REGISTER IBU NIFAS Lembar KIA - 12

PUSKESMAS : TUGARNI DESA : TUGARNI

ALAMAT : JL. AFU-AFU BIDAN :
TELP/FAX : BULAN : JUNI TAHUN : 2020

KF Integrasi program
Keadaan
Pelayanan Kecacin Hepatiti Pelayanan KB Komplikasi Dirujuk Ke

TB
KF 1 KF 2 KF 3 PPIA PMDK IMS
gan sB Tiba Pulang

Ibu hamil diobati kecacingan ***

Ibu hamil diobati Hepatitis B***

Ibu hamil diobati IMS***
SASARAN

Obat kina/ACT ***

Mendapatkan ART
Catat di Buku KIA
DESA

Obat TB***

Puskesmas

R. Bersalin

Meninggal

Meninggal
RSIA/RSB
Vit. A Ibu
BUFAS

Kondom

Lain-lain

Lain-lain
Absolut

Absolut

Absolut

Infeksi
Suntik

MOW

Hidup

Hidup
MOP
MAL

HDK
PPP
IUD
PIL

RS
%

%
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

AFU-AFU 6 0 0.00 0 0.00 1 16.67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

GUSIMAWA 9 0 0.00 0 0.00 1 11.11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAYEDA 8 0 0.00 1 12.50 3 37.50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

KOKOROBA 8 1 0.00 3 37.50 1 12.50 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2 0

MOYANA 5 1 20.00 1 20.00 0 0.00 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 1 0

WAINAGA 5 1 20.00 1 20.00 1 20.00 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 1 0

KENSI 5 1 20.00 1 20.00 0 0.00 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 1 0

MASKUR 4 0 0.00 0 0.00 0 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

ERIGARA 3 0 0.00 0 0.00 1 33.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

PIGO 4 0 0.00 0 0.00 0 0.00 0 0 0 0 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
57 4 7.02 7 12.28 8 14.04 5 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 5 0

Mengetahui Tugarni, 03 Juli 2020

Kepala Puskesmas Tugarni Yang Membuat Laporan
ARHAM WANIA, Amd. Kep HAMRIAH, S.ST
NIP. 19850305 201004 1 002 NIP. 19910524 201705 2 003