FORM IBU HAMIL PUSKESMAS....................

DINAS KESEHATAN KABUPATEN LOMBOK TIMUR

NO POLINDES DUSUN NAMA IBU HAMIL UMUR

HPHT
TURUN TANGIS Eva juliana 17 10/6/2020
surniati 38 6/6/2020
siswari 21 20-7-2020
1 SUWANGI TIMUR
saimah 38 30-6-2020
husniati 26 25-7-2020
laili nurul wardani 30 7/9/2020
harniati 21 7/8/2020
karmiati 20 10/6/2020
santika 19 7/10/2020
salmiaton 26 10/10/2020

Jurang Munte murnihati 32 11/5/2020

dewi ernawati 30 22-5-2020
sriani 30 12/6/2020
2
nurhaliza 22 19-6-2020
lia amelia 19 16-8-2020
murtini 24 10/7/2020
zohratul 29 11/11/2020
eli patmawati 30 25-11-2020

penye indrayani 35 17-6-2020

riniyanti 22 10/6/2020
3
suhartini 27 16-6-2020
nurhayati 35 25-5-2020
linda ramdani 22 10/8/2020
hapsatul handayani 32 5/10/2020

kenaot iranda pilin s. 22 3/5/2020

yanita herni 28 1/7/2020
nurul pajri 27 7/9/2020
4
baiq suci 34 1/11/2020

pegondang suriati 24 7/5/2020

suhaibatul 28 10/6/2020
irmayanti 26 10/7/2020
rumanis 38 20-6-2020
romiah 39 4/9/2020
5 patmah 35 2/10/2020
jauriah 24 12/12/2020
patniwati 28 1/12/2020
6
6
batu lawang suhartini 30 10/7/2020
uswatun hasanah 24 7/9/2020

jurang gadung sri mulyani 25 4/6/2020

superi 23 15-7-2020
jumilah 25 15-7-2020
7 sahre 30 23-9-2020
sumiati 26 4/9/2020
nurul hikmah 35 8/10/2020
ayuni 25 5/8/2020
murni 31 1/12/2020

ta
genting sareah 43 20-6-2020
siti fatmawati 31 7/7/2020
uswatun hasanah 30 9/7/2020
ayuni ratnasari 20 1/9/2020
sri hayuni 30 10/11/2020
 HASIL PEMERIKSAAN
HPL GRAVIDA BB TB LILA TD HB PENYAKIT PENYERTA
17-3-2021 g1p0a0 52 154 24 100/70 11.8 taa
13-3-2021 g3p2a0 52 150 28 90/60 13 taa
27-4-2021 g1p0a0 44 150 25 120/70 11.3 taa
7/4/2021 g4p3a0 63 155 29 100/70 12.6 taa
3/5/2021 g2p1a0 67.5 156 25 110/60 10.9 taa
14-6-2021 g2p1a0 54 149 23.5 120/60 11.4 taa
14-5-2021 g2p1a0 52 150 25.5 90/60 13.6 taa
17-3-2021 g2p1a0 64 154 27 120/80 12.7 taa
14-7-2021 g1p0a0 51 154 24 90/60 11.5 taa
17-7-2021 g2p1a0 48 153 23.5 100/60 10.6 taa

18-2-2021 g3p2a0 50 147 23.5 100/70 14.2 taa

29-2-2021 g2p1a0 58 160 24.5 120/80 10.5 taa
19-3-2021 g3p2a0 60 160 25.7 90/60 11.6 taa
26-3-2021 g1p0a0 48 155 23.5 90/60 11.3 taa
23-5-2021 g1p0a0 49 155 24 110/70 12.2 taa
17-4-2021 g2p1a0 52 156 24.5 100/60 11.9 taa
18-8-2021 g2p1a0 61 154 25 100/70 11.7 taa
3/9/2021 g3p2a0 40 142 24.5 100/60 10.8 taa

23-3-2021 g3p2a0 52 150 25 100/60 11.2 taa

17-3-2021 g1p0a0 46 148 23.3 100/70 11.6 taa
23-3-2021 g1p0a0 48 149 24 100/70 10.9 taa
2/2/2021 g5p3a1 53 155 24.5 90/60 13.3 taa
17-5-2021 g1p0a0 48 150 23.5 100/60 13.4 taa
22-7-2021 g3p2a0 67 157 30 120/60 10.7 taa

10/2/2021 g2p1a0 55 152 24 90/60 12.2 taa

8/4/2021 g1p0a0 50 157 24 100/60 11.6 taa
14-7-2021 g2p1a0 56 156 27 100/70 13.2 taa
8/8/2021 g4p3a0 54 158 24 90/60 10.3 taa

14-2-2021 g2p1a0 55 149 25.5 100/70 10.5 taa

1703-2021 g2p1a0 58.5 158 24 110/60 12.4 taa
17-4-2021 g2p1a0 49 154 24 120/60 12.5 taa
17-3-2021 g3p2a0 67 158 23 100/70 10.7 taa
11/6/2021 g4p3a0 41 148 23.5 90/70 13.5 taa
9/7/2021 g2p1a0 50 150 24 120/60 13.6 taa
19-9-2021 g2p1a0 45 144 24 100/60 10.5 taa
8-9-2021 g2p1a0 62 141 25 90/60 11.5 taa
14-4-2021 g1p0a0 50 157 24 100/60 11.5 taa
14-4-2021 g1p0a0 50 150 24 120/70 12.6 taa

11/3/2021 g2p1a0 50 150 25.5 100/60 10.8 taa

22-7-2021 g2p1a0 47 152 24 100/70 12.6 taa
22-4-2021 g1p0a0 48 154 24.5 90/60 13.5 taa
30-6-2021 g6p3a2 40 154 25 100/60 12.7 taa
11/6/2021 g2p1a0 48 150 22 120/60 10.5 taa
15-7-2021 g3p2a0 56 154 24 110/60 11.6 taa
12/5/2021 g1p0a0 48 150 24 100/70 10.3 taa
8-92021 g3p2a0 51 155 24 100/70 taa

27-3-2021 g2p1a0 48 145 24.5 90/60 11.3 taa

14-4-2021 g3p2a0 47 250 24.6 100/70 12.1 taa
16-4-2021 g2p1a0 48 152 25 110/70 12.8 taa
8/6/2021 g1p0a0 47 150 23.5 120/60 9.3 taa
17-8-2021 g2p1a0 50 154 24 90/60 11.7 taa
 KEPEMILIKAN KARTU BPJS
(YA/TIDAK)
tidak
ya
ya
tidak
tidak
ya
ya
tidak
ya
ya

ya
tidak
tidak
ya
ya
ya
ya
tidak

ya
tidak
ya
tidak
ya
ya

ya
ya
ya
ya

ya
tidak
tidak
ya
ya
ya
ya
ya
ya
ya

tidak
ya
tidak
tidak
ya
tidak
ya
tidak

tidak
ya
ya
ya
ya
 FORM IBU HAMIL PUSKESMAS....................
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR

NO POLINDES DUSUN NAMA IBU HAMIL UMUR

HPHT
suwangi timur turun tangis Eva juliana 17 10/6/2020
surniati 38 6/6/2020
siswari 21 20-7-2020
1
saimah 38 30-6-2020
husniati 26 25-7-2020
laili nurul wardani 30 7/9/2020
harniati 21 7/8/2020
santika 19 7/10/2020
salmiaton 26 10/10/2020
2
murniaton 35 20-12-2020
idayanti 28 Dec-20
mahmuni munayep 30 7/1/2021

jurang munte nurhaliza 22 19-6-2020

3
murtini 24 10/7/2020
zohratul 29 11/11/2020
eli patmawati 30 25-11-2020
khairunisa 21 20-2-2021
susanti 22 1/2/2021
napsiah 25 1/2/2021

penye linda ramdani 22 10/8/2020

hapsatul handayani 32 5/10/2020
sahmin 40 7/12/2020
suhartini ningsih 35 14-12-2020
baiq nurdiani 39 5/12/2020
mariani 28 20-12-2020

penye timur yanita herni 28 1/7/2020

nurul pajri 27 7/9/2020
baiq suci 34 1/11/2020
baiq ira irawan 30 4/2/2021

pegondang irmayanti 26 10/7/2020

romiah 39 4/9/2020
patmah 35 2/10/2020
jauriah 24 12/12/2020
patniwati 28 1/12/2020
rabiatuladawiah 35 20-11-2020
ayuni 28 3/1/2020
 musriah 31 28-12-20205-10-201
era rosdiana 20 20-1-2020

batu lawang uswatun hasanah 24 7/9/2020

jurang gadung superi 23 15-7-2020

jumilah 25 15-7-2020
sahre 30 23-9-2020
sumiati 26 4/9/2020
nurul hikmah 35 8/10/2020
ayuni 25 5/8/2020
murni 31 1/12/2020
nurmin 36 Nov-20

genting siti fatmawati 31 7/7/2020

uswatun hasanah 30 9/7/2020
ayuni ratnasari 20 1/9/2020
sri hayuni 30 10/11/2020
indrayuni 32 22-12-2020
miladiah 35 Jan-21
 HASIL PEMERIKSAAN
HPL GRAVIDA BB TB LILA TD HB PENYAKIT PENYERTA
17-3-2021 g1p0a0 52 154 24 100/70 11.8 taa
13-3-2021 g3p2a0 52 150 28 90/60 13 taa
27-4-2021 g1p0a0 44 150 25 120/70 11.3 taa
7/4/2021 g4p3a0 63 155 29 100/70 12.6 taa
3/5/2021 g2p1a0 67.5 156 25 110/60 10.9 taa
14-6-2021 g2p1a0 54 149 23.5 120/60 11.4 taa
14-5-2021 g2p1a0 52 150 25.5 90/60 13.6 taa
14-7-2021 g1p0a0 51 154 24 90/60 11.5 taa
17-7-2021 g2p1a0 48 153 23.5 100/60 10.6 taa
27-9-2021 g5p2a2 59 146.3 25 90/60 taa
Sep-21 g2p1a0 48 145 24.5 90/60 taa
14-10-2021 g3p2a0 46 150 26 100/70 taa

26-3-2021 g1p0a0 48 155 23.5 90/60 11.3 taa

17-4-2021 g2p1a0 52 156 24.5 100/60 11.9 taa
18-8-2021 g2p1a0 61 154 25 100/70 11.7 taa
3/9/2021 g3p2a0 40 142 24.5 100/60 10.8 taa
27-11-2021 g1p0a0 40 151 25 90/60 taa
8/12/2021 g1p0a0 49 150 26 100/70 taa
8/12/2021 g4p1a0 61 148 30 90/60 taa

17-5-2021 g1p0a0 48 150 23.5 100/60 13.4 taa

22-7-2021 g3p2a0 67 157 30 120/60 10.7 taa
21-9-2021 g14p3a0 42 147 23.5 100/70 taa
21-9-2021 g3p2a0 56 152 25 110/70 taa
12/9/2021 g4p2a0 48 148 24 90/60 taa
27-9-2021 g1p0a0 49 156 23.5 100/60 taa

8/4/2021 g1p0a0 50 157 24 100/60 11.6 taa

14-7-2021 g2p1a0 56 156 27 100/70 13.2 taa
8/8/2021 g4p3a0 54 158 24 90/60 10.3 taa
11-11-2021gip0a0 70 153 30 100/70 taa

17-4-2021 g2p1a0 49 154 24 120/60 12.5 taa

11/6/2021 g4p3a0 41 148 23.5 90/70 13.5 taa
9/7/2021 g2p1a0 50 150 24 120/60 13.6 taa
19-9-2021 g2p1a0 45 144 24 100/60 10.5 taa
8-9-2021 g2p1a0 62 141 25 90/60 11.5 taa
27-8-2021 g4p3a0 70 151 100/70 taa
10/20/2021 g2p1a0 50 146 100/60 taa
8-12-20205-10-201 g2p1a0 64 153 30 100/70 taa
27-10-201 g1p0a0 55 150 26 90/60 taa

14-4-2021 g1p0a0 50 150 24 120/70 12.6 taa

22-7-2021 g2p1a0 47 152 24 100/70 12.6 taa

22-4-2021 g1p0a0 48 154 24.5 90/60 13.5 taa
30-6-2021 g6p3a2 40 154 25 100/60 12.7 taa
11/6/2021 g2p1a0 48 150 22 120/60 10.5 taa
15-7-2021 g3p2a0 56 154 24 110/60 11.6 taa
12/5/2021 g1p0a0 48 150 24 100/70 10.3 taa
8-92021 g3p2a0 51 155 24 100/70 taa
Aug-21 g5p4a0 81 160 30 90/60 taa

14-4-2021 g3p2a0 47 250 24.6 100/70 12.1 taa

16-4-2021 g2p1a0 48 152 25 110/70 12.8 taa
8/6/2021 g1p0a0 47 150 23.5 120/60 9.3 taa
17-8-2021 g2p1a0 50 154 24 90/60 11.7 taa
29-9-2021 g2p1a0 48 147 23.5 100/70 taa
Oct-21 g3p2a0 52 154 27 100/60 taa
 KEPEMILIKAN KARTU BPJS
(YA/TIDAK)
tidak
ya
ya
tidak
tidak
ya
ya
ya
ya
tidak
ya
ya

ya
ya
ya
tidak
ya
ya
ya

ya
ya
ya
ya
ya
tidak

ya
ya
ya
ya

tidak
ya
ya
ya
ya
ya
ya
tidak
tidak

ya

ya
tidak
tidak
ya
tidak
ya
tidak
ya

ya
ya
ya
ya
ya
ya
 FORM IBU HAMIL PUSKESMAS....................
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR

DUSUN NAMA IBU HAMIL

NO POLINDES UMUR
HPHT
suwangi timur turun tangis Eva juliana 17 10/6/2020
surniati 38 6/6/2020
siswari 21 20-7-2020
1
saimah 38 30-6-2020
husniati 26 25-7-2020
laili nurul wardani 30 7/9/2020
harniati 21 7/8/2020
karmiati 20 10/6/2020
santika 19 7/10/2020
2
salmiaton 26 10/10/2020
murniaton 35 20-12-2020
idayanti 28 Dec-20

jurang munte murnihati 32 11/5/2020

3
dewi ernawati 30 22-5-2020
sriani 30 12/6/2020
nurhaliza 22 19-6-2020
murtini 24 10/7/2020
zohratul 29 11/11/2020
eli patmawati 30 25-11-2020
khairunisa 21 20-2-2021

penye indrayani 35 17-6-2020

riniyanti 22 10/6/2020
suhartini 27 16-6-2020
nurhayati 35 25-5-2020
linda ramdani 22 10/8/2020
hapsatul handayani 32 5/10/2020
sahmin 40 7/12/2020
suhartini ningsih 35 14-12-2020
baiq nurdiani 39 5/12/2020

penye timur yanita herni 28 1/7/2020

nurul pajri 27 7/9/2020
baiq suci 34 1/11/2020

pegondang suhaibatul 28 10/6/2020

irmayanti 26 10/7/2020
rumanis 38 20-6-2020
romiah 39 4/9/2020
 patmah 35 2/10/2020
jauriah 24 12/12/2020
patniwati 28 1/12/2020
rabiatuladawiah 35 20-11-2020
ayuni 28 3/1/2020

batu lawang suhartini 30 10/7/2020

uswatun hasanah 24 7/9/2020

jurang gadung sri mulyani 25 4/6/2020

superi 23 15-7-2020
jumilah 25 15-7-2020
sahre 30 23-9-2020
sumiati 26 4/9/2020
nurul hikmah 35 8/10/2020
ayuni 25 5/8/2020
murni 31 1/12/2020
nurmin 36 Nov-20

genting sareah 43 20-6-2020

siti fatmawati 31 7/7/2020
uswatun hasanah 30 9/7/2020
ayuni ratnasari 20 1/9/2020
sri hayuni 30 10/11/2020
indrayuni 32 22-12-2020
 HASIL PEMERIKSAAN
HPL GRAVIDA BB TB LILA TD HB PENYAKIT PENYERTA
17-3-2021 g1p0a0 52 154 24 100/70 11.8 taa
13-3-2021 g3p2a0 52 150 28 90/60 13 taa
27-4-2021 g1p0a0 44 150 25 120/70 11.3 taa
7/4/2021 g4p3a0 63 155 29 100/70 12.6 taa
3/5/2021 g2p1a0 67.5 156 25 110/60 10.9 taa
14-6-2021 g2p1a0 54 149 23.5 120/60 11.4 taa
14-5-2021 g2p1a0 52 150 25.5 90/60 13.6 taa
17-3-2021 g2p1a0 64 154 27 120/80 12.7 taa
14-7-2021 g1p0a0 51 154 24 90/60 11.5 taa
17-7-2021 g2p1a0 48 153 23.5 100/60 10.6 taa
27-9-2021 g5p2a2 59 146.3 25 90/60 taa
Sep-21 g2p1a0 48 145 24.5 90/60 taa

18-2-2021 g3p2a0 50 147 23.5 100/70 14.2 taa

29-2-2021 g2p1a0 58 160 24.5 120/80 10.5 taa
19-3-2021 g3p2a0 60 160 25.7 90/60 11.6 taa
26-3-2021 g1p0a0 48 155 23.5 90/60 11.3 taa
17-4-2021 g2p1a0 52 156 24.5 100/60 11.9 taa
18-8-2021 g2p1a0 61 154 25 100/70 11.7 taa
3/9/2021 g3p2a0 40 142 24.5 100/60 10.8 taa
27-11-2021 g1p0a0 40 151 25 90/60 taa

23-3-2021 g3p2a0 52 150 25 100/60 11.2 taa

17-3-2021 g1p0a0 46 148 23.3 100/70 11.6 taa
23-3-2021 g1p0a0 48 149 24 100/70 10.9 taa
2/2/2021 g5p3a1 53 155 24.5 90/60 13.3 taa
17-5-2021 g1p0a0 48 150 23.5 100/60 13.4 taa
22-7-2021 g3p2a0 67 157 30 120/60 10.7 taa
21-9-2021 g14p3a0 42 147 23.5 100/70 taa
21-9-2021 g3p2a0 56 152 25 110/70 taa
12/9/2021 g4p2a0 48 148 24 90/60 taa

8/4/2021 g1p0a0 50 157 24 100/60 11.6 taa

14-7-2021 g2p1a0 56 156 27 100/70 13.2 taa
8/8/2021 g4p3a0 54 158 24 90/60 10.3 taa

1703-2021 g2p1a0 58.5 158 24 110/60 12.4 taa

17-4-2021 g2p1a0 49 154 24 120/60 12.5 taa
17-3-2021 g3p2a0 67 158 23 100/70 10.7 taa
11/6/2021 g4p3a0 41 148 23.5 90/70 13.5 taa
 9/7/2021 g2p1a0 50 150 24 120/60 13.6 taa
19-9-2021 g2p1a0 45 144 24 100/60 10.5 taa
8-9-2021 g2p1a0 62 141 25 90/60 11.5 taa
27-8-2021 g4p3a0 70 151 100/70 taa
10/20/2021 g2p1a0 50 146 100/60 taa

14-4-2021 g1p0a0 50 157 24 100/60 11.5 taa

14-4-2021 g1p0a0 50 150 24 120/70 12.6 taa

11/3/2021 g2p1a0 50 150 25.5 100/60 10.8 taa

22-7-2021 g2p1a0 47 152 24 100/70 12.6 taa
22-4-2021 g1p0a0 48 154 24.5 90/60 13.5 taa
30-6-2021 g6p3a2 40 154 25 100/60 12.7 taa
11/6/2021 g2p1a0 48 150 22 120/60 10.5 taa
15-7-2021 g3p2a0 56 154 24 110/60 11.6 taa
12/5/2021 g1p0a0 48 150 24 100/70 10.3 taa
8-92021 g3p2a0 51 155 24 100/70 taa
Aug-21 g5p4a0 81 160 30 90/60 taa

27-3-2021 g2p1a0 48 145 24.5 90/60 11.3 taa

14-4-2021 g3p2a0 47 250 24.6 100/70 12.1 taa
16-4-2021 g2p1a0 48 152 25 110/70 12.8 taa
8/6/2021 g1p0a0 47 150 23.5 120/60 9.3 taa
17-8-2021 g2p1a0 50 154 24 90/60 11.7 taa
29-9-2021 g2p1a0 48 147 23.5 100/70 taa
KEPEMILIKAN KARTU BPJS
(YA/TIDAK)
tidak
ya
ya
tidak
tidak
ya
ya
tidak
ya
ya
tidak
ya

ya
tidak
tidak
ya
ya
ya
tidak
ya

ya
tidak
ya
tidak
ya
ya
ya
ya
ya

ya
ya
ya

tidak
tidak
ya
ya
ya
ya
ya
ya
ya

ya
ya

tidak
ya
tidak
tidak
ya
tidak
ya
tidak
ya

tidak
ya
ya
ya
ya
ya
 FORM IBU HAMIL PUSKESMAS....................
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR

NO POLINDES DUSUN NAMA IBU HAMIL UMUR

HPHT
suwangi timur turun tangis siswari 21 20-7-2020
saimah 38 30-6-2020
husniati 26 25-7-2020
1
laili nurul wardani 30 7/9/2020
harniati 21 7/8/2020
santika 19 7/10/2020
salmiaton 26 10/10/2020
murniaton 35 20-12-2020
idayanti 28 Dec-20
2
mahuni 30 7/1/2021
suriani 25 21-2-2021
sasti parlina 20 Dec-20
siti rohani 40 31-1-2021
sahnim 22 20-2-2021
sii nurhaliza 18 1/2/2021
3

jurang munte nurhaliza 22 19-6-2020

murtini 24 10/7/2020
zohratul 29 11/11/2020
eli patmawati 30 25-11-2020
khairunisa 21 20-2-2021
susanti 22 1/2/2021
napsiah 25 1/2/2021

penye linda ramdani 22 10/8/2020

hapsatul handayani 32 5/10/2020
sahmin 40 7/12/2020
suhartini ningsih 35 14-12-2020
baiq nurdiani 39 5/12/2020
mariani 28 20-12-2020

penye timur nurul pajri 27 7/9/2020

baiq suci 34 1/11/2020
baiq ira irawan 30 4/2/2021
alvia malawi 36 23-1-2021

pegondang romiah 39 4/9/2020

patmah 35 2/10/2020
jauriah 24 12/12/2020
patniwati 28 1/12/2020
rabiatuladawiah 35 20-11-2020
ayuni 28 3/1/2020
 musriah 31 28-12-20205-10-201
era rosdiana 20 20-1-2020
nursobah 28 17-2-2021
nurhasanah 34 Mar-21

batu lawang uswatun hasanah 24 7/9/2020

baiq muniati 39 24-1-2021
fitriah 20 12/2/2021

jurang gadung sahre 30 23-9-2020

sumiati 26 4/9/2020
nurul hikmah 35 8/10/2020
ayuni 25 5/8/2020
murni 31 1/12/2020
nurmin 36 Nov-20

genting ayuni ratnasari 20 1/9/2020

sri hayuni 30 10/11/2020
indrayuni 32 22-12-2020
miladiah 35 Jan-21
 HASIL PEMERIKSAAN
HPL GRAVIDA BB TB LILA TD HB PENYAKIT PENYERTA
27-4-2021 g1p0a0 44 150 25 120/70 11.3 taa
7/4/2021 g4p3a0 63 155 29 100/70 12.6 taa
3/5/2021 g2p1a0 67.5 156 25 110/60 10.9 taa
14-6-2021 g2p1a0 54 149 23.5 120/60 11.4 taa
14-5-2021 g2p1a0 52 150 25.5 90/60 13.6 taa
14-7-2021 g1p0a0 51 154 24 90/60 11.5 taa
17-7-2021 g2p1a0 48 153 23.5 100/60 10.6 taa
27-9-2021 g5p2a2 59 146.3 25 90/60 11,6 taa
Sep-21 g2p1a0 48 145 24.5 90/60 10'7 taa
14-10-2021 g3p2a0 46 150 26 100/70 12,4 taa
28-11-2021 g2p1a0 47 156 25 100/60 10,6 taa
Sep-21 g2p1a0 48 150 23,5 120/70 taa
6/11/2021 g1p0a0 47 147 23 90/60 taa
27-11-2021 g3p2a0 52 152 24 110/70 taa
8/11/2021 g2p1a0 54 148 28 110/60 taa

26-3-2021 g1p0a0 48 155 23.5 90/60 11.3 taa

17-4-2021 g2p1a0 52 156 24.5 100/60 11.9 taa
18-8-2021 g2p1a0 61 154 25 100/70 11.7 taa
3/9/2021 g3p2a0 40 142 24.5 100/60 10.8 taa
27-11-2021 g1p0a0 40 151 25 90/60 taa
8/12/2021 g1p0a0 49 150 26 100/70 taa
8/12/2021 g4p1a0 61 148 30 90/60 taa

17-5-2021 g1p0a0 48 150 23.5 100/60 13.4 taa

22-7-2021 g3p2a0 67 157 30 120/60 10.7 taa
21-9-2021 g14p3a0 42 147 23.5 100/70 taa
21-9-2021 g3p2a0 56 152 25 110/70 taa
12/9/2021 g4p2a0 48 148 24 90/60 taa
27-9-2021 g1p0a0 49 156 23.5 100/60 taa

14-7-2021 g2p1a0 56 156 27 100/70 13.2 taa

8/8/2021 g4p3a0 54 158 24 90/60 10.3 taa
11-11-2021gip0a0 70 153 30 100/70 taa
30-10-2021g2p1a0 45 141 25 110/70 taa

11/6/2021 g4p3a0 41 148 23.5 90/70 13.5 taa

9/7/2021 g2p1a0 50 150 24 120/60 13.6 taa
19-9-2021 g2p1a0 45 144 24 100/60 10.5 taa
8-9-2021 g2p1a0 62 141 25 90/60 11.5 taa
27-8-2021 g4p3a0 70 151 28 100/70 taa
10/20/2021 g2p1a0 50 146 24,5 100/60 taa
8-12-20205-10-201 g2p1a0 64 153 30 100/70 taa
27-10-201 g1p0a0 55 150 26 90/60 taa
24-11-2021 g2p1a0 58 146 25 100/60 taa
Nov-21 g3p2a0 55 153 24 100/70 taa

14-4-2021 g1p0a0 50 150 24 120/70 12.6 taa

31-10-2021 g2p0a1 38 150 23 110/60 taa
19-11-2021 g1p0a0 39 152 23,5 100/70 taa

30-6-2021 g6p3a2 40 154 25 100/60 12.7 taa

11/6/2021 g2p1a0 48 150 22 120/60 10.5 taa
15-7-2021 g3p2a0 56 154 24 110/60 11.6 taa
12/5/2021 g1p0a0 48 150 24 100/70 10.3 taa
8-92021 g3p2a0 51 155 24 100/70 taa
Aug-21 g5p4a0 81 160 30 90/60 taa

8/6/2021 g1p0a0 47 150 23.5 120/60 9.3 taa

17-8-2021 g2p1a0 50 154 24 90/60 11.7 taa
29-9-2021 g2p1a0 48 147 23.5 100/70 taa
Oct-21 g3p2a0 52 154 27 100/60 taa
 KEPEMILIKAN KARTU BPJS
(YA/TIDAK)
ya
tidak
tidak
ya
ya
ya
ya
tidak
ya
ya
ya
tidak
tidak
ya
tidak

ya
ya
ya
tidak
ya
ya
ya

ya
ya
ya
ya
ya
tidak

ya
ya
ya
ya

ya
ya
ya
ya
ya
ya
tidak
tidak
ya
tidak

ya
ya
tidak

tidak
ya
tidak
ya
tidak
ya

ya
ya
ya
ya
 FORM IBU HAMIL PUSKESMAS....................
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR

NO POLINDES NAMA IBU HAMIL UMUR

HPHT HPL
NAMA IBU
POLINDES DUSUN UMUR
HAMIL
Laili nurul w 30
1
santika 19
salmiatun 26
murniaton 35
idayanti 28
mahuni 30
TURUN TANGIS suriani 25
2
sasti parlina 20
siti rohani 21
sahnim 40
siti nurhaliza 22
suriani 18
hibiliati 35
3

SUWANGI TIMUR
zohratul 29
eli patmawat 30
jurang munte khairunisa 21
susanti 22
napsiah 25

hapsatul han 32
sahmin 40
suhartini nin 35
penye baiq nurdiani 39
mariani 28
raudatul 28

nurul pajri 27
baiq suci 34
penye timur baiq ira iraw 30
alvia malawi 36

romiah 39
patmah 35
jauriah 24
patniwati 28
rabiatuladaw 35
ayuni 28
pegondang musriah 31
era rosdiana 20
 pegondang

nursobah 28
nurhasanah 34
nurhidayah 29

uswatun has 24
baiq muniati 39
batu lawang fitriah 20

sahre 30
sumiati 26
nurul hikmah 35
jurang gadung ayuni 25
murni 31
nurmin 36
yuliana r 26

ayuni ratnasa 20
genting
sri hayuni 30
indrayuni 32
miladiah 35
 HASIL PEMERIKSAAN
GRAVIDA BB TB LILA TD HB
HASIL PEMERIKSAAN
HPHT HPL GRAVIDA BB TB LILA
7/9/2020 14-6-2021 g2p1a0 54 156 25
7/10/2020 14-7-2021 g1p0a0 51 154 24
10/9/2020 17-7-2021 g2p1a0 48 153 23,5
20-12-2020 27-9-2021 g5p2a2 59 146 25
17-12-2020 24-9-2021 g2p1a0 48 145 24,5
7/1/2021 14-10-2021 g3p2a0 46 150 26
21-2-2021 28-11-2021 g2p1a0 46,9 158 24
7/12/2020 10/9/2021 g2p1a0 48 149 24
31-1-2021 7/10/2021 g1p0a0 49 147 23
20-2-2021 27-11-2021 g3p2a0h1 56 154 25,5
1/2/2021 8/11/2021 g2p1a0 52 148,3 26,5
28-2-2021 5/12/2021 g2p0a1 52 157 24
10/2/2021 17-11-2021 g4p2a1h2 64 160 30

11/11/2020 18-8-2021 g2p1a0 61 154 25

25-11-2020 3/9/2021 g3p2a0 40 142 24.5
20-2-2021 27-11-2021 g1p0a0 40 151 25
1/2/2021 8/12/2021 g1p0a0 49 150 26
1/2/2021 8/12/2021 g4p1a0 61 148 30

5/10/2020 22-7-2021 g3p2a0 67 157 30

7/12/2020 21-9-2021 g14p3a0 42 147 23.5
14-12-2020 21-9-2021 g3p2a0 56 152 25
5/12/2020 12/9/2021 g4p2a0 48 148 24
20-12-2020 27-9-2021 g1p0a0 49 156 23.5
14-3-2021

7/9/2020 14-7-2021 g2p1a0 56 156 27

1/11/2020 8/8/2021 g4p3a0 54 158 24
4/2/2021 11-11-2021gip0a0 70 153 30
23-1-2021 30-10-2021g2p1a0 45 141 25

4/9/2020 11/6/2021 g4p3a0 41 148 23.5

2/10/2020 9/7/2021 g2p1a0 50 150 24
12/12/2020 19-9-2021 g2p1a0 45 144 24
1/12/2020 8-9-2021 g2p1a0 62 141 25
20-11-2020 27-8-2021 g4p3a0 70 151 28
3/1/2020 10/20/2021 g2p1a0 50 146 24,5
28-12-20205-10-201 g2p1a0 64 153 30
20-1-2020 27-10-201 g1p0a0 55 150 26
17-2-2021 24-11-2021 g2p1a0 58 146 25
Mar-21 Nov-21 g3p2a0 55 153 24
20-4-2021 27-1-2022 g2p1a0 43 152 24,5

7/9/2020 14-4-2021 g1p0a0 50 150 24

24-1-2021 31-10-2021 g2p0a1 38 150 23
12/2/2021 19-11-2021 g1p0a0 39 152 23,5

23-9-2020 30-6-2021 g6p3a2 40 154 25

4/9/2020 11/6/2021 g2p1a0 48 150 22
8/10/2020 15-7-2021 g3p2a0 56 154 24
5/8/2020 12/5/2021 g1p0a0 48 150 24
1/12/2020 8-92021 g3p2a0 51 155 24
Nov-20 Aug-21 g5p4a0 81 160 30
15-4-2021 22-1-2022 g2p1a0 4o 152 24

1/9/2020 8/6/2021 g1p0a0 47 150 23.5

10/11/2020 17-8-2021 g2p1a0 50 154 24
22-12-2020 29-9-2021 g2p1a0 48 147 23.5
Jan-21 Oct-21 g3p2a0 52 154 27
 KEPEMILIKAN KARTU BPJS
(YA/TIDAK) KEPEMILI
PENYAKIT PENYERTA KAN
ERIKSAAN KARTU
TD HB BPJS
PENYAKIT PENYERTA
(YA/TIDA
100/60 11,2 taa ya
K)
110/70 10,7 taa ya
90/60 12 taa tidak
100/60 11,7 taa tidak
110/70 13 taa tidak
110/60 11,3 taa ya
90/60 10,2 taa ya
120/70 11 taa tidak
110/70 12,5 taa tidak
90/60 11,8 taa ya
120/80 10,9 taa ya
90/60 taa ya
100/60 taa tidak

100/70 11.7 taa ya

100/60 10.8 taa tidak
90/60 taa ya
100/70 taa ya
90/60 taa ya

120/60 10.7 taa ya

100/70 taa ya
110/70 taa ya
90/60 taa ya
100/60 taa tidak

100/70 13.2 taa ya

90/60 10.3 taa ya
100/70 taa ya
110/70 taa ya

90/70 13.5 taa ya

120/60 13.6 taa ya
100/60 10.5 taa ya
90/60 11.5 taa ya
100/70 13,4 taa ya
100/60 taa ya
100/70 taa tidak
90/60 taa tidak
100/60 taa ya
100/70 taa tidak
90/60 taa ya

120/70 12.6 taa ya

110/60 11,2 taa ya
100/70 taa tidak

100/60 12.7 taa tidak

120/60 10.5 taa ya
110/60 11.6 taa tidak
100/70 10.3 taa ya
100/70 11,7 taa tidak
90/60 taa ya
100/60 taa ya

120/60 9.3 taa ya

90/60 11.7 taa ya
100/70 10.9 taa ya
100/60 taa ya
 FORM IBU HAMIL PUSKESMAS....................
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR

NO POLINDES DUSUN NAMA IBU HAMIL UMUR

HPHT
santika 19 7/10/2020
salmiatun 26 10/9/2020
murniaton 35 20-12-2020
1 suwangi timur
idayanti 28 17-12-2020
mahuni 30 7/1/2021
suriani 25 21-2-2021
sasti parlina 20 7/12/2020
siti rohani 21 31-1-2021
turun tangis
sahnim 40 20-2-2021
2
siti nurhaliza 22 1/2/2021
suriani 18 28-2-2021
hibiliati 35 10/2/2021
halimah 40 7/4/2021
purtini 27 27-3-2021
amrina paroja 21 10/3/2021
3
zohratul 29 11/11/2020
eli patmawati 30 25-11-2020
khairunisa 21 20-2-2021
susanti 22 1/2/2021
jurang munte napsiah 25 1/2/2021
suniati 27 17-3-2021
ronah 37 10/3/2021
hernawati 20 15-1-2021

hapsatul handayani 32 5/10/2020

sahmin 40 7/12/2020
suhartini ningsih 35 14-12-2020
penye baiq nurdiani 39 5/12/2020
mariani 28 20-12-2020
raudatul jannah 28 14-3-2021

baiq suci 34 1/11/2020

baiq ira irawan 30 4/2/2021
penye bat
alvia malawi 36 23-1-2021

patmah 35 2/10/2020
jauriah 24 12/12/2020
patniwati 28 1/12/2020
rabiatuladawiah 35 20-11-2020
ayuni 28 3/1/2020
musriah 31 28-12-20205-10-201
era rosdiana 20 20-1-2020
pegondang
nursobah 28 17-2-2021
nurhasanah 34 Mar-21
nurhidayah 29 20-4-2021
 pegondang

siti halimah 30 15-3-2021

zuriaton 24 18-4-2021
ernawati 27 10/5/2021

baiq muniati 39 24-1-2021

batu lawang fitriah 20 12/2/2021

sahre 30 23-9-2020
murni 31 1/12/2020
nurmin 36 Nov-20
jurang gadung
yuliana rostika 26 15-4-2021
citrawani 21 12/4/2021

genteng sri hayuni 30 10/11/2020

indrayuni 32 22-12-2020
miladiah 35 Jan-21
 HASIL PEMERIKSAAN
HPL GRAVIDA BB TB LILA TD HB PENYAKIT PENYERTA
14-7-2021 g1p0a0 51 154 24 110/70 10,7 taa
17-7-2021 g2p1a0 48 153 23,5 90/60 12 taa
27-9-2021 g5p2a2 59 146 25 100/60 11,7 taa
24-9-2021 g2p1a0 48 145 24,5 110/70 13 taa
14-10-2021 g3p2a0 46 150 26 110/60 11,3 taa
28-11-2021 g2p1a0 46,9 158 24 90/60 10,2 taa
10/9/2021 g2p1a0 48 149 24 120/70 11 taa
7/10/2021 g1p0a0 49 147 23 110/70 12,5 taa
27-11-2021 g3p2a0h1 56 154 25,5 90/60 11,8 taa
8/11/2021 g2p1a0 52 148,3 26,5 120/80 10,9 taa
5/12/2021 g2p0a1 52 157 24 90/60 taa
17-11-2021 g4p2a1h2 64 160 30 100/60 taa
14-1-2022 g3p2a0 58 149 27 120/70 taa
3/1/2021 g3p2a0 62 152 25 100/70 taa
17-12-2021 g1p0a0 48,7 158 23 110/60 taa

18-8-2021 g2p1a0 61 154 25 100/70 11.7 taa

3/9/2021 g3p2a0 40 142 24.5 100/60 10.8 taa
27-11-2021 g1p0a0 40 151 25 90/60 11,2 taa
8/12/2021 g1p0a0 49 150 26 100/70 11,8 taa
8/12/2021 g4p1a0 61 148 30 90/60 taa
24-12-2021 g3p2a0 57,7 160 30 100/60 taa
17-12-2021 g5p2a2 57 150 26 120/80 taa
23-10-2021 g1p0a0 62,9 158 28 110/70 taa

22-7-2021 g3p2a0 67 157 30 120/60 10.7 taa

21-9-2021 g14p3a0 42 147 23.5 100/70 12 taa
21-9-2021 g3p2a0 56 152 25 110/70 12,5 taa
12/9/2021 g4p2a0 48 148 24 90/60 taa
27-9-2021 g1p0a0 49 156 23.5 100/60 taa
21-12-2021 g3p2a0 70 160 28 110/60 taa

8/8/2021 g4p3a0 54 158 24 90/60 10.3 taa

11-11-2021gip0a0 70 153 30 100/70 11,2 taa
30-10-2021g2p1a0 45 141 25 110/70 13 taa

9/7/2021 g2p1a0 50 150 24 120/60 13.6 taa

19-9-2021 g2p1a0 45 144 24 100/60 10.5 taa
8-9-2021 g2p1a0 62 141 25 90/60 11.5 taa
27-8-2021 g4p3a0 70 151 28 100/70 13,4 taa
10/20/2021 g2p1a0 50 146 24,5 100/60 11.2 taa
8-12-20205-10-201 g2p1a0 64 153 30 100/70 12 taa
27-10-201 g1p0a0 55 150 26 90/60 10'9 taa
24-11-2021 g2p1a0 58 146 25 100/60 11,3 taa
Nov-21 g3p2a0 55 153 24 100/70 taa
27-1-2022 g2p1a0 43 152 24,5 90/60 taa
22-12-2021 g2p1a0 43 152 24 100/60 taa
25-1-2022 g2p1a0 42 150 24 110/60 taa
17-2-2022 g1a0p0 54 152 25 120/70 taa

31-10-2021 g2p0a1 38 150 23 110/60 11,2 taa

19-11-2021 g1p0a0 39 152 23,5 100/70 taa

30-6-2021 g6p3a2 40 154 25 100/60 12.7 taa

8-92021 g3p2a0 51 155 24 100/70 11,7 taa
Aug-21 g5p4a0 81 160 30 90/60 taa
22-1-2022 g2p1a0 4o 152 24 100/60 taa
19-1-2022 g2p1a0 53 153 25 90/60 taa

17-8-2021 g2p1a0 50 154 24 90/60 11.7 taa

29-9-2021 g2p1a0 48 147 23.5 100/70 10.9 taa
Oct-21 g3p2a0 52 154 27 100/60 12,2 taa
 KEPEMILIKAN KARTU BPJS
(YA/TIDAK)
ya
tidak
tidak
tidak
ya
ya
tidak
tidak
ya
ya
ya
tidak
ya
tidak
ya

ya
tidak
ya
ya
ya
ya
ya
tidak

ya
ya
ya
ya
tidak
ya

ya
ya
ya

ya
ya
ya
ya
ya
tidak
tidak
ya
tidak
ya
ya
tidak
tidak

ya
tidak

tidak
tidak
ya
ya
ya

ya
ya
ya
 FORM IBU HAMIL PUSKESMAS....................
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR

NO POLINDES DUSUN NAMA IBU HAMIL UMUR

HPHT
murniaton 35 20-12-2020
idayanti 28 17-12-2020
mahuni 30 7/1/2021
1
suriani 25 21-2-2021
sasti parlina 20 7/12/2020
siti rohani 21 31-1-2021
turun tangis sahnim 40 20-2-2021
siti nurhaliza 22 1/2/2021
suriani 18 28-2-2021
2 hibiliati 35 10/2/2021
halimah 40 7/4/2021
purtini 27 27-3-2021
amrina paroja 21 10/3/2021
3
eli patmawati 30 25-11-2020
khairunisa 21 20-2-2021
susanti 22 1/2/2021
napsiah 25 1/2/2021
Jurang Munte
suniati 27 17-3-2021
ronah 37 10/3/2021
hernawati 20 15-1-2021
khairun nisak 19 11/5/2021

hapsatul handayani 32 5/10/2020

sahmin 40 7/12/2020
suhartini ningsih 35 14-12-2020
baiq nurdiani 39 5/12/2020
suwangi timur mariani 28 20-12-2020
Penye
raudatul jannah 28 14-3-2021
suriati 37 15-5-2021
seme 38 20-4-2021
lina ramdani 37 16-5-2021

baiq suci 34 1/11/2020

baiq ira irawan 30 4/2/2021
penye timur alvia malawi 36 23-1-2021
baiq surianom 29 23-5-2021

jauriah 24 12/12/2020
patniwati 28 1/12/2020
rabiatuladawiah 35 20-11-2020
ayuni 28 3/1/2020
musriah 31 28-12-20205-10-201
era rosdiana 20 20-1-2020
pegondang nursobah 28 17-2-2021
nurhasanah 34 Mar-21
 pegondang

nurhidayah 29 20-4-2021
siti halimah 30 15-3-2021
zuriaton 24 18-4-2021
ernawati 27 10/5/2021

baiq muniati 39 24-1-2021

batu lawang
fitriah 20 12/2/2021

murni 31 1/12/2020
nurmin 36 Nov-20
yuliana rostika 26 15-4-2021
jurang gadung
surohartini 30 20-5-2021
iq.windi 25 15-6-2021
rohaetun 36 22-4-2021

indrayuni 32 22-12-2020
genteng
miladiah 35 Jan-21
 HASIL PEMERIKSAAN
HPL GRAVIDA BB TB LILA TD HB PENYAKIT PENYERTA
27-9-2021 g5p2a2 59 146 25 100/60 11,7 taa
24-9-2021 g2p1a0 48 145 24,5 110/70 13 taa
14-10-2021 g3p2a0 46 150 26 110/60 11,3 taa
28-11-2021 g2p1a0 46,9 158 24 90/60 10,2 taa
10/9/2021 g2p1a0 48 149 24 120/70 11 taa
7/10/2021 g1p0a0 49 147 23 110/70 12,5 taa
27-11-2021 g3p2a0h1 56 154 25,5 90/60 11,8 taa
8/11/2021 g2p1a0 52 148,3 26,5 120/80 10,9 taa
5/12/2021 g2p0a1 52 157 24 90/60 taa
17-11-2021 g4p2a1h2 64 160 30 100/60 taa
14-1-2022 g3p2a0 58 149 27 120/70 taa
3/1/2021 g3p2a0 62 152 25 100/70 taa
17-12-2021 g1p0a0 48,7 158 23 110/60 taa

3/9/2021 g3p2a0 40 142 24.5 100/60 10.8 taa

27-11-2021 g1p0a0 40 151 25 90/60 11,2 taa
8/12/2021 g1p0a0 49 150 26 100/70 11,8 taa
8/12/2021 g4p1a0 61 148 30 90/60 12 taa
24-12-2021 g3p2a0 57,7 160 30 100/60 11,7 taa
17-12-2021 g5p2a2 57 150 26 120/80 taa
23-10-2021 g1p0a0 62,9 158 28 110/70 taa
18-2-2021 g1p0a0 45 150 24 100/60 taa

22-7-2021 g3p2a0 67 157 30 120/60 10.7 taa

21-9-2021 g14p3a0 42 147 23.5 100/70 12 taa
21-9-2021 g3p2a0 56 152 25 110/70 12,5 taa
12/9/2021 g4p2a0 48 148 24 90/60 taa
27-9-2021 g1p0a0 49 156 23.5 100/60 taa
21-12-2021 g3p2a0 70 160 28 110/60 taa
21-2-2-21 g4p2a1h2 57 149 32 100/70 taa
26-1-2021 g4p3ao 58 148 30 9o/60 taa
23-2-2021 g5p3a1 60 151 30 120/80 taa

8/8/2021 g4p3a0 54 158 24 90/60 10.3 taa

11-11-2021gip0a0 70 153 30 100/70 11,2 taa
30-10-2021g2p1a0 45 141 25 110/70 13 taa
2/3/2021 g2p1a0 63 153 29 100/60 taa

19-9-2021 g2p1a0 45 144 24 100/60 10.5 taa

8-9-2021 g2p1a0 62 141 25 90/60 11.5 taa
27-8-2021 g4p3a0 70 151 28 100/70 13,4 taa
10/20/2021 g2p1a0 50 146 24,5 100/60 11.2 taa
8-12-20205-10-201 g2p1a0 64 153 30 100/70 12 taa
27-10-201 g1p0a0 55 150 26 90/60 10.9 taa
24-11-2021 g2p1a0 58 146 25 100/60 11,3 taa
Nov-21 g3p2a0 55 153 24 100/70 taa
27-1-2022 g2p1a0 43 152 24,5 90/60 taa
22-12-2021 g2p1a0 43 152 24 100/60 taa
25-1-2022 g2p1a0 42 150 24 110/60 taa
17-2-2022 g1a0p0 54 152 25 120/70 taa

31-10-2021 g2p0a1 38 150 23 110/60 11,2 taa

19-11-2021 g1p0a0 39 152 23,5 100/70 taa

8-92021 g3p2a0 51 155 24 100/70 11,7 taa

Aug-21 g5p4a0 81 160 30 90/60 taa
22-1-2022 g2p1a0 4o 152 24 100/60 taa
27-2-2021 g3p2a0 62 152 29 110/80 taa
22-3-2021 g2p1a0 68 154 30 100/60 taa
29-1-2022 g2p1a0 52 149 24 120/70 taa

29-9-2021 g2p1a0 48 147 23.5 100/70 10.9 taa

Oct-21 g3p2a0 52 154 27 100/60 12,2 taa
 KEPEMILIKAN KARTU BPJS
(YA/TIDAK)
tidak
tidak
ya
ya
tidak
tidak
ya
ya
ya
tidak
ya
tidak
ya

tidak
ya
ya
ya
ya
ya
tidak
ya

ya
ya
ya
ya
tidak
ya
ya
tidak
ya

ya
ya
ya
ya

ya
ya
ya
ya
tidak
tidak
ya
tidak
ya
ya
tidak
tidak

ya
tidak

tidak
ya
ya
ya
ya
tidak

ya
ya
 FORM IBU HAMIL PUSKESMAS....................
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR

NO POLINDES DUSUN NAMA IBU HAMIL UMUR

HPHT

1 JURANG MUNTE khairunisa 21 20-2-2021

susanti 22 44198
napsiah 25 44198
suniati 27 17-3-2021
ronah 37 44472
hernawati 20 15-1-2021
Fatmawati 20 23-06-2021
iswatun 21 15-06-2021
ernawati 22 20-07-2021
selamah 37 20-06-2021
Jamiati 19 11/5/2021
fatimah 35 15-06-2021
2 PENYE sahmin 40 44024
suhartini ningsih 35 14-12-2020
mariani 28 20-12-2020
raudatul jannah 28 14-3-2021
suriati 37 15-5-2021
seme 38 20-4-2021
3 PENYE TIMUR baiq ira irawan 30 44288
alvia malawi 36 23-1-2021
baiq surianom 29 23-5-2021
4 PEGONDANG jauriah 24 44177
patniwati 28 43842
rabiatuladawiah 35 20-11-2020
ayuni 28 43891
musriah 31 28-12-20205-10-201
era rosdiana 20 20-1-2020
nursobah 28 17-2-2021
nurhasanah 34 44256
nurhidayah 29 20-4-2021
siti halimah 30 15-3-2021
zuriaton 24 18-4-2021
ernawati 27 44474
5 BATU LAWANG baiq muniati 39 24-1-2021
fitriah 20 44532
Ita Nurmalasari 23 25-05-2021
Nurhaini 35 1/6/2021
6 JURANG GADUNG murni 31 43842
yuliana rostika 26 15-4-2021
surohartini 30 20-5-2021
iq.windi 25 15-6-2021
rohaetun 36 22-4-2021
Nadia muliana 22 20-03-2021
Husni 30 10/6/2021
 Nurmah 25 2/6/2021
7 GENTENG miladiah 35 22-12-2020
Makiah 32 30-07-2021
8 TURUN Tangis murniaton 35 20-12-2020
idayanti 28 17-12-2020
mahuni 30 44378
suriani 25 21-2-2021
siti rohani 21 31-1-2021
sahnim 40 20-2-2021
siti nurhaliza 22 44198
suriani 18 28-2-2021
hibiliati 35 44471
halimah 40 44381
purtini 27 27-3-2021
amrina paroja 21 44472
iswatun 21 16-06-2021
Fatmawati 20 23-06-2021
ernawati 22 10/7/2021
salamah 37 10/6/2021
 HASIL PEMERIKSAAN
HPL GRAVIDA BB TB LILA TD HB PENYAKIT PENYERTA

27-11-2021 g1p0a0 40 151 25 90/60 11,2 taa

44420 g1p0a0 49 150 26 100/70 11,8 taa
44420 g4p1a0 61 148 30 90/60 12 taa
24-12-2021 g3p2a0 57,7 160 30 100/60 11,7 taa
17-12-2021 g5p2a2 57 150 26 120/80 taa
23-10-2021 g1p0a0 62,9 158 28 110/70 taa
30-03-2022 g2p1ao 41 150 24 110/70 taa
22-02-2022 g2p0a1 37,7 145 23.5 100/70 taa
27-04-2022 g2p1a0 51,2 150 25 100/80 taa
27-03-2022 g4p3a0 48 151 25 110/70 taa
18-02-2022 g1p0a0 45 150 24 90/70 taa
23-03-2022 g3p2a0 60.9 159 27 100/60 taa
21-9-2021 g14p3a0 42 147 23.5 100/70 12 taa
21-9-2021 g3p2a0 56 152 25 110/70 12,5 taa
27-9-2021 g1p0a0 49 156 23.5 100/60 taa
21-12-2021 g3p2a0 70 160 28 110/60 taa
21-2-2-21 g4p2a1h2 57 149 32 100/70 taa
26-1-2021 g4p3ao 58 148 30 9o/60 taa
11-11-2021gip0a0 70 153 30 100/70 11,2 taa
30-10-2021g2p1a0 45 141 25 110/70 13 taa
44230 g2p1a0 63 153 29 100/60 taa
19-9-2021 g2p1a0 45 144 24 100/60 10.5 taa
8-9-2021 g2p1a0 62 141 25 90/60 11.5 taa
27-8-2021 g4p3a0 70 151 28 100/70 13,4 taa
44489 g2p1a0 50 146 24,5 100/60 11.2 taa
12-20205-10-201 g2p1a0 64 153 30 100/70 12 taa
27-10-201 g1p0a0 55 150 26 90/60 10'9 taa
24-11-2021 g2p1a0 58 146 25 100/60 11,3 taa
44501 g3p2a0 55 153 24 100/70 taa
27-1-2022 g2p1a0 43 152 24,5 90/60 taa
22-12-2021 g2p1a0 43 152 24 100/60 taa
25-1-2022 g2p1a0 42 150 24 110/60 taa
17-2-2022 g1a0p0 54 152 25 120/70 taa
31-10-2021 g2p0a1 38 150 23 110/60 11,2 taa
19-11-2021 g1p0a0 39 152 23,5 100/70 taa
3/3/2022 g1p0a0 42 150 24 90/70 taa
8/3/2022 g2p1a0 52 148 26 120/80 taa
8-92021 g3p2a0 51 155 24 100/70 11,7 taa
22-1-2022 g2p1a0 40 152 24 100/60 taa
27-2-2021 g3p2a0 62 152 29 110/80 taa
22-3-2021 g2p1a0 68 154 30 100/60 taa
29-1-2022 g2p1a0 52 149 24 120/70 taa
27-12-2021 g1p0a0 43.7 148 24 110/60 taa
17-03-2022 g2p1a0 41 151 24 100/70 taa
 9/3/2022 g1p0a0 50 153 24.5 120/70 taa
44470 g3p2a0 52 154 27 100/60 12,2 taa
7/4/2021 g2p1a0 33 150 21 100/60 12,2 taa
27-9-2021 g5p2a2 59 146 25 100/60 11,7 taa
24-9-2021 g2p1a0 48 145 24,5 110/70 13 taa
14-10-2021 g3p2a0 46 150 26 110/60 11,3 taa
28-11-2021 g2p1a0 46,9 158 24 90/60 10,2 taa
44387 g1p0a0 49 147 23 110/70 12,5 taa
27-11-2021 g3p2a0h1 56 154 25,5 90/60 11,8 taa
44419 g2p1a0 52 148,3 26,5 120/80 10,9 taa
44328 g2p0a1 52 157 24 90/60 taa
17-11-2021 g4p2a1h2 64 160 30 100/60 taa
14-1-2022 g3p2a0 58 149 27 120/70 taa
44256 g3p2a0 62 152 25 100/70 taa
17-12-2021 g1p0a0 48,7 158 23 110/60 taa
22-03-2022 g2poa1 37 145 23.5 90/70 taa
30-03-2022 g2p1a0 41 150 24 100/80 taa
17-04-2022 g2p1a0 51,2 150 25 110/80 taa
17-03-2022 g4p3a0 48 150 25 100/90 taa
KEPEMILIKAN KARTU BPJS
(YA/TIDAK)

ya
ya
ya
ya
ya
tidak
ya
ya
ya
ya
ya
ya
ya
ya
tidak
ya
ya
tidak
ya
ya
ya
ya
ya
ya
ya
tidak
tidak
ya
tidak
ya
ya
tidak
tidak
ya
tidak
tidak
ya
tidak
ya
ya
ya
tidak
ya
tidak
tidak
ya
ya
tidak
tidak
ya
ya
tidak
ya
ya
ya
tidak
ya
tidak
ya
tidak
yaa
ya
ya
 FORM IBU HAMIL PUSKESMAS SAKRA POLINDES SUWANGI TIMUR
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR

NO POLINDES DUSUN NAMA IBU HAMIL UMUR

HPHT
suniati 27 17-3-2021
ronah 37 10-3-2021
Fatmawati 20 23-06-2021
iswatun 21 15-06-2021
JURANG MUNTE
ernawati 22 20-07-2021
selamah 37 20-06-2021
Eka mariana 23 07-07-2021
fatimah 35 15-06-2021
jumaiyah 26 10-08-2021
raudatul jannah 28 14-3-2021
suriati 37 15-5-2021
2 PENYE
seme 38 20-4-2021
Febriana Ramdani 26 10-05-2021
Masyuni 27 05-08-2021
suriani 40 03-09-2021
rabiatul adawiah 27 10-08-2021
raah 40 02-07-2021

baiq ira irawan 30 04-02-2021

alvia malawi 36 23-1-2021
3 PENYE TIMUR
baiq surianom 29 23-5-2021
Yuliana Muliana 29 10-07-2021
ayuni 28 03-01-2021
musriah 31 28-12-20205-10-201
era rosdiana 20 20-1-2020
nursobah 28 17-2-2021
nurhasanah 34 10-03-2021
4 PEGONDANG
nurhidayah 29 20-4-2021
siti halimah 30 15-3-2021
zuriaton 24 18-4-2021
ernawati 27 10-03-2021
Nurmah 27 10-06-2021
baiq muniati 39 24-1-2021
fitriah 20 12-2-2021
Ita Nurmalasari 23 25-05-2021
5 BATU LAWANG Nurhaini 35 01-06-2021
Eka harianti 27 25-07-2021
Rohaini 23 03-08-2021
Baiq resi astuti 26 16-07-2021
yuliana rostika 26 15-4-2021
surohartini 30 20-5-2021
iq.windi 25 15-6-2021
rohaetun 36 22-4-2021
6 JURANG GADUNG
Nadia muliana 22 20-03-2021
Husni 30 23-06-2021
Nurmah 25 02-06-2021
6 JURANG GADUNG

Aisah 31 03-07-2021
miladiah 35 22-12-2020
7 GENTENG Makiah 32 30-07-2021
Elviana eli susanti 19 13-08-2021
murniaton 35 20-12-2020
idayanti 28 17-12-2020
mahuni 30 07-01-2021
suriani 25 21-2-2021
siti rohani 21 31-1-2021
sahnim 40 20-2-2021
siti nurhaliza 22 01-02-2021
suriani 18 21-02-2021
hibiliati 35 10-05-2021
8 TURUN TANGIS
halimah 40 07-04-2021
purtini 27 27-3-2021
amrina paroja 21 10-03-2021
Yanti laela 21 29-04-2021
Sahri 29 10-06-2021
Rohanah 38 10-06-2021
Nurul Hidayah 27 25-06-2021
Ida komala sari 25 04-07-2021
Raehan 30 20-07-2021
 HASIL PEMERIKSAAN
HPL GRAVIDA BB TB LILA TD HB PENYAKIT PENYERTA
24-12-2021 g3p2a0 57,7 160 30 100/60 11,7 taa
17-12-2021 g5p2a2 57 150 26 120/80 taa
30-03-2022 g2p1ao 41 150 24 110/70 taa
22-02-2022 g2p0a1 37,7 145 23.5 100/70 taa
27-04-2022 g2p1a0 51,2 150 25 100/80 taa
27-03-2022 g4p3a0 48 151 25 110/70 taa
14-04-2021 g2p0a1 45 149 24 100/70 taa
23-03-2022 g3p2a0 60.9 159 27 100/60 taa
17-05-2021 g2p1a0h1 50 150 24 100/80 taa
21-12-2021 g3p2a0 70 160 28 110/60 taa
21-2-2022 g4p2a1h2 57 149 32 100/70 taa
26-1-2022 g4p3a0 58 148 30 90/60 taa
17-02-2021 g2p1a0h1 49 149 24 100/70 taa
12-05-2022 g2p0a1h0 47 147 24.5 90/60 taa
10-06-2022 g3p2a0h2 50 150 25 100/70 taa
17-05-2021 g2p1a0h1 36 1412 24 110/70 taa
09-04-2021

11-11-2021 g4p2a1h2 70 153 30 100/70 11,2 taa

30-10-2021 g2p1a0h1 45 141 25 110/70 13 taa
03-03-2022 g2p1a0 63 153 29 100/60 taa
17-04-2022 g2p1a0h1 57 159 28 80/60 11.3 taa
10-10-2021 g2p1a0 50 146 24,5 100/60 11.2 taa
8-12-20205-10-201 g2p1a0 64 153 30 100/70 12 taa
27-10-201 g1p0a0 55 150 26 90/60 10'9 taa
24-11-2021 g2p1a0 58 146 25 100/60 11,3 taa
17-11-2021 g3p2a0 55 153 24 100/70 taa
27-1-2022 g2p1a0 43 152 24,5 90/60 taa
22-12-2021 g2p1a0 43 152 24 100/60 taa
25-1-2022 g2p1a0 42 150 24 110/60 taa
17-2-2022 g1a0p0 54 152 25 120/70 taa
17-03-2022 g3p2a0h2 48 148 24 110/70 taa
31-10-2021 g2p0a1 38 150 23 110/60 11,2 taa
19-11-2021 g1p0a0 39 152 23,5 100/70 taa
03-03-2022 g1p0a0 42 150 24 90/70 taa
08-03-2022 g2p1a0 52 148 26 120/80 taa
02-05-2021 g1p0a0 42 150 24 100/70 taa
10-05-2022 g2p1a0h1 58 151.2 29 110/80 taa
23-04-2022 g1poa0 63.5 154 29 100/60 taa
22-1-2022 g2p1a0 40 152 24 100/60 taa
27-2-2021 g3p2a0 62 152 29 110/80 taa
22-3-2021 g2p1a0 68 154 30 100/60 taa
29-1-2022 g2p1a0 52 149 24 120/70 taa
27-12-2021 g1p0a0 43.7 148 24 110/60 taa
17-03-2022 g2p1a0 41 151 24 100/70 taa
09-03-2022 g1p0a0 50 153 24.5 120/70 taa
10-04-2021 g2p1a0h1 50 153.5 24 90/60 taa
31-10-2021 g3p2a0 52 154 27 100/60 12,2 taa
07-04-2022 g2p1a0 33 150 21 100/60 12,2 taa
20-05-2022 g1p0a0 40.3 150.9 23.5 110/70 taa
27-9-2021 g5p2a2 59 146 25 100/60 11,7 taa
24-9-2021 g2p1a0 48 145 24,5 110/70 13 taa
14-10-2021 g3p2a0 46 150 26 110/60 11,3 taa
28-11-2021 g2p1a0 46,9 158 24 90/60 10,2 taa
31-11-2021 g1p0a0 49 147 23 110/70 12,5 taa
27-11-2021 g3p2a0h1 56 154 25,5 90/60 11,8 taa
08-11-2022 g2p1a0 52 148,3 26,5 120/80 10,9 taa
28-11-2021 g2p0a1 52 157 24 90/60 taa
17-11-2021 g4p2a1h2 64 160 30 100/60 taa
14-1-2022 g3p2a0 58 149 27 120/70 taa
03-01-2022 g3p2a0 62 152 25 100/70 taa
17-12-2021 g1p0a0 48.7 158 23 110/60 taa
05-02-2022 g2p1a0a1 49 150 24 100/70 taa
17-03-2022 g3p2a0h2 53.4 155 24 110/70 taa
17-03-2022 g2p1a0h1 53 150 24.2 110/60 taa
02-04-2022 g1p0a0 50 148 24 100/70 taa
11-04-2022 g2p1a0h1 47 147 23.5 90/60 taa
27-04-2022 g1p0a0 52 151 26 90/60 taa
KEPEMILIKAN KARTU BPJS
(YA/TIDAK)
YA
 FORM IBU HAMIL PUSKESMAS SAKRA ( POL.SUWANGI TIMUR )
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR

NO POLINDES DUSUN NAMA IBU HAMIL UMUR

HPHT
suniati 27 17-3-2021
ronah 37 10-3-2021
Fatmawati 20 23-06-2021
iswatun 21 15-06-2021
1 jurang munte ernawati 22 20-07-2021
selamah 37 20-06-2021
Eka mariana 23 07-07-2021
fatimah 35 15-06-2021
jumaiyah 26 10-08-2021
raudatul jannah 28 14-3-2021
suriati 37 15-5-2021
seme 38 20-4-2021
Febriana Ramdani 26 10-05-2021
2 Penye Masyuni 27 05-08-2021
suriani 40 03-09-2021
rabiatul adawiah 27 10-08-2021
raah 40 02-07-2021
suhartini 39 03-09-2021
baiq surianom 29 23-5-2021
3 Penye timur
Yuliana Muliana 29 10-07-2021
nurhidayah 29 20-4-2021
siti halimah 30 15-3-2021
zuriaton 24 18-4-2021
4 Pegondang
ernawati 27 10-03-2021
Nurmah 27 10-06-2021
Rumanis 41 09-08-2021
baiq muniati 39 24-1-2021
fitriah 20 12-2-2021
Ita Nurmalasari 23 25-05-2021
Nurhaini 35 01-06-2021
5 Batu Lawang Eka harianti 27 25-07-2021
Rohaini 23 03-08-2021
Nurhayati 30 07-07-2021
Uswatun Hasanah 29 13-07-2021
Nurhaini 28 10-08-2021
yuliana rostika 26 15-4-2021
surohartini 30 20-5-2021
iq.windi 25 15-6-2021
rohaetun 36 22-4-2021
6 Jurang Gadung
Nadia muliana 22 20-03-2021
Husni 30 23-06-2021
Nurmah 25 02-06-2021
Aisah 31 03-07-2021
Makiah 32 30-07-2021
Elviana eli susanti 19 13-08-2021
7 Genteng
Suziana 21 15-08-2021
7 Genteng
hendri 25 06-06-2021
halimah 40 07-04-2021
purtini 27 27-3-2021
amrina paroja 21 10-03-2021
Yanti laela 21 29-04-2021
Sahri 29 10-06-2021
Rohanah 38 10-06-2021
8 Turun Tangis
Nurul Hidayah 27 25-06-2021
Ida komala sari 25 04-07-2021
Raehan 30 20-07-2021
Mahyani 32 10-08-2021
Fatmawati 30 13-08-2021
idayatun fitri 18 16-09-2021
 HASIL PEMERIKSAAN
HPL GRAVIDA BB TB LILA TD HB PENYAKIT PENYERTA
24-12-2021 g3p2a0 57,7 160 30 100/60 11,7 taa
17-12-2021 g5p2a2 57 150 26 120/80 taa
30-03-2022 g2p1ao 41 150 24 110/70 taa
22-02-2022 g2p0a1 37,7 145 23.5 100/70 taa
27-04-2022 g2p1a0 51,2 150 25 100/80 taa
27-03-2022 g4p3a0 48 151 25 110/70 taa
14-04-2021 g2p0a1 45 149 24 100/70 taa
23-03-2022 g3p2a0 60.9 159 27 100/60 taa
17-05-2021 g2p1a0h1 50 150 24 100/80 taa
21-12-2021 g3p2a0 70 160 28 110/60 taa
21-2-2022 g4p2a1h2 57 149 32 100/70 taa
26-1-2022 g4p3a0 58 148 30 90/60 taa
17-02-2021 g2p1a0h1 49 149 24 100/70 taa
12-05-2022 g2p0a1h0 47 147 24.5 90/60 taa
10-06-2022 g3p2a0h2 50 150 25 100/70 taa
17-05-2021 g2p1a0h1 36 142 24 110/70 taa
09-04-2021 g3p2a0h2 42 147 24 100/70 taa
10-06-2021 g4p3ah3 57 156 25 120/70 taa
03-03-2022 g2p1a0 63 153 29 100/60 taa
17-04-2022 g2p1a0h1 57 159 28 80/60 11.3 taa
27-1-2022 g2p1a0 43 152 24,5 90/60 taa
22-12-2021 g2p1a0 43 152 24 100/60 taa
25-1-2022 g2p1a0 42 150 24 110/60 taa
17-2-2022 g1a0p0 54 152 25 120/70 taa
17-03-2022 g3p2a0h2 48 148 24 110/70 taa
16-05-2022 g3p2a0h2 50 147 24 110/70 taa
31-10-2021 g2p0a1 38 150 23 110/60 11,2 taa
19-11-2021 g1p0a0 39 152 23,5 100/70 taa
03-03-2022 g1p0a0 42 150 24 90/70 taa
08-03-2022 g2p1a0 52 148 26 120/80 taa
02-05-2021 g1p0a0 42 150 24 100/70 taa
10-05-2022 g2p1a0h1 58 151.2 29 110/80 taa
14-04-2022 g3p2a0h2 50 148 24 90/60 taa
20-04-2022 g2p1a0h1 47 150 24 110/70 taa
17-05-2022 g2p2a0h1 49 147 25 120/70 taa
22-1-2022 g2p1a0 40 152 24 100/60 taa
27-2-2021 g3p2a0 62 152 29 110/80 taa
22-3-2021 g2p1a0 68 154 30 100/60 taa
29-1-2022 g2p1a0 52 149 24 120/70 taa
27-12-2021 g1p0a0 43.7 148 24 110/60 taa
17-03-2022 g2p1a0 41 151 24 100/70 taa
09-03-2022 g1p0a0 50 153 24.5 120/70 taa
10-04-2021 g2p1a0h1 50 153.5 24 90/60 taa
07-04-2022 g2p1a0 33 150 21 100/60 12,2 taa
20-05-2022 g1p0a0 40.3 150.9 23.5 110/70 taa
23-05-2022 g2p1a0h1 45.3 148 24 100/70 taa
13-03-2022 g1p0a0 58 157 25.5 120/80 taa
14-1-2022 g3p2a0 58 149 27 120/70 taa
03-01-2022 g3p2a0 62 152 25 100/70 taa
17-12-2021 g1p0a0 48.7 158 23 110/60 taa
05-02-2022 g2p1a0a1 49 150 24 100/70 taa
17-03-2022 g3p2a0h2 53.4 155 24 110/70 taa
17-03-2022 g2p1a0h1 53 150 24.2 110/60 taa
02-04-2022 g1p0a0 50 148 24 100/70 taa
11-04-2022 g2p1a0h1 47 147 23.5 90/60 taa
27-04-2022 g1p0a0 52 151 26 90/60 taa
17-05-2022 g4p3a0h3 49 148 24 110/60 taa
20-05-2022 g4p3a0h3 53 153 25 120/70 taa
23-06-2022 g1p0a0 43 148 24 90/60 taa
KEPEMILIKAN KARTU BPJS
(YA/TIDAK)

YA
ya
 FORM IBU HAMIL PUSKESMAS....................
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR

NO POLINDES DUSUN NAMA IBU HAMIL UMUR

HPHT

3
 HASIL PEMERIKSAAN
HPL GRAVIDA BB TB LILA TD HB PENYAKIT PENYERTA
KEPEMILIKAN KARTU BPJS
(YA/TIDAK)
 FORM IBU HAMIL PUSKESMAS....................
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR

NO POLINDES DUSUN NAMA IBU HAMIL UMUR

HPHT

3
 HASIL PEMERIKSAAN
HPL GRAVIDA BB TB LILA TD HB PENYAKIT PENYERTA
KEPEMILIKAN KARTU BPJS
(YA/TIDAK)