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  • Borang Imunisasi

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    Putri Dwi Sarii
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    The document is a record of immunization activities in October 2018 and May 2019. It lists the name, age, diagnosis, and immunizations received for 12 patients per time period. The immunizations provided included BCG, polio, DPT-HB, IPV, and measles vaccines according to the standard Indonesian immunization schedule by patient age.

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    BORANG IMUNISASI

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    The document is a record of immunization activities in October 2018 and May 2019. It lists the name, age, diagnosis, and immunizations received for 12 patients per time period. The immunizations provided included BCG, polio, DPT-HB, IPV, and measles vaccines according to the standard Indonesian immunization schedule by patient age.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    2 views4 pages

    Borang Imunisasi

    Uploaded by

    Putri Dwi Sarii
    The document is a record of immunization activities in October 2018 and May 2019. It lists the name, age, diagnosis, and immunizations received for 12 patients per time period. The immunizations provided included BCG, polio, DPT-HB, IPV, and measles vaccines according to the standard Indonesian immunization schedule by patient age.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 4

    Format Rekapitulasi Kegiatan Praktik Profesi / Pelayanan Kebidanan

    Pelayanan : Imunisasi

    Periode kegiatan : 2018

    No Hari/Tanggal Nama Umur Diagnosa Tindakan/ Pelayanan/


    Paien/Klien Asuhan
    1. 10/0ktober/2018 By. Ny. H 1 bln By. Ny H usia 1 bln dgn Suntik BCG, Polio 1
    imunisasi BCG & Polio 1
    2. 10/0ktober/2018 By. Ny. A 2 bln By. Ny A usia 2 bln dgn Suntik DPT-HB 1, Polio
    imunisasi DPT-HB 1 & Polio 2 2
    3. 10/0ktober/2018 By. Ny. Y 4 bln By. Ny Y usia 4 bln dgn Suntik DPT-HB 3, IPV,
    imunisasi DPT-HB 3, IPV & Polio 4
    Polio 4
    4. 10/0ktober/2018 By. Ny. I 2 bln By. Ny I usia 2 bln dgn imunisasi Suntik DPT-HB 1, Polio
    DPT-HB 1 & polio 2 2
    5. 10/0ktober/2018 By. Ny. F 2 bln By. Ny F usia 2 bln dgn Suntik DPT-HB 1, Polio
    imunisasi DPT-HB 1 & Polio 2 2
    6. 10/0ktober/2018 By. Ny. R 2 bln By. Ny R usia 2 bln dgn Suntik DPT-HB 1, Polio
    imunisasi DPT-HB 1 & Polio 2 2
    7. 10/0ktober/2018 By. Ny. D 6 bln By. Ny D usia 6 bln dgn Suntik DPT-HB 3, IPV,
    imunisasi DPT-HB 3,IPV & Polio 4
    Polio 4
    8. 10/0ktober/2018 By. Ny. Y 9 bln By. Ny Y usia 9 bln dgn Suntik Campak
    imunisasi Campak
    9. 10/0ktober/2018 By. Ny. A 10 bln By. Ny A usia 10 bln dgn Suntik Campak
    imunisasi Campak
    10. 10/0ktober/2018 By. Ny. R 4 bln By. Ny R usia 4 bln dgn Suntik DPT-HB 2, Polio
    imunisasi DPT-HB 2 & Polio 3 3
    11. 10/0ktober/2018 By. Ny. V 5 bln By. Ny V usia 5 bln dgn SuntikDPT-HB 3, IPV,
    imunisasi DPT-HB 3,IPV & Polio 4
    Polio 4
    12. 10/0ktober/2018 By. Ny. M 4 bln By. Ny M usia 4 bln dgn Suntik DPT-HB 2, Polio
    imunisasi Dpt-HB 2 & Polio 3 3

    .............................2022
    Mengetahui,
    Ketua Ranting Banten Girang
    Atasan Langsung Bidan

    ( )

    ( ) ( )

    Format Rekapitulasi Kegiatan Praktik Profesi / Pelayanan Kebidanan


    Pelayanan : Imunisasi

    Periode kegiatan : 2018

    No Hari/Tanggal Nama Umur Diagnosa Tindakan/ Pelayanan/


    Paien/Klien Asuhan
    1 12/0ktober/2018 By. Ny. S 6 bln By. Ny.S usia 6 bln dgn Suntik DPT-HB 3, IPV,
    imunisasi DPT-HB 3,IPV & Polio 4
    Polio 4
    2 12/0ktober/2018 By. Ny. I 3 bln By. Ny I usia 3 bln dgn Suntik DPT-HB 2, Polio
    imunisasi DPT-HB 2 & Polio 3 3
    3 12/0ktober/2018 By. Ny. S 3 bln By. Ny S usia 3 bln dgn Suntik DPT-HB 2, Polio
    imunisasi DPT-HB 2 & Polio 3 3
    4 12/0ktober/2018 By. Ny. D 3 bln By. Ny D usia 3 bln dgn Suntik DPT-HB 2, polio
    imunisasi DPT-HB 2 & Polio 3 3
    5 12/0ktober/2018 By. Ny. L 1 bln By. Ny L usia 1 bln dgn Suntik BCG, Polio 1
    imunisasi BCG & Polio 1
    6 12/0ktober/2018 By. Ny. H 2 bln By. Ny H usia 2 bln dgn Suntik DPT-HB 1, Polio
    imunisasi DPT-HB 1 & Polio 2 2
    7 12/0ktober/2018 By. Ny. S 6 bln By. Ny S usia 6 bln dgn Suntik DPT-HB 3, IPV,
    imunisasi DPT-Hb 3, IPV & Polio 4
    Polio 4
    8 12/0ktober/2018 By. Ny. F 3 bln By. Ny F usia 3 bln dgn Suntik DPT-HB 2, Polio
    imunisasi DPT-HB 2 & Polio 3 3
    9 12/0ktober/2018 By. Ny. T 3 bln By. Ny T usia 3 bln dgn Suntik DPT-HB 2, Polio
    imunisasi DPT-HB 2 & Polio 1 1
    10 12/0ktober/2018 By. Ny R 2 bln By. Ny R usia 3 bln dgn Suntik DPT-HB 1, Polio
    imunisasi DPT-HB 1 & Polio 2 2
    11 12/0ktober/2018 By. Ny G 4 bln By. Ny G usia 4 bln dgn Suntik DPT-HB 2, Polio
    imunisasi DPT-HB 2 & Polio 3 3
    12 12/0ktober/2018 By. Ny J 9 bln By. Ny J usia 9 bln dgn Suntik Campak
    imunisasi Campak

    .............................2022
    Mengetahui,
    Ketua Ranting Banten Girang
    Atasan Langsung Bidan

    ( )

    ( ) ( )

    Format Rekapitulasi Kegiatan Praktik Profesi / Pelayanan Kebidanan

    Pelayanan : Imunisasi
    Periode kegiatan : 2019

    No Hari/Tanggal Nama Umur Diagnosa Tindakan/ Pelayanan/


    Paien/Klien Asuhan

    1. 13/Mei/2019 By. Ny. F 3 bln By. Ny F usia 3 bln dgn imunisasi Suntik DPT-HB 2,
    DPT-HB 2 & Polio 3 Polio 3
    2. 13/Mei/2019 By. Ny. D 9 bln By. Ny D usia 9 bln dgn imunisasi Suntik Campak
    Campak
    3. 13/Mei/2019 By. Ny. Y 6 bln By. Ny Y usia 6 bln dgn imunisasi Suntik DPT-HB 3,
    DPT-HB 3, IPV & Polio 4 IPV, Polio 4
    4. 13/Mei/2019 By. Ny. K 3 bln By. Ny K usia 3 bln dgn imunisasi Suntik DPT-HB 2,
    DPT-HB 2 & polio 3 Polio 3
    5. 13/Mei/2019 By. Ny. H 6 bln By. Ny H usia 6 bln dgn imunisasi Suntik IPV
    IPV
    6. 13/Mei/2019 By. Ny. I 7 bln By. Ny I usia 7 bln dgn imunisasi Suntik DPT-HB 3,IPV
    DPT-HB 3, IPV & Polio 4 & Polio 4
    7. 13/Mei/2019 By. Ny. G 1 bln By. Ny G usia 1 bln dgn imunisasi Suntik BCG & Polio
    BCG & Polio 1 1
    8. 13/Mei/2019 By. Ny. T 5 bln By. Ny T usia 5 bln dgn imunisasi Suntik DPT-HB 2 &
    DPT-HB 2 & Polio 3 Polio 3
    9. 13/Mei/2019 By. Ny. E 2 bln By. Ny E usia 2 bln dgn imunisasi Suntik DPT-HB 1 &
    DPT-HB 1 & Polio 2 Polio 2
    10. 13/Mei/2019 By. Ny. L 3 bln By. Ny L usia 3 bln dgn imunisasi Suntik DPT-HB 2,
    DPT-HB 2 & Polio 3 Polio 3
    11. 13/Mei/2019 By. Ny. R 1 bln By. Ny R usia 1 bln dgn imunisasi Suntik BCG & Polio
    BCG & Polio 1 1
    12. 13/Mei/2019 By. Ny. B 7 bln By. Ny B usia 7 bln dgn imunisasi Suntik IPV
    IPV

    .............................2022
    Mengetahui,
    Ketua Ranting Banten Girang
    Atasan Langsung Bidan

    ( )

    ( ) ( )

    Format Rekapitulasi Kegiatan Praktik Profesi / Pelayanan Kebidanan

    Pelayanan : Imunisasi

    Periode kegiatan : 2019


    No Hari/Tanggal Nama Umur Tindakan/ Pelayanan/
    Paien/Klien Diagnosa Asuhan

    1 16/Mei/2019 By. Ny. A 6 bln By. Ny A usia 6 bln dgn imunisasi Suntik DPT-HB 3, IPV
    DPT-HB 3,IPV & Polio 4 & Polio 4
    2 16/Mei/2019 By. Ny. S 3 bln By. Ny S usia 3 bln dgn imunisasi Suntik DPT-HB 2, Polio
    DPT-HB 2 & Polio 3 3
    3 16/Mei/2019 By. Ny. R 2 bln By. Ny R usia 2 bln dgn imunisasi Suntik DPT-HB 1, polio
    DPT-HB 1 & Polio 2 2
    4 16/Mei/2019 By. Ny. W 4 bln By. Ny W usia 4 bln dgn imunisasi Suntik DPT-HB 2, Polio
    DPT-HB 2 & Polio 3 3
    5 16/Mei/2019 By. Ny. L 2 bln By. Ny L usia 2 bln dgn imunisasi Suntik DPT-HB 1, Polio
    DPT-HB 1 & Polio 2 2
    6 16/Mei/2019 By. Ny. T 7 bln By. Ny T usia 7 bln dgn imunisasi Suntik DPT-HB 3, IPV,
    DPT-Hb 3, IPV & Polio 4 Polio 4
    7 16/Mei/2019 By. Ny. F 5 bln By. Ny F usia 5 bln dgn imunisasi Suntik DPT-HB 3, IPV
    DPT-HB 3 & Polio 4 & Polio 4
    8 16/Mei/2019 By. Ny. Y 2 bln By. Ny Y usia 2 bln dgn imunisasi Suntik DPT-HB 1, Polio
    DPT-HB 1 & Polio 2 2
    9 16/Mei/2019 By. Ny. C 9 bln By. Ny C usia 9 bln dgn imunisasi Suntik Campak
    Campak
    10 16/Mei/2019 By. Ny. H 6 bln By. Ny H usia 6 bln dgn imunisasi Suntik DPT-HB 3, IPV
    DPT-HB 3 & Polio 4 & Polio 4
    11 16/Mei/2019 By. Ny. O 1 bln By. Ny O usia 1 bln dgn imunisasi Suntik BCG, Polio 1
    BCG & Polio 1
    12 16/Mei/2019 By. Ny. M 3 bln By. Ny M usia 3 bln dgn imunisasi Suntik DPT-HB 2, Polio
    DPT-HB 2 & Polio 3 3

    .............................2022
    Mengetahui,
    Ketua Ranting Banten Girang
    Atasan Langsung Bidan

    ( )

    ( ) ( )

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