LAPORAN BULANAN

REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA

PUSKESMAS WANING BULAN JANUARI 2020

Luar
WANING TEHONG PATENG MOMOL NDOSO LUMUT WAE BUKA Total
No. ELEMEN DATA Wilayah
L P L P L P L P L P L P L P L P L P L+P

I Total Kunjungan KB :
1 Bulan ini 0 6 0 7 0 1 0 6 0 4 0 1 0 2 0 0 0 27 27
2 Kumulatif s.d. Bulan lalu
II Peserta KB :
1 Baru
1 Pil 0 2 0 3 0 1 0 6 0 4 0 1 0 2 0 0 0 114 114
2 IUD 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 2 0 3 0 4 0 0 0 0 0 0 0 0 0 0 0 9 9
5 Implant 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 2 2
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Aktif : (KB Baru dan Lama)

1 Pil 0 53 0 17 0 27 0 5 0 4 0 7 0 1 0 0 0 114 114
2 IUD 0 42 0 0 0 5 0 0 0 15 0 0 0 0 0 0 0 62 62
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 52 0 8 0 8 0 8 0 3 0 3 0 6 0 0 0 88 88
5 Implant 0 29 0 13 0 9 0 1 0 1 0 0 0 0 0 0 0 53 53
6 MOW 0 3 0 1 0 3 0 0 0 2 0 2 0 0 0 0 0 11 11
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Peserta KB Pasca Bersalin :

1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III Kondisi Peserta KB :

1 Ada komplikasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Drop-out
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IV Di rujuk :
1 Puskesmas RI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Puskesmas Memadai 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Puskesmas Poned 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 RSUD Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 RSUD Non Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 RSIA/RSB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Fasilitas Keseh. Lainnya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 (sebutkan)
VI Kontrasepsi diterima :
1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 22 0 0 0 16 0 4 0 0 0 18 0 8 0 0 0 68 68
5 Implant 0 2 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 4 4
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

VII Penggunaan :
1 Pil 0 12 0 0 0 7 0 6 0 3 0 0 0 7 0 0 0 35 35
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 2 0 0 0 3 0 2 0 0 0 10 0 3 0 0 0 20 20
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 2 2
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

V Sisa/Stok Kontrasepsi
Pil 0 42 0 0 0 3 0 10 0 3 0 0 0 18 0 0 0 76 76
IUD 0 3 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 5 5
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 22 0 0 0 16 0 13 0 0 0 2 0 6 0 0 0 59 59
Implant 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui Waning, 31 Januari 2020

Kepala Puskesmas Waning Pengelola Program KIA

FERDINANDUS SUWARDI MARIA ANUT

NIP: 19750227 199903 1 003 NIP. 197505112005012025
 LAPORAN BULANAN
REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA
PUSKESMAS WANING BULAN FEBRUARI 2019

WANING TEHONG PATENG MOMOL NDOSO LUMUT WAE BUKA Luar Total
No. ELEMEN DATA Wilayah
L P L P L P L P L P L P L P L P L P L+P

I Total Kunjungan KB :
1 Bulan ini 0 34 0 0 0 11 0 18 0 3 0 19 0 9 0 0 0 94 94
2 Kumulatif s.d. Bulan lalu 0 56 0 0 0 19 0 29 0 12 0 29 0 14 0 0 0 159 159
II Peserta KB :
1 Baru
1 Pil 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 3 3
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 1 0 2 0 0 0 1 0 0 0 0 0 4 4
5 Implant 0 1 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 3 3
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Aktif : (KB Baru dan Lama)

1 Pil 0 67 0 16 0 24 0 11 0 75 0 83 0 48 0 0 0 324 324
2 IUD 0 34 0 10 0 5 0 17 0 15 0 16 0 10 0 0 0 107 107
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 85 0 78 0 50 0 87 0 84 0 90 0 79 0 0 0 553 553
5 Implant 0 14 0 9 0 9 0 29 0 17 0 7 0 13 0 0 0 98 98
6 MOW 0 2 0 0 0 2 0 5 0 2 0 1 0 1 0 0 0 13 13
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Peserta KB Pasca Bersalin :

1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III Kondisi Peserta KB :

1 Ada komplikasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Drop-out
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IV Di rujuk :
1 Puskesmas RI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Puskesmas Memadai 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Puskesmas Poned 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 RSUD Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 RSUD Non Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 RSIA/RSB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Fasilitas Keseh. Lainnya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 (sebutkan)
VI Kontrasepsi diterima :
1 Pil 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 5 5
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 10 10
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

VII Penggunaan :
1 Pil 0 12 0 0 0 7 0 6 0 3 0 7 0 0 0 0 0 35 35
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 21 0 0 0 4 0 12 0 0 0 12 0 7 0 0 0 56 56
5 Implant 0 1 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 3 3
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

V Sisa/Stok Kontrasepsi
Pil 0 42 0 0 0 3 0 10 0 3 0 18 0 0 0 0 0 76 76
IUD 0 3 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 5 5
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 22 0 0 0 16 0 13 0 0 0 6 0 2 0 0 0 59 59
Implant 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui Waning, 28 Februari 2019

Kepala Puskesmas Waning Pengelola Program KIA

FERDINANDUS SUWARDI SURYATI

NIP: 19750227 199903 1 003 NIP. 19910119 201705 2 002
35

56
3
 LAPORAN BULANAN
REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA
PUSKESMAS WANING BULAN MARET 2019

WANING TEHONG PATENG MOMOL NDOSO LUMUT WAE BUKA Luar Total
No. ELEMEN DATA Wilayah
L P L P L P L P L P L P L P L P L P L+P

I Total Kunjungan KB :
1 Bulan ini 0 29 0 0 0 14 0 38 0 14 0 14 0 10 0 0 0 119 119
2 Kumulatif s.d. Bulan lalu 0 85 0 0 0 33 0 67 0 26 0 43 0 24 0 0 0 278 278
II Peserta KB :
1 Baru
1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 4 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 5 5
5 Implant 0 0 0 0 0 0 0 7 0 0 0 0 0 4 0 0 0 11 11
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Aktif : (KB Baru dan Lama)

1 Pil 0 67 0 16 0 24 0 11 0 75 0 83 0 48 0 0 0 324 324
2 IUD 0 34 0 10 0 5 0 17 0 15 0 16 0 10 0 0 0 107 107
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 89 0 78 0 50 0 88 0 84 0 90 0 79 0 0 0 558 558
5 Implant 0 14 0 9 0 9 0 36 0 17 0 7 0 17 0 0 0 109 109
6 MOW 0 2 0 0 0 2 0 5 0 2 0 1 0 1 0 0 0 13 13
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Peserta KB Pasca Bersalin :

1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III Kondisi Peserta KB :

1 Ada komplikasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Drop-out
Pil 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
IUD 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IV Di rujuk :
1 Puskesmas RI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Puskesmas Memadai 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Puskesmas Poned 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 RSUD Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 RSUD Non Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 RSIA/RSB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Fasilitas Keseh. Lainnya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 (sebutkan)
VI Kontrasepsi diterima :
1 Pil 0 183 0 20 0 10 0 25 0 23 0 20 0 20 0 0 0 301 301
2 IUD 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 2
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 128 0 20 0 20 0 50 0 20 0 30 0 20 0 0 0 288 288
5 Implant 0 20 0 0 0 0 0 25 0 0 0 0 0 10 0 0 0 55 55
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

VII Penggunaan :
1 Pil 0 16 0 0 0 6 0 9 0 5 0 9 0 5 0 0 0 50 50
2 IUD 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 4 4
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 13 0 0 0 8 0 6 0 9 0 5 0 1 0 0 0 42 42
5 Implant 0 0 0 0 0 0 0 19 0 0 0 0 0 4 0 0 0 23 23
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

V Sisa/Stok Kontrasepsi
Pil 0 209 0 20 0 4 0 27 0 18 0 22 0 15 0 0 0 315 315
IUD 0 1 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 3 3
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 137 0 20 0 17 0 57 0 11 0 31 0 19 0 0 0 292 292
Implant 0 23 0 0 0 0 0 1 0 0 0 0 0 6 0 0 0 30 30
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui Waning, 31 Maret 2019

Kepala Puskesmas Waning Pengelola Program KIA

FERDINANDUS SUWARDI SURYATI

NIP: 19750227 199903 1 003 NIP. 19910119 201705 2 002
50 183
42
225
42 16
23 209
 LAPORAN BULANAN
REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA
PUSKESMAS WANING BULAN APRIL 2019

WANING TEHONG PATENG MOMOL NDOSO LUMUT WAE BUKA Luar Total
No. ELEMEN DATA Wilayah
L P L P L P L P L P L P L P L P L P L+P

I Total Kunjungan KB :
1 Bulan ini 0 16 0 15 0 14 0 18 0 5 0 14 0 24 0 0 0 106 106
2 Kumulatif s.d. Bulan lalu 0 101 0 15 0 47 0 85 0 31 0 57 0 48 0 0 0 384 384
II Peserta KB :
1 Baru
1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 3 3
5 Implant 0 0 0 0 0 0 0 7 0 0 0 0 0 1 0 0 0 8 8
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Aktif : (KB Baru dan Lama)

1 Pil 0 69 0 16 0 24 0 11 0 76 0 83 0 48 0 0 0 327 327
2 IUD 0 34 0 10 0 5 0 17 0 15 0 16 0 10 0 0 0 107 107
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 90 0 78 0 50 0 89 0 87 0 91 0 80 0 0 0 565 565
5 Implant 0 11 0 9 0 9 0 43 0 17 0 7 0 18 0 0 0 114 114
6 MOW 0 2 0 0 0 2 0 5 0 2 0 1 0 1 0 0 0 13 13
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Peserta KB Pasca Bersalin :

1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III Kondisi Peserta KB :

1 Ada komplikasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Drop-out
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IV Di rujuk :
1 Puskesmas RI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Puskesmas Memadai 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Puskesmas Poned 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 RSUD Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 RSUD Non Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 RSIA/RSB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 Fasilitas Keseh. Lainnya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 (sebutkan)
VI Kontrasepsi diterima :
1 Pil 0 0 0 0 0 10 0 0 0 0 0 30 0 0 0 0 0 40 40
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 20 0 0 0 20 0 30 0 0 0 0 0 70 70
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

VII Penggunaan :
1 Pil 0 9 0 7 0 7 0 8 0 2 0 9 0 9 0 0 0 51 51
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 7 0 8 0 7 0 10 0 3 0 5 0 12 0 0 0 52 52
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 3 3
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

V Sisa/Stok Kontrasepsi
Pil 0 146 0 13 0 7 0 19 0 16 0 43 0 6 0 0 0 250 250
IUD 0 1 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 3 3
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 69 0 12 0 30 0 47 0 28 0 56 0 7 0 0 0 249 249
Implant 0 23 0 0 0 0 0 1 0 0 0 0 0 3 0 0 0 27 27
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui Waning, 30 April 2019

Kepala Puskesmas Waning Pengelola Program KIA

FERDINANDUS SUWARDI SURYATI

NIP: 19750227 199903 1 003 NIP. 19910119 201705 2 002
 Peserta KB Lama

IUD Suntik Pil KondomImplant MOW MOP lain2 Jumlah

34 90 69 0 11 2 0 0 206
10 78 16 0 9 0 0 0 113
5 50 24 0 9 2 0 0 90
327 17 88 11 0 36 5 0 0 157
107 15 87 76 0 17 2 0 0 197
0 16 90 83 0 7 1 0 0 197
565 10 79 48 0 17 1 0 0 155
114 107 562 327 0 106 13 0 0 1115
13
0
0
1126
 58 183
42
225
60 16
3 209
49
160
155
5

137
70
67
 LAPORAN BULANAN
REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA
PUSKESMAS WANING BULAN MEI 2019

WANING TEHONG PATENG MOMOL NDOSO LUMUT WAE BUKA Luar Total
No. ELEMEN DATA Wilayah
L P L P L P L P L P L P L P L P L P L+P

I Total Kunjungan KB :
1 Bulan ini 0 60 0 16 0 7 0 17 0 9 0 16 0 14 0 0 0 139 139
2 Kumulatif s.d. Bulan lalu 0 101 0 15 0 47 0 85 0 31 0 57 0 48 0 0 0 384 384
II Peserta KB :
1 Baru
1 Pil 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 4 4
2 IUD 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 2 2
5 Implant 0 5 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 6 6
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Aktif : (KB Baru dan Lama)

1 Pil 0 65 0 17 0 24 0 13 0 76 0 83 0 49 0 0 0 327 327
2 IUD 0 37 0 10 0 5 0 16 0 15 0 16 0 10 0 0 0 109 109
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 78 0 77 0 50 0 89 0 90 0 91 0 79 0 0 0 554 554
5 Implant 0 24 0 9 0 9 0 42 0 14 0 7 0 18 0 0 0 123 123
6 MOW 0 3 0 1 0 2 0 6 0 2 0 1 0 1 0 0 0 16 16
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Peserta KB Pasca Bersalin :

1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III Kondisi Peserta KB :

1 Ada komplikasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Drop-out
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IV Di rujuk :
1 Puskesmas RI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Puskesmas Memadai 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Puskesmas Poned 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 RSUD Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 RSUD Non Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 RSIA/RSB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Fasilitas Keseh. Lainnya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 (sebutkan)
VI Kontrasepsi diterima :
1 Pil 0 0 0 10 0 10 0 0 0 10 0 20 0 10 0 0 0 60 60
2 IUD 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 20
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 300 0 20 0 20 0 0 0 0 0 20 0 20 0 0 0 380 380
5 Implant 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 20
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

VII Penggunaan :
1 Pil 0 17 0 7 0 4 0 8 0 2 0 6 0 0 0 0 0 44 44
2 IUD 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 10
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 11 0 9 0 3 0 9 0 7 0 10 0 12 0 0 0 61 61
5 Implant 0 22 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 24 24
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

V Sisa/Stok Kontrasepsi
Pil 0 139 0 16 0 13 0 11 0 24 0 46 0 16 0 0 0 265 265
IUD 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 20
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 358 0 23 0 47 0 38 0 21 0 44 0 15 0 0 0 546 546
Implant 0 21 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 22 22
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui Waning, 31 Mei 2019

Kepala Puskesmas Waning Pengelola Program KIA

FERDINANDUS SUWARDI SURYATI

NIP: 19750227 199903 1 003 NIP. 19910119 201705 2 002
 LAPORAN BULANAN
REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA
PUSKESMAS WANING BULAN JUNI 2019

Luar
WANING TEHONG PATENG MOMOL NDOSO LUMUT WAE BUKA Total
Wilayah

No. ELEMEN DATA

L P L P L P L P L P L P L P L P L P L+P

I Total Kunjungan KB :
1 Bulan ini 0 13 0 3 0 2 0 12 0 6 0 3 0 10 0 0 0 49 49
2 Kumulatif s.d. Bulan lalu 0 114 0 18 0 49 0 97 0 37 0 60 0 58 0 0 0 433 433
II Peserta KB :
1 Baru
1 Pil 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 2 2
5 Implant 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Aktif : (KB Baru dan Lama)

1 Pil 0 65 0 17 0 24 0 15 0 78 0 74 0 49 0 0 0 322 322
2 IUD 0 38 0 10 0 5 0 16 0 15 0 16 0 10 0 0 0 110 110
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 79 0 78 0 50 0 90 0 90 0 89 0 79 0 0 0 555 555
5 Implant 0 28 0 9 0 9 0 42 0 14 0 18 0 19 0 0 0 139 139
6 MOW 0 3 0 1 0 3 0 6 0 2 0 1 0 1 0 0 0 17 17
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Peserta KB Pasca Bersalin :

1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III Kondisi Peserta KB :

1 Ada komplikasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Drop-out
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IV Di rujuk :
1 Puskesmas RI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Puskesmas Memadai 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Puskesmas Poned 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 RSUD Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 RSUD Non Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 RSIA/RSB 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 0 0 0 0 0 0 0 0 0 0
8 Fasilitas Keseh. Lainnya (sebutkan)
VI Kontrasepsi diterima :
1 Pil 0 25 0 10 0 10 0 0 0 0 0 0 0 10 0 0 0 55 55
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 17 0 10 0 20 0 0 0 0 0 0 0 20 0 0 0 67 67
5 Implant 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 20 20
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

VII Penggunaan :
1 Pil 0 9 0 1 0 2 0 7 0 2 0 4 0 8 0 0 0 33 33
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 4 0 2 0 0 0 5 0 4 0 8 0 2 0 0 0 25 25
5 Implant 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 11 11
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

V Sisa/Stok Kontrasepsi
Pil 0 3 0 25 0 21 0 4 0 22 0 34 0 18 0 0 0 127 127
IUD 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 20
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 200 0 41 0 67 0 33 0 17 0 42 0 33 0 0 0 433 433
Implant 0 0 0 0 0 0 0 0 0 0 0 9 0 1 0 0 0 10 10
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui Waning, 30 Juni 2019

Kepala Puskesmas Waning Pengelola Program KIA

FERDINANDUS SUWARDI SURYATI

NIP: 19750227 199903 1 003 NIP. 19910119 201705 2 002
 LAPORAN BULANAN
REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA
PUSKESMAS WANING BULAN JULI 2019

Luar
WANING TEHONG PATENG MOMOL NDOSO LUMUT WAE BUKA Total
Wilayah
GUDANG
No. ELEMEN DATA PUSKESM
AS L P L P L P L P L P L P L P L P L P L+P

I Total Kunjungan KB :
1 Bulan ini 0 31 0 3 0 10 0 14 0 6 0 10 0 3 0 0 0 77 77
2 Kumulatif s.d. Bulan lalu 0 114 0 18 0 49 0 97 0 37 0 60 0 58 0 0 0 433 433
II Peserta KB :
1 Baru
1 Pil 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 1 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 6 6
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Aktif : (KB Baru dan Lama)

1 Pil 0 68 0 17 0 24 0 16 0 78 0 74 0 49 0 0 0 326 326
2 IUD 0 38 0 10 0 5 0 16 0 15 0 16 0 10 0 0 0 110 110
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 77 0 78 0 50 0 90 0 90 0 89 0 81 0 0 0 555 555
5 Implant 0 27 0 9 0 9 0 42 0 14 0 19 0 19 0 0 0 139 139
6 MOW 0 3 0 1 0 3 0 6 0 2 0 1 0 1 0 0 0 17 17
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Peserta KB Pasca Bersalin :

1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III Kondisi Peserta KB :

1 Ada komplikasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Drop-out
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IV Di rujuk :
1 Puskesmas RI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Puskesmas Memadai 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Puskesmas Poned 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 RSUD Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 RSUD Non Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 RSIA/RSB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Fasilitas Keseh. Lainnya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 (sebutkan)
VI Kontrasepsi diterima :
1 Pil 300 0 10 0 10 0 10 0 0 0 10 0 0 0 0 0 0 0 40 40
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 10 0 0 0 20 0 0 0 10 0 0 0 0 0 0 0 40 40
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

VII Penggunaan :
1 Pil 0 18 0 2 0 7 0 0 0 1 0 2 0 0 0 0 0 30 30
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 13 0 1 0 3 0 14 0 5 0 8 0 2 0 0 0 46 46
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

V Sisa/Stok Kontrasepsi
Pil 260 0 5 0 40 0 24 0 4 0 21 0 40 0 18 0 0 0 152 152
IUD 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 15 0 10 0 23 0 60 0 19 0 22 0 26 0 31 0 0 0 191 191
Implant 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 9 9
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui Waning, 31 Juli 2019

Kepala Puskesmas Waning Pengelola Program KIA

FERDINANDUS SUWARDI SURYATI

NIP: 19750227 199903 1 003 NIP. 19910119 201705 2 002
 LAPORAN BULANAN
REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA
PUSKESMAS WANING BULAN september 2019

Luar
WANING TEHONG PATENG MOMOL NDOSO LUMUT WAE BUKA Total
Wilayah
GUDANG
No. ELEMEN DATA PUSKESM
AS L P L P L P L P L P L P L P L P L P L+P

I Total Kunjungan KB :
1 Bulan ini 0 23 0 5 0 10 0 9 0 21 0 21 0 4 0 0 0 93 93
2 Kumulatif s.d. Bulan lalu 0 139 0 21 0 59 0 111 0 43 0 70 0 61 0 0 0 504 504
II Peserta KB :
1 Baru
1 Pil 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 2 2
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 1 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 6 6
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Aktif : (KB Baru dan Lama)

1 Pil 0 68 0 17 0 25 0 16 0 78 0 74 0 49 0 0 0 327 327
2 IUD 0 38 0 10 0 5 0 16 0 15 0 16 0 10 0 0 0 110 110
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 78 0 78 0 50 0 90 0 90 0 89 0 81 0 0 0 556 556
5 Implant 0 27 0 9 0 9 0 42 0 14 0 19 0 19 0 0 0 139 139
6 MOW 0 3 0 1 0 3 0 7 0 2 0 1 0 1 0 0 0 18 18
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Peserta KB Pasca Bersalin :

1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III Kondisi Peserta KB :

1 Ada komplikasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Drop-out
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IV Di rujuk :
1 Puskesmas RI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Puskesmas Memadai 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Puskesmas Poned 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 RSUD Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 RSUD Non Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 RSIA/RSB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Fasilitas Keseh. Lainnya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 (sebutkan)
VI Kontrasepsi diterima :
1 Pil 0 0 10 0 0 0 0 0 20 0 5 0 0 0 0 0 0 0 35 35
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 25 25
5 Implant 30 0 0 0 0 0 0 0 0 0 14 0 0 0 10 0 0 0 24 24
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

VII Penggunaan :
1 Pil 0 15 0 5 0 4 0 0 0 5 0 10 0 2 0 0 0 41 41
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 8 0 0 0 6 0 9 0 6 0 11 0 2 0 0 0 42 42
5 Implant 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 10 10
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

V Sisa/Stok Kontrasepsi
Pil 178 0 2 0 12 0 21 0 24 0 21 0 40 0 14 0 0 0 134 134
IUD 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 45 0 20 0 38 0 70 0 26 0 31 0 28 0 20 0 0 0 233 233
Implant 0 0 0 0 0 0 0 0 0 0 4 0 9 0 10 0 0 0 23 23
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui Waning, 30 September 2019

Kepala Puskesmas Waning Pengelola Program KIA

FERDINANDUS SUWARDI Marselina Saina

NIP: 19750227 199903 1 003 NIP. -
 LAPORAN BULANAN
REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA
PUSKESMAS WANING BULAN OKTOBER 2019

Luar
WANING TEHONG PATENG MOMOL NDOSO LUMUT WAE BUKA Total
Wilayah
GUDANG
No. ELEMEN DATA PUSKESM
AS L P L P L P L P L P L P L P L P L P L+P

I Total Kunjungan KB :
1 Bulan ini 0 26 0 0 0 3 0 22 0 16 0 13 0 0 0 0 0 80 80
2 Kumulatif s.d. Bulan lalu 0 162 0 26 0 69 0 120 0 64 0 91 0 65 0 0 0 597 597
II Peserta KB :
1 Baru
1 Pil 0 0 0 0 0 0 0 2 0 0 1 0 0 0 0 0 3 3
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 1 0 0 0 0 0 1 0 4 0 1 0 0 0 0 0 7 7
5 Implant 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 3 3
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Aktif : (KB Baru dan Lama)

1 Pil 0 69 0 17 0 26 0 16 0 79 0 74 0 49 0 0 0 330 330
2 IUD 0 38 0 10 0 5 0 16 0 15 0 16 0 10 0 0 0 110 110
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 80 0 78 0 50 0 92 0 92 0 89 0 82 0 0 0 563 563
5 Implant 0 27 0 9 0 9 0 42 0 18 0 19 0 19 0 0 0 143 143
6 MOW 0 3 0 1 0 3 0 7 0 2 0 2 0 1 0 0 0 19 19
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Peserta KB Pasca Bersalin :

1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III Kondisi Peserta KB :

1 Ada komplikasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Drop-out
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IV Di rujuk :
1 Puskesmas RI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Puskesmas Memadai 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Puskesmas Poned 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 RSUD Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 RSUD Non Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 RSIA/RSB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Fasilitas Keseh. Lainnya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 (sebutkan)
VI Kontrasepsi diterima :
1 Pil 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 20
2 IUD 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 10 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 20 20
5 Implant 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

VII Penggunaan :
1 Pil 0 15 0 0 0 3 0 15 0 0 0 7 0 0 0 0 0 40 40
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 11 0 0 0 0 0 7 0 13 0 6 0 0 0 0 0 37 37
5 Implant 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 3 3
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

V Sisa/Stok Kontrasepsi
Pil 169 0 7 0 12 0 18 0 9 0 21 0 33 0 14 0 0 0 114 114
IUD 20 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 20 0 19 0 38 0 70 0 19 0 18 0 22 0 30 0 0 0 216 216
Implant 0 0 0 0 0 0 0 0 1 0 1 0 9 0 10 0 0 0 21 21
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui Waning, 31 Oktober 2019

Kepala Puskesmas Waning Pengelola Program KIA

FERDINANDUS SUWARDI Suryati

NIP: 19750227 199903 1 003 NIP. 19910119 201705 2 002
 Peserta KB Lama

IUD Suntik Pil Kondom Implant MOW MOP lain2 Jumlah

W 38 80 69 0 27 3 0 0 217
T 10 78 17 0 9 1 0 0 115
P 5 50 26 0 9 3 0 0 93
M 16 92 16 0 42 7 0 0 173
N 15 92 79 0 18 2 0 0 206
L 16 89 74 0 19 2 0 0 200
WB 10 82 49 0 19 1 0 0 161
110 563 330 0 143 19 0 0 1165
 LAPORAN BULANAN
REKAPITULASI KB DI PUSKESMAS DAN JEJARINGNYA
PUSKESMAS WANING BULAN DESEMBER 2019

Luar
WANING TEHONG PATENG MOMOL NDOSO LUMUT WAE BUKA Total
Wilayah
GUDANG
No. ELEMEN DATA PUSKESM
AS L P L P L P L P L P L P L P L P L P L+P

I Total Kunjungan KB :
1 Bulan ini 0 18 0 3 0 6 0 6 0 4 0 2 0 2 0 0 0 41 41
2 Kumulatif s.d. Bulan lalu 0 188 0 26 0 72 0 142 0 80 0 104 0 65 0 0 0 677 677
II Peserta KB :
1 Baru
1 Pil 0 2 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 3 3
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 1 0 0 0 0 0 0 0 2 0 1 0 0 0 4 4
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 MOP 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Aktif : (KB Baru dan Lama)

1 Pil 0 70 0 20 0 26 0 13 0 80 0 75 0 52 0 0 0 336 336
2 IUD 0 44 0 10 0 5 0 17 0 15 0 16 0 10 0 0 0 117 117
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 77 0 75 0 50 0 101 0 95 0 91 0 89 0 0 0 578 578
5 Implant 0 29 0 8 0 9 0 43 0 21 0 19 0 19 0 0 0 148 148
6 MOW 0 3 0 1 0 3 0 7 0 2 0 2 0 1 0 0 0 19 19
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Peserta KB Pasca Bersalin :

1 Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

III Kondisi Peserta KB :

1 Ada komplikasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Kontrasepsi gagal
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Ada efek samping

Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Drop-out
Pil 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
IV Di rujuk :
1 Puskesmas RI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Puskesmas Memadai 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Puskesmas Poned 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 RSUD Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 RSUD Non Ponek 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 RS SWASTA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 RSIA/RSB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Fasilitas Keseh. Lainnya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 (sebutkan)
VI Kontrasepsi diterima :
1 Pil 300 0 0 0 10 0 5 0 10 0 10 0 20 0 10 0 0 0 65 65
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 200 0 20 0 20 0 0 0 20 0 20 0 0 0 0 0 0 0 80 80
5 Implant 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

VII Penggunaan :
1 Pil 0 13 0 0 0 3 0 0 0 4 0 0 0 0 0 0 0 20 20
2 IUD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Suntik 0 6 0 3 0 3 0 6 0 0 0 2 0 1 0 0 0 21 21
5 Implant 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1
6 MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

V Sisa/Stok Kontrasepsi
Pil 489 0 10 0 18 0 15 0 16 0 27 0 42 0 21 0 0 0 149 149
IUD 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kondom 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Suntik 425 0 43 0 54 0 63 0 23 0 32 0 13 0 16 0 0 0 244 244
Implant 10 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 9 9
MOW 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vagina 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lainnya sebutkan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui Waning, 31 Desember 2019

Kepala Puskesmas Waning Pengelola Program KIA

FERDINANDUS SUWARDI SURYATI

NIP: 19750227 199903 1 003 NIP.19910119 201705 2 002
 Peserta KB Lama

IUD Suntik Pil KondomImplant MOW MOP lain2 Jumlah

waning 44 77 70 0 29 3 0 0 223
tehon 10 75 20 0 8 1 0 0 114
pateng 5 50 26 0 9 3 0 0 93
momol 17 101 13 0 43 7 0 0 181
ndoso 15 95 80 0 21 2 0 0 213
lumut 16 91 75 0 19 2 0 0 203
wae bukas 10 89 52 0 19 1 0 0 171
117 578 336 0 148 19 0 0 1198