45.5
1 9.1 4 40.0 5 23.8 29 7 24.1 4 13.8 6 20.7 2 6.9 2 6.9 221 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 2.8 4 1.6 6 2.4 2 0.8 2 0.8 14 48.3
0 0.0 2 25.0 2 12.5 18 5 28.4 3 17.0 4 22.7 0 0.0 4 22.7 171 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 2.7 3 1.6 4 2.1 0 0.0 4 2.1 11 62.5
2 15.4 4 30.8 6 23.1 34 7 20.6 6 17.6 5 14.7 1 2.9 4 11.8 264 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 7 2.4 6 2.0 5 1.7 1 0.3 4 1.3 16 47.1
1 12.5 0 0.0 1 6.3 18 5 28.4 0 0.0 0 0.0 1 5.7 1 5.7 170 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 2.7 0 0.0 0 0.0 1 0.5 1 0.5 2 11.4
3 42.9 1 14.3 4 28.6 15 10 64.9 7 45.5 2 13.0 0 0.0 5 32.5 153 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 10 5.9 7 4.2 2 1.2 0 0.0 5 3.0 14 90.9
2 40.0 0 0.0 2 20.0 11 0 0.0 1 9.1 2 18.2 0 0.0 0 0.0 100 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.9 2 1.8 0 0.0 0 0.0 3 27.3
37 24.2 42 27.6 79 25.9 378 76 20.1 56 14.8 65 17.2 15 4.0 32 8.5 3199 1 0.0 0 0.0 0 0.0 0 0.0 0 0.0 77 2.2 56 1.6 65 1.8 15 0.4 32 0.9 168 44.4
PUSKESMAS
:
BULAN JANUARI 2019
SURVIVING INFANT
JUMLAH BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB-Hib (1) POLIO 2 DPT-HB-HIB 2
DESA / (0 - 11 BLN
NO PDDK
KELURAHAN
TAHUN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 1 5.0 2 10.0 3 7.5 1 5.0 1 20.0 2 5.0 1 5.0 1 5.0 2 5.0 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 1 14.3 2 0.0 1 14.3 1 14.3 2 14.3 1 14.3 0 0.0 1 7.1
3 AOSOLE 1,066 12 12 24 11 11 22 1 9.1 1 9.1 2 9.1 4 36.4 1 2.8 5 22.7 4 36.4 1 9.1 5 22.7 1 9.1 1 9.1 2 9.1 1 9.1 1 9.1 2 9.1 0 0.0 0 0.0 0 0.0
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 7.1 0 0.0 1 14.3 1 7.1 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 1 14.3 0 0.0 1 7.1
5 WAWORAHA 611 7 7 14 6 6 14 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 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 650 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 2 14.3
7 WAWOURU 1,125 13 12 25 12 12 24 0 0.0 0 0.0 0 0.0 1 8.3 1 12.0 2 8.3 1 8.3 1 8.3 2 8.3 0 0.0 2 16.7 2 8.3 0 0.0 2 16.7 2 8.3 0 0.0 2 16.7 2 8.3
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 0 0.0 0 0.0 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 2 13.3 0 0.0 2 6.7
9 WATUMEREMBE 854 10 9 19 9 9 18 1 11.1 1 11.1 2 11.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6
10 EEWA 666 8 7 15 7 7 14 0 0.0 1 14.3 1 7.1 0 0.0 0 #REF! 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 1,007 11 11 22 11 10 21 1 9.1 0 0.0 1 4.8 0 0.0 2 25.0 2 9.5 0 0.0 2 20.0 2 9.5 2 18.2 0 0.0 2 9.5 2 18.2 0 0.0 2 9.5 0 0.0 0 0.0 0 0.0
12 ANGGONDARA 779 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 2 25.0 1 4.0 3 18.8 2 25.0 1 12.5 3 18.8 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 1 12.5 2 25.0 3 18.8
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 1 7.7 0 0.0 1 3.8 1 7.7 1 13.0 2 7.7 1 7.7 1 7.7 2 7.7 0 0.0 4 30.8 4 15.4 0 0.0 4 30.8 4 15.4 0 0.0 0 0.0 0 0.0
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 1 12.5 1 6.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 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 12.5 1 6.3
15 SANGGI-SANGGI 698 8 8 16 7 7 14 0 0.0 1 14.3 1 7.1 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 0 0.0 2 14.3
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 2 40.0 0 0.0 2 20.0 2 40.0 0 0.0 2 20.0 1 20.0 0 0.0 1 10.0
PALANGGA 14,608 166 159 326 153 152 307 5 3.3 7 4.6 12 3.9 13 8.5 8 94.2 21 6.8 13 8.5 8 5.3 21 6.8 13 8.5 12 7.9 25 8.1 13 8.5 12 7.9 25 8.1 9 5.9 8 5.3 17 5.5
Jenis Vaksin / Alat

Stock Bln Penerim Pemakai Sisa Bln
No. Suntik & Safety Jumlah Permint No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P No. Keadaan
Lalu aan Bln an Bln ini Jenis Cold Chain Jumlah
Box aan
ini ini (buah)
1 Vak. BCG 10 10 20 6 14 (8) 2 DPT-HB 66 dosis - Vial ### 1 Lemari ES
6 Vak. HB. UNIJECT - 100 100 12 88 (76) 7 TT 20 dosis 8 Vial 2.5 MENGETAHUI :
II. ALAT SUNTIK
1 ADS 5 ml 33 20 53 15 38 (23)
2 ADS 0,5 ml 117 200 317 137 180 (43)
3 ADS 0,0 5 ml 104 100 204 19 185 (166) Amrin,S.Kep
PUSKESMAS
:
BULAN FEBRUARI 2019
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB-Hib (1) POLIO 2 DPT-HB-HIB 2
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 1 1.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 3 15.0 1 5.0 4 10.0
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 2 28.6 3 21.4 1 14.3 2 28.6 3 21.4 1 14.3 1 14.3 2 14.3
3 AOSOLE 1,066 12 12 24 11 11 22 1 9.1 0 0.0 1 4.5 2 18.2 1 5.5 3 13.6 2 18.2 1 9.1 3 13.6 5 45.5 1 9.1 6 27.3 5 45.5 1 9.1 6 27.3 1 9.1 0 0.0 1 4.5
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 2 28.6 1 14.3 3 21.4
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 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 16.7 0 0.0 1 7.1
6 KAPUJAYA 650 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 WAWOURU 1,125 13 12 25 12 12 24 1 8.3 1 8.3 2 8.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 1 6.7 1 3.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
9 WATUMEREMBE 854 10 9 19 9 9 18 0 0.0 1 11.1 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 EEWA 666 8 7 15 7 7 14 2 28.6 0 0.0 2 14.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 1 9.1 1 11.0 2 9.5 1 9.1 1 10.0 2 9.5 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
12 ANGGONDARA 779 9 8 17 8 8 16 0 0.0 1 12.5 1 6.3 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 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
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 1 7.7 0 0.0 1 3.8 3 23.1 0 0.0 3 11.5 3 23.1 0 0.0 3 11.5 1 7.7 1 7.7 2 7.7 1 7.7 1 7.7 2 7.7 1 7.7 2 15.4 3 11.5
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 4 #DIV/0! 4 25.0 0 0.0 4 50.0 4 25.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 457 5 5 10 5 5 10 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 40.0 0 0.0 2 20.0
PALANGGA 14,608 166 159 325 153 152 307 7 4.6 4 2.6 11 3.6 10 6.5 8 122.4 18 5.9 10 6.5 8 5.3 18 5.9 10 6.5 5 3.3 15 4.9 10 6.5 5 3.3 15 4.9 11 7.2 5 3.3 16 5.2
Jenis Vaksin / Alat

Box aan
ini ini (buah)
1 Vak. BCG 14 10 24 7 17 (10) 2 DPT-HB 40 dosis 6 Vial 6.6667 1 Lemari ES
2 Vak. Polio IPV 10 10 20 6 14 (8) 3 DPT-HB-Hib 64 dosis 15 Vial 4.2667 2 M. Freezer
3 Vak. DPT-HB-Hib 8 30 38 15 23 (8) 4 POLIO 70 dosis 14 Vial 5 3 V. Crrier
5 Vak. CAMPAK 36 - 36 8 28 (20) 6 HB. UNIJECT 11 dosis 10 Buah 1.1
1 ADS 5 ml 38 100 138 15 123 (108)
2 ADS 0,5 ml 180 200 380 122 258 (136)
3 ADS 0,0 5 ml 185 - 185 23 162 (139)
PUSKESMAS
:
BULAN MARET 2019
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB -Hib (1) Polio 2 DPT/HB-Hib (2)
KELURAHAN TAHUN
(0 - 11 BLN
1 2 3 4 5 6 7 8 9 10 0 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 1 5.0 0 0.0 1 2.5 1 5.0 1 20.0 2 5.0 1 5.0 1 5.0 2 5.0 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 0 6,3 0 0.0 0 0.0
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 1 14.3 2 14.3
3 AOSOLE 1,066 12 12 24 11 11 22 0 0.0 0 0.0 0 0.0 2 18.2 0 0.0 2 9.1 2 18.2 0 0.0 2 9.1 2 18.2 0 0.0 2 9.1 2 18.2 0 0.0 2 9.1 2 18.2 1 9.1 3 13.6
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1
5 WAWORAHA 611 7 7 14 6 6 14 1 16.7 0 0.0 1 7.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 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 16.7 0 0.0 1 7.1
6 KAPUJAYA 650 7 7 14 7 7 14 1 14.3 0 0.0 1 7.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 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 14.3 0 0.0 1 7.1
7 WAWOURU 1,125 13 12 25 12 12 24 0 0.0 1 8.3 1 4.2 2 16.7 1 6.0 3 12.5 2 16.7 1 8.3 3 12.5 1 8.3 1 8.3 2 8.3 1 8.3 1 8.3 2 8.3 0 0.0 1 8.3 1 4.2
8 MEKAR SARI 1,433 16 16 32 15 15 30 1 1.0 1 6.7 2 6.7 3 20.0 2 10.0 5 16.7 3 20.0 2 13.3 5 16.7 2 13.3 0 0.0 2 6.7 2 13.3 0 0.0 2 6.7 0 0.0 1 6.7 1 3.3
9 WATUMEREMBE 854 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 2 22.2 1 4.5 3 16.7 2 22.2 1 11.1 3 16.7 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6 1 11.1 0 0.0 1 5.6
10 EEWA 666 8 7 15 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 2 28.6 0 0.0 2 14.3
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0,0 0 0.0 0 0.0 2 18.2 3 3.0 5 23.8 2 18.2 3 30.0 5 23.8 2 18.2 1 10.0 3 14.3
12 ANGGONDARA 779 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 4 50.0 2 25.0 6 37.5 4 50.0 2 25.0 6 37.5 0 0.0 2 25.0 2 12.5
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 1 7.7 2 15.4 3 11.5 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 4 30.8 0 0.0 4 15.4 4 30.8 0 0.0 4 15.4 2 15.4 4 30.8 6 23.1
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 1.0 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 1 12.5 1 12.5 2 12.5
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 325 153 152 307 5 3.3 4 2.6 9 2.9 12 7.8 7 89.3 19 6.2 12 7.8 7 4.6 19 6.2 16 10.5 14 9.2 30 9.8 16 10.5 14 9.2 30 9.8 15 9.8 13 8.6 28 9.1
Jenis Vaksin / Alat

Box aan
ini ini (buah)
1 Vak. BCG 17 10 27 8 19 (11) 2 DPT-HB 86 dosis 12 Vial 7.1667 1 Lemari ES
2 Vak. Polio IPV 14 10 24 12 12 - 3 DPT-HB-Hib 122 dosis 32 Vial 3.8125 2 M. Freezer
3 Vak. DPT-HB-HIB 23 30 53 32 23 9 4 POLIO 112 dosis 18 Vial 6.2222 3 V. Crrier
1 ADS 5 ml 123 - 123 22 101 (79)
2 ADS 0,5 ml 258 - 258 245 13 232
3 ADS 0,0 5 ml 162 - 162 21 141 (120)
PUSKESMAS
:
BULAN APRIL 2019
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 0 0.0 0 0.0 0 0.0 2 10.0 0 0.0 2 5.0 2 10.0 0 0.0 2 5.0 2 10.0 0 0.0 2 5.0 2 10.0 0 0.0 2 5.0 1 5.0 0 0.0 1 2.5
2 WATUDEMBA 697 8 8 16 7 7 14 0 0 0.0 0 0.0 0 0.0 2 #DIV/0! 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1
3 AOSOLE 1,066 12 12 24 11 11 22 0 0.0 1 9.1 1 4.5 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 3 27.3 1 9.1 4 18.2 3 27.3 1 9.1 4 18.2 5 45.5 0 0.0 5 22.7
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 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 14.3 0 0.0 1 7.1
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 0 0.0 0 0.0 2 33.3 0 0.0 2 14.3 2 33.3 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 650 7 7 14 7 7 14 1 14.3 0 0.0 1 7.1 3 42.9 0 0.0 3 21.4 3 42.9 0 0.0 3 21.4 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
7 WAWOURU 1,125 13 12 25 12 12 24 1 8.3 1 8.3 2 8.3 0 0.0 2 #DIV/0! 2 8.3 0 0.0 2 16.7 2 8.3 2 16.7 1 8.3 3 12.5 2 16.7 1 8.3 3 12.5 1 8.3 2 16.7 3 12.5
8 MEKAR SARI 1,433 16 16 32 15 15 30 1 6.7 1 6.7 2 6.7 1 6.7 1 15.0 2 6.7 1 6.7 1 6.7 2 6.7 3 20.0 2 13.3 5 16.7 3 20.0 2 13.3 5 16.7 2 13.3 1 6.7 3 10.0
9 WATUMEREMBE 854 10 9 19 9 9 18 1 11.1 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 EEWA 666 8 7 15 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 9.5
12 ANGGONDARA 779 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 62.5 0 0.0 5 31.3
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 0 0.0 0 0.0 0 0.0 6 46.2 2 4.3 8 30.8 6 46.2 2 15.4 8 30.8 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 0 0.0 4 30.8 4 15.4
14 WAWONGGURA 776 9 8 17 8 8 16 1 12.5 1 12.5 2 12.5 0 0.0 1 #DIV/0! 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5
16 UPT.TOLIHE 457 5 5 10 5 5 10 1 20.0 0 0.0 1 10.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 325 153 152 307 6 3.9 4 2.6 10 3.3 16 10.5 8 76.5 24 7.8 16 10.5 8 5.3 24 7.8 13 8.5 5 3.3 18 5.9 13 8.5 5 3.3 18 5.9 15 9.8 14 9.2 29 9.4
Jenis Vaksin / Alat

No. Suntik & Safety Jumlah Permint No. Jenis Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P Keadaan
Lalu aan Bln an Bln ini No. Jenis Cold Chain Jumlah
Box aan
ini ini (buah)
1 Vak. BCG 19 - 19 9 10 (1) 2 DPT-HB 67 dosis - Vial ### 1 Lemari ES
2 Vak. DPT-HB - - - 3 DPT-HB-Hib 74 dosis 22 Vial 3.3636 2 M. Freezer
6 Vak. HB. UNIJECT 69 - 69 10 59 (49) 7 TT 0 dosis - Vial ###
7 Vak. TT - - - - - - MENGETAHUI :
1 ADS 5 ml 101 - 101 18 83 (65)
2 ADS 0,5 ml 13 200 213 125 88 37
3 ADS 0,0 5 ml 141 - 141 25 116 (91)
PUSKESMAS
:
BULAN MEI 2019
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB -HIB(1) POLIO2 DPT/HB -HIB(2)
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 0 0.0 1 5.0 1 2.5 0 0.0 1 #DIV/0! 1 2.5 0 0.0 1 5.0 1 2.5 2 10.0 1 5.0 3 7.5 2 10.0 1 5.0 3 7.5 2 10.0 1 5.0 3 7.5
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 1 14.3 1 7.1 2 28.6 1 3.5 3 21.4 2 28.6 1 14.3 3 21.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1
3 AOSOLE 1,066 12 12 24 11 11 22 0 0.0 2 18.2 2 9.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 36.4 1 9.1 5 22.7
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 611 7 7 14 6 6 14 1 16.7 0 0.0 1 7.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 0 0.0 2 14.3 2 33.3 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 650 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 2 14.0 3 21.4 1 14.3 2 28.6 3 21.4 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0
7 WAWOURU 1,125 13 12 25 12 12 24 2 16.7 1 8.3 3 12.5 1 8.3 4 14.3 5 20.8 1 8.3 4 4.0 5 20.8 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 2 16.7 1 8.3 3 12.5
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 1 6.7 1 3.3 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 2 13.3 3 10.0
9 WATUMEREMBE 854 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 1 11.1 1 9.0 2 11.1 1 11.1 1 11.1 2 11.1 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 0 0.0 1 11.1 1 5.6
10 EEWA 666 8 7 15 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 0 2.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 4.8 0 0.0 1 10.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 0 0.0 1 10.0 1 4.8
12 ANGGONDARA 779 9 8 17 8 8 16 2 25.0 0 0.0 2 12.5 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 2 12.5
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 0 0.0 0 0.0 0 0.0 2 15.4 1 6.5 3 11.5 2 15.4 1 7.7 3 11.5 6 46.2 2 15.4 8 30.8 6 46.2 2 15.4 8 30.8 2 15.4 1 7.7 3 11.5
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 37.5 3 18.8 0 0.0 3 37.5 3 18.8 0 0.0 0 0.0 3 18.8
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 10.0
PALANGGA 14,608 166 159 325 153 152 307 5 3.3 6 3.9 11 3.6 11 7.2 12 166.9 23 7.5 11 7.2 12 7.9 23 7.5 16 10.5 8 5.3 24 7.8 16 10.5 8 5.3 0 0.0 12 7.8 13 8.6 25 8.1
Jenis Vaksin / Alat

Box aan
ini ini (buah)
1 Vak. BCG 10 15 25 8 17 (9) 2 IPV 76 dosis - Vial ### 1 Lemari ES
2 IPV - - - - - - 3 DPT-HB-Hib 56 dosis 22 Vial 2.5455 2 M. Freezer
7 Vak. TT - 15 15 3 12 (9)
1 ADS 5 ml 83 20 103 9 94 (85) Kepala Puskesmas Palangga Kab. Konsel
2 ADS 0,5 ml 88 200 288 155 133 22
3 ADS 0,0 5 ml 116 - 116 25 91 (66)
Nip. 196506021987031017
PUSKESMAS
:
BULAN JUNI 2019
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 1 5.0 0 0.0 1 2.5 1 5.0 2 40.0 3 7.5 1 5.0 2 10.0 3 7.5 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 1 5.0 1 5.0 2 5.0
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 1 14.3 1 7.1 3 42.9 1 2.3 4 28.6 3 42.9 1 14.3 4 28.6 0 0.0 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 AOSOLE 1,066 12 12 24 11 11 22 0 0.0 0 0.0 0 0.0 0 0.0 3 #DIV/0! 3 13.6 0 0.0 3 27.3 3 13.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 ALAKAYA 704 8 8 16 7 7 14 1 14.3 1 14.3 2 14.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 611 7 7 14 6 6 14 1 16.7 1 16.7 2 14.3 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 33.3 0 0.0 2 14.3
6 KAPUJAYA 650 7 7 14 7 7 14 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 2 28.6 0 0.0 2 14.3
7 WAWOURU 1,125 13 12 25 12 12 24 1 8.3 0 0.0 1 4.2 3 25.0 0 0.0 3 12.5 3 25.0 0 0.0 3 12.5 1 8.3 4 33.3 5 20.8 1 8.3 4 33.3 5 20.8 0 0.0 1 8.3 1 4.2
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 2 13.3 2 6.7 3 20.0 2 10.0 5 16.7 3 20.0 2 13.3 5 16.7 0 0.0 1 6.7 1 3.3 0 0.0 1 6.7 1 3.3 2 13.3 1 6.7 3 10.0
9 WATUMEREMBE 854 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 1 11.1 1 9.0 2 11.1 1 11.1 1 11.1 2 11.1 1 11.1 1 11.1 2 11.1 1 11.1 1 11.1 2 11.1 2 22.2 0 0.0 2 11.1
10 EEWA 666 8 7 15 7 7 14 0 0.0 1 14.3 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0
11 ONEMBUTE 1,007 11 11 22 11 10 21 1 9.1 0 0.0 1 4.8 1 9.1 2 22.0 3 14.3 1 9.1 2 20.0 3 14.3 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 2 18.2 0 0.0 2 9.5
12 ANGGONDARA 779 9 8 17 8 8 16 1 12.5 0 0.0 1 6.3 4 50.0 2 4.0 6 37.5 4 50.0 2 25.0 6 37.5 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 1 7.7 2 15.4 3 11.5 1 7.7 2 15.4 3 11.5 4 30.8 2 15.4 6 23.1
14 WAWONGGURA 776 9 8 17 8 8 16 1 12.5 0 0.0 1 6.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 326 153 152 307 9 5.9 6 3.9 15 4.9 20 13.1 14 107.1 34 11.1 20 13.1 14 9.2 34 11.1 9 5.9 11 7.2 20 6.5 9 5.9 11 7.2 20 6.5 15 9.8 6 3.9 21 6.8
Jenis Vaksin / Alat

Box aan
ini ini (buah)
1 Vak. BCG 17 - 17 10 7 3 2 DPT-HB 58 dosis - Vial ### 1 Lemari ES
3 Vak. DPT-HB-Hib 49 - 49 21 28 (7) 4 POLIO 98 dosis 17 Vial 5.7647 3 V. Crrier
4 Vak. POLIO 45 - 45 17 28 (11) 5 CAMPAK 12 dosis 9 Vial 1.3333 4 Thermos
7 Vak. TT 12 - 12 8 4 4
1 ADS 5 ml 94 - 94 21 73 (52) Kepala Puskesmas .Palangga Kab.Konsel
2 ADS 0,5 ml 133 200 333 155 178 (23)
3 ADS 0,0 5 ml 91 - 91 32 59 (27)
5 Safety Box 0,25 liter - - - - - Amrin,S.Kep
Nip.196506021987031017
PUSKESMAS
:
BULAN JULI 2019
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB-Hib (1) Polio 2 DPT/HB-Hib (2)
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 1 5.0 2 10.0 3 7.5 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 0 0.0 0 0.0 0 0.0
2 WATUDEMBA 697 8 8 16 7 7 14 1 14.3 0 0.0 1 7.1 0 0.0 3 42,9 3 21.4 0 0.0 3 42.9 3 21.4 5 71.4 3 42.9 8 57.1 5 71.4 3 42.9 8 57.1 0 0.0 1 14.3 1 7.1
3 AOSOLE 1,066 12 12 24 11 11 22 1 9.1 0 0.0 1 4.5 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 27.3 3 13.6 0 0.0 3 27.3 3 13.6 0 0.0 0 0.0 0 0.0
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 650 7 7 14 7 7 14 0 0.0 1 14.3 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 1 14,3 2 14.3 1 14.3 1 14.3 2 14.3 2 28.6 1 14.3 3 21.4
7 WAWOURU 1,125 13 12 25 12 12 24 0 0.0 1 8.3 1 4.2 2 16.7 2 12.0 4 16.7 2 16.7 2 16.7 4 16.7 4 33.3 0 0.0 4 16.7 4 33.3 0 0.0 4 16.7 1 8.3 4 33.3 5 20.8
8 MEKAR SARI 1,433 16 16 32 15 15 30 1 6.7 0 0.0 1 3.3 2 13.3 2 15.0 4 13.3 2 13.3 2 13.3 4 13.3 3 20.0 1 6.7 4 13.3 3 20.0 1 6.7 4 13.3 1 6.7 1 6.7 2 6.7
9 WATUMEREMBE 854 10 9 19 9 9 18 1 11.1 0 0.0 1 5.6 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6
10 EEWA 666 8 7 15 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 2 28,6 2 14.3 0 0.0 2 28.6 2 14.3 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 2 18.2 0 0.0 2 9.5 2 18.2 0 0.0 2 9.5 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 1 9.1 1 10.0 2 9.5
12 ANGGONDARA 779 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 6 75.0 2 25.0 8 50.0 6 75.0 2 25.0 8 50.0 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 2 15.4 1 7.7 3 11.5 0 0.0 3 23,1 3 11.5 0 0.0 3 23.1 3 11.5 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 2 15.4 2 15.4 4 15.4
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 1 8.0 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3
15 SANGGI-SANGGI 698 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 2 14.0 3 21.4 1 14.3 2 28.6 3 21.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 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 20.0 0 0.0 1 10.0
PALANGGA 14,608 166 159 326 153 152 307 7 4.6 5 3.3 12 3.9 11 7.2 15 208.6 26 8.5 11 7.2 15 9.9 26 8.5 23 15.0 13 8.6 36 11.7 23 15.0 13 8.6 36 11.7 9 5.9 13 8.6 22 7.2
Jenis Vaksin / Alat

Box aan
ini ini (buah)
4 Vak. POLIO 28 - 28 20 8 12 5 CAMPAK #REF! dosis 11 Vial #REF! 4 Thermos
7 Vak. TT 4 10 10 6 4 2
2 ADS 0,5 ml 178 200 378 205 173 32
3 ADS 0,0 5 ml 59 - 59 28 31 (3)
5 Safety Box 0,25 liter - - - - Amrin,S.Kep.
Nip.196506021987031017
PUSKESMAS
:
BULAN AGUSTUS 2019
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 0 0.0 0 0.0 0 0.0 2 10.0 3 30.0 5 12.5 2 10.0 3 15.0 5 12.5 1 5.0 2 10.0 3 7.5 1 5.0 2 10.0 3 7.5 0 0.0 0 0.0 0 0.0
2 WATUDEMBA 697 8 8 16 7 7 14 1 14.3 0 0.0 1 7.1 1 14.3 3 21.0 4 28.6 1 14.3 3 42.9 4 28.6 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 4 57.1 3 42.9 7 50.0
3 AOSOLE 1,066 12 12 24 11 11 22 1 9.1 0 0.0 1 4.5 0 0.0 3 #DIV/0! 3 13.6 0 0.0 3 27.3 3 13.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 27.3 3 13.6
4 ALAKAYA 704 8 8 16 7 7 14 1 14.3 0 0.0 1 7.1 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 0 0.0 0 0.0 1 16.7 1 6.0 2 14.3 1 16.7 1 16.7 2 14.3 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1
6 KAPUJAYA 650 7 7 14 7 7 14 1 14.3 1 14.3 2 14.3 0 0.0 1 #DIV/0! 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 1 14.3 2 14.3
7 WAWOURU 1,125 13 12 25 12 12 24 1 8.3 0 0.0 1 4.2 1 8.3 2 24.0 3 12.5 1 8.3 2 16.7 3 12.5 2 16.7 2 16.7 4 16.7 2 16.7 2 16.7 4 16.7 3 25.0 0 0.0 3 12.5
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 0 0.0 0 0.0 1 6.7 2 30.0 3 10.0 1 6.7 2 13.3 3 10.0 2 13.3 1 6.7 3 10.0 2 13.3 1 6.7 3 10.0 3 20.0 0 0.0 3 10.0
9 WATUMEREMBE 854 10 9 19 9 9 18 1 11.1 0 0.0 1 5.6 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6
10 EEWA 666 8 7 15 7 7 14 0 0.0 1 14.3 1 7.1 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 0 0.0 1 7.1
11 ONEMBUTE 1,007 11 11 22 11 10 21 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 3 27.3 0 0.0 3 14.3 3 27.3 0 0.0 3 14.3 0 0.0 1 10.0 1 4.8
12 ANGGONDARA 779 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 4 50.0 1 12.5 5 31.3
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 0 0.0 0 0.0 0 0.0 4 30.8 0 0.0 4 15.4 4 30.8 0 0.0 4 15.4 0 0.0 3 23.1 3 11.5 0 0.0 3 23.1 3 11.5 1 7.7 0 0.0 1 3.8
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 1 12.5 1 6.3 0 0.0 3 #DIV/0! 3 18.8 0 0.0 3 37.5 3 18.8 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 1 12.5 1 12.5 2 12.5
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 326 153 152 307 7 4.6 4 2.6 11 3.6 13 8.5 18 211.8 31 10.1 13 8.5 18 11.8 31 10.1 15 9.8 12 7.9 27 8.8 15 9.8 12 7.9 27 8.8 20 13.1 10 6.6 30 9.8
Jenis Vaksin / Alat

Box aan
ini ini (buah)
4 Vak. POLIO 8 30 38 19 19 - 5 CAMPAK #REF! dosis 12 Vial #REF! 4 Thermos
5 Vak. CAMPAK 14 - - 12 2 10 6 HB. UNIJECT 11 dosis 11 Buah 1
6 Vak. HB. UNIJECT 41 - - 11 30 (19) 7 TT 4 dosis 4 Vial 1
7 Vak. Td 4 - - 4 - 4
1 ADS 5 ml 73 - 73 25 48 (23) Kepala Puskesmas Palangga Kab.Konsel
2 ADS 0,5 ml 173 200 373 163 210 (47)
3 ADS 0,0 5 ml 31 100 131 11 120 (109)
Nip.196506021987031017
PUSKESMAS
:
BULAN SEPTEMBER 2019
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 1 1.0 1 5.0 2 5.0 0 0.0 1 #DIV/0! 1 2.5 0 0.0 1 5.0 1 2.5 0 0.0 2 10.0 2 5.0 0 0.0 2 10.0 2 5.0 0 0.0 1 5.0 1 2.5
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 1 #DIV/0! 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 5 71.4 6 42.9 1 14.3 5 71.4 6 42.9 1 14.3 0 0.0 1 7.1
3 AOSOLE 1,066 12 12 24 11 11 22 3 27.3 1 9.1 4 18.2 2 18.2 0 0.0 2 9.1 2 18.2 0 0.0 2 9.1 0 0.0 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 0 0.0 0 0.0
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 1 0,0 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 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 16.7 1 16.7 2 14.3 1 16.7 1 16.7 2 14.3 1 16.7 0 0.0 1 7.1
6 KAPUJAYA 650 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 1 0,0 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 0 0.0 1 7.1
7 WAWOURU 1,125 13 12 25 12 12 24 1 8.3 0 0.0 1 4.2 2 16.7 1 0,0 3 12.5 2 16.7 1 8.3 3 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 25.0 2 16.7 5 20.8
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 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 6.7 2 13.3 3 10.0 1 6.7 2 13.3 3 10.0 1 6.7 1 6.7 2 6.7
9 WATUMEREMBE 854 10 9 19 9 9 18 1 11.1 0 0.0 1 5.6 3 33.3 0 0,0 3 16.7 3 33.3 0 0.0 3 16.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 1 11.1 2 11.1
10 EEWA 666 8 7 15 7 7 14 2 28.6 0 0.0 2 14.3 1 14.3 2 0,0 3 21.4 1 14.3 2 28.6 3 21.4 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 1 9.1 1 11.0 2 9.5 1 9.1 1 10.0 2 9.5 1 9.1 2 20.0 3 14.3 1 9.1 2 20.0 3 14.3 3 27.3 0 0.0 3 14.3
12 ANGGONDARA 779 9 8 17 8 8 16 1 12.5 1 12.5 2 12.5 0 0.0 1 #DIV/0! 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 1 12.5 3 18.8
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 0 0.0 0 0.0 0 0.0 0 0.0 3 #DIV/0! 3 11.5 0 0.0 3 23.1 3 11.5 2 15.4 1 7.7 3 11.5 2 15.4 1 7.7 3 11.5 0 0.0 1 7.7 1 3.8
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 1 0,0 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 1 12.5 0 0.0 1 6.3
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 0,0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 326 153 152 307 9 5.9 3 2.0 12 3.9 11 7.2 15 208.6 26 8.5 11 7.2 15 9.9 26 8.5 7 4.6 18 11.8 25 8.1 7 4.6 18 11.8 25 8.1 14 9.2 10 6.6 24 7.8
Jenis Vaksin / Alat

Box aan
ini ini (buah)
6 Vak. HB. UNIJECT 30 50 80 12 68 (56) 7 TT 0 dosis - Vial ###
7 Vak. Td - - - - - - MENGETAHUI :
1 ADS 5 ml 48 - 48 22 26 (4)
2 ADS 0,5 ml 210 200 410 262 148 114
3 ADS 0,0 5 ml 120 - 120 26 94 (68)
lkkmmmm
PUSKESMAS
:
BULAN OKTOBER 2019
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 0 0.0 1 5.0 1 2.5 1 5.0 0 0,0 1 2.5 1 5.0 0 0.0 1 2.5 3 15.0 2 10.0 5 12.5 3 15.0 2 10.0 5 12.5 1 5.0 5 25.0 6 15.0
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 0 0,0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 5 71.4 6 42.9
3 AOSOLE 1,066 12 12 24 11 11 22 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 3 27.3 1 9.1 4 18.2 3 27.3 1 9.1 4 18.2 0 0.0 1 9.1 1 4.5
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 3 42.9 0 0,0 3 21.4 3 42.9 0 0.0 3 21.4 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 1 14.3 0 0.0 1 7.1
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 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 16.7 1 16.7 2 14.3
6 KAPUJAYA 650 7 7 14 7 7 14 0 0.0 2 28.6 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1
7 WAWOURU 1,125 13 12 25 12 12 24 0 0.0 1 8.3 1 4.2 1 8.3 0 0.0 1 4.2 1 8.3 0 0.0 1 4.2 3 25.0 2 16.7 5 20.8 3 25.0 2 16.7 5 20.8 0 0.0 0 0.0 0 0.0
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 0 0.0 0 0.0 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 3 20.0 4 13.3
9 WATUMEREMBE 854 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 3 33.3 0 0.0 3 16.7 3 33.3 0 0.0 3 16.7 0 0.0 0 0.0 0 0.0
10 EEWA 666 8 7 15 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 1 14.3 1 7.1
11 ONEMBUTE 1,007 11 11 22 11 10 21 1 9.1 0 0.0 1 4.8 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 9.5
12 ANGGONDARA 779 9 8 17 8 8 16 1 12.5 0 0.0 1 6.3 0 0.0 0 #DIV/0! 0 0.0 0 0.0 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 12.5 1 12.5 2 12.5
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 1 7.7 0 0.0 1 3.8 2 15.4 2 13.0 4 15.4 2 15.4 2 15.4 4 15.4 1 7.7 1 7.7 2 7.7 1 7.7 1 7.7 2 7.7 3 23.1 2 15.4 5 19.2
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 1 12.5 3 37.5 4 25.0
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 326 153 152 307 3 2.0 4 2.6 7 2.3 15 9.8 2 20.4 17 5.5 15 9.8 2 1.3 17 5.5 17 11.1 14 9.2 31 10.1 17 11.1 14 9.2 31 10.1 10 6.5 25 16.4 35 11.4
Jenis Vaksin / Alat

Box aan
ini ini (buah)
2 Vak. DPT-HB - - - - - - 3 DPT-HB-Hib 96 dosis 24 Vial 4 2 M. Freezer
6 Vak. HB. UNIJECT 68 - 68 7 61 (54) 7 TT 0 dosis - Vial ###
7 Vak. TT - 15 15 - 15 (15) MENGETAHUI :
1 ADS 5 ml 26 - 26 16 10 6
2 ADS 0,5 ml 148 200 348 168 180 (12)
3 ADS 0,0 5 ml 94 100 194 18 176 (158)
PUSKESMAS
:
BULAN NOPEMBER 2019
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 1 5.0 1 5.0 2 5.0 0 0.0 1 0.0 1 2.5 0 0.0 1 5.0 1 2.5 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 4 20.0 1 5.0 5 12.5
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 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 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 2 28.6 2 14.3
3 AOSOLE 1,066 12 12 24 11 11 22 2 0.0 1 9.1 3 13.6 2 18.2 4 22.0 6 27.3 2 18.2 4 36.4 6 27.3 1 9.1 1 9.1 2 9.1 1 9.1 1 9.1 2 9.1 1 9.1 0 0.0 1 4.5
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 1 0.0 1 7.1 0 0.0 1 14.3 1 7.1 3 42.9 1 14.3 4 28.6 3 42.9 1 14.3 4 28.6 2 28.6 2 28.6 4 28.6
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 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
6 KAPUJAYA 650 7 7 14 7 7 14 1 14.3 0 0.0 1 7.1 0 0.0 2 0.0 2 14.3 0 0.0 2 28.6 2 14.3 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 1 14.3 0 0.0 1 7.1
7 WAWOURU 1,125 13 12 25 12 12 24 0 0.0 1 8.3 1 4.2 1 8.3 1 0.0 2 8.3 1 8.3 1 8.3 2 8.3 2 16.7 1 8.3 3 12.5 2 16.7 1 8.3 3 12.5 3 25.0 2 16.7 5 20.8
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 3 20.0 3 10.0 1 6.7 1 15.0 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 2 13.3 2 13.3 4 13.3
9 WATUMEREMBE 854 10 9 19 9 9 18 1 11.1 0 0.0 1 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 0.0 3 33.3 0 0.0 3 16.7
10 EEWA 666 8 7 15 7 7 14 1 14.3 1 14.3 2 14.3 1 14.3 1 0.0 2 14.3 1 14.3 1 14.3 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 2 28.6 2 14.3
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 1 10.0 2 9.5
12 ANGGONDARA 779 9 8 17 8 8 16 1 12.5 1 12.5 2 12.5 2 25.0 2 0.0 4 25.0 2 25.0 2 25.0 4 25.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 1 7.7 0 0.0 1 3.8 2 15.4 2 0.0 4 15.4 2 15.4 2 15.4 4 15.4 0 0.0 3 23.1 3 11.5 0 0.0 3 23.1 3 11.5 1 7.7 1 7.7 2 7.7
14 WAWONGGURA 776 9 8 17 8 8 16 1 12.5 0 0.0 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 2 25.0 2 12.5
15 SANGGI-SANGGI 698 8 8 16 7 7 14 1 14.3 1 14.3 2 14.3 1 14.3 1 0.0 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 2 28.6 3 21.4
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0! 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 326 153 152 307 10 6.5 9 5.9 19 6.2 12 7.8 16 204.0 28 9.1 12 7.8 16 10.5 28 9.1 16 10.5 11 7.2 27 8.8 16 10.5 11 7.2 27 8.8 19 12.4 17 11.2 36 11.7
1
Jenis Vaksin / Alat

Box aan
ini ini (buah)
1 Vak. BCG 18 - 18 10 8 2 2 DPT-HB 63 dosis - Vial ### 1 Lemari ES
3 Vak. DPT-HB-Hib 37 - 37 27 10 17 4 POLIO 128 dosis 15 Vial 8.5333 3 V. Crrier
4 Vak. POLIO 32 - 32 15 17 (2) 5 CAMPAK #REF! dosis 12 Vial #REF! 4 Thermos
1 ADS 5 ml 10 20 30 22 8 14
2 ADS 0,5 ml 180 200 380 233 147 86
3 ADS 0,0 5 ml 176 100 276 22 254 (232)
PUSKESMAS
:
BULAN DESEMBER 2019
SURVIVING INFANT
DESA / PDDK
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 0 0.0 1 5.0 1 2.5 0 0.0 3 15.0 3 7.5 0 0.0 3 15.0 3 7.5 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
2 WATUDEMBA 697 8 8 16 7 7 14 0 0.0 1 14.3 1 7.1 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 1 14.3 0 0.0 1 7.1
3 AOSOLE 1,066 12 12 24 11 11 22 0 0.0 0 0.0 0 0.0 2 18.2 1 9.1 3 13.6 2 18.2 1 9.1 3 13.6 2 18.2 4 36.4 6 27.3 2 18.2 4 36.4 6 27.3 1 9.1 1 9.1 2 9.1
4 ALAKAYA 704 8 8 16 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 1 14.3 3 21.4
5 WAWORAHA 611 7 7 14 6 6 14 0 0.0 2 33.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0
6 KAPUJAYA 650 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 1 14.3 3 21.4
7 WAWOURU 1,125 13 12 25 12 12 24 0 0.0 0 0.0 0 0.0 3 25.0 1 8.3 4 16.7 3 25.0 1 8.3 4 16.7 1 8.3 1 8.3 2 8.3 1 8.3 1 8.3 2 8.3 2 16.7 1 8.3 3 12.5
8 MEKAR SARI 1,433 16 16 32 15 15 30 0 0.0 0 0.0 0 0.0 1 6.7 3 20.0 4 13.3 1 6.7 3 20.0 4 13.3 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7
9 WATUMEREMBE 854 10 9 19 9 9 18 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6
10 EEWA 666 8 7 15 7 7 14 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 2 28.6 0 0.0 2 14.3
11 ONEMBUTE 1,007 11 11 22 11 10 21 0 0.0 1 10.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 20.0 2 9.5
12 ANGGONDARA 779 9 8 17 8 8 16 1 12.5 1 12.5 2 12.5 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 0 0.0 0 0.0 0 0.0 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 2 15.4 4 30.8 6 23.1 2 15.4 4 30.8 6 23.1 0 0.0 1 7.7 1 3.8
14 WAWONGGURA 776 9 8 17 8 8 16 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 0.0 2 12.5
15 SANGGI-SANGGI 698 8 8 16 7 7 14 0 0.0 1 14.3 1 7.1 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0
16 UPT.TOLIHE 457 5 5 10 5 5 10 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PALANGGA 14,608 166 159 326 153 152 307 1 0.7 7 4.6 8 2.6 14 9.2 9 5.9 23 7.5 14 9.2 9 5.9 23 7.5 10 6.5 13 8.6 23 7.5 10 6.5 13 8.6 23 7.5 12 7.8 11 7.2 23 7.5
Jenis Vaksin / Alat

Box aan
ini ini (buah)
7 Vak. TT - 10 10 10 - 10 MENGETAHUI :
1 ADS 5 ml 8 20 28 18 10 8
2 ADS 0,5 ml 147 200 347 179 168 11
3 ADS 0,0 5 ml 254 100 354 23 331 (308)
PUSKESMAS
:
BULAN JANUARI S/D. desember 2019
SURVIVING INFANT
DESA / PDDK
NO BAYI BARU LAHIR HB0 (0<7 HARI) BCG POLIO1 DPT/HB-HIB(1) POLIO2 DPT-HB-HIB2
KELURAHAN TAHUN
(0 - 11 BLN
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 31 32 33 34 35 36 37 38 39 40 41 42 43 44
1 KIAEA 1,881 21 20 42 20 20 40 7 35.0 9 45.0 16 40.0 9 45.0 13 28.9 22 55.0 9 45.0 1 5.0 10 25.0 12 60.0 10 50.0 22 55.0 12 60.0 10 50.0 22 55.0 12 60.0 11 55.0 23 52.8
2 WATUDEMBA 697 8 8 16 7 7 14 2 28.6 3 42.9 5 35.7 8 114.3 12 10.5 20 142.9 8 114.3 12 171.4 20 142.9 9 128.6 14 200.0 23 164.3 9 128.6 14 200.0 23 164.3 10 142.9 15 214.3 25 178.6
3 AOSOLE 1,066 12 12 24 11 11 22 9 81.8 6 54.5 15 68.2 14 127.3 13 10.2 27 122.7 14 127.3 13 118.2 27 122.7 17 154.5 13 118.2 30 136.4 17 154.5 13 118.2 30 136.4 14 127.3 7 63.6 21 95.5
4 ALAKAYA 704 8 8 16 7 7 14 2 28.6 1 14.3 3 21.4 6 85.7 3 3.5 9 64.3 6 85.7 3 42.9 9 64.3 9 128.6 4 57.1 13 92.9 9 128.6 4 57.1 13 92.9 9 128.6 5 71.4 14 100.0
5 WAWORAHA 611 7 7 14 6 6 14 3 50.0 3 50.0 6 42.9 6 100.0 1 1.0 7 50.0 6 100.0 1 16.7 7 50.0 7 116.7 1 16.7 8 57.1 7 116.7 1 16.7 8 57.1 7 116.7 1 16.7 8 57.1
6 KAPUJAYA 650 7 7 14 7 7 14 5 71.4 4 57.1 9 64.3 10 142.9 6 4.2 16 114.3 10 142.9 6 85.7 16 114.3 9 128.6 4 57.1 13 92.9 9 128.6 4 57.1 13 92.9 10 142.9 6 85.7 16 114.3
7 WAWOURU 1,125 13 12 25 12 12 24 7 58.3 7 58.3 14 58.3 17 141.7 15 10.6 32 133.3 17 141.7 15 125.0 32 133.3 16 133.3 15 125.0 31 129.2 16 133.3 15 125.0 31 129.2 15 125.0 16 133.3 31 129.2
8 MEKAR SARI 1,433 16 16 32 15 15 30 3 20.0 9 60.0 12 40.0 15 100.0 13 13.0 28 93.3 15 100.0 13 86.7 28 93.3 16 106.7 12 80.0 28 93.3 16 106.7 12 80.0 28 93.3 16 106.7 13 86.7 29 96.7
9 WATUMEREMBE 854 10 9 19 9 9 18 6 66.7 2 22.2 8 44.4 10 111.1 3 2.7 13 72.2 10 111.1 3 33.3 13 72.2 10 111.1 3 33.3 13 72.2 10 111.1 3 33.3 13 72.2 10 111.1 3 33.3 13 72.2
10 EEWA 666 8 7 15 7 7 14 5 71.4 4 57.1 9 64.3 6 85.7 6 7.0 12 85.7 6 85.7 6 85.7 12 85.7 7 100.0 7 100.0 14 100.0 7 100.0 7 100.0 14 100.0 6 85.7 5 71.4 11 78.6
11 ONEMBUTE 1,007 11 11 22 11 10 21 4 36.4 1 10.0 5 23.8 8 72.7 7 9.6 15 71.4 8 72.7 7 70.0 15 71.4 11 100.0 6 60.0 17 81.0 11 100.0 6 60.0 17 81.0 9 81.8 11 110.0 20 95.2
12 ANGGONDARA 779 9 8 17 8 8 16 7 87.5 4 50.0 11 68.8 15 187.5 6 3.2 21 131.3 15 187.5 6 75.0 21 131.3 11 137.5 8 100.0 19 118.8 11 137.5 8 100.0 19 118.8 13 162.5 11 137.5 24 150.0
13 KEL.PALANGGA 1,204 14 13 27 13 13 26 8 61.5 3 23.1 11 42.3 25 192.3 14 7.3 39 150.0 25 192.3 14 107.7 39 150.0 20 153.8 21 161.5 41 157.7 20 153.8 21 161.5 41 157.7 16 123.1 20 153.8 36 138.5
14 WAWONGGURA 776 9 8 17 8 8 16 3 37.5 3 37.5 6 37.5 2 25.0 10 40.0 12 75.0 2 25.0 10 125.0 12 75.0 3 37.5 10 125.0 13 81.3 3 37.5 10 125.0 13 81.3 4 50.0 13 162.5 17 106.3
15 SANGGI-SANGGI 698 8 8 16 7 7 14 1 14.3 4 57.1 5 35.7 5 71.4 10 14.0 15 107.1 5 71.4 10 142.9 15 107.1 4 57.1 8 114.3 0 0.0 4 57.1 8 114.3 12 85.7 5 71.4 8 114.3 13 92.9
16 UPT.TOLIHE 457 5 5 10 5 5 10 2 40.0 0 0.0 2 20.0 2 40.0 0 0.0 2 20.0 2 40.0 0 0.0 2 20.0 4 80.0 0 0.0 4 40.0 4 80.0 0 0.0 4 40.0 5 100.0 0 0.0 5 50.0
PALANGGA 14,608 166 159 326 153 152 307 74 0.0 63 41.4 137 44.6 158 103.3 132 127.8 290 94.5 158 103.3 120 78.9 239 77.9 165 107.8 136 89.5 251 81.8 165 107.8 136 89.5 301 98.0 161 105.2 145 95.4 306 99.7
Jenis Vaksin / Alat

Box aan
ini ini (buah)
5 Vak. CAMPAK 45 - 45 9 36 (27) 6 HB. UNIJECT 137 dosis 12 Buah 11.417
6 Vak. HB. UNIJECT - 100 100 12 88 (76) 7 TT 269 dosis 8 Vial 33.625
1 ADS 5 ml 33 20 53 15 38 (23)
2 ADS 0,5 ml 117 200 317 137 180 (43)
3 ADS 0,0 5 ml 104 100 204 19 185 (166)
5 Safety Box 0,25 liter - - - Nip.196506021987031017
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 37 56 93 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1 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 23 27 50 1 4.3 1 3.7 2 4.0
0 0.0 0 0.0 0 0.0 2 18.2 1 9.1 3 13.6 2 18.2 1 9.1 3 13.6 2 18.2 1 9.1 3 13.6 0 0.0 3 27.3 3 13.6 0 0.0 3 27.3 3 13.6 31 38 69 1 3.2 0 0.0 1 1.4
1 14.3 0 0.0 1 7.1 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 19 42 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 16.7 1 16.7 2 14.3 1 16.7 1 16.7 2 14.3 1 16.7 1 16.7 2 14.3 0 0.0 3 50.0 3 21.4 0 0.0 3 50.0 3 21.4 22 13 35 0 0.0 0 0.0 0 0.0
0 0.0 2 28.6 2 14.3 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0 0.0 1 6.3 1 2.9
0 0.0 2 16.7 2 8.3 1 8.3 0 0.0 1 4.2 1 8.3 0 0.0 1 4.2 1 8.3 0 0.0 1 4.2 1 8.3 0 0.0 1 4.2 1 8.3 0 0.0 1 4.2 33 35 68 1 3.0 1 2.9 2 2.9
2 13.3 0 0.0 2 6.7 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 0 0.0 1 6.7 1 3.3 0 0.0 1 6.7 1 3.3 38 36 74 3 7.9 0 0.0 3 4.1
1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 25 19 44 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 35 38 73 0 0.0 0 0.0 0 0.0
1 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 31 18 49 2 6.5 0 0.0 2 4.1
0 0.0 0 0.0 0 0.0 3 23.1 3 23.1 6 23.1 3 23.1 3 23.1 6 23.1 3 23.1 3 23.1 6 23.1 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 56 60 116 0 0.0 0 0.0 0 0.0
0 0.0 1 12.5 1 6.3 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 1.0 1 12.5 1 12.5 2 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 21 43 0 0.0 0 0.0 0 0.0
2 28.6 0 0.0 2 14.3 0 0.0 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 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 16 30 46 1 6.3 0 0.0 1 2.2
1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0
9 5.9 8 5.3 17 5.5 13 8.5 12 7.9 25 8.1 13 8.5 12 7.9 25 8.1 12 7.8 12 7.9 24 7.8 4 2.6 9 5.9 13 4.2 4 2.6 9 5.9 13 4.2 452 466 918 9 2.0 3 0.6 12 1.3
Palangga ...................................................2019
Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1001 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
3 15.0 1 5.0 4 10.0 0 0.0 2 10.0 2 5.0 0 0.0 2 10.0 2 5.0 0 0.0 2 10.0 2 5.0 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 37 56 93 1 2.7 2 3.6 3 3.2
1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 23 27 50 0 0.0 0 0.0 0 0.0
1 9.1 0 0.0 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 2 18.2 2 9.1 0 0.0 2 18.2 2 9.1 31 38 69 1 3.2 1 2.6 2 2.9
2 28.6 1 14.3 3 21.4 1 0.0 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 23 19 42 1 4.3 0 0.0 1 2.4
1 16.7 0 0.0 1 7.1 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 1 16.7 1 7.1 0 0.0 1 16.7 1 7.1 22 13 35 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0 0.0 1 6.3 1 2.9
0 0.0 0 0.0 0 0.0 0 0.0 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 8.3 1 8.3 2 8.3 1 8.3 1 8.3 2 8.3 33 35 68 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 6.7 2 13.3 3 10.0 1 6.7 2 13.3 3 10.0 38 36 74 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 66.7 1 11.1 7 38.9 6 66.7 1 11.1 7 38.9 32 27 59 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 25 19 44 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 50.0 5 23.8 0 0.0 5 50.0 5 23.8 35 38 73 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 18 49 0 0.0 0 0.0 0 0.0
1 7.7 2 15.4 3 11.5 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 2 15.4 1 7.7 3 11.5 2 15.4 1 7.7 3 11.5 56 60 116 1 1.8 1 1.7 2 1.7
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 21 43 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 16 30 46 2 12.5 1 3.3 3 6.5
2 40.0 0 0.0 2 20.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 1 11.1 0 0.0 1 4.5
11 7.2 5 3.3 16 5.2 5 3.3 4 2.6 9 2.9 5 3.3 4 2.6 9 2.9 5 3.3 4 2.6 9 2.9 13 8.5 14 9.2 27 8.8 13 8.5 14 9.2 27 8.8 452 466 918 7 1.5 6 1.3 13 1.4

Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
0 0.0 0 0.0 0 0.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 1 5.0 2 10.0 3 7.5 2 10.0 2 10.0 4 10.0 2 10.0 2 10.0 4 10.0 37 56 93 1 2.7 4 7.1 5 5.4
1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 23 27 50 0 0.0 0 0.0 0 0.0
2 18.2 1 9.1 3 13.6 0 0.0 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 3 27.3 3 13.6 0 0.0 3 27.3 3 13.6 31 38 69 0 0.0 0 0.0 0 0.0
0 0.0 1 14.3 1 7.1 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 19 42 1 4.3 1 5.3 2 4.8
1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 2 33.3 0 0.0 2 14.3 2 33.3 0 0.0 2 14.3 22 13 35 0 0.0 1 7.7 1 2.9
1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 19 16 35 0 0.0 0 0.0 0 0.0
0 0.0 1 8.3 1 4.2 0 0.0 3 25.0 3 12.5 0 0.0 3 25.0 3 12.5 0 0.0 3 25.0 3 12.5 4 33.3 1 8.3 5 20.8 4 33.3 1 8.3 5 20.8 33 35 68 0 0.0 4 11.4 4 5.9
0 0.0 1 6.7 1 3.3 2 13.3 0 0.0 2 6.7 2 13.3 0 0.0 2 6.7 2 13.3 0 0.0 2 6.7 2 13.3 2 13.3 4 13.3 2 13.3 2 13.3 4 13.3 38 36 74 2 5.3 5 13.9 7 9.5
1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 1 11.1 2 11.1 1 11.1 1 11.1 2 11.1 32 27 59 1 3.1 0 0.0 1 1.7
2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 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 14.3 1 7.1 0 0.0 1 14.3 1 7.1 25 19 44 1 4.0 1 5.3 2 4.5
2 18.2 1 10.0 3 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 36.4 0 0.0 4 19.0 4 36.4 0 0.0 4 19.0 35 38 73 0 0.0 1 2.6 1 1.4
0 0.0 2 25.0 2 12.5 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 31 18 49 2 6.5 0 0.0 2 4.1
2 15.4 4 30.8 6 23.1 1 7.7 3 23.1 4 15.4 1 7.7 3 23.1 4 15.4 1 7.7 3 23.1 4 15.4 4 30.8 4 30.8 8 30.8 4 30.8 4 30.8 8 30.8 56 60 116 0 0.0 1 1.7 1 0.9
1 12.5 1 12.5 2 12.5 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 21 43 1 4.5 0 0.0 1 2.3
2 28.6 0 0.0 2 14.3 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 16 30 46 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 2 40.0 0 0.0 2 20.0 2 40.0 0 0.0 2 20.0 2 40.0 0 0.0 2 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0
15 9.8 13 8.6 28 9.1 14 9.2 13 8.6 27 8.8 14 9.2 13 8.6 27 8.8 14 9.2 14 9.2 28 9.1 20 13.1 18 11.8 38 12.4 20 13.1 18 11.8 38 12.4 452 466 918 9 2.0 18 3.9 27 2.9
Palangga, ………………….2019
Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 0 0.0 3 15.0 3 7.5 0 0.0 3 15.0 3 7.5 37 56 93 2 5.4 0 0.0 2 2.2
0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 2 28.6 0 0.0 2 0.0 2 28.6 0 0.0 2 14.3 23 27 50 0 0.0 0 0.0 0 0.0
5 45.5 0 0.0 5 22.7 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 2 18.2 0 0.0 2 9.1 2 18.2 0 0.0 2 9.1 31 38 69 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 23 19 42 1 4.3 0 0.0 1 2.4
0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 13 35 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0 0.0 0 0.0 0 0.0
1 8.3 2 16.7 3 12.5 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 33 35 68 2 6.1 1 2.9 3 4.4
2 13.3 1 6.7 3 10.0 0 0.0 1 6.7 1 3.3 0 21.4 1 6.7 1 3.3 0 0.0 1 6.7 1 3.3 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 38 36 74 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 32 27 59 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 25 19 44 0 0.0 0 0.0 0 0.0
0 0.0 2 20.0 2 9.5 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 35 38 73 0 0.0 0 0.0 0 0.0
5 62.5 0 0.0 5 31.3 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 3 37.5 0 0.0 3 18.8 3 37.5 0 0.0 3 18.8 31 18 49 0 0.0 0 0.0 0 0.0
0 0.0 4 30.8 4 15.4 2 15.4 2 15.4 4 #REF! 2 15.4 2 15.4 4 15.4 2 15.4 2 15.4 4 15.4 0 0.0 5 38.5 5 19.2 0 0.0 5 38.5 5 19.2 56 60 116 1 1.8 2 3.3 3 2.6
0 0.0 2 25.0 2 12.5 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 22 21 43 2 9.1 1 4.8 3 7.0
0 0.0 2 28.6 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 16 30 46 0 0.0 1 3.3 1 2.2
0 0.0 0 0.0 0 0.0 0 0.0 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 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 9 13 22 1 11.1 0 0.0 1 4.5
15 9.8 14 9.2 29 9.4 12 7.8 8 5.3 20 6.5 12 7.8 8 5.3 20 6.5 12 7.8 8 5.3 20 6.5 12 7.8 10 6.6 22 7.2 12 7.8 10 6.6 22 7.2 452 466 918 9 2.0 5 1.1 14 1.5

Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
POLIO3 DPT-HB-HIB3 POLIO4 IPV CAMPAK IDL SASARAN BATITA DPT/HB/Hib
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
2 10.0 1 5.0 3 7.5 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 0 0.0 2 10.0 2 5.0 0 0.0 2 10.0 2 5.0 37 56 93 1 2.7 1 1.8 2 2.2
0 0.0 1 14.3 1 7.1 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 27 50 0 0.0 0 0.0 0 0.0
4 36.4 1 9.1 5 22.7 4 36.4 1 9.1 5 22.7 4 36.4 1 9.1 5 22.7 4 36.4 1 9.1 5 22.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 38 69 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 23 19 42 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 22 13 35 0 0.0 1 7.7 1 2.9
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0 0.0 0 0.0 0 0.0
2 16.7 1 8.3 3 12.5 1 8.3 2 16.7 3 12.5 1 8.3 2 16.7 3 12.5 1 8.3 2 16.7 3 12.5 1 8.3 1 8.3 2 8.3 1 8.3 1 8.3 2 8.3 33 35 68 1 3.0 0 0.0 1 1.5
1 6.7 2 13.3 3 10.0 3 20.0 0 0.0 3 10.0 3 20.0 0 0.0 3 10.0 3 20.0 0 0.0 3 10.0 0 0.0 1 6.7 1 3.3 0 0.0 1 6.7 1 3.3 38 36 74 0 0.0 1 2.8 1 1.4
0 0.0 1 11.1 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 2 6.3 0 0.0 2 3.4
0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 25 19 44 1 4.0 0 0.0 1 2.3
0 0.0 1 10.0 1 4.8 1 9.1 1 10.0 2 9.5 1 9.1 1 10.0 2 9.5 1 9.1 1 10.0 2 9.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 35 38 73 1 2.9 0 0.0 1 1.4
0 0.0 2 25.0 2 12.5 1 12.5 1 12.5 2 12.5 1 12.5 1 2.0 2 12.5 1 12.5 1 12.5 2 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 18 49 0 0.0 1 5.6 1 2.0
2 15.4 1 7.7 3 11.5 3 23.1 2 15.4 5 19.2 3 23.1 2 15.4 5 19.2 3 23.1 2 15.4 5 19.2 3 23.1 0 0.0 3 11.5 3 23.1 0 0.0 3 11.5 56 60 116 2 3.6 1 1.7 3 2.6
0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 22 21 43 1 4.5 0 0.0 1 2.3
0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 3 42.9 0 0.0 3 21.4 3 42.9 0 0.0 3 21.4 16 30 46 0 0.0 0 0.0 0 0.0
1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0
12 7.8 13 8.6 25 8.1 16 10.5 11 7.2 27 8.8 16 10.5 11 7.2 27 8.8 16 10.5 11 7.2 27 8.8 9 5.9 6 3.9 15 4.9 9 5.9 6 3.9 15 4.9 452 466 918 9 2.0 5 1.1 14 1.5

Tgl Jam No. Batch
4 Umur : :
Nip. ........................... 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
1 5.0 1 5.0 2 5.0 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 0 0.0 0 0.0 0 0.0 3 15.0 0 0.0 3 7.5 3 15.0 0 0.0 3 7.5 37 56 93 0 0.0 1 1.8 1 1.1
0 0.0 0 0.0 0 0.0 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 27 50 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 5 45.5 1 9.1 6 27.3 5 45.5 1 9.1 6 27.3 5 45.5 1 9.1 6 27.3 4 36.4 0 0.0 4 18.2 4 36.4 0 0.0 4 18.2 31 38 69 1 3.2 1 2.6 2 2.9
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 14.3 1 7.1 0 0.0 1 14.3 1 7.1 23 19 42 0 0.0 0 0.0 0 0.0
2 33.3 0 0.0 2 14.3 0 0.0 0 0.0 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 16.7 1 7.1 0 0.0 1 16.7 1 7.1 22 13 35 0 0.0 0 0.0 0 0.0
2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 19 16 35 0 0.0 0 0.0 0 0.0
0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 0 0.0 0 0.0 0 0.0 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 33 35 68 3 9.1 0 0.0 3 4.4
2 13.3 1 6.7 3 10.0 0 0.0 3 20.0 3 10.0 0 0.0 3 20.0 3 10.0 0 0.0 3 20.0 3 10.0 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 38 36 74 0 0.0 0 0.0 0 0.0
2 22.2 0 0.0 2 11.1 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 32 27 59 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 25 19 44 0 0.0 0 0.0 0 0.0
2 18.2 0 0.0 2 9.5 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 35 38 73 0 0.0 0 0.0 0 0.0
0 0.0 1 12.5 1 6.3 0 0.0 2 25.0 2 12.5 0 20.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 1 12.5 1 12.5 2 12.5 1 12.5 1 12.5 2 12.5 31 18 49 0 0.0 1 5.6 1 2.0
4 30.8 2 15.4 6 23.1 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 0 0.0 3 23.1 3 11.5 0 0.0 3 23.1 3 11.5 56 60 116 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 22 21 43 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 16 30 46 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0
15 9.8 6 3.9 21 6.8 10 6.5 11 7.2 21 6.8 10 6.5 11 7.2 21 6.8 8 5.2 9 5.9 17 5.5 12 7.8 10 6.6 22 7.2 12 7.8 10 6.6 22 7.2 452 466 918 4 0.9 3 0.6 7 0.8
Palangga, ………………….2019
Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
Polio 3 DPT/HB-Hib (3) POLIO4 IPV CAMPAK IDL SASARAN BATITA DPT/HB/Hib
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
0 0.0 0 0.0 0 0.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 37 56 93 0 0.0 1 1.8 1 1.1
0 0.0 1 14.3 1 7.1 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 23 27 50 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 0 0.0 2 18.2 2 9.1 0 0.0 2 18.2 2 9.1 31 38 69 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 23 19 42 1 4.3 3 15.8 4 9.5
0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 13 35 0 0.0 0 0.0 0 0.0
2 28.6 1 14.3 3 21.4 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 19 16 35 1 5.3 0 0.0 1 2.9
1 8.3 4 33.3 5 20.8 1 8.3 1 8.3 2 8.3 1 8.3 1 8.3 2 8.3 1 8.3 1 8.3 2 8.3 0 0.0 2 16.7 2 8.3 0 0.0 2 16.7 2 8.3 33 35 68 1 3.0 2 5.7 3 4.4
1 6.7 1 6.7 2 6.7 3 20.0 1 6.7 4 13.3 3 20.0 1 6.7 4 13.3 3 20.0 1 6.7 4 13.3 2 13.3 0 0.0 2 6.7 2 13.3 0 0.0 2 6.7 38 36 74 2 5.3 0 0.0 2 2.7
0 0.0 1 11.1 1 5.6 2 22.2 1 11.1 3 16.7 2 22.2 1 11.1 3 16.7 2 22.2 1 11.1 3 16.7 2 22.2 0 0.0 2 11.1 2 22.2 0 0.0 2 11.1 32 27 59 0 0.0 3 11.1 3 5.1
1 14.3 0 0.0 1 7.1 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 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 25 19 44 0 0.0 0 0.0 0 0.0
1 9.1 1 10.0 2 9.5 2 18.2 1 10.0 3 14.3 2 18.2 1 10.0 3 14.3 2 18.2 1 10.0 3 14.3 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 35 38 73 0 0.0 1 2.6 1 1.4
0 0.0 0 0.0 0 0.0 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8 1 12.5 3 37.5 4 25.0 1 12.5 3 37.5 4 25.0 31 18 49 1 3.2 1 5.6 2 4.1
2 15.4 2 15.4 4 15.4 3 23.1 3 23.1 6 23.1 3 23.1 3 23.1 6 23.1 3 23.1 3 23.1 6 23.1 3 23.1 1 7.7 4 15.4 3 23.1 1 7.7 4 15.4 56 60 116 0 0.0 1 1.7 1 0.9
0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 22 21 43 0 0.0 0 0.0 0 0.0
0 0.0 1 14.3 1 7.1 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 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 16 30 46 0 0.0 0 0.0 0 0.0
1 20.0 0 0.0 1 10.0 0 0.0 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 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 9 13 22 0 0.0 0 0.0 0 0.0
9 5.9 13 8.6 22 7.2 18 11.8 10 6.6 28 9.1 18 11.8 10 6.6 28 9.1 18 11.8 10 6.6 28 9.1 12 7.8 14 9.2 26 8.5 12 7.8 14 9.2 26 8.5 452 466 918 6 1.3 12 2.6 18 2.0
Palangga ..................................................2019
Tgl Jam No. Batch
4 Umur : :
Iwan Setiawan 5 Nama ayah : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
0 0.0 0 0.0 0 0.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 1 5.0 1 5.0 2 5.0 1 5.0 0 0.0 1 2.5 1 5.0 0 0.0 1 2.5 37 56 93 2 5.4 2 3.6 4 4.3
4 57.1 3 42.9 7 50.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 1 14.3 2 28.6 3 21.4 1 14.3 2 28.6 3 21.4 23 27 50 0 0.0 0 0.0 0 0.0
0 0.0 3 27.3 3 13.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 18.2 0 0.0 2 9.1 2 18.2 0 0.0 2 9.1 31 38 69 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 19 42 0 0.0 0 0.0 0 0.0
1 16.7 0 0.0 1 7.1 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 2 33.3 0 0.0 2 14.3 2 33.3 0 0.0 2 14.3 22 13 35 0 0.0 0 0.0 0 0.0
1 14.3 1 14.3 2 14.3 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 19 16 35 0 0.0 0 0.0 0 0.0
3 25.0 0 0.0 3 12.5 2 16.7 3 25.0 5 20.8 2 16.7 3 25.0 5 20.8 2 16.7 3 25.0 5 20.8 0 0.0 2 16.7 2 8.3 0 0.0 2 16.7 2 8.3 33 35 68 1 3.0 1 2.9 2 2.9
3 20.0 0 0.0 3 10.0 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 38 36 74 2 5.3 1 2.8 3 4.1
1 11.1 0 0.0 1 5.6 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 25 19 44 0 0.0 0 0.0 0 0.0
0 0.0 1 10.0 1 4.8 1 9.1 1 10.0 2 9.5 1 9.1 1 10.0 2 9.5 1 9.1 1 10.0 2 9.5 3 27.3 0 0.0 3 14.3 3 27.3 0 0.0 3 14.3 35 38 73 0 0.0 0 0.0 0 0.0
4 50.0 1 12.5 5 31.3 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 1 12.5 3 37.5 4 25.0 1 12.5 3 37.5 4 25.0 31 18 49 0 0.0 0 0.0 0 0.0
1 7.7 0 0.0 1 3.8 2 21.4 1 7.7 3 11.5 2 15.4 1 7.7 3 11.5 2 15.4 1 7.7 3 11.5 0 0.0 5 38.5 5 19.2 0 0.0 5 38.5 5 19.2 56 60 116 1 1.8 0 0.0 1 0.9
1 12.5 1 12.5 2 12.5 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 1 12.5 0 0.0 1 6.3 1 12.5 0 0.0 1 6.3 22 21 43 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 16 30 46 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 9 13 22 0 0.0 0 0.0 0 0.0
20 13.1 10 6.6 30 9.8 13 8.5 11 7.2 24 7.8 13 8.5 11 7.2 24 7.8 13 8.5 11 7.2 24 7.8 14 9.2 14 9.2 28 9.1 14 9.2 14 9.2 28 9.1 452 466 918 6 1.3 4 0.9 10 1.1
Palangga, …………………….. 2019

Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
0 0.0 1 5.0 1 2.5 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 2 10.0 0 0.0 2 5.0 2 10.0 0 0.0 2 5.0 37 56 93 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1 2 28.6 2 28.6 4 28.6 2 28.6 2 28.6 4 28.6 2 28.6 2 28.6 4 28.6 2 28.6 2 28.6 4 28.6 2 28.6 2 28.6 4 28.6 23 27 50 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 3 27.3 3 13.6 0 0.0 3 27.3 3 13.6 0 0.0 3 27.3 3 13.6 2 18.2 0 0.0 2 9.1 2 18.2 0 0.0 2 9.1 31 38 69 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 23 19 42 0 0.0 2 10.5 2 4.8
1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 13 35 1 4.5 3 23.1 4 11.4
1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 1 5.3 0 0.0 1 2.9
3 25.0 2 16.7 5 20.8 3 25.0 1 8.3 4 16.7 3 25.0 1 8.3 4 16.7 3 25.0 1 8.3 4 16.7 2 16.7 1 8.3 3 12.5 2 16.7 1 8.3 3 12.5 33 35 68 0 0.0 0 0.0 0 0.0
1 6.7 1 6.7 2 6.7 2 13.3 0 0.0 2 6.7 2 13.3 0 0.0 2 6.7 2 13.3 0 0.0 2 6.7 3 20.0 2 13.3 5 16.7 3 20.0 2 13.3 5 16.7 38 36 74 0 0.0 0 0.0 0 0.0
1 11.1 1 11.1 2 11.1 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 32 27 59 0 0.0 2 7.4 2 3.4
0 0.0 1 14.3 1 7.1 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 25 19 44 0 0.0 0 0.0 0 0.0
3 27.3 0 0.0 3 14.3 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 0 0.0 3 30.0 3 14.3 0 0.0 3 30.0 3 14.3 35 38 73 1 2.9 1 2.6 2 2.7
2 0.0 1 12.5 3 18.8 3 37.5 1 12.5 4 25.0 3 37.5 1 12.5 4 25.0 3 37.5 1 12.5 4 25.0 3 37.5 1 12.5 4 25.0 3 37.5 1 12.5 4 25.0 31 18 49 0 0.0 0 0.0 0 0.0
0 0.0 1 7.7 1 3.8 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 2 15.4 0 0.0 2 7.7 2 15.4 0 0.0 2 7.7 56 60 116 1 1.8 0 0.0 1 0.9
1 12.5 0 0.0 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 22 21 43 0 0.0 1 4.8 1 2.3
0 0.0 2 28.6 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 16 30 46 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0
14 9.2 10 6.6 24 7.8 13 8.5 10 6.6 23 7.5 13 8.5 10 6.6 23 7.5 13 8.5 10 6.6 23 7.5 17 11.1 11 7.2 28 9.1 17 11.1 11 7.2 28 9.1 452 466 918 4 0.9 9 1.9 13 1.4
Palangga, ………………….2019
Koordinator Jurim Puskesmas .palangga 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) :
Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1 001. 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
1 5.0 5 25.0 6 15.0 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 0 0.0 1 5.0 1 2.5 37 56 93 2 5.4 2 3.6 4 4.3
1 14.3 5 71.4 6 42.9 3 42.9 1 14.3 4 28.6 3 42.9 1 14.3 4 28.6 3 42.9 1 14.3 4 28.6 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 23 27 50 0 0.0 0 0.0 0 0.0
0 0.0 1 9.1 1 4.5 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 2 18.2 1 9.1 3 13.6 2 18.2 1 9.1 3 13.6 31 38 69 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 23 19 42 0 0.0 0 0.0 0 0.0
1 16.7 1 16.7 2 14.3 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 22 13 35 0 0.0 1 7.7 1 2.9
0 0.0 1 14.3 1 7.1 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 19 16 35 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 3 25.0 2 16.7 5 20.8 3 25.0 2 16.7 5 20.8 3 25.0 2 16.7 5 20.8 0 0.0 1 8.3 1 4.2 0 0.0 1 8.3 1 4.2 33 35 68 0 0.0 1 2.9 1 1.5
1 6.7 3 20.0 4 13.3 2 13.3 1 6.7 3 10.0 2 13.3 1 6.7 3 10.0 2 13.3 1 6.7 3 10.0 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 38 36 74 2 5.3 3 8.3 5 6.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 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 11.1 1 5.6 0 0.0 1 11.1 1 5.6 32 27 59 0 0.0 1 3.7 1 1.7
0 0.0 1 14.3 1 7.1 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 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 25 19 44 0 0.0 0 0.0 0 0.0
0 0.0 2 20.0 2 9.5 3 27.3 0 0.0 3 14.3 3 27.3 0 0.0 3 14.3 3 27.3 0 0.0 3 14.3 2 18.2 1 10.0 3 14.3 2 18.2 1 10.0 3 14.3 35 38 73 0 0.0 0 0.0 0 0.0
1 12.5 1 12.5 2 12.5 2 25.0 2 25.0 4 25.0 2 25.0 2 25.0 4 25.0 2 25.0 2 25.0 4 25.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 31 18 49 0 0.0 0 0.0 0 0.0
3 23.1 2 15.4 5 19.2 2 15.4 2 15.4 4 15.4 2 15.4 2 15.4 4 15.4 2 15.4 2 15.4 4 15.4 1 7.7 0 0.0 1 3.8 1 7.7 0 0.0 1 3.8 56 60 116 1 1.8 2 3.3 3 2.6
1 12.5 3 37.5 4 25.0 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 22 21 43 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 16 30 46 2 12.5 0 0.0 2 4.3
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0
10 6.5 25 16.4 35 11.4 20 13.1 12 7.9 32 10.4 20 13.1 12 7.9 32 10.4 20 13.1 12 7.9 32 10.4 6 3.9 10 6.6 16 5.2 6 3.9 10 6.6 16 5.2 452 466 918 7 1.5 10 2.1 17 1.9
Palangga,31 Oktober 2019

Tgl Jam No. Batch
4 Umur : :
Nip. .19730720 199502 1 001. 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
4 20.0 1 5.0 5 12.5 1 5.0 6 30.0 7 17.5 1 5.0 6 30.0 7 17.5 0 0.0 0 0.0 0 0.0 2 10.0 2 10.0 4 10.0 2 10.0 2 10.0 4 10.0 37 56 93 1 2.7 0 0.0 1 1.1
0 0.0 2 28.6 2 14.3 1 14.3 5 71.4 6 42.9 1 14.3 5 71.4 6 42.9 0 0.0 0 0.0 0 0.0 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 23 27 50 0 0.0 0 0.0 0 0.0
1 9.1 0 0.0 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 0 0.0 0 0.0 1 9.1 0 0.0 1 4.5 1 9.1 0 0.0 1 4.5 31 38 69 0 0.0 0 0.0 0 0.0
2 28.6 2 28.6 4 28.6 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 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 23 19 42 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 16.7 1 16.7 2 14.3 1 16.7 1 16.7 2 14.3 0 0.0 0 0.0 0 0.0 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 22 13 35 0 0.0 1 7.7 1 2.9
1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 0 0.0 0 0.0 2 28.6 0 0.0 2 14.3 2 28.6 0 0.0 2 14.3 19 16 35 0 0.0 0 0.0 0 0.0
3 25.0 2 16.7 5 20.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 16.7 2 16.7 4 16.7 2 16.7 2 16.7 4 16.7 33 35 68 0 0.0 0 0.0 0 0.0
2 13.3 2 13.3 4 13.3 1 6.7 2 13.3 3 10.0 1 6.7 2 13.3 3 10.0 0 0.0 0 0.0 0 0.0 1 6.7 0 0.0 1 3.3 1 6.7 0 0.0 1 3.3 38 36 74 1 2.6 1 2.8 2 2.7
3 33.3 0 0.0 3 16.7 0 0.0 1 11.1 1 5.6 0 0.0 1 11.1 1 5.6 0 0.0 0 0.0 0 0.0 2 22.2 1 11.1 3 16.7 2 22.2 1 11.1 3 16.7 32 27 59 3 9.4 0 0.0 3 5.1
0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 25 19 44 1 4.0 0 0.0 1 2.3
1 9.1 1 10.0 2 9.5 0 0.0 1 10.0 1 4.8 0 0.0 1 10.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 35 38 73 2 5.7 2 5.3 4 5.5
0 0.0 0 0.0 0 0.0 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 1 6.3 0 0.0 1 12.5 1 6.3 31 18 49 0 0.0 0 0.0 0 0.0
1 7.7 1 7.7 2 7.7 2 15.4 2 15.4 4 15.4 2 15.4 2 15.4 4 15.4 0 0.0 0 0.0 0 0.0 4 30.8 0 0.0 4 15.4 4 30.8 0 0.0 4 15.4 56 60 116 1 1.8 0 0.0 1 0.9
0 0.0 2 25.0 2 12.5 1 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 0 0.0 0 0.0 0 0.0 2 25.0 1 12.5 3 18.8 2 25.0 1 12.5 3 18.8 22 21 43 0 0.0 0 0.0 0 0.0
1 14.3 2 28.6 3 21.4 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 16 30 46 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 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 20.0 0 0.0 1 10.0 1 20.0 0 0.0 1 10.0 9 13 22 0 0.0 0 0.0 0 0.0
19 12.4 17 11.2 36 11.7 10 6.5 25 16.4 35 11.4 10 6.5 25 16.4 35 11.4 0 0.0 0 0.0 0 0.0 21 13.7 8 5.3 29 9.4 21 13.7 8 5.3 29 9.4 452 466 918 9 2.0 4 0.9 13 1.4
Palangga, ………………….2019
Koordinator Jurim Puskesmas .Palangga. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) :
Tgl Jam No. Batch
4 Umur : :
Nip. 19730720 199502 1 001 6 Nama ibu : :
7 Alamat : :
POLIO 3 DPT/HB-Hib (3) POLIO 4 IPV CAMPAK IDL SASARAN BATITA DPT/HB/Hib
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
0 0.0 0 0.0 0 0.0 2 10.0 1 5.0 3 7.5 2 10.0 1 5.0 3 7.5 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 37 56 93 0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 0 0.0 0 0.0 1 14.3 1 14.3 2 14.3 1 14.3 1 14.3 2 14.3 23 27 50 0 0.0 2 7.4 2 4.0
1 9.1 1 9.1 2 9.1 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 31 38 69 0 0.0 1 2.6 1 1.4
2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 2 28.6 1 14.3 3 21.4 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 23 19 42 0 0.0 1 5.3 1 2.4
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 1 16.7 0 0.0 1 7.1 1 16.7 0 0.0 1 7.1 22 13 35 2 9.1 0 0.0 2 5.7
2 28.6 1 14.3 3 21.4 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 1 14.3 0 0.0 1 7.1 1 14.3 0 0.0 1 7.1 19 16 35 0 0.0 0 0.0 0 0.0
2 16.7 1 8.3 3 12.5 3 25.0 1 8.3 4 16.7 3 25.0 1 8.3 4 16.7 0 0.0 0 0.0 0 0.0 1 8.3 2 16.7 3 12.5 1 8.3 2 16.7 3 12.5 33 35 68 2 6.1 2 5.7 0 0.0
1 6.7 1 6.7 2 6.7 2 13.3 3 20.0 5 16.7 2 13.3 3 20.0 5 16.7 0 0.0 0 0.0 0 0.0 1 6.7 1 6.7 2 6.7 1 6.7 1 6.7 2 6.7 38 36 74 0 0.0 0 0.0 0 0.0
1 11.1 0 0.0 1 5.6 4 44.4 0 0.0 4 22.2 4 44.4 0 0.0 4 22.2 0 0.0 0 0.0 0 0.0 1 11.1 0 0.0 1 5.6 1 11.1 0 0.0 1 5.6 32 27 59 4 12.5 1 3.7 5 8.5
2 28.6 0 0.0 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 25 19 44 0 0.0 0 0.0 0 0.0
0 0.0 2 20.0 2 9.5 1 9.1 0 0.0 1 4.8 1 9.1 0 0.0 1 4.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 35 38 73 3 8.6 1 2.6 4 5.5
0 0.0 1 12.5 1 6.3 0 0.0 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 12.5 2 25.0 3 18.8 1 12.5 2 25.0 3 18.8 31 18 49 0 0.0 0 0.0 0 0.0
0 0.0 1 7.7 1 3.8 0 0.0 1 7.7 1 3.8 0 0.0 1 7.7 1 3.8 0 0.0 0 0.0 0 0.0 2 15.4 3 23.1 5 19.2 2 15.4 3 23.1 0 0.0 56 60 116 0 0.0 1 1.7 1 0.9
0 0.0 2 25.0 2 12.5 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 2 25.0 2 12.5 0 0.0 2 25.0 2 12.5 22 21 43 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 2 28.6 2 14.3 0 0.0 2 28.6 2 14.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 16 30 46 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 9 13 22 0 0.0 0 0.0 0 0.0
12 7.8 11 7.2 23 7.5 15 9.8 12 7.9 27 8.8 15 9.8 12 7.9 27 8.8 0 0.0 0 0.0 0 0.0 10 6.5 11 7.2 21 6.8 10 6.5 11 7.2 21 6.8 452 466 918 11 2.4 9 1.9 20 2.2
Palangga, ………………….2019
Koordinator Jurim Puskesmas ................. 1 Nama : Imunisasi terdahulu (lebih dari 30 hari, dari imunisasi terakhir) :
Tgl Jam No. Batch
4 Umur : :
Iwan Setiawan. 5 Nama ayah : :
Nip. 19730720 199502 1 001. 6 Nama ibu : :
7 Alamat : :
45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 93 94 95 96 97 98 99 100 101
12 60.0 11 55.0 23 57.5 9 45.0 14 70.0 23 57.5 9 45.0 14 70.0 23 57.5 5 25.0 8 40.0 13 32.5 3 15.0 11 55.0 14 35.0 3 5.0 2 0.0 5 2.5 37 56 93 10 27.0 13 23.2 23 24.7
10 142.9 15 214.3 25 178.6 10 142.9 1 14.3 11 78.6 10 142.9 1 14.3 11 78.6 9 128.6 1 14.3 10 71.4 11 157.1 8 114.3 19 135.7 3 28.6 1 0.0 4 14.3 23 27 50 1 4.3 3 11.1 4 8.0
14 127.3 7 63.6 21 95.5 13 118.2 9 81.8 22 100.0 13 118.2 9 81.8 22 100.0 13 118.2 8 72.7 21 95.5 13 118.2 8 72.7 21 95.5 0 0.0 8 45.5 8 22.7 31 38 69 3 9.7 3 7.9 6 8.7
9 128.6 5 71.4 14 100.0 7 100.0 6 85.7 13 92.9 7 100.0 6 85.7 13 92.9 4 57.1 5 71.4 9 64.3 5 71.4 4 57.1 9 64.3 0 0.0 1 14.3 1 7.1 23 19 42 4 17.4 7 36.8 11 26.2
7 116.7 1 16.7 8 57.1 7 116.7 2 33.3 9 64.3 7 116.7 2 33.3 9 64.3 6 100.0 1 16.7 7 50.0 7 116.7 5 83.3 12 85.7 2 0.0 4 66.7 6 28.6 22 13 35 3 13.6 7 53.8 10 28.6
10 142.9 6 85.7 16 114.3 9 128.6 6 85.7 15 107.1 9 128.6 6 85.7 15 107.1 8 114.3 5 71.4 13 92.9 3 42.9 5 71.4 8 57.1 0 0.0 1 0.0 1 0.0 19 16 35 2 10.5 2 12.5 4 11.4
15 125.0 16 133.3 31 129.2 14 116.7 15 125.0 29 120.8 14 116.7 15 125.0 29 120.8 11 91.7 13 108.3 24 100.0 6 50.0 14 116.7 20 83.3 6 8.3 2 8.3 8 8.3 33 35 68 11 33.3 12 34.3 23 33.8
16 106.7 13 86.7 29 96.7 17 113.3 12 80.0 29 96.7 17 113.3 12 80.0 29 96.7 14 93.3 7 46.7 21 70.0 14 93.3 10 66.7 24 80.0 3 6.7 5 20.0 8 13.3 38 36 74 12 31.6 11 30.6 23 31.1
10 111.1 3 33.3 13 72.2 10 111.1 3 33.3 13 72.2 10 111.1 3 33.3 13 72.2 1 11.1 2 22.2 1 5.6 7 77.8 4 44.4 11 61.1 7 11.1 2 11.1 9 11.1 32 27 59 10 31.3 7 25.9 17 28.8
6 85.7 5 71.4 11 78.6 4 57.1 6 85.7 10 71.4 4 57.1 6 85.7 10 71.4 4 57.1 2 28.6 6 42.9 1 14.3 4 57.1 5 35.7 1 100.0 1 0.0 2 50.0 25 19 44 3 12.0 1 5.3 4 9.1
9 81.8 11 110.0 20 95.2 10 90.9 6 60.0 16 76.2 10 90.9 6 60.0 16 76.2 9 81.8 4 40.0 13 61.9 9 81.8 11 110.0 20 95.2 4 0.0 6 60.0 10 28.6 35 38 73 7 20.0 6 15.8 13 17.8
13 162.5 11 137.5 24 150.0 14 175.0 13 162.5 27 168.8 14 175.0 13 162.5 27 168.8 12 150.0 12 150.0 24 150.0 0 0.0 2 25.0 2 12.5 0 0.0 2 12.5 2 6.3 31 18 49 5 16.1 3 16.7 8 16.3
16 123.1 20 153.8 36 138.5 21 161.5 19 146.2 40 153.8 21 161.5 19 146.2 40 153.8 19 146.2 16 123.1 35 134.6 7 53.8 22 169.2 29 111.5 7 7.7 5 7.7 12 7.7 56 60 116 8 14.3 9 15.0 17 14.7
4 50.0 13 162.5 17 106.3 4 50.0 8 100.0 12 75.0 4 50.0 8 100.0 12 75.0 3 37.5 6 75.0 9 56.3 2 25.0 8 100.0 10 62.5 2 25.0 0 0.0 2 12.5 22 21 43 4 18.2 2 9.5 6 14.0
5 71.4 8 114.3 13 92.9 5 71.4 7 100.0 12 85.7 5 71.4 7 100.0 12 85.7 5 71.4 5 71.4 10 71.4 6 85.7 1 14.3 7 50.0 1 14.3 1 0.0 2 7.1 16 30 46 5 31.3 2 6.7 7 15.2
5 100.0 0 0.0 5 50.0 5 100.0 0 0.0 5 50.0 5 100.0 0 0.0 5 50.0 4 80.0 0 0.0 4 40.0 4 80.0 0 0.0 4 40.0 0 0.0 0 0.0 0 0.0 9 13 22 2 22.2 0 0.0 2 9.1
161 105.2 145 95.4 306 99.7 159 103.9 127 83.6 236 76.9 159 103.9 127 83.6 236 76.9 127 83.0 95 62.5 222 72.3 98 64.1 117 77.0 235 76.5 39 25.5 41 27.0 235 76.5 452 466 918 90 19.9 88 18.9 178 19.4
37 41 78
Palangga, ………………………. 2019
Iwan Setiawan,SKM
Nip. 19730720 199502 1 001

JMLH
JUMLAH DAN PERSENTASE IBU HAMIL DIIMUNISASI & JUMLAH DAN PERSENTASE WUS TIDAK HAMIL DIIMUNISASI JUMLAH TOTAL DAN PERSENTASE WUS (HAMIL+TIDAK HAMILTT2+ BUMIL
PERSE
CAMPAK SASARA TT1 TT2 TT3 TT4 TT5 NTASE TT1 TT2 TT3 TT4 TT5 TT1 TT2 TT3 TT4 TT5 TT2+
N WUS
BUMIL TDK
#L % #P % # JML % # % # % # % # % # % HAMIL # % # % # % # % # % # % # % # % # % # % # %
DIIMU
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 NISASI
119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 412 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 5.0
0 0.0 0 0.0 0 0.0 30 1 3.3 0 0.0 1 3.3 0 0.0 0 0.0 233 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 1 0.4 0 0.0 0 0.0 1 3.3
0 0.0 0 0.0 0 0.0 15 2 13.0 1 6.5 0 0.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 2 1.2 1 0.6 0 0.0 0 0.0 0 0.0 1 6.5
0 0.0 0 0.0 0 0.0 17 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 134 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.7 0 0.0 0 0.0 0 0.0 1 5.9
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 1 5.3 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 1 5.3
0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 246 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 314 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 1 6.5 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 221 0.0 0.0 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 3.2 0 0.0 1 2.0 18 1 5.7 1 5.7 0 0.0 0 0.0 0 0.0 171 0.0 0.0 0.0 0.0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 0 0.0 1 5.7
0 0.0 0 0.0 0 0.0 34 0 0.0 1 2.9 1 2.9 0 0.0 1 2.9 264 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.3 1 0.3 0 0.0 1 0.3 3 8.8
0 0.0 1 4.8 1 2.3 18 1 5.7 1 5.7 2 11.4 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 1 0.5 1 0.5 2 1.1 0 0.0 0 0.0 3 17.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 1 6.5 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 1 6.5
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 1 9.1 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.9 0 0.0 0 0.0 1 9.1
1 0.2 1 0.2 2 0.2 378 6 1.6 6 1.6 5 1.3 0 0.0 3 0.8 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 0.2 6 0.2 5 0.1 0 0.0 3 0.1 14 3.7
IMUNISASI
Jumlah dosis
Imunisasi Tgl. Cara Pemberian (Intra kutan, Lokasi
Tgl Jam No. Batch VVM vaksin (ml /
(Vaksin) Kadaluarsa Sub-kutan, IM, tetes) penyuntikan
tetes)

PERSE
JUMLAH DAN PERSENTASE IBU HAMIL DIIMUNISASI JUMLAH DAN PERSENTASE WUS TIDAK HAMIL DIIMUNISASI JUMLAH TOTAL DAN PERSENTASE WUS (HAMIL+TIDAK HAMIL) DIITT2+ BUMIL
NTASE
SASARA
CAMPAK TT1 TT2 TT3 TT4 TT5 WUS TT1 TT2 TT3 TT4 TT5 TT1 TT2 TT3 TT4 TT5 TT2+
N BUMIL
TDK
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
HAMIL
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 1 1.8 1 1.1 44 4 9.1 0 0.0 0 0.0 0 0.0 0 0.0 412 0 0.0 0.0 0.0 0.0 0.0 4 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 1 5.0 0 0.0 0 0.0 2 10.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 2 1.2 0 0.0 2 10.0
0 0.0 0 0.0 0 0.0 30 1 3.3 2 6.7 0 0.0 0 0.0 0 0.0 233 0.0 0.0 0.0 0.0 0.0 1 0.4 2 0.8 0 0.0 0 0.0 0 0.0 2 6.7
0 0.0 0 0.0 0 0.0 15 1 6.5 1 6.5 0 0.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 0 0.0 1 6.5
0 0.0 0 0.0 0 0.0 17 1 5.9 0 0.0 0 0.0 0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 1 0.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 19 1 5.3 2 10.5 0 0.0 0 0.0 0 0.0 142 0.0 0.0 0.0 0.0 0.0 1 0.6 2 1.2 0 0.0 0 0.0 0 0.0 2 10.5
0 0.0 0 0.0 0 0.0 32 2 6.3 0 0.0 0 0.0 0 0.0 0 0.0 246 0.0 0.0 0.0 0.0 0.0 2 0.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 41 2 4.9 0 0.0 0 0.0 0 0.0 0 0.0 314 0 0.0 0.0 0.0 0.0 0.0 2 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 1 3.4 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 1 3.4
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 171 0.0 0.0 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 1.8 0 0.0 1 0.9 34 1 2.9 1 2.9 1 2.9 0 0.0 0 0.0 264 0.0 0.0 0.0 0.0 0.0 1 0.3 1 0.3 1 0.3 0 0.0 0 0.0 2 5.9
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 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 6.3 0 0.0 1 2.2 15 0 0.0 0 0.0 0 0.0 0 0.0 1 6.5 153 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 1 6.5
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 0.4 1 0.2 3 0.3 378 14 3.7 6 1.6 2 0.5 2 0.5 1 0.3 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 14 0.4 6 0.2 2 0.1 2 0.1 1 0.0 11 2.9
IMUNISASI
Jumlah dosis
tetes)

PERSE
NTASE
SASARA
N BUMIL
TDK
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
HAMIL
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 412 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.0 1 5.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 2 10.0
0 0.0 0 0.0 0 0.0 30 1 3.3 1 3.3 0 0.0 0 0.0 0 0.0 233 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1 3.3
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 1 6.5 154 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 1 6.5
0 0.0 0 0.0 0 0.0 17 0 0.0 1 5.9 0 0.0 0 0.0 0 0.0 134 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.7 0 0.0 0 0.0 0 0.0 1 5.9
0 0.0 0 0.0 0 0.0 19 0 0.0 2 10.5 0 0.0 0 0.0 0 0.0 142 0.0 0.0 0.0 0.0 0.0 0 0.0 2 1.2 0 0.0 0 0.0 0 0.0 2 10.5
0 0.0 0 0.0 0 0.0 32 0 0.0 1 3.1 3 9.4 0 0.0 1 3.1 246 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 3 1.1 0 0.0 1 0.4 5 15.6
0 0.0 0 0.0 0 0.0 41 1 2.4 0 0.0 1 2.4 0 0.0 0 0.0 314 0.0 0.0 0.0 0.0 0.0 1 0.3 0 0.0 1 0.3 0 0.0 0 0.0 1 2.4
0 0.0 0 0.0 0 0.0 20 1 5.1 0 0.0 2 10.1 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 2 1.0 0 0.0 0 0.0 2 10.1
0 0.0 0 0.0 0 0.0 15 1 6.5 3 19.5 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 1 0.6 3 1.9 0 0.0 0 0.0 0 0.0 3 19.5
0 0.0 0 0.0 0 0.0 29 2 6.9 0 0.0 1 3.4 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 2 0.8 0 0.0 1 0.4 0 0.0 0 0.0 1 3.4
0 0.0 0 0.0 0 0.0 18 0 0.0 1 5.7 0 0.0 0 0.0 0 0.0 171 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 5.7
0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 3 8.8 0 0.0 1 2.9 264 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 3 1.0 0 0.0 1 0.3 4 11.8
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 2 11.4 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 1.1 0 0.0 0 0.0 2 11.4
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 378 6 1.6 10 2.6 13 3.4 0 0.0 3 0.8 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 0.2 10 0.3 13 0.4 0 0.0 3 0.1 26 6.9
IMUNISASI
Jumlah dosis
tetes)

PERSE
NTASE
SASARA
N BUMIL
TDK
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
HAMIL
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 412 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 233 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 154 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 134 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 142 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 246 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 314 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 221 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 171 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 264 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 378 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI
Jumlah dosis
tetes)

PERSE
NTASE
SASARA
N BUMIL
TDK
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
HAMIL
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 412 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 233 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 246 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 314 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 1 6.5 3 19.5 0 0.0 0 0.0 146 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 3 1.9 0 0.0 0 0.0 4 26.0
0 0.0 0 0.0 0 0.0 29 1 3.4 0 0.0 0 0.0 0 0.0 0 0.0 221 0 0.0 0.0 0.0 0.0 0.0 1 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 18 0 0.0 0 0.0 1 5.7 0 0.0 1 5.7 171 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 1 0.5 2 11.4
0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 264 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 1 6.5 0 0.0 0 0.0 0 0.0 2 13.0 153 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 2 1.2 2 13.0
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 378 2 0.5 1 0.3 4 1.1 0 0.0 3 0.8 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 0.1 1 0.0 4 0.1 0 0.0 3 0.1 8 2.1
IMUNISASI
Jumlah dosis
tetes)

PERSE
NTASE
SASARA
N BUMIL
TDK
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
HAMIL
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 5 11.4 1 2.3 1 2.3 0 0.0 0 0.0 412 0.0 0.0 0.0 0.0 0.0 5 1.1 1 0.2 1 0.2 0 0.0 0 0.0 2 4.5
0 0.0 0 0.0 0 0.0 20 1 5.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 30 1 3.3 1 3.3 0 0.0 0 0.0 0 0.0 233 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 0 0.0 1 3.3
0 0.0 0 0.0 0 0.0 15 1 6.5 0 0.0 2 13.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 2 1.2 0 0.0 0 0.0 2 13.0
0 0.0 0 0.0 0 0.0 17 0 0.0 1 5.9 1 5.9 0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.7 1 0.7 0 0.0 0 0.0 2 11.8
0 0.0 0 0.0 0 0.0 19 1 5.3 2 10.5 0 0.0 0 0.0 0 0.0 142 0.0 0.0 0.0 0.0 0.0 1 0.6 2 1.2 0 0.0 0 0.0 0 0.0 2 10.5
0 0.0 0 0.0 0 0.0 32 1 3.1 0 0.0 1 3.1 0 0.0 0 0.0 246 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 1 0.4 0 0.0 0 0.0 1 3.1
1 2.6 0 0.0 1 1.4 41 0 0.0 1 2.4 1 2.4 0 0.0 0 0.0 314 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.3 1 0.3 0 0.0 0 0.0 2 4.9
0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.1 1 5.1 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 2 10.1
0 0.0 0 0.0 0 0.0 15 1 6.5 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 3 10.3 1 3.4 0 0.0 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 3 1.2 1 0.4 0 0.0 0 0.0 0 0.0 1 3.4
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 1 5.7 0 0.0 0 0.0 171 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 1 5.7
0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 2 5.9 1 2.9 1 2.9 264 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 0.7 1 0.3 1 0.3 4 11.8
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 1 6.5 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 6.5
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 1 9.1 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.9 0 0.0 0 0.0 1 9.1
1 0.2 0 0.0 1 0.1 378 14 3.7 9 2.4 11 2.9 1 0.3 1 0.3 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 14 0.4 9 0.3 11 0.3 1 0.0 1 0.0 22 5.8
IMUNISASI
Jumlah dosis
tetes)

PERSE
NTASE
SASARA
N BUMIL
TDK
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
HAMIL
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 1 2.3 1 2.3 0 0.0 0 0.0 0 0.0 412 0.0 0.0 0.0 0.0 0.0 1 0.2 1 0.2 0 0.0 0 0.0 0 0.0 1 2.3
0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.0 1 5.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 2 10.0
0 0.0 0 0.0 0 0.0 30 1 3.3 1 3.3 1 3.3 2 6.7 0 0.0 233 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 1 0.4 2 0.8 0 0.0 4 13.3
1 4.3 0 0.0 1 2.4 15 0 0.0 1 6.5 0 0.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 1 6.5
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 1 5.9 0 0.0 134 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.7 0 0.0 1 5.9
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 1 5.3 0 0.0 1 5.3 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 1 0.6 2 10.5
1 3.0 0 0.0 1 1.5 32 1 3.1 2 6.3 0 0.0 0 0.0 0 0.0 246 0.0 0.0 0.0 0.0 0.0 1 0.4 2 0.7 0 0.0 0 0.0 0 0.0 2 6.3
0 0.0 0 0.0 0 0.0 41 2 4.9 0 0.0 2 4.9 0 0.0 0 0.0 314 0.0 0.0 0.0 0.0 0.0 2 0.6 0 0.0 2 0.6 0 0.0 0 0.0 2 4.9
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0 0.0 1 3.4 2 6.9 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 2 0.8 0 0.0 0 0.0 3 10.3
0 0.0 0 0.0 0 0.0 18 1 5.7 0 0.0 0 0.0 0 0.0 1 5.7 171 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 0.5 1 5.7
0 0.0 1 1.7 1 0.9 34 1 2.9 0 0.0 1 2.9 0 0.0 1 2.9 264 0.0 0.0 0.0 0.0 0.0 1 0.3 0 0.0 1 0.3 0 0.0 1 0.3 2 5.9
1 4.5 0 0.0 1 2.3 18 0 0.0 0 0.0 0 0.0 0 0.0 1 5.7 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 1 5.7
0 0.0 0 0.0 0 0.0 15 1 6.5 1 6.5 2 13.0 0 0.0 2 13.0 153 0.0 0.0 0.0 0.0 0.0 1 0.6 1 0.6 2 1.2 0 0.0 2 1.2 5 32.5
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 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 0.7 1 0.2 4 0.4 378 8 2.1 8 2.1 10 2.6 3 0.8 6 1.6 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 0.2 8 0.2 10 0.3 3 0.1 6 0.2 27 7.1
IMUNISASI
Jumlah dosis
tetes)

PERSE
NTASE
SASARA
N BUMIL
TDK
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
HAMIL
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 3 6.8 0 0.0 0 0.0 0 0.0 0 0.0 412 1 0.2 0.0 0.0 0.0 0.0 4 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 6.5 0 0.0 2 2.9 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 233 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 3 8.6 3 4.4 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 246 0.0 0.0 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 2.6 0 0.0 1 1.4 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 314 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 171 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 1.7 1 0.9 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 264 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 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 0.7 4 0.9 7 0.8 378 3 0.8 0 0.0 0 0.0 0 0.0 0 0.0 3199 1 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 0.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI
Jumlah dosis
tetes)

PERSE
NTASE
SASARA
N BUMIL
TDK
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
HAMIL
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 412 0.0 0.0 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 4.3 0 0.0 1 2.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 233 0.0 0.0 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 4.3 0 0.0 1 2.4 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 154 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 142 0.0 0.0 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 1 1.5 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 246 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 5.6 2 2.7 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 314 0.0 0.0 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 3.1 0 0.0 1 1.7 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 171 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 264 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 0.9 2 0.4 6 0.7 378 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI
Jumlah dosis
tetes)

PERSE
NTASE
SASARA
N BUMIL
TDK
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
HAMIL
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 412 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 2.6 1 1.4 30 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 233 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 8.7 1 5.3 3 7.1 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 154 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 7.7 1 2.9 17 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 134 0.0 0.0 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 5.3 0 0.0 1 2.9 19 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 142 0.0 0.0 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 9.1 2 5.7 5 7.4 32 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 246 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 41 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 314 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 20 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 187 0.0 0.0 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 4.0 0 0.0 1 2.3 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 29 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 171 0.0 0.0 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 1.8 0 0.0 1 0.9 34 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 264 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0.0 0.0 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 6.3 0 0.0 1 2.2 15 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 153 0.0 0.0 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 11.1 0 0.0 1 4.5 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
10 2.2 5 1.1 15 1.6 378 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
IMUNISASI
Jumlah dosis
tetes)

PERSE
NTASE
SASARA
N BUMIL
TDK
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
HAMIL
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 1 1.8 1 1.1 44 1 2.3 3 6.8 2 4.5 0 0.0 4 9.1 412 0.0 0.0 0.0 0.0 0.0 1 0.2 3 0.7 2 0.4 0 0.0 4 0.9 9 20.5
0 0.0 0 0.0 0 0.0 20 1 5.0 0 0.0 3 15.0 1 5.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 3 1.7 1 0.6 0 0.0 4 20.0
0 0.0 0 0.0 0 0.0 30 2 6.7 0 0.0 0 0.0 0 0.0 3 10.0 233 0 0.0 0.0 0.0 0.0 0.0 2 0.8 0 0.0 0 0.0 0 0.0 3 1.1 3 10.0
1 4.3 1 5.3 2 4.8 15 0 0.0 1 6.5 2 13.0 0 0.0 1 6.5 154 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.6 2 1.2 0 0.0 1 0.6 4 26.0
1 4.5 2 15.4 3 8.6 17 1 5.9 0 0.0 0 0.0 1 5.9 0 0.0 134 0.0 0.0 0.0 0.0 0.0 1 0.7 0 0.0 0 0.0 1 0.7 0 0.0 1 5.9
0 0.0 3 18.8 3 8.6 19 0 0.0 0 0.0 2 10.5 0 0.0 0 0.0 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 2 1.2 0 0.0 0 0.0 2 10.5
0 0.0 0 0.0 0 0.0 32 0 0.0 1 3.1 1 3.1 0 0.0 0 0.0 246 0 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.4 1 0.4 0 0.0 0 0.0 2 6.3
0 0.0 0 0.0 0 0.0 41 3 7.3 0 0.0 2 4.9 0 0.0 0 0.0 314 0.0 0.0 0.0 0.0 0.0 3 0.8 0 0.0 2 0.6 0 0.0 0 0.0 2 4.9
0 0.0 2 7.4 2 3.4 20 0 0.0 1 5.1 5 25.3 0 0.0 1 5.1 187 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 5 2.4 0 0.0 1 0.5 7 35.4
0 0.0 0 0.0 0 0.0 15 1 6.5 0 0.0 1 6.5 0 0.0 2 13.0 146 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 1 0.6 0 0.0 2 1.2 3 19.5
0 0.0 0 0.0 0 0.0 29 1 3.4 1 3.4 2 6.9 1 3.4 2 6.9 221 0.0 0.0 0.0 0.0 0.0 1 0.4 1 0.4 2 0.8 1 0.4 2 0.8 6 20.7
0 0.0 2 11.1 2 4.1 18 1 5.7 3 17.0 1 5.7 0 0.0 0 0.0 171 0.0 0.0 0.0 0.0 0.0 1 0.5 3 1.6 1 0.5 0 0.0 0 0.0 4 22.7
0 0.0 2 3.3 2 1.7 34 2 5.9 2 5.9 0 0.0 0 0.0 1 2.9 264 0 0.0 0.0 0.0 0.0 0.0 2 0.7 2 0.7 0 0.0 0 0.0 1 0.3 3 8.8
0 0.0 0 0.0 0 0.0 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 170 0 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 15 1 6.5 1 6.5 0 0.0 0 0.0 1 6.5 153 0.0 0.0 0.0 0.0 0.0 1 0.6 1 0.6 0 0.0 0 0.0 1 0.6 2 13.0
0 0.0 0 0.0 0 0.0 11 0 0.0 1 9.1 1 9.1 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.9 1 0.9 0 0.0 0 0.0 2 18.2
2 0.4 13 2.8 15 1.6 378 14 3.7 14 3.7 22 5.8 3 0.8 15 4.0 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 14 0.4 14 0.4 22 0.6 3 0.1 15 0.4 54 14.3
IMUNISASI
Jumlah dosis
tetes)

PERSE
NTASE
SASARA
N BUMIL
TDK
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
HAMIL
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 0 0.0 0 0.0 44 2 4.5 2 4.5 1 2.3 0 0.0 0 0.0 412 0 0.0 0.0 0.0 0.0 0.0 2 0.4 2 0.4 1 0.2 0 0.0 0 0.0 3 6.8
0 0.0 0 0.0 0 0.0 20 1 5.0 0 0.0 1 5.0 1 5.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 1 0.6 1 0.6 0 0.0 2 10.0
0 0.0 1 2.6 1 1.4 30 1 3.3 2 6.7 0 0.0 0 0.0 0 0.0 233 0 0.0 0.0 0.0 0.0 0.0 1 0.4 2 0.8 0 0.0 0 0.0 0 0.0 2 6.7
1 4.3 1 5.3 2 4.8 15 1 6.5 0 0.0 3 19.5 0 0.0 0 0.0 154 0 0.0 0.0 0.0 0.0 0.0 1 0.6 0 0.0 3 1.8 0 0.0 0 0.0 3 19.5
0 0.0 0 0.0 0 0.0 17 0 0.0 0 0.0 1 5.9 0 0.0 0 0.0 134 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 1 0.7 0 0.0 0 0.0 1 5.9
1 5.3 0 0.0 1 2.9 19 0 0.0 0 0.0 0 0.0 1 5.3 0 0.0 142 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 1 5.3
1 3.0 0 0.0 1 1.5 32 0 0.0 2 6.3 0 0.0 0 0.0 1 3.1 246 0.0 0.0 0.0 0.0 0.0 0 0.0 2 0.7 0 0.0 0 0.0 1 0.4 3 9.4
1 2.6 0 0.0 1 1.4 41 0 0.0 1 2.4 0 0.0 0 0.0 1 2.4 314 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.3 0 0.0 0 0.0 1 0.3 2 4.9
0 0.0 0 0.0 0 0.0 20 0 0.0 1 5.1 0 0.0 0 0.0 0 0.0 187 0.0 0.0 0.0 0.0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 5.1
0 0.0 1 5.3 1 2.3 15 2 13.0 0 0.0 0 0.0 0 0.0 0 0.0 146 0.0 0.0 0.0 0.0 0.0 2 1.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 2 5.3 2 2.7 29 1 3.4 0 0.0 1 3.4 0 0.0 0 0.0 221 0.0 0.0 0.0 0.0 0.0 1 0.4 0 0.0 1 0.4 0 0.0 0 0.0 1 3.4
0 0.0 0 0.0 0 0.0 18 1 5.7 0 0.0 0 0.0 0 0.0 1 5.7 171 0.0 0.0 0.0 0.0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 1 0.5 1 5.7
0 0.0 0 0.0 0 0.0 34 1 2.9 0 0.0 1 2.9 0 0.0 1 2.9 264 0.0 0.0 0.0 0.0 0.0 1 0.3 0 0.0 1 0.3 0 0.0 1 0.3 2 5.9
0 0.0 0 0.0 0 0.0 18 2 11.4 0 0.0 0 0.0 1 5.7 0 0.0 170 0.0 0.0 0.0 0.0 0.0 2 1.1 0 0.0 0 0.0 1 0.5 0 0.0 1 5.7
0 0.0 0 0.0 0 0.0 15 3 19.5 1 6.5 0 0.0 0 0.0 0 0.0 153 0.0 0.0 0.0 0.0 0.0 3 1.8 1 0.6 0 0.0 0 0.0 0 0.0 1 6.5
0 0.0 0 0.0 0 0.0 11 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 100 0.0 0.0 0.0 0.0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 0.9 5 1.1 9 1.0 378 15 4.0 9 2.4 8 2.1 3 0.8 4 1.1 3199 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 15 0.4 9 0.3 8 0.2 3 0.1 4 0.1 24 6.3
IMUNISASI
Jumlah dosis
tetes)

PERSE
NTASE
SASARA
N BUMIL
TDK
#L % #P % # JML % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # % # %
HAMIL
102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
0 0.0 2 3.6 2 2.2 44 16 36.4 7 15.9 4 18,3 0 0.0 4 9.1 412 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 17 3.7 7 1.5 4 0.9 0 0.0 4 0.9 15 34.1
1 4.3 0 0.0 1 2.0 20 4 20.0 3 15.0 6 30.0 4 20.0 0 0.0 153 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 2.3 3 1.7 6 3.5 4 2.3 0 0.0 13 65.0
2 6.5 2 5.3 4 5.8 30 8 26.7 7 23.3 2 6.7 2 6.7 3 10.0 233 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 3.0 7 2.7 2 0.8 2 0.8 3 1.1 14 46.7
6 26.1 3 15.8 9 21.4 15 5 32.5 4 26.0 7 45.5 0 0.0 2 13.0 154 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 2.9 4 2.4 7 4.1 0 0.0 2 1.2 13 84.4
1 4.5 3 23.1 4 11.4 17 2 11.8 3 17.6 2 11.8 2 11.8 0 0.0 134 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 1.3 3 2.0 2 1.3 2 1.3 0 0.0 7 41.2
2 10.5 3 18.8 5 14.3 19 2 10.5 6 31.6 3 15.8 1 5.3 2 10.5 142 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 1.2 6 3.7 3 1.9 1 0.6 2 1.2 12 63.2
6 18.2 5 14.3 11 16.2 32 4 12.5 6 18.8 5 15.6 0 0.0 2 6.3 246 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 1.4 6 2.2 5 1.8 0 0.0 2 0.7 13 40.6
3 7.9 2 5.6 5 6.8 41 8 19.5 2 4.9 6 14.6 0 0.0 1 2.4 314 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 2.3 2 0.6 6 1.7 0 0.0 1 0.3 9 22.0
1 3.1 2 7.4 3 5.1 20 1 5.1 3 15.2 8 40.4 0 0.0 1 5.1 187 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 3 1.5 8 3.9 0 0.0 1 0.5 12 60.6
1 4.0 1 5.3 2 4.5 15 6 39.0 4 26.0 4 26.0 0 0.0 2 13.0 146 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 3.7 4 2.5 4 2.5 0 0.0 2 1.2 10 64.9
0 0.0 2 5.3 2 2.7 29 8 27.6 3 10.3 7 24.1 1 3.4 2 6.9 221 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 8 3.2 3 1.2 7 2.8 1 0.4 2 0.8 13 44.8
1 3.2 2 11.1 3 6.1 18 4 22.7 5 28.4 3 17.0 0 0.0 3 17.0 171 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 2.1 5 2.7 3 1.6 0 0.0 3 1.6 11 62.5
2 3.6 4 6.7 6 5.2 34 5 14.7 4 11.8 9 26.5 1 2.9 6 17.6 264 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 5 1.7 4 1.3 9 3.0 1 0.3 6 2.0 20 58.8
1 4.5 1 4.8 2 4.7 18 3 17.0 1 5.7 4 22.7 1 5.7 1 5.7 170 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 1.6 1 0.5 4 2.1 1 0.5 1 0.5 7 39.8
2 12.5 0 0.0 2 4.3 15 6 39.0 4 26.0 2 13.0 0 0.0 7 45.5 153 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 3.6 4 2.4 2 1.2 0 0.0 7 4.2 13 84.4
1 11.1 0 0.0 1 4.5 11 0 0.0 1 9.1 3 27.3 0 0.0 0 0.0 100 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.9 3 2.7 0 0.0 0 0.0 4 36.4
30 6.6 32 6.9 62 6.8 378 82 21.7 63 16.7 75 19.8 12 3.2 36 9.5 3199 1 0.0 0 0.0 0 0.0 0 0.0 0 0.0 83 2.3 63 1.8 75 2.1 12 0.3 36 1.0 186 49.2
HASIL CAKUPAN IMUNISASI PER DESA/KELURAHAN PUSKESMAS PALANGGA KABUPATEN / KOTA KONAWE SELATAN TAHUN 2
PUSKESMAS PALANGGA Warna Kuning yang diisi
BULAN JANUARI 2019
NO DESA / KELURAHAN JUMLAH PDDK THASIL IMUNISASI BAYI
BAYI BARU LAHIR SURVIVING INFANT
L P JLH L P JLH
1 2 3 4 5 6 7 8
1 KIAEA 1794 21 15 36 21 15 36
2 WATUDEMBA 665 11 6 17 11 6 17
3 AOSOLE 1018 9 11 20 9 11 20
4 ALAKAYA 669 10 8 18 10 8 18
5 WAWORAHA 583 5 8 13 5 8 13
6 KAPUJAYA 620 8 6 14 8 6 14
7 WAWOURU 1072 6 8 14 6 8 14
8 MEKAR SARI 1367 16 10 26 16 10 26
9 WATUMEREMBE 814 5 12 17 5 12 17
10 EEWA 636 7 9 16 7 9 16
11 ONEMBUTE 960 10 8 18 10 8 18
12 ANGGONDARA 741 4 6 10 4 6 10
13 KEL.PALANGGA 1148 23 17 40 23 17 40
14 WAWONGGURA 740 10 8 18 10 8 18
15 SANGGI-SANGGI 666 14 7 21 14 7 21
16 UPT.TOLIHE 436 1 7 8 1 7 8
PALANGGA 13929 160 146 306 160 146 306

No. Jenis Vaksin / Alat S Stock Bln Lalu Penerimaan BlJumlah Pemakaian Bln
Sisa Bln ini Permintaan
I. VAKSIN
1 Vak. BCG 10 10 20 6 14 -8
2 Vak. DPT-HB 0 0 0 0 0 0
3 Vak. DPT-HB-Hib 14 15 29 21 8 13
4 Vak. POLIO 9 20 29 17 12 5
5 Vak. CAMPAK 45 0 45 9 36 -27
6 Vak. HB. UNIJECT 0 100 100 12 88 -76
7 Vak. TT 21 10 31 8 23 -15
II. ALAT SUNTIK
1 ADS 5 ml 33 20 53 15 38 -23
2 ADS 0,5 ml 117 200 317 137 180 -43
3 ADS 0,0 5 ml 104 100 204 19 185 -166
4 Safety Box 5 liter 0 0 0 0
5 Safety Box 0,25 liter 0 0 0
ONAWE SELATAN TAHUN 2019.
HB0 (0<7 HARI) BCG POLIO1

#L % #P % # JML % #L % #P % # JML % #L %
9 10 11 12 13 14 15 16 17 18 19 20 21 22
1 4.7619 2 13.333 3 8.3333 1 4.761904762 1 21 2 5.5556 1 4.7619
0 0 0 0 0 0 1 9.090909091 0 0 1 5.8824 1 9.0909
1 11.111 1 9.0909 2 10 4 44.44444444 1 2.25 5 25 4 44.444
0 0 0 0 0 0 0 0 1 12.5 1 5.5556 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 1 16.66666667 1 6 2 14.286 1 16.667
0 0 0 0 0 0 1 6.25 0 0 1 3.8462 1 6.25
1 20 1 8.3333 2 11.765 0 0 0 ### 0 0 0 0
0 0 1 11.111 1 6.25 0 0 0 ### 0 0 0 0
1 10 0 0 1 5.5556 0 0 2 25 2 11.111 0 0
0 0 0 0 0 0 2 50 1 2 3 30 2 50
1 4.3478 0 0 1 2.5 1 4.347826087 1 23 2 5 1 4.3478
0 0 1 12.5 1 5.5556 0 0 0 ### 0 0 0 0
0 0 1 14.286 1 4.7619 2 14.28571429 0 0 2 9.5238 2 14.286
0 0 0 0 0 0 0 0 0 ### 0 0 0 0
5 3.125 7 4.7945 12 3.9216 13 8.125 8 98.462 21 6.8627 13 8.125

No. Jenis Vaksin Jmlh Ckp. Dosis
1 BCG 21 dosis
2 DPT-HB 66 dosis
3 DPT-HB-Hib 75 dosis
4 POLIO 76 dosis
5 CAMPAK #REF! dosis
6 HB. UNIJECT 12 dosis
7 TT 20 dosis
DPT/HB-Hib (1) POLIO 2
#P % # JML % #L % #P % # JML % #L % #P %
23 24 25 26 27 28 29 30 31 32 33 34 35 36
1 6.6667 2 5.5556 0 0 1 6.6667 1 2.7778 0 0 1 6.6667
0 0 1 5.8824 1 9.0909 1 16.667 2 0 1 9.0909 1 16.667
1 9.0909 5 25 1 11.111 1 9.0909 2 10 1 11.111 1 9.0909
1 12.5 1 5.5556 2 20 1 12.5 3 16.667 2 20 1 12.5
0 0 0 0 1 20 0 0 1 7.6923 1 20 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 12.5 2 14.286 0 0 2 25 2 14.286 0 0 2 25
0 0 1 3.8462 1 6.25 1 10 2 7.6923 1 6.25 1 10
0 0 0 0 1 20 0 0 1 5.8824 1 20 0 0
0 0 0 0 2 28.571 0 0 2 12.5 2 28.571 0 0
2 25 2 11.111 2 20 0 0 2 11.111 2 20 0 0
1 16.667 3 30 0 0 1 16.667 1 10 0 0 1 16.667
1 5.8824 2 5 0 0 4 23.529 4 10 0 0 4 23.529
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 2 9.5238 0 0 0 0 0 0 0 0 0 0
0 0 0 0 2 200 0 0 2 25 2 200 0 0
8 5.4795 21 6.8627 13 8.125 12 8.2192 25 8.1699 13 8.125 12 8.2192
LAPORAN COLD CHAIN

Jmlh Vak. Di Pakai I.P No. Jenis Cold Chain Jumlah Keadaan
6 Ampul 3.5 Baik Rusak
0 Vial ### 1 Lemari ES
21 Vial 3.5714 2 M. Freezer
17 Vial 4.4706 3 V. Crrier
9 Vial #REF! 4 Thermos
12 Buah 1
8 Vial 2.5 MENGETAHUI :
Kepala Puskesmas Palangga.Kab.Konawe selatan.
Amrin,S.Kep
Nip.196506021987031017
DPT-HB-HIB 2 POLIO 3
# JML % #L % #P % # JML % #L % #P % # JML %
37 38 39 40 41 42 43 44 45 46 47 48 49 50
1 2.7778 0 0 1 6.6667 1 2.7778 0 0 1 6.6667 1 2.7778
2 11.765 1 9.0909 0 0 1 5.8824 1 9.0909 0 0 1 5.8824
2 10 0 0 0 0 0 0 0 0 0 0 0 0
3 16.667 1 10 0 0 1 5.5556 1 10 0 0 1 5.5556
1 7.6923 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 2 33.333 2 14.286 0 0 2 33.333 2 14.286
2 14.286 0 0 2 25 2 14.286 0 0 2 25 2 14.286
2 7.6923 2 12.5 0 0 2 7.6923 2 12.5 0 0 2 7.6923
1 5.8824 1 20 0 0 1 5.8824 1 20 0 0 1 5.8824
2 12.5 0 0 0 0 0 0 0 0 0 0 0 0
2 11.111 0 0 0 0 0 0 0 0 0 0 0 0
1 10 1 25 2 33.333 3 30 1 25 2 33.333 3 30
4 10 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 12.5 1 5.5556 0 0 1 12.5 1 5.5556
0 0 2 14.286 0 0 2 9.5238 2 14.286 0 0 2 9.5238
2 25 1 100 0 0 1 12.5 1 100 0 0 1 12.5
25 8.1699 9 5.625 8 5.4795 17 5.5556 9 5.625 8 5.4795 17 5.5556
Palangga.Kab.Konawe selatan..
DPT/HB-Hib (3) POLIO4 IPV
#L % #P % # JML % #L % #P % # JML % #L %
51 52 53 54 55 56 57 58 59 60 61 62 63 64
0 0 1 6.6667 1 2.7778 0 0 1 6.6667 1 2.7778 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 22.222 1 9.0909 3 15 2 22.222 1 9.0909 3 15 2 22.222
0 0 2 25 2 11.111 0 0 2 25 2 11.111 0 0
1 20 1 12.5 2 15.385 1 20 1 12.5 2 15.385 1 20
0 0 1 16.667 1 7.1429 0 0 1 16.667 1 7.1429 0 0
1 16.667 0 0 1 7.1429 1 16.667 0 0 1 7.1429 1 16.667
1 6.25 0 0 1 3.8462 1 6.25 0 0 1 3.8462 1 6.25
1 20 0 0 1 5.8824 1 20 0 0 1 5.8824 0 0
1 14.286 0 0 1 6.25 1 14.286 0 0 1 6.25 1 14.286
1 10 0 0 1 5.5556 1 10 0 0 1 5.5556 1 10
1 25 2 33.333 3 30 1 25 2 33.333 3 30 1 25
3 13.043 3 17.647 6 15 3 13.043 3 17.647 6 15 3 13.043
1 10 1 12.5 2 11.111 1 10 1 12.5 2 1 1 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 8.125 12 8.2192 25 8.1699 13 8.125 12 8.2192 25 8.1699 12 7.5
Palangga ...................................................2019 IDENTITAS DIDUGA KIPI (1)

Koordinator Jurim Puskesmas Palangga 1 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
Nip. 19730720 199502 1001 6 Nama ibu :
7 Alamat :
a. Jalan ………………………… Nomor …
b. Dusun/Kampung…………….. Desa/
c. Kecamatan ………………….. Kabupa
CAMPAK IMUNISASI DASAR LENGKAP
#P % # JML % #L % #P % # JML % #L % #P %
65 66 67 68 69 70 71 72 73 74 75 76 77 78
1 6.6667 1 2.7778 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 9.0909 3 15 0 0 3 27.273 3 15 0 0 3 27.273
2 25 2 11.111 0 0 0 0 0 0 0 0 0 0
1 12.5 2 15.385 0 0 3 37.5 3 23.077 0 0 3 37.5
1 16.667 1 7.1429 0 0 0 0 0 0 0 0 0 0
0 0 1 7.1429 1 16.667 0 0 1 7.1429 1 16.667 0 0
0 0 1 3.8462 0 0 1 10 1 3.8462 0 0 1 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 1 6.25 1 14.286 0 0 1 6.25 1 14.286 0 0
0 0 1 5.5556 0 0 1 12.5 1 5.5556 0 0 1 12.5
2 33.333 3 30 0 0 1 16.667 1 10 0 0 1 16.667
3 17.647 6 15 1 4.3478 0 0 1 2.5 1 4.3478 0 0
1 12.5 2 11.111 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 7.1429 0 0 1 4.7619 1 7.1429 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 8.2192 24 7.8431 4 2.5 9 6.1644 13 4.2484 4 2.5 9 6.1644
IMUNISASI
Imunisasi (VaksTgl Jam No. Batch
n ………………………… Nomor …. RT/RW ………………. Reaksi timbul pada tgl ..........................................

un/Kampung…………….. Desa/Kelurahan ………………… Gejala & Waktu timbulnya gejala ..............................................
amatan ………………….. Kabupaten …………………………
vinsi Sulawesi Tenggara
dara kandung :
SASARAN BATITA DPT/HB/Hib CAMPAK
# JML % L P JLH #L % #P % # JML % #L % #P %
79 80 93 94 95 96 97 98 99 100 101 102 103 104 105
0 0 37 56 93 0 0 0 0 0 0 0 0 0 0
0 0 23 27 50 1 4.348 1 3.704 2 4 0 0 0 0
3 15 31 38 69 1 3.226 0 0 1 1.449 0 0 0 0
0 0 23 19 42 0 0 0 0 0 0 0 0 0 0
3 23.077 22 13 35 0 0 0 0 0 0 0 0 0 0
0 0 19 16 35 0 0 1 6.25 1 2.857 0 0 0 0
1 7.1429 33 35 68 1 3.03 1 2.857 2 2.941 0 0 0 0
1 3.8462 38 36 74 3 7.895 0 0 3 4.054 0 0 0 0
0 0 32 27 59 0 0 0 0 0 0 0 0 0 0
1 6.25 25 19 44 0 0 0 0 0 0 0 0 0 0
1 5.5556 35 38 73 0 0 0 0 0 0 0 0 0 0
1 10 31 18 49 2 6.452 0 0 2 4.082 1 3.226 0 0
1 2.5 56 60 116 0 0 0 0 0 0 0 0 0 0
0 0 22 21 43 0 0 0 0 0 0 0 0 1 4.762
1 4.7619 16 30 46 1 6.25 0 0 1 2.174 0 0 0 0
0 0 9 13 22 0 0 0 0 0 0 0 0 0 0
13 4.2484 452 466 918 9 1.991 3 0.644 12 1.307 1 0.221 1 0.215
IMUNISASI
hari, dari imunisasi terakhir) : Imunisasi terdahulu (lebih dari 30 hari, d
Tgl. Kadaluarsa : Imunisasi (VakTgl
:
:
:
:
:
........................ Jalan ………………………… Nomor …. RT/RW ………………. Reaksi timbul pada tgl ...........................
..............................................
Dusun/Kampung…………….. Desa/Kelurahan ………………… Gejala & Waktu timbulnya gejala .........
SASARAJUMLAH DAN PERSENTASE IBU HAMIL DIIMUNISASI JMLH &JUMLAH DAN PERSENTASE
TT1 TT2 TT3 TT4 TT5 TT1
# JML % # % # % # % # % # % # %
106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121
0 0 39.6 0 0 0 0 0 0 0 0 0 0 392.9 0
0 0 20 0 0 1 5 0 0 0 0 0 0 145.6 0
0 0 30 1 3.333 0 0 1 3.333 0 0 0 0 222.9 0
0 0 19.8 2 10.1 1 5.051 0 0 0 0 0 0 146.5 0
0 0 17 0 0 1 5.882 0 0 0 0 0 0 127.7 0 0
0 0 19 0 0 0 0 0 0 0 0 1 5.263 135.8 0
0 0 32 0 0 0 0 0 0 0 0 0 0 234.8 0
0 0 41 0 0 0 0 0 0 0 0 0 0 299.4 0
0 0 18.7 0 0 0 0 0 0 0 0 0 0 178.3 0
0 0 17.6 1 5.682 0 0 0 0 0 0 0 0 139.3 0
0 0 29 0 0 0 0 0 0 0 0 0 0 210.2 0
1 2.041 11 1 9.091 1 9.091 0 0 0 0 0 0 162.3 0
0 0 34 0 0 1 2.941 1 2.941 0 0 1 2.941 251.4 0
1 2.326 19.8 1 5.051 1 5.051 2 10.1 0 0 0 0 162.1 0
0 0 23.1 0 0 0 0 0 0 0 0 1 4.329 145.9 0
0 0 8.8 0 0 0 0 1 11.36 0 0 0 0 95.48 0
2 0.218 380.4 6 1.577 6 1.577 5 1.314 0 0 3 0.789 3050 0 0
terdahulu (lebih dari 30 hari, dari imunisasi terakhir)

Jam No. Batch Tgl. Kadaluars VVM Cara Pemberian (Intra kutan,Jumlah dosis vLokasi penyuntikan
mbul pada tgl ..........................................

Waktu timbulnya gejala .........................................................
MLAH DAN PERSENTASE WUS TIDAK HAMIL DIIMUNISASI JUMLAH TOTAL DAN PERSENTASE WUS (HAMIL+TIDAK HAMIL) DIIMU
TT2 TT3 TT4 TT5 TT1 TT2 TT3 TT4
# % # % # % # % # % # % # % # %
122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 0.604 0 0 0 0
0 0 0 0 1 0.395 0 0 1 0.395 0 0
0 0 0 0 2 1.203 1 0.601 0 0 0 0
0 0 0 0 0 0 1 0.691 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 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 0.637 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0.577 1 0.577 0 0 0 0
0 0 0 0 0 0 1 0.35 1 0.35 0 0
0 0 0 0 1 0.55 1 0.55 2 1.1 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0.959 0 0
0 0 0 0 0 0 0 0 6 0.175 6 0.175 5 0.146 0 0
MIL+TIDAK HAMIL) DIIMUNITT2+ BUMIL
TT5 TT2+
# % # %
138 139 140 141
0 0 0 0
0 0 1 5
0 0 1 3.333
0 0 1 5.051
0 0 1 5.882
1 0.646 1 5.263
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1 9.091
1 0.35 3 8.824
0 0 3 15.15
1 0.592 1 4.329
0 0 1 11.36
3 0.087 14 3.68
#REF! #REF! Warna Kuning yang diisi
JUMLAH SURVIVING INFANT

DESA / PDDK BAYI BARU LAHIR
NO (0 - 11 BLN
KELURAHAN TAHUN
2017 L P JLH L P JLH
1 2 3 4 5 6 7 8
1 #REF! 1,881 21 20 42 20 20 40
2 #REF! 697 8 8 16 7 7 14
3 #REF! 1,066 12 12 24 11 11 22
4 #REF! 704 8 8 16 7 7 14
5 #REF! 611 7 7 14 6 6 14
6 #REF! 650 7 7 14 7 7 14
7 #REF! 1,125 13 12 25 12 12 24
8 #REF! 1,433 16 16 32 15 15 30
9 #REF! 854 10 9 19 9 9 18
10 #REF! 666 8 7 15 7 7 14
11 #REF! 1,007 11 11 22 11 10 21
12 #REF! 779 9 8 17 8 8 16
13 #REF! 1,204 14 13 27 13 13 26
14 #REF! 776 9 8 17 8 8 16
15 #REF! 698 8 8 16 7 7 14
16 #REF! 457 5 5 10 5 5 10
#REF! 14,608 166 159 326 153 152 307
1

I. VAKSIN
1 Vak. BCG 18 - 18 10 8 2
2 Vak. DPT-HB - - - - - -
3 Vak. DPT-HB-Hib 37 - 37 27 10 17
4 Vak. POLIO 32 - 32 15 17 (2)
5 Vak. CAMPAK 14 - 14 12 2 10
6 Vak. HB. UNIJECT 61 - 61 19 42 (23)
7 Vak. TT 15 - 15 15 - 15
II. ALAT SUNTIK
1 ADS 5 ml 10 20 30 22 8 14
2 ADS 0,5 ml 180 200 380 233 147 86
3 ADS 0,0 5 ml 176 100 276 22 254 (232)
HB0 (0<7 HARI) BCG
#L % #P % # JML % #L % #P %
9 10 11 12 13 14 15 16 17 18
1 5.0 1 5.0 2 5.0 0 0.0 1 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 0.0 1 9.1 3 13.6 2 18.2 4 22.0
0 0.0 0 0.0 0 0.0 0 0.0 1 0.0
0 0.0 0 0.0 0 0.0 1 16.7 0 0.0
1 14.3 0 0.0 1 7.1 0 0.0 2 0.0
0 0.0 1 8.3 1 4.2 1 8.3 1 0.0
0 0.0 3 20.0 3 10.0 1 6.7 1 15.0
1 11.1 0 0.0 1 0.0 0 0.0 0 #DIV/0!
1 14.3 1 14.3 2 14.3 1 14.3 1 0.0
0 0.0 0 0.0 0 0.0 1 9.1 0 0.0
1 12.5 1 12.5 2 12.5 2 25.0 2 0.0
1 7.7 0 0.0 1 3.8 2 15.4 2 0.0
1 12.5 0 0.0 1 6.3 0 0.0 0 0.0
1 14.3 1 14.3 2 14.3 1 14.3 1 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 #DIV/0!
10 6.5 9 5.9 19 6.2 12 7.8 16 204.0
No. Jenis Vaksin
1 BCG
2 DPT-HB
3 DPT-HB-Hib
4 POLIO
5 CAMPAK
6 HB. UNIJECT
7 TT
CG POLIO1 DPT/HB-Hib (1)
# JML % #L % #P % # JML % #L %
19 20 21 22 23 24 25 26 27 28
1 2.5 0 0.0 1 5.0 1 2.5 1 5.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 27.3 2 18.2 4 36.4 6 27.3 1 9.1
1 7.1 0 0.0 1 14.3 1 7.1 3 42.9
1 7.1 1 16.7 0 0.0 1 0.0 0 0.0
2 14.3 0 0.0 2 28.6 2 14.3 2 28.6
2 8.3 1 8.3 1 8.3 2 8.3 2 16.7
2 6.7 1 6.7 1 6.7 2 6.7 1 6.7
0 0.0 0 0.0 0 0.0 0 0.0 1 11.1
2 14.3 1 14.3 1 14.3 2 14.3 2 28.6
1 4.8 1 9.1 0 0.0 1 4.8 1 9.1
4 25.0 2 25.0 2 25.0 4 25.0 0 0.0
4 15.4 2 15.4 2 15.4 4 15.4 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 1 12.5
2 14.3 1 14.3 1 14.3 2 14.3 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
28 9.1 12 7.8 16 10.5 28 9.1 15 9.8
Vaksin Jmlh Ckp. Dosis Jmlh Vak. Di Pakai I.P
28 dosis 10 Ampul 2.8

94 dosis 27 Vial 3.48148148
#REF! dosis 12 Vial #REF!
1 dosis 19 Buah 0.05263158
68 dosis 15 Vial 4.53333333
DPT/HB-Hib (1) POLIO 2
#P % # JML % #L % #P % # JML %
29 30 31 32 33 34 35 36 37 38
1 5.0 2 5.0 1 5.0 1 5.0 2 5.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 9.1 2 9.1 1 9.1 1 9.1 2 9.1
1 14.3 4 28.6 3 42.9 1 14.3 4 28.6
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 14.3 3 21.4 2 28.6 1 14.3 3 21.4
1 8.3 3 12.5 2 16.7 1 8.3 3 12.5
1 6.7 2 6.7 1 6.7 1 6.7 2 6.7
0 0.0 1 5.6 1 11.1 0 0.0 1 0.0
0 0.0 2 14.3 2 28.6 0 0.0 2 14.3
0 0.0 1 4.8 1 9.1 0 0.0 1 4.8
1 12.5 1 6.3 0 0.0 1 12.5 1 6.3
3 23.1 3 11.5 0 0.0 3 23.1 3 11.5
1 12.5 2 12.5 1 12.5 1 12.5 2 12.5
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
11 7.2 26 8.5 15 9.8 11 7.2 26 8.5
LAPORAN COLD CHAIN
Jumlah Keadaan
(buah)
Baik Rusak
1 Lemari ES
2 M. Freezer
3 V. Crrier
4 Thermos
MENGETAHUI :
Amrin,S.Kep
Nip.196506021987031017
DPT/HB-Hib (2)
#L % #P % # JML %
39 40 41 42 43 44
4 20.0 1 5.0 5 12.5
0 0.0 0 0.0 0 0.0
1 9.1 0 0.0 1 4.5
2 28.6 2 28.6 4 28.6
0 0.0 0 0.0 0 0.0
1 14.3 0 0.0 1 7.1
3 25.0 2 16.7 5 20.8
2 13.3 2 13.3 4 13.3
3 33.3 0 0.0 3 16.7
0 0.0 2 28.6 2 14.3
1 9.1 1 10.0 2 9.5
0 0.0 0 0.0 0 0.0
1 7.7 1 7.7 2 7.7
0 0.0 2 25.0 2 12.5
1 14.3 2 28.6 3 21.4
0 0.0 0 0.0 0 0.0
19 12.4 15 9.9 34 11.1
POLIO 3 DPT/HB-Hib (3)
#L % #P % # JML % #L % #P %
45 46 47 48 49 50 51 52 53 54
4 20.0 1 5.0 5 12.5 1 5.0 6 30.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 9.1 0 0.0 1 4.5 0 0.0 1 9.1
2 28.6 2 28.6 4 28.6 1 14.3 0 0.0
0 0.0 0 0.0 0 0.0 1 16.7 1 16.7
1 14.3 0 0.0 1 7.1 0 0.0 1 14.3
3 25.0 2 16.7 5 20.8 0 0.0 0 0.0
2 13.3 2 13.3 4 13.3 1 6.7 2 13.3
3 33.3 0 0.0 3 16.7 0 0.0 1 11.1
0 0.0 2 28.6 2 14.3 0 0.0 2 28.6
1 9.1 1 10.0 2 9.5 0 0.0 1 10.0
0 0.0 0 0.0 0 0.0 2 25.0 1 12.5
1 7.7 1 7.7 2 7.7 2 15.4 2 15.4
0 0.0 2 25.0 2 12.5 1 12.5 2 25.0
1 14.3 2 28.6 3 21.4 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
19 12.4 15 9.9 34 11.1 9 5.9 20 13.2
Palangga, ………………….2019
Koordinator Jurim Puskesmas .Palangga.
Iwan Setiawan,SKM
Nip. 19730720 199502 1 001
B-Hib (3) POLIO4 IPV
# JML % #L % #P % # JML % #L %
55 56 57 58 59 60 61 62 63 64
7 17.5 1 5.0 6 30.0 7 17.5 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 4.5 0 0.0 1 9.1 1 4.5 0 0.0
1 7.1 1 14.3 0 0.0 1 7.1 0 0.0
2 14.3 1 16.7 1 16.7 2 14.3 0 0.0
1 7.1 0 0.0 1 14.3 1 7.1 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
3 10.0 1 6.7 2 13.3 3 10.0 0 0.0
1 5.6 0 0.0 1 11.1 1 5.6 0 0.0
2 14.3 0 0.0 2 28.6 2 14.3 0 0.0
1 4.8 0 0.0 1 10.0 1 4.8 0 0.0
3 18.8 2 25.0 1 12.5 3 18.8 0 0.0
4 15.4 2 15.4 2 15.4 4 15.4 0 0.0
3 18.8 1 12.5 2 25.0 3 18.8 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
29 9.4 9 5.9 20 13.2 29 9.4 0 0.0
………………….2019
or Jurim Puskesmas .Palangga. 1 Nama :
2 Kelamin :
3 Tggl / Lahir :
4 Umur :
5 Nama ayah :
0720 199502 1 001 6 Nama ibu :
7 Alamat :
a. Jalan ………………………… Nomor …. R
b. Dusun/Kampung…………….. Desa/Kelurahan
c. Kecamatan ………………….. Kabupaten ……
IPV CAMPAK
#P % # JML % #L % #P % # JML %
65 66 67 68 69 70 71 72 73 74
0 0.0 0 0.0 2 10.0 2 10.0 4 10.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 1 9.1 0 0.0 1 4.5
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 1 16.7 0 0.0 1 7.1
0 0.0 0 0.0 2 28.6 0 0.0 2 14.3
0 0.0 0 0.0 2 16.7 2 16.7 4 16.7
0 0.0 0 0.0 1 6.7 0 0.0 1 3.3
0 0.0 0 0.0 2 22.2 1 11.1 3 16.7
0 0.0 0 0.0 1 14.3 0 0.0 1 7.1
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 1 12.5 1 6.3
0 0.0 0 0.0 4 30.8 0 0.0 4 15.4
0 0.0 0 0.0 2 25.0 1 12.5 3 18.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 0 0.0 1 20.0 0 0.0 1 10.0
0 0.0 0 0.0 19 12.4 7 4.6 26 8.5
IMUNISASI
Imunisasi terdahulu (lebih dari 30 hari, dari imun
Imunisasi (Vaksin)
…………………… Nomor …. RT/RW ………………. Reaksi timbul pada tgl ........................................

pung…………….. Desa/Kelurahan ………………… Gejala & Waktu timbulnya gejala ......................
………………….. Kabupaten …………………………
awesi Tenggara
IDL SASARAN BATITA DP
#L % #P % # JML % L P JLH #L
75 76 77 78 79 80 93 94 95 96
2 10.0 2 10.0 4 10.0 #REF! #REF! #REF! 1
0 0.0 0 0.0 0 0.0 #REF! #REF! #REF! 0
1 9.1 0 0.0 1 4.5 #REF! #REF! #REF! 0
0 0.0 0 0.0 0 0.0 #REF! #REF! #REF! 0
1 16.7 0 0.0 1 7.1 #REF! #REF! #REF! 0
2 28.6 0 0.0 2 14.3 #REF! #REF! #REF! 0
2 16.7 2 16.7 4 16.7 #REF! #REF! #REF! 0
1 6.7 0 0.0 1 3.3 #REF! #REF! #REF! 1
2 22.2 1 11.1 3 16.7 #REF! #REF! #REF! 3
1 14.3 0 0.0 1 7.1 #REF! #REF! #REF! 1
0 0.0 0 0.0 0 0.0 #REF! #REF! #REF! 2
0 0.0 1 12.5 1 6.3 #REF! #REF! #REF! 0
4 30.8 0 0.0 4 15.4 #REF! #REF! #REF! 1
2 25.0 1 12.5 3 18.8 #REF! #REF! #REF! 0
0 0.0 0 0.0 0 0.0 #REF! #REF! #REF! 0
1 20.0 0 0.0 1 10.0 #REF! #REF! #REF! 0
19 12.4 7 4.6 26 8.5 #REF! #REF! #REF! 9
rdahulu (lebih dari 30 hari, dari imunisasi terakhir) :

:
Tgl Jam No. Batch Tgl. Kadaluarsa
:
:
:
:
:
ul pada tgl .......................................... Jalan ………………………… Nomor …. RT/RW ……………….
Waktu timbulnya gejala ......................................................... Dusun/Kampung…………….. Desa/Kelurahan …………………
DPT/HB/Hib
% #P % # JML %
97 98 99 100 101
#REF! 0 #REF! 1 #REF!
or …. RT/RW ……………….
Kelurahan …………………
paten …………………………
JUMLAH DAN PERSEN
CAMPAK SASARAN TT1 TT2
BUMIL
#L % #P % # JML % # % #
102 103 104 105 106 107 108 109 110 111
0 #REF! 1 #REF! 1 #REF! 44 1 2.3 3
0 #REF! 0 #REF! 0 #REF! 20 1 5.0 0
0 #REF! 0 #REF! 0 #REF! 30 2 6.7 0
1 #REF! 1 #REF! 2 #REF! 15 0 0.0 1
1 #REF! 2 #REF! 3 #REF! 17 1 5.9 0
0 #REF! 3 #REF! 3 #REF! 19 0 0.0 0
0 #REF! 0 #REF! 0 #REF! 32 0 0.0 1
0 #REF! 0 #REF! 0 #REF! 41 3 7.3 0
0 #REF! 2 #REF! 2 #REF! 20 0 0.0 1
0 #REF! 0 #REF! 0 #REF! 15 1 6.5 0
0 #REF! 0 #REF! 0 #REF! 29 1 3.4 1
0 #REF! 2 #REF! 2 #REF! 18 1 5.7 3
0 #REF! 2 #REF! 2 #REF! 34 2 5.9 2
0 #REF! 0 #REF! 0 #REF! 18 0 0.0 0
0 #REF! 0 #REF! 0 #REF! 15 1 6.5 1
0 #REF! 0 #REF! 0 #REF! 11 0 0.0 1
2 #REF! 13 #REF! 15 #REF! 378 14 3.7 14
IMUNISASI
Imunisasi (Vaksin) Tgl Jam No. Batch Tgl. Kadaluarsa VVM

JMLH &
JUMLAH DAN PERSENTASE IBU HAMIL DIIMUNISASI PERSENT JUMLAH DAN PE
TT2 TT3 TT4 TT5 ASE WUS TT1
TDK
HAMIL
% # % # % # % # %
DIIMUNIS
ASI
112 113 114 115 116 117 118 119 120 121
6.8 2 4.5 0 0.0 4 9.1 412 0.0
0.0 3 15.0 1 5.0 0 0.0 153 0.0
0.0 0 0.0 0 0.0 3 10.0 233 0 0.0
6.5 2 13.0 0 0.0 1 6.5 154 0.0
0.0 0 0.0 1 5.9 0 0.0 134 0.0
0.0 2 10.5 0 0.0 0 0.0 142 0.0
3.1 1 3.1 0 0.0 0 0.0 246 0 0.0
0.0 2 4.9 0 0.0 0 0.0 314 0.0
5.1 5 25.3 0 0.0 1 5.1 187 0.0
0.0 1 6.5 0 0.0 2 13.0 146 0.0
3.4 2 6.9 1 3.4 2 6.9 221 0.0
17.0 1 5.7 0 0.0 0 0.0 171 0.0
5.9 0 0.0 0 0.0 1 2.9 264 0 0.0
0.0 0 0.0 0 0.0 0 0.0 170 0 0.0
6.5 0 0.0 0 0.0 1 6.5 153 0.0
9.1 1 9.1 0 0.0 0 0.0 100 0.0
3.7 22 5.8 3 0.8 15 4.0 3199 0 0.0
Jumlah dosis vaksin

Cara Pemberian (Intra kutan, Sub-kutan, IM, tetes) Lokasi penyuntikan
(ml / tetes)
JUMLAH DAN PERSENTASE WUS TIDAK HAMIL DIIMUNISASI JUMLAH TOTAL DAN PERSENTASE WUS
TT2 TT3 TT4 TT5 TT1
# % # % # % # % # %
122 123 124 125 126 127 128 129 130 131
0.0 0.0 0.0 0.0 1 0.2
0.0 0.0 0.0 0.0 1 0.6
0.0 0.0 0.0 0.0 2 0.8
0.0 0.0 0.0 0.0 0 0.0
0.0 0.0 0.0 0.0 1 0.7
0.0 0.0 0.0 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 0.8
0.0 0.0 0.0 0.0 0 0.0
0.0 0.0 0.0 0.0 1 0.6
0.0 0.0 0.0 0.0 1 0.4
0.0 0.0 0.0 0.0 1 0.5
0.0 0.0 0.0 0.0 2 0.7
0.0 0.0 0.0 0.0 0 0.0
0.0 0.0 0.0 0.0 1 0.6
0.0 0.0 0.0 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 14 0.4
TOTAL DAN PERSENTASE WUS (HAMIL+TIDAK HAMIL) DIIMUNISASI TT TT2+ BUMIL
TT2 TT3 TT4 TT5 TT2+
# % # % # % # % # %
132 133 134 135 136 137 138 139 140 141
3 0.7 2 0.4 0 0.0 4 0.9 9 20.5
0 0.0 3 1.7 1 0.6 0 0.0 4 20.0
0 0.0 0 0.0 0 0.0 3 1.1 3 10.0
1 0.6 2 1.2 0 0.0 1 0.6 4 26.0
0 0.0 0 0.0 1 0.7 0 0.0 1 5.9
0 0.0 2 1.2 0 0.0 0 0.0 2 10.5
1 0.4 1 0.4 0 0.0 0 0.0 2 6.3
0 0.0 2 0.6 0 0.0 0 0.0 2 4.9
1 0.5 5 2.4 0 0.0 1 0.5 7 35.4
0 0.0 1 0.6 0 0.0 2 1.2 3 19.5
1 0.4 2 0.8 1 0.4 2 0.8 6 20.7
3 1.6 1 0.5 0 0.0 0 0.0 4 22.7
2 0.7 0 0.0 0 0.0 1 0.3 3 8.8
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
1 0.6 0 0.0 0 0.0 1 0.6 2 13.0
1 0.9 1 0.9 0 0.0 0 0.0 2 18.2
14 0.4 22 0.6 3 0.1 15 0.4 54 14.3

Softwere Laporan Puskesmas Tahun 2018

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HASIL CAKUPAN IMUNISASI PER DESA/KELURAHAN PUSKESMAS PALANGGA KABUPATEN / KOTA KONAWE SELATAN TAHUN 2014.

PUSKESMAS : PALANGGA Warna Kuning yang diisi

PUSKESMAS : PALANGGA Warna Kuning yang diisi

PUSKESMAS : PALANGGA Warna Kuning yang diisi

PUSKESMAS : PALANGGA Warna Kuning yang diisi

PUSKESMAS : PALANGGA Warna Kuning yang diisi

PUSKESMAS : PALANGGA Warna Kuning yang diisi

PUSKESMAS : PALANGGA Warna Kuning yang diisi

PUSKESMAS : PALANGGA Warna Kuning yang diisi

PUSKESMAS : PALANGGA Warna Kuning yang diisi

PUSKESMAS : PALANGGA Warna Kuning yang diisi

PUSKESMAS : PALANGGA Warna Kuning yang diisi

PUSKESMAS : PALANGGA Warna Kuning yang diisi

PUSKESMAS : PALANGGA Warna Kuning yang diisi

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIM

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIM

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIM

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIM

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIM

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIM

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIM

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIM

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIM

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIM

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

HASIL IMUNISASI BATITA JUMLAH DAN PERSENTASE IBU HAMIL DIIM

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % L P JLH #L % #P % # JML % #L % #P % # JML % # % # % # %

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Jenis Vaksin / Alat Suntik &

Jenis Vaksin / Alat Suntik &

Jenis Vaksin / Alat Suntik &

Jenis Vaksin / Alat Suntik &

Jenis Vaksin / Alat Suntik &

Jenis Vaksin / Alat Suntik &

Jenis Vaksin / Alat Suntik &

Jenis Vaksin / Alat Suntik &

Jenis Vaksin / Alat Suntik &

Jenis Vaksin / Alat Suntik &

Jenis Vaksin / Alat Suntik &

Jenis Vaksin / Alat Suntik &

Jenis Vaksin / Alat Suntik &

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Palangga, 29 Februari 2016

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Palangga, 30 April 2016

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Palangga, 30 Mei 2017

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Palangga, 31 Agustus 2017