LAPORAN KEGIATAN ASUHAN GIZI RAWAT INAP

RSUD UNGARAN
BULAN JANUARI 2012

RUANG : BUGENVIL

No NAMA TGL LAHIR/UMUR CM INTERVENSI GIZI

1 BUDIMAN (TN) 58 Th 4 bln 482344 LUNAK DM, RG 1900 KKAL
2 SRI KARTINI (Ny) 66 Th 3 bln 156427 LUNAK DM, RG, RP 1700 KKAL
3 MARSIYAH (NY) 54 Th 8 bln 164771 LUNAK DM, RL 1500 KKAL
4 SARMINI (NY) 51 Th 9 bln 154771 LUNAK RG 1500 KKAL
5 WARSINO (TN) 56 Th 3 bln 170593 LUNAK DM 1500 KKAL
6 KAMSINAH(NY) 81 Th 8 bln 162926 LUNAK DM, RG 1300 KKAL
7 RUBAEDAH (NY) 60 Th 0 bln 170639 LUNAK DM 1500 KKAL
8 KAMDANAH (Ny) 56 Th 5 bln 170542 LUNAK DM, RL 1700 KKAL
9 WAIKEM (NY) 50 Th 5 bln 165884 LUNAK RG, RP 1500 KKAL
10 KASIJATI (Ny) 78 Th 0 bln 170718 LUNAK RG 1100 KKAL
11 NINIK INDRAWATI (NY) 56 Th 5 bln 149965 LUNAK DM 1500 KKAL
12 MUNTAMAH (Ny) 44 Th 1 bln 169786 LUNAK DM, UREMI 1700 KKAL
13 TUKIRAH (NY) 40 Th 0 bln 170964 LUNAK RG 1900 KKAL
14 ENDANG KINASIH (NY) 47 Th 0 bln 171018 LUNAK RG 1700 KKAL
15 SALAMAH (Ny) 65 Th 2 bln 121973 LUNAK DM, RG, RL 1500 KKAL
16 JUMEDI (TN) 58 Th 7 bln 536930 LUNAK DM 1900 KKAL
17 SIS ZARIANSYAH (TN) 44 Th 8 bln 170219 LUNAK DJ 1700 KKAL
18 SARWADI (TN) 52 Th 0 bln 170221 LUNAK DJ 1900 KKAL
19 SUKIRNO (TN) 49 Th 10 bln 105878 LUNAK DM, DJ 1900 KKAL
20 HERI SUBAGIYO (Tn) 52 Th 8 bln 465361 LUNAK DJ 1700 KKAL
21 SAKIJAN (Tn) 83 Th 10 bln 170246 LUNAK DJ 1500 KKAL
22 RAMISAH (NY) 68 Th 0 bln 104889 LUNAK DJ, RP 1300 KKAL
23 SUWARNO (TN) 42 Th 6 bln 170472 LUNAK DJ 1900 KKAL
24 SUMARMAN,AMD (Tn) 63 Th 6 bln 146324 LUNAK DJ, DM 1500 KKAL
25 DARTO WAHAB (BP) 43 Th 5 bln 483042 LUNAK DJ 1900 KKAL

Ungaran,
Mengetahui,
Kepala Instalasi Gizi Pelaksana Asuhan Gizi

Puji Astuti, SKM Suntari Yudiati, AMG

NIP. 19661006 199103 2 009 NIP. 19851024 201101 2 014
 LAPORAN KEGIATAN ASUHAN GIZI RAWAT INAP
RSUD UNGARAN
BULAN FEBRUARI 2012

RUANG : BUGENVIL

No NAMA TGL LAHIR/UMUR CM INTERVENSI GIZI

1 KALIYEM (NY) 79 Th 1 bln 171097 LUNAK DJ 1300 KKAL
2 SURIP (NY) 68 Th 6 bln 171137 LUNAK RG 1500 KKAL
3 RUBADI (TN) 52 Th 7 bln 153513 LUNAK DJ 1700 KKAL
4 SUNARNO [BP] 61 Th 6 bln 524742 LUNAK DJ 1500 KKAL
5 MUJIYATI (NY) 62 Th 0 bln 171257 LUNAK RG 1300 KKAL
6 NGADIRIN (TN) 55 Th 1 bln 171307 LUNAK RG, RL 1900 KKAL
7 MARKENI (Tn) 79 Th 10 bln 86393 LUNAK RG 1500 KKAL
8 SUWONDO (Tn) 74 Th 1 bln 98398 LUNAK RG 1500 KKAL
9 SAHRI (Tn) 62 Th 0 bln 171286 LUNAK DJ 1500 KKAL
10 DIDIK SETYANTO (Tn) 37 Th 4 bln 121183 LUNAK RG 1900 KKAL
11 NURHAYATI (Ny) 65 Th 6 bln 465276 LUNAK RG, RP 1300 KKAL
12 JANEM (NY) 81 Th 0 bln 100078 LUNAK RG, RL 1100 KKAL
13 NGADIMAH (NY) 64 Th 7 bln 174045 LUNAK TKTP 2100 KKAL
14 NGATINI (NY) 42 Th 10 bln 535844 LUNAK UREMI, RG 1900 KKAL
15 JUNAIDI (TN) 44 Th 6 bln 171503 LUNAK DJ 1900 KKAL
16 SUKINEM (Ny) 65 Th 4 bln 428576 LUNAK RG 1500 KKAL
17 AGUSTINUS SUMITRO (TN) 65 Th 5 bln 521353 LUNAK DJ 1900 KKAL
18 HIDAYATUN ROHMAN (Tn) 37 Th 6 bln 511262 LUNAK RG 1900 KKAL
19 SLAMET JUREMI (TN) 58 Th 0 bln 171596 LUNAK DJ 1700 KKAL
20 KADARWATI (Ny) 71 Th 7 bln 514710 LUNAK DJ 1500 KKAL
21 SADINA HARIJANTO (Tn) 67 Th 4 bln 129411 LUNAK DJ 1700 KKAL
22 PUJIYATI (NY) 55 Th 0 bln 171669 LUNAK RG 1900 KKAL
23 SISWO SUPENO (TN) 51 Th 0 bln 171765 LUNAK DJ 1900 KKAL
24 KASNI (NY) 65 Th 0 bln 90725 LUNAK RG 1500 KKAL
25 SUTIAH (NY) 50 Th 0 bln 171723 LUNAK RG 1500 KKAL

Ungaran,
Mengetahui,
Kepala Instalasi Gizi Pelaksana Asuhan Gizi

Puji Astuti, SKM Suntari Yudiati, AMG

NIP. 19661006 199103 2 009 NIP. 19851024 201101 2 014
 LAPORAN KEGIATAN ASUHAN GIZI RAWAT INAP
RSUD UNGARAN
BULAN MARET 2012

RUANG : BUGENVIL

No NAMA TGL LAHIR/UMUR CM INTERVENSI GIZI

1 ROSIDIN (Tn) 47 Th 1 bln 502324 LUNAK DJ 1900 KKAL
2 SAHRI (Tn) 62 Th 0 bln 171286 LUNAK DJ 1700 KKAL
3 KHOMSIYATUN (Ny) 55 Th 4 bln 513037 LUNAK DJ 1500 KKAL
4 KAMERUN (TN) 69 Th 2 bln 171894 NASI DM, RG 1700 KKAL
5 SARIDUN (TN) 56 Th 4 bln 171932 LUNAK RG, RL 1900 KKAL
6 YULIYATI (Ny) 61 Th 7 bln 499862 LUNAK DM 1500 KKAL
7 SRI KISWATI (Ny) 56 Th 11 bln 461319 LUNAK RG 1500 KKAL
8 SUYATI (NY) 61 Th 9 bln 526613 LUNAK DM 1300 KKAL
9 NGATIRAH (NY) 48 Th 9 bln 171930 LUNAK RG 1900 KKAL
10 ABDUL SALAM (TN) 63 Th 0 bln 171957 LUNAK DM, RG, RP 1500 KKAL
11 SATINEM (NY) 75 Th 0 bln 172062 LUNAK RG, RP 1300 KKAL
12 NGAESAH (NY) 78 Th 5 bln 168090 LUNAK DJ 1300 KKAL
13 HADI PURNOMO (TN) 55 Th 0 bln 172144 LUNAK RG, RL, RP 1900 KKAL
14 KARTI (NY) 56 Th 11 bln 151025 LUNAK DJ 1500 KKAL
15 MARKUS SLAMET (TN) 53 Th 2 bln 165758 LUNAK DM, UREMI 1700 KKAL
16 SUMANAH (NY) 65 Th 0 bln 172219 LUNAK RG, RL 1300 KKAL
17 TAMSURI (TN) 81 Th 2 bln 159862 NASI RG 1500 KKAL
18 JUMINAH (NY) 58 Th 0 bln 172418 CAIR RG, RL, RP 1100 KKAL
19 KASTAMAH (NY) 71 Th 2 bln 172357 LUNAK RG 1300 KKAL
20 NGATINI (NY) 42 Th 10 bln 535844 LUNAK UREMI 1700 KKAL
21 MACHMOED (Tn) 74 Th 7 bln 512349 LUNAK DJ 1500 KKAL
22 KASANAH (Ny) 76 Th 2 bln 134087 LUNAK DM 1300 KKAL
23 YUSTINA SUPARNI (NY) 43 Th 9 bln 523181 LUNAK RG 1500 KKAL
24 WASINAH (NY) 86 Th 0 bln 172170 LUNAK DIET LAMBUNG 1300 KKAL
25 SUDARMANTO (TN) 70 Th 6 bln 537935 LUNAK RG 1500 KKAL

Ungaran,
Mengetahui,
Kepala Instalasi Gizi Pelaksana Asuhan Gizi

Puji Astuti, SKM Suntari Yudiati, AMG

NIP. 19661006 199103 2 009 NIP. 19851024 201101 2 014
 LAPORAN KEGIATAN ASUHAN GIZI RAWAT INAP
RSUD UNGARAN
BULAN APRIL 2012

RUANG : BUGENVIL

No NAMA TGL LAHIR/UMUR CM INTERVENSI GIZI

1 MARIYATUN (NY) 55 Th 0 bln 172752 LUNAK RG, RP 1500 KKAL
2 MUKHAERI (TN) 53 Th 3 bln 172818 LUNAK RG 1500 KKAL
3 SULASIH (NY) 43 Th 0 bln 538508 LUNAK DIIT LAMBUNG 1900 KKAL
4 KUSRIPAH (NY) 83 Th 0 bln 173197 LUNAK RG 1300 KKAL
5 NGADIYAH (NY) 74 Th 10 bln 171660 LUNAK TKTP 1500 KKAL
6 EDI SETIYAWAN (TN) 51 Th 7 bln 76505 LUNAK RG, RL 1700 KKAL
7 SRI WATI (NY) 56 Th 11 bln 173012 LUNAK TKTP 1900 KKAL
8 HERI SUBAGIYO (Tn) 52 Th 11 bln 465361 LUNAK RG 1900 KKAL
9 MARYADI (TN) 37 Th 8 bln 524888 LUNAK TKTP 2100 KKAL
10 SUWITO (Tn) 70 Th 11 bln 67387 LUNAK DM 1500 KKAL
11 ZUBAEDAH (NY) 57 Th 1 bln 172232 LUNAK RG, RL, RP 1500 KKAL
12 RUMIYATI (NY) 42 Th 9 bln 173057 LUNAK RG 1900 KKAL
13 NGATINAH (NY) 37 Th 4 bln 173277 LUNAK TKTP 2100 KKAL
14 RUKINI (NY) 71 Th 3 bln 538147 LUNAK RG 1500 KKAL
15 BOTOK (NY) 70 Th 0 bln 172569 NASI RG 1300 KKAL
16 HERU SETIYADI (TN) 44 Th 1 bln 173229 LUNAK RG, RP 1900 KKAL
17 DWI HADI TYAS DEWI M (Ny) 48 Th 2 bln 492666 LUNAK RG 1900 KKAL
18 SABAN (Tn) 69 Th 10 bln 117043 LUNAK RG 1500 KKAL
19 BEJO (TN) 65 Th 0 bln 538852 LUNAK DIIT LAMBUNG 1500 KKAL
20 SATIRAH (Ny) 74 Th 3 bln 512476 LUNAK RG, RL 1300 KKAL
21 MUNTOFIAH (NY) 35 Th 10 bln 114068 LUNAK RG,RP 1900 KKAL
22 IMAM SOEGENG (TN) 66 Th 5 bln 172747 LUNAK DIET LAMBUNG 1500 KKAL
23 MUH NURACHMAN (TN) 32 Th 10 bln 172863 LUNAK DIET LAMBUNG, RG 1900 KKAL
24 ASMINAH (NY) HAJI 61 Th 6 bln 532684 LUNAK DIET LAMBUNG 1300 KKAL
25 MASYKURI (Tn) 76 Th 3 bln 491420 LUNAK RG 1500 KKAL

Ungaran,
Mengetahui,
Kepala Instalasi Gizi Pelaksana Asuhan Gizi

Puji Astuti, SKM Suntari Yudiati, AMG

NIP. 19661006 199103 2 009 NIP. 19851024 201101 2 014
 LAPORAN KEGIATAN ASUHAN GIZI RAWAT INAP
RSUD UNGARAN
BULAN MEI 2012

RUANG : BUGENVIL

No NAMA TGL LAHIR/UMUR CM INTERVENSI GIZI

1 SUSIDARTIN (Ny) 63 Th 4 bln 62955 LUNAK DIIT LAMBUNG 1100 KKAL
2 JIBIN (TN) 80 Th 0 bln 176727 LUNAK RG 1300 KKAL
3 SUSIYATI (NY) 44 Th 1 bln 539255 NASI RG 1900 KKAL
4 TURYONO (Tn) 70 Th 2 bln 60692 LUNAK RG 1300 KKAL
5 SURATI (NY) 76 Th 7 bln 156759 LUNAK RG, RP 1500 KKAL
6 MIYAH (NY) 55 Th 0 bln 173604 LUNAK DM, TKTP 1900 KKAL
7 KUSWATI (NY) 46 Th 2 bln 173722 LUNAK RG, RP 1900 KKAL
8 JAENAB (NY) 55 Th 0 bln 173800 LUNAK RG 1700 KKAL
9 WAKIMAN (Tn) 58 Th 5 bln 80136 LUNAK RG 1900 KKAL
10 MUHAMMAD KHOLIL (Tn) 36 Th 2 bln 123702 LUNAK DIIT LAMBUNG 1900 KKAL
11 KARSINAH (NY) 54 Th 1 bln 530000 LUNAK DM 1300 KKAL
12 TURYATI (NY) 35 Th 11 bln 539433 LUNAK TKTP 2100 KKAL
13 WINARMIYATI(NY) 47 Th 0 bln 173733 NASI RG 1900 KKAL
14 DEDI WASKITO (TN) 30 Th 5 bln 173766 LUNAK DM 1900 KKAL
15 SISMAN HADISISWAJA (TN) 75 Th 5 bln 173538 LUNAK TKTP 1900 KKAL
16 SARNO (TN) 77 Th 7 bln 173866 LUNAK TKTP 1900 KKAL
17 RUSMIYATI (NY) 57 Th 5 bln 173896 LUNAK RG, RL 1500 KKAL
18 ISANIYATI (NY) 42 Th 10 bln 177532 LUNAK RG, RP 1500 KKAL
19 ARI SUPRIYANTO (TN) 23 Th 11 bln 173917 LUNAK TKTP 2100 KKAL
20 SAMI (NY) 70 Th 0 bln 174040 LUNAK RG, RP 1100 KKAL
21 SRINI (Ny) 66 Th 10 bln 473054 NASI RG 1300 KKAL
22 NGADIMAH (NY) 64 Th 7 bln 174045 LUNAK TKTP 1700 KKAL
23 YANTO (TN) 46 Th 0 bln 174133 LUNAK RG, RL 1900 KKAL
24 SJAFI I SAMTUSI (TN) 47 Th 9 bln 174109 LUNAK TKTP 1700 KKAL
25 HENDRA WIBOWO (TN) 28 Th 11 bln 539784 LUNAK DM 1900 KKAL

Ungaran,
Mengetahui,
Kepala Instalasi Gizi Pelaksana Asuhan Gizi

Puji Astuti, SKM Suntari Yudiati, AMG

NIP. 19661006 199103 2 009 NIP. 19851024 201101 2 014
 LAPORAN KEGIATAN ASUHAN GIZI RAWAT INAP
RSUD UNGARAN
BULAN JUNI 2012

RUANG : BUGENVIL

No NAMA TGL LAHIR/UMUR CM INTERVENSI GIZI

1 AMIN SUTIKNO (TN) 28 Th 1 bln 174436 NASI RG 1900 KKAL
2 SUPADI (TN) 56 Th 7 bln 534251 LUNAK RG, RP 1700 KKAL
3 KUSMINI (NY) 93 Th 0 bln 174103 LUNAK RG, RP 1100 KKAL
4 CATUR TARUNO (TN) 47 Th 0 bln 174313 LUNAK RG, RL 1700 KKAL
5 LIESNAWATI (Ny) 44 Th 11 bln 435400 LUNAK R KOLESTEROL 1900 KKAL
6 SUPRIHADI BROTO (Tn) 62 Th 4 bln 401803 LUNAK RG, R KOL 1300 KKAL
7 ENDANG SRI REJEKI (Ny) 54 Th 5 bln 471817 NASI RG 1500 KKAL
8 HARJO SUTOYO (Tn) 77 Th 5 bln 123516 LUNAK RG 1500 KKAL
9 ESRI SUSIANTI (NY) 32 Th 3 bln 470303 LUNAK DIET LAMBUNG 1900 KKAL
10 LASENI (NY) 65 Th 8 bln 540361 LUNAK RG, RL 1100 KKAL
11 CUCUK SUTRISNO (Tn) 57 Th 3 bln 507820 LUNAK RG 1500 KKAL
12 SITI MARIYAH (NY) 70 Th 1 bln 540716 NASI RG 1100 KKAL
13 SLAMET ISMAN (TN) 61 Th 11 bln 530734 LUNAK RG, RP, RL 1500 KKAL
14 IMAM NOVIYANTO NUGROHO ( TN) 16 Th 7 bln 477162 LUNAK RENDAH KALORI 1500 KKAL
15 KURSINAH (NY) 74 Th 3 bln 175106 LUNAK DM 1300 KKAL
16 MARFUATUN (NY) 44 Th 10 bln 175188 LUNAK DIIT LAMBUNG 1700 KKAL
17 ROEKAYAH (Ny) 82 Th 5 bln 469525 LUNAK RG 1300 KKAL
18 SUMANTO (Tn) 47 Th 10 bln 509520 NASI RG 1900 KKAL
19 RIWAYATI (NY) 27 Th 6 bln 175020 LUNAK TKTP 2100 KKAL
20 SITI UTAMI (NY) 20 Th 10 bln 175780 LUNAK TKTP 2100 KKAL
21 PARIYANTO (TN) 29 Th 8 bln 176021 LUNAK DM 1900 KKAL
22 JUMINAH (Ny) 60 Th 2 bln 491491 LUNAK RG 1100 KKAL
23 MUHAMADIN (TN) 76 Th 0 bln 174901 LUNAK RG 1300 KKAL
24 AGUSTINA PARWIKI PUJIN LESTARI (NN) 21 Th 0 bln 540809 LUNAK DIET LAMBUNG 1900 KKAL
25 FEBE BETI LESTARI (NY) 39 Th 10 bln 175125 LUNAK DIET LAMBUNG 1900 KKAL

Ungaran,
Mengetahui,
Kepala Instalasi Gizi Pelaksana Asuhan Gizi

Puji Astuti, SKM Suntari Yudiati, AMG

NIP. 19661006 199103 2 009 NIP. 19851024 201101 2 014
 LAPORAN KEGIATAN ASUHAN GIZI RAWAT INAP
RSUD UNGARAN
BULAN JULI 2012

RUANG : BUGENVIL

No NAMA TGL LAHIR/UMUR CM INTERVENSI GIZI

1 MARJIAH (Ny) 67 Th 11 bln 142429 LUNAK RG 1300 KKAL
2 HARUM SUSANTI (NY) 43 Th 10 bln 460394 CAIR RG 1100 KKAL
3 AGUS SULISTIYONO (TN) 18 Th 8 bln 168680 LUNAK TKTP 2100 KKAL
4 DARTO WAHAB (BP) 43 Th 11 bln 483042 NASI RG 1900 KKAL
5 SUMARNI (NY) 41 Th 10 bln 103251 LUNAK RG, R KOL 1700 KKAL
6 YULIA MASTUR (NY) 43 Th 11 bln 541014 LUNAK DIET JANTUNG 1900 KKAL
7 ZUBAEDAH (Nn) 20 Th 2 bln 473735 NASI RG 1900 KKAL
8 JUNTARI (NY) 25 Th 5 bln 541108 LUNAK TKTP 2100 KKAL
9 SULAMI (NY) 52 Th 5 bln 160731 LUNAK RG 1500 KKAL
10 SITI UTAMI (NY) 20 Th 10 bln 175780 LUNAK TKTP 2100 KKAL
11 SAMSIAH (NY) 65 Th 0 bln 175438 LUNAK RG 1300 KKAL
12 SUGIYANTI (NY) 29 Th 10 bln 539934 LUNAK TINGGI PROTEIN 1900 KKAL
13 AULIA RAHMA PRATIWI (NN) 18 Th 6 bln 541177 LUNAK TKTP 1900 KKAL
14 SALBIYAH (NY) 69 Th 6 bln 175728 LUNAK RG, RL 1300 KKAL
15 SUHAYIN (TN) 60 Th 0 bln 175824 LUNAK RG 1500 KKAL
16 SRIANAH (NY) 51 Th 6 bln 540992 LUNAK RG, RP 1700 KKAL
17 SUYITNO (TN) 55 Th 4 bln 175839 LUNAK DIET JANTUNG 1700 KKAL
18 TUWUH (NY) 52 Th 0 bln 522455 LUNAK RG 1500 KKAL
19 WASINAH (Ny) 56 Th 5 bln 112116 NASI RG 1500 KKAL
20 SOFIATUN (NY) 37 Th 6 bln 175755 LUNAK RG, RP, RL 1700 KKAL
21 DARWATI (NY) 48 Th 9 bln 171414 LUNAK RG, RP 1700 KKAL
22 DARSAN(TN) 80 Th 0 bln 175449 LUNAK RG 1300 KKAL
23 KUKOH SANTOSO (TN) 39 Th 5 bln 160288 NASI RG 1900 KKAL
24 NASIKUN (TN) 43 Th 11 bln 175514 LUNAK RG, UREMI 1900 KKAL
25 SUBADI ABDUL ROHMAN (Tn) 75 Th 4 bln 502149 LUNAK RG, R KOL 1300 KKAL

Ungaran,
Mengetahui,
Kepala Instalasi Gizi Pelaksana Asuhan Gizi

Puji Astuti, SKM Suntari Yudiati, AMG

NIP. 19661006 199103 2 009 NIP. 19851024 201101 2 014
 LAPORAN KEGIATAN ASUHAN GIZI RAWAT INAP
RSUD UNGARAN
BULAN AGUSTUS 2012

RUANG : BUGENVIL

No NAMA TGL LAHIR/UMUR CM INTERVENSI GIZI

1 RUSMADAK (Tn) 71 Th 4 bln 512591 LUNAK TKTP 1900 KKAL
2 SULASTRI (Ny) 55 Th 11 bln 493377 LUNAK DM 1500 KKAL
3 ROHMAN (Tn) 52 Th 0 bln 512404 LUNAK TKTP 1900 KKAL
4 WAHINI (NY) 54 Th 2 bln 173801 LUNAK DM 1500 KKAL
5 LILIK UMATUL K (NY) 40 Th 11 bln 541650 LUNAK DM 1700 KKAL
6 TURMUDI (TN) 37 Th 0 bln 176322 LUNAK RG, RP 1900 KKAL
7 SARTINAH (NY) 42 Th 6 bln 176333 LUNAK RG 1700 KKAL
8 HARTI (NY) 61 Th 0 bln 176296 LUNAK TKTP 1900 KKAL
9 DJUMADI ( BP) 66 Th 7 bln 541638 LUNAK DIET JANTUNG 1500 KKAL
10 SUMIYEM (NY) 70 Th 0 bln 176328 LUNAK RG 1300 KKAL
11 ABU NAIM (Tn) 68 Th 0 bln 66118 LUNAK TINGGI PROTEIN 1500 KKAL
12 KARTINI (NY) 61 Th 5 bln 176465 LUNAK RG, RP 1300 KKAL
13 LASIYEM (NY) 87 Th 8 bln 176411 LUNAK RG 1300 KKAL
14 TOEMADI (TN) 69 Th 1 bln 176610 NASI RG 1500 KKAL
15 YATINI (NY) 57 Th 5 bln 529351 CAIR RG, RL 1100 KKAL
16 JUMIRAH (NY) 48 Th 0 bln 73334 LUNAK DM 1900 KKAL
17 SUTIPAH (Ny) 66 Th 3 bln 87207 LUNAK TKTP 1900 KKAL
18 SUNARTI (NY) 37 Th 6 bln 541840 LUNAK DM, RL 1900 KKAL
19 NGATMI (NY) 42 Th 1 bln 493724 LUNAK RG 1700 KKAL
20 EKA KRISTIAN (NY) 22 Th 0 bln 541923 NASI RL 1900 KKAL
21 NUR ROCHMAN (Tn) 46 Th 8 bln 121517 LUNAK DM 1900 KKAL
22 ANTONI SIBOROK (TN) 37 Th 0 bln 176931 LUNAK RG 1900 KKAL
23 MURWATI (Ny) 40 Th 1 bln 456682 LUNAK DIET LAMBUNG 1900 KKAL
24 RUKINI (NY) 37 Th 0 bln 177447 LUNAK DIET LAMBUNG, RG 1900 KKAL
25 HENDRI IKROM MAKDUM JATI (TN) 32 Th 9 bln 542496 LUNAK DIET LAMBUNG 1900 KKAL

Ungaran,
Mengetahui,
Kepala Instalasi Gizi Pelaksana Asuhan Gizi

Puji Astuti, SKM Suntari Yudiati, AMG

NIP. 19661006 199103 2 009 NIP. 19851024 201101 2 014
 LAPORAN KEGIATAN ASUHAN GIZI RAWAT INAP
RSUD UNGARAN
BULAN SEPTEMBER 2012

RUANG : BUGENVIL

No NAMA TGL LAHIR/UMUR CM INTERVENSI GIZI

1 SRI WAHYUNI (NY) 59 Th 10 bln 69817 LUNAK DIET JANTUNG 1500 KKAL
2 ANIS TANJUNG CATUR PAMUNGKAS (Tn) 19 Th 9 bln 140001 LUNAK TINGGI PROTEIN 1900 KKAL
3 IKA DWI ARNI (NY) 26 Th 4 bln 468826 LUNAK RG, RP 1900 KKAL
4 JUMERI (TN) 47 Th 0 bln 176932 LUNAK TKTP 2100 KKAL
5 PARINDUN (NY) 52 Th 0 bln 177048 LUNAK DIET JANTUNG 1700 KKAL
6 SUTRISNO (TN) 56 Th 8 bln 177055 LUNAK RG, RP 1500 KKAL
7 MEI INDRAWATI[NY] 44 Th 3 bln 520913 LUNAK RG 1700 KKAL
8 MARJIDAH (NY) 48 Th 2 bln 174831 NASI RG 1500 KKAL
9 ROSARIA DWI KARTIKA PUTRI (NY) 29 Th 3 bln 171373 LUNAK DIIT LAMBUNG 1900 KKAL
10 HALIMATUS SA`DIYAH (NY) 31 Th 3 bln 176234 LUNAK TKTP 2100 KKAL
11 SOMAD (TN) 70 Th 0 bln 177389 LUNAK RG 1500 KKAL
12 RANTIYEM (NY) 62 Th 2 bln 102211 LUNAK DM, RG 1100 KKAL
13 DJUMIRAH (NY) 77 Th 8 bln 177364 LUNAK RG, RG, RL 1300 KKAL
14 MARTINUS SUPRIYONO (TN) 63 Th 7 bln 528141 LUNAK DM 1500 KKAL
15 SUYATI (Ny) 56 Th 4 bln 404894 LUNAK DM, RP 1500 KKAL
16 UMAROH (NY) 56 Th 0 bln 177638 LUNAK TINGGI PROTEIN 1700 KKAL
17 NINIK WAHYUNINGRUM(NY) 43 Th 4 bln 89083 LUNAK DM 1900 KKAL
18 KADIYEM (NY) 77 Th 2 bln 177669 LUNAK TKTP 1900 KKAL
19 SETIYATI (Ny) 68 Th 9 bln 10485 LUNAK DM, RL 1300 KKAL
20 SRI DARYUNI (NY) 59 Th 2 bln 83554 CAIR DM, RL 1100 KKAL
21 SAMINEM (NY) 66 Th 8 bln 176757 LUNAK RG 1300 KKAL
22 EKA KRISTIAN (NY) 22 Th 0 bln 541923 LUNAK RENDAH KALORI 1300 KKAL
23 TEGAR DADI PRAKOSO (TN) 16 Th 0 bln 176820 LUNAK TKTP 2100 KKAL
24 SUYATMI (NY) 45 Th 1 bln 460907 LUNAK DM 1700 KKAL
25 RUBIYANTO (BP) 50 Th 3 bln 542029 LUNAK DM 1900 KKAL

Ungaran,
Mengetahui,
Kepala Instalasi Gizi Pelaksana Asuhan Gizi

Puji Astuti, SKM Suntari Yudiati, AMG

NIP. 19661006 199103 2 009 NIP. 19851024 201101 2 014
 LAPORAN KEGIATAN ASUHAN GIZI RAWAT INAP
RSUD UNGARAN
BULAN OKTOBER 2012

RUANG : BUGENVIL

No NAMA TGL LAHIR/UMUR CM INTERVENSI GIZI

1 BACHTIAR ARIFIN (TN) PBI 58 Th 1 bln 528944 LUNAK DM 1700 KKAL
2 DODIK GUNAWAN (TN) 34 Th 11 bln 177721 LUNAK RG 1900 KKAL
3 IWANG PUSPO AJI (TN) 17 Th 5 bln 480012 LUNAK TKTP 2100 KKAL
4 EDUARDUS VICTOR WIDIYANTO (TN) 40 Th 11 bln 177753 LUNAK TKTP 1900 KKAL
5 SITI CHOTIAH (NY) 45 Th 7 bln 460862 LUNAK DM, RG 1900 KKAL
6 HARLAN SUPRIYANTO (BP) 47 Th 0 bln 535241 LUNAK TKTP 1900 KKAL
7 SUWARDI (Tn) 68 Th 10 bln 109647 LUNAK DM 1500 KKAL
8 SUDARYANI (NY) 38 Th 0 bln 178027 LUNAK TKTP 2100 KKAL
9 SULASIH(NY) 65 Th 0 bln 178086 LUNAK RG, RL 1300 KKAL
10 SOEMINI (NY) 78 Th 0 bln 178010 LUNAK DM, RG, RL 1300 KKAL
11 SUMIYATI (NY) 41 Th 4 bln 527884 LUNAK RG 1900 KKAL
12 SUWARSITO (Tn) 24 Th 5 bln 510952 LUNAK DIIT LAMBUNG 1900 KKAL
13 ISMU PANDOYO (TN) 38 Th 0 bln 151073 LUNAK DIIT LAMBUNG 1900 KKAL
14 ALFIDA SAHARA (NN) 20 Th 5 bln 543232 LUNAK RG 1900 KKAL
15 MARDJUKI (TN) 55 Th 11 bln 177979 LUNAK RG 1700 KKAL
16 KOMARI (TN) 54 Th 0 bln 178311 LUNAK DM 1700 KKAL
17 EKA YULIYANA (NN) 18 Th 3 bln 178324 NASI RG 1900 KKAL
18 GIYONO (TN) 40 Th 0 bln 178063 LUNAK DM, UREMI 1900 KKAL
19 SUKANDI (Tn) 60 Th 11 bln 146021 LUNAK DM 1500 KKAL
20 SADAD (TN) 72 Th 5 bln 173935 LUNAK TKTP 1900 KKAL
21 AGUS SUGIRI (Tn) 52 Th 1 bln 67679 LUNAK DM 1500 KKAL
22 SUDI PARDI (TN) 55 Th 0 bln 178702 LUNAK DM, RG 1700 KKAL
23 MARMAN (Tn) 65 Th 6 bln 154007 LUNAK RG, RL 1500 KKAL
24 SUMIAH (Ny) 76 Th 0 bln 124167 LUNAK RG 1300 KKAL
25 SUWARNO (TN) 60 Th 0 bln 178481 LUNAK RG, RP 1500 KKAL

Ungaran,
Mengetahui,
Kepala Instalasi Gizi Pelaksana Asuhan Gizi

Puji Astuti, SKM Suntari Yudiati, AMG

NIP. 19661006 199103 2 009 NIP. 19851024 201101 2 014
 LAPORAN KEGIATAN ASUHAN GIZI RAWAT INAP
RSUD UNGARAN
BULAN NOVEMBER 2012

RUANG : BUGENVIL

No NAMA TGL LAHIR/UMUR CM INTERVENSI GIZI

1 SUHADI (TN) 58 Th 6 bln 177509 LUNAK RG, RL 1700 KKAL
2 LASIMAN (Tn) AW 58 Th 9 bln 519361 LUNAK DM, RP 1500 KKAL
3 RATISAN (Ny) 71 Th 7 bln 489298 LUNAK TKTP 1900 KKAL
4 YULIYATI (Ny) 62 Th 3 bln 499862 LUNAK DM 1300 KKAL
5 KAMSINI (NY) 51 Th 5 bln 163523 LUNAK RG, RL 1500 KKAL
6 KUSWATI RAHAYU (Ny) 64 Th 0 bln 400812 LUNAK DM, RG, RP 1300 KKAL
7 SADIRAN (TN) 80 Th 8 bln 178812 LUNAK TKTP 1900 KKAL
8 SAMSUL KANI (TN) 49 Th 9 bln 417726 NASI RG 1900 KKAL
9 SITI RUSIKAH (Ny) 63 Th 6 bln 136647 LUNAK DM, RL 1300 KKAL
10 KOMSAH (NY) 55 Th 0 bln 179059 LUNAK DM 1500 KKAL
11 YASMI (NY) 34 Th 1 bln 543748 LUNAK DM 1900 KKAL
12 SRI SUNDARI (NY) 62 Th 7 bln 525049 LUNAK DM, RP, RL 1300 KKAL
13 NGATINAH (NY) 61 Th 5 bln 178949 LUNAK DM, RL 1100 KKAL
14 JOKO SANTOSO (BP) 52 Th 3 bln 536461 LUNAK DM 1500 KKAL
15 SUNARDI [TN] 58 Th 9 bln 527187 LUNAK DIET JANTUNG 1700 KKAL
16 LESTARI (NY) 52 Th 7 bln 179217 LUNAK TINGGI PROTEIN 1500 KKAL
17 TARMINI (NY) 45 Th 0 bln 178759 NASI DM 1900 KKAL
18 KUSMINI (Ny) 46 Th 11 bln 467265 NASI DM, RL 1700 KKAL
19 AMSURI (Tn) 60 Th 10 bln 484506 LUNAK DM, RL 1500 KKAL
20 NOERJANTO (Tn) 69 Th 4 bln 478010 LUNAK DM 1300 KKAL
21 SITI PARTIMAH (Ny) 77 Th 10 bln 457646 NASI RG 1300 KKAL
22 MUHAMAD AL IKSAN (TN) 17 Th 0 bln 179271 LUNAK DM 1900 KKAL
23 SAMSUDIN [BP] 52 Th 6 bln 522830 LUNAK RG 1700 KKAL
24 SULISTIYONO (Tn) 49 Th 0 bln 473523 LUNAK DM, RG 1900 KKAL
25 JUMINAH (NY) 50 Th 0 bln 179288 LUNAK DM 1700 KKAL

Ungaran,
Mengetahui,
Kepala Instalasi Gizi Pelaksana Asuhan Gizi

Puji Astuti, SKM Suntari Yudiati, AMG

NIP. 19661006 199103 2 009 NIP. 19851024 201101 2 014
 LAPORAN KEGIATAN ASUHAN GIZI RAWAT INAP
RSUD UNGARAN
BULAN DESEMBER 2012

RUANG : BUGENVIL

No NAMA TGL LAHIR/UMUR CM INTERVENSI GIZI

1 SUNARTI (NY) 61 Th 5 bln 463399 LUNAK DM 1300 KKAL
2 SLAMET ISMAN (TN) 62 Th 4 bln 530734 LUNAK UREMI 1500 KKAL
3 PAULUS BARATA (TN) 46 Th 0 bln 179958 LUNAK DM, RG 1900 KKAL
4 RIDWAN (BP) 71 Th 11 bln 543140 LUNAK TKTP 1900 KKAL
5 YULIAMISARI MARTARAHAYU (NY) 22 Th 4 bln 179883 LUNAK TKTP 2100 KKAL
6 ROMDIYAH (NY) 51 Th 4 bln 165518 LUNAK DM 1500 KKAL
7 YULIDAR (NY) 69 Th 3 bln 520888 LUNAK TKTP 1900 KKAL
8 RUKAYAH (NY) 65 Th 0 bln 180012 LUNAK TKTP 1900 KKAL
9 MEGA WULANSARI (NN) 21 Th 4 bln 544261 LUNAK R KOLESTEROL 1700 KKAL
10 MUSRIFAH (Ny) 49 Th 3 bln 473654 LUNAK RG 1500 KKAL
11 SUNARNI (NY) 59 Th 5 bln 462452 LUNAK DM 1500 KKAL
12 SINDU ATMOKO (TN) 25 Th 0 bln 180312 LUNAK RG 1900 KKAL
13 MUNTAMAH (NY) 45 Th 10 bln 180072 LUNAK DM, RL 1700 KKAL
14 SUJARI (TN) 70 Th 0 bln 180214 LUNAK DIET JANTUNG 1300 KKAL
15 PAINAH (NY) AW 54 Th 8 bln 180401 LUNAK DM, DIET JANTUNG 1500 KKAL
16 BUDI SUROSO (TN) 28 Th 0 bln 180417 LUNAK TKTP 2100 KKAL
17 SRI MAHMUDAH (Ny) 49 Th 1 bln 475034 LUNAK RG 1700 KKAL
18 VENI ARSLANI (NN) 18 Th 0 bln 180411 LUNAK TKTP 2100 KKAL
19 SUTINEM (NY) 58 Th 4 bln 176194 LUNAK DIET JANTUNG, RP 1500 KKAL
20 DORKAS TATI SUMIATI (NY) 54 Th 0 bln 180144 LUNAK RG 1500 KKAL
21 KASMI (Ny) 73 Th 11 bln 146537 LUNAK RG, RP 1300 KKAL
22 KARSINI (NY) 70 Th 0 bln 180146 LUNAK RG, RP 1300 KKAL
23 ARIS PRASETYO (TN) 31 Th 7 bln 179832 LUNAK DIET HATI 1900 KKAL
24 MUH KHOIRUL LUTFAN (AN) 15 Th 3 bln 503268 LUNAK RG, RL 1900 KKAL
25 NUR IFTIYANINGSIH (NY)/PT 17 Th 3 bln 544553 LUNAK DIET HATI 1700 KKAL

Ungaran,
Mengetahui,
Kepala Instalasi Gizi Pelaksana Asuhan Gizi

Puji Astuti, SKM Suntari Yudiati, AMG

NIP. 19661006 199103 2 009 NIP. 19851024 201101 2 014