DINAS KESEHATAN KABUPATEN OGAN KOMERING ILIR

TAHUN 2021
Pasien Baru Pasien Lama Penyalahguna Napza Gangguan Psikotik Gangguan Neurotik Retardasi Mental Gangguan Jiwa Bayi, Anak, Remaja Epilepsi Kelainan Susunan Syaraf Lain Seluruh Kunjungan

% KesJiwa
Penyakit Jiwa Lainnya

kunjunga
No Puskesmas

seluruh
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L P TOT L P TOT L P TOT L P Tot L P Tot L P Tot L P Tot L P Tot L P Tot L P Tot L P Tot

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1 Pengarayan 0 0 0 51 11 62 0 0 0 51 11 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 11 62 1884 59 %

2
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4
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9
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JUMLAH 0 0 0 51 11 62 0 0 0 51 11 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 11 62 1884 59 %

Mengetahui Pengarayan, 1 Februari 2021

Pimpinan Puskesmas Pengarayan Pengelola Program Kesehatan Jiwa

Baharuddin, SKM, M.Kes Uuntriza, AM.Kep

NIP 197606121996 03 1 003 NIP_
DATA PEMBERIAN OBAT TAHUN 2021 PUSKESMAS : PENGARAYAN
DINAS KESEHATAN KABUPATEN OGAN KOMERING ILIR, KAYU AGUNG

FEBRUARI
N0 NAMA USIA/Th L/P ALAMAT KS
MG1 MG2 MG3 MG4 MG5
1 Abu Bakar 26 L Ulak Kapal (-) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
2 Iskandar 23 L Tanjung Baru (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
3 M. Amin 38 L Pengarayan (-) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
Clozapine 2x25 mg Clozapine 2x25 mg Clozapine 2x25 mg Clozapine 2x25 mg Clozapine 2x25 mg
4 Ahmad 26 L Tanjung Baru (-) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
5. Kamila 55 P Tanjung Baru (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
6 Syamsudin 60 L Pengarayan (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
7 Ahmad 46 L Pengarayan (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
8 Soleh 38 L Pulau Gemantung Ulu (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
9 Hidir 38 P Pulau Gemantung Ilir (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
10 M. Yusuf 44 L Pulau Gemantung Ulu (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
11. Burlian 45 L Tanjung Baru (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
12. Mariam 37 P Tanjung Baru (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
13. Husin 44 L Bumi Agung (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
14 M. Ali 52 L Sukarami (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg

15 Fatimah 70 L Pengarayan (+) V V V V V

Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
16 M. Adam 34 L Pulau Gemantung Ulu (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
17 Iwan Susanto 36 L Pengarayan (-) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
18 Iskandar 23 L Tanjung Baru (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg

19 Ahmad Yasin 31 P Jambu Ilir (+) V V V V V

 Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg

20 Hartati 38 P Pengarayan (+) V V V V V

Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
21 Abu Bakar 24 L Ulak Kapal (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg

22 Juairiah 35 P Tanjung Baru (+) V V V V V

Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
23 Ali Yusuf 43 L Pulau Gemantung Ilir (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg

24 Masitoh 38 P Tanjung Merindu (+) V V V V V

Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg

25 Muslim Ansory 24 L Pulau Gemantung Ilir (+) V V V V V

Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg

Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg

26 Muhtar 44 L Tanjung Baru (+) V V V V V

Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg

27 Lokon 31 P Ulak Kapal (+) V V V V V

Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg

28 Syamsudin 32 P Jukdadak (+) V V V V V

Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg
29 Idris 30 L Pulau Gemantung Ilir (+) V V V V V
Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg Risperidone 2x 2 mg
Thrihexiphenidyl HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg Thrihexiphenidil HCL 2X2 mg
Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg Clorpromazine HCL 2x100 mg

Definisi Operational
A: Urutan no data ODGJ Berat yang ada di wilayah kerja didapatkan dari pendataan, pelacakan, pelaporan masyarakat, kunjungan ke puskesmas, kegiatan posyandu, posbindu
B: Nama Lengkap ODGJBerat
C: Usia ODGJ Berat
D: Jenis Kelamin ODGJBerat
E: Tempat Tinggal ODGJ Berat, Jalan, RT/RW, Kelurahan/Desa, Kecamatan
F: Memiliki Kartu Sehat atauTidak
G-K: di conteng pada tiap minggu disesuaikan dengan pemberian obat yang diresepkan oleh tenaga puskesmas pada bulan itu dan disertakan Nama Obat
DATA ODGJ BERAT 2021
PUSKESMAS : PENGARAYAN
DINAS KESEHATAN KABUPATEN OGAN KOMERING ILIR, KAYU AGUNG

NO NAMA USIA L/P ALAMAT KS JAN FEB MA APR MEI JUNI JUL AGS SEP OKT NOV DES
R
A B C D E F G H I J K L M N O P Q R
1 Musa 30 L P.Gemantung Darat - v v
2 Hidir 46 L Pengarayan + v v
3 Anita 22 P Bumi Agung + v v
4 Ruaidah 34 P Tanjung Laut + v v
5 Abdul Ghofar 28 L Seri Tanjung + - v
6 Hairul 34 L Atar Balam + v -
7 Ahmad Yasin 31 L Jambu Ilir + v v
8 Yuliyana 28 P Pulau Gemantung + - v
9 Hasanah 26 P Pulau Gemantung + v -
10 Solbiah 42 P P. Gemantung Ulu + v v
11 Suryadi 20 L Jukdadak + - v
12 Firmansyah 27 L P. Gemantung Ilir - v -
13 Susilawati 33 P Atar Balam + - v
14 Yakkub 35 L Tanjung Merindu - - v
15 Samsiah 65 P Tanjung Beringin - - v
16 Sarimah 25 P Pengarayan + - v
17 Muhtar 40 L Tanjung Baru - - v
18 Hambali 50 L Pengarayan + - v
19 Sumarno 43 L Tanjung Beringin - - v
20 Honadit 36 L Tanjung Beringin - - v
21 Dora Juniah 33 P Tanjung Laga - v v
22 Nyaman 29 L Ulak Kapal + v v
23 Iwan Susanto 36 L Pengarayan - v v
24 Hasan 38 L Tanjung Merindu - - v
25 Ahmad Anang 33 L Ulak Kapal - v -
26 Raden Afrianto 38 L Jambu Ilir + - v
27 Martin 36 L Jambu Ilir + - -
28 Abu Bakar 26 L Ulak Kapal - - -
29 Gustio Sunardi 23 L Pengarayan + - v
30 Muhtar 40 L Tanjung Baru + - v
31 Herman 27 L Jambu Ilir + - v
32 Yakkub 33 L Pulau Gemantung Ulu + - v
33 Handan 23 L Ulak Kapal - - v
Definisi Operational
A: Urutan no data ODGJ Berat yang ada diwilayah kerja didapatkan dari pendataan,pelacakan,pelaporan masyarakat,kunjungan kepuskesmas,kegiatan posyandu,posbindu

B: Nama Lengkap ODGJ Berat

C: Usia ODGJ Berat
 D: Jenis Kelamin ODGJ Berat
E: Tempat Tinggal ODGJ Berat,Jalan,RT/RW,Kelurahan/Desa,Kecamatan

F: Memiliki Kartu Sehat atau Tidak

G-K: diconteng pada tiap minggu disesuaikan dengan pemberian obat yang diresepkan oleh tenaga puskesmas pada bulan itu dan disertakan Nama Obat
PUSKESMAS PENGARAYAN
KASUS PASUNG DINAS KESEHATAN KABUPATEN OGAN KOMERING ILIR, KAYU AGUNG

No Nama Alamat Desa/Lurah/ Ditemukan Cara Pasung Alasan di Pasung Riwayat Pengobatan Penatalaksanaan di Lepas Pasung Kembali Kondisi Sekarang
ODGJ yang Kecamatan dd/mm/yyyy dan Inisiator dan Diagnosis dd/mm/yyyy dd/mm/yyyy ODGJ Pasca Pasung
di Pasung Pemasungan

NIHIL