You are on page 1of 1

SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS

( KASUS BARU )
Propinsi : Jawa Barat Tahun : 2023
Kabupaten : Garut Bulan : Mei
Puskesmas : UPT Puskesmas Sukawening Jumlah Kunjungan
Golongan Umur ( Tahun ) Total Total
No Jenis Penyakit Kunjunga
0-7 Hari 8-28 Hari <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70 + Laki-laki Perempuan n
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 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
1 Kolera 0 0 0 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 Diare 0 0 0 0 3 1 0 5 2 6 4 6 3 3 2 9 1 2 0 0 0 0 0 0 15 32 47
3 Diare Berdarah 0 0 0 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 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 0 0 0 0 0 0 0 0 2 1 3
5 TBC Paru BTA ( + ) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 2 2
6 Tersangka TBC Paru 0 0 0 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 Kusta PB 0 0 0 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 Kusta MB 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 1 1
9 Campak 0 0 0 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 Difteri 0 0 0 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 Batuk Rejan 0 0 0 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 Tetanus 0 0 0 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 Hepatitis Klinis 0 0 0 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 Malaria Klinis 0 0 0 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 Malaria Vivax 0 0 0 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 Malaria Falsiparum 0 0 0 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 Malaria Mix 0 0 0 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 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 1 0 0 0 2 0 0 1 0 0 0 0 0 0 0 0 3 1 4
19 Demam Dengue 0 0 0 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 Pneumonia 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
21 Sifilis 0 0 0 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 Gonorhoe 0 0 0 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 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 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 Influenza 0 0 0 0 4 2 5 5 2 8 2 4 3 9 0 7 4 3 6 2 0 3 2 5 28 48 58
26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3 5 22 5 11 2 10 2 4 15 50 65
27 Diabetes Melitus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1

Laporan Awal/Perbaikan (lingkari pilihan) Mengetahui, Sukawening, 5 Juni 2023


Jumlah Puskesmas Pembantu yang ada bulan laporan : 1 Pustu Sokol Kepala UPT Puskesmas Sukawening Petugas Surveilans
Jumlah Puskesmas Pembantu melapor bulan laporan : ......................... ( ........ % )
Jumlah Puskesmas Pembantu melapor tepat waktu bulan laporan : ......................... ( ........ % )
H. Cecep Hamzah,S.Kep,Ners,M.M Nanang Rachmat, Amd.Kep
NIP.19670108 198902 1 001 NIP. 198505152023211001

You might also like