LAPORAN BULANAN

REKAPITULASI HASIL PENIMBANGAN BAYI BALITA

PUSKESMAS OINLASI BULAN JANUARI 2019

Desa Oinlasi Desa Kokoi Desa Fatulunu Desa Nunleu Desa Kualeu Desa Fenun Desa Fae Desa Anin Desa Toi Desa Nifuleo Desa Sunu Desa Lanu Desa Netutnana Total
No Elemen Data
L P L P L P L P L P L P L P L P L P L P L P L P L P L P L+P
I Jumlah Posyandu :
a. Ada 4 3 3 4 3 4 4 4 3 4 4 3 2 45
b. Lapor 0 2 0 2 0 0 4 3 0 4 4 3 2 24

II Jumlah Kader :
a. Ada 0 20 2 13 5 10 6 14 0 15 4 16 4 16 2 18 5 10 5 12 4 16 3 12 1 9 41 181 222
b. Aktif 0 20 2 13 5 10 6 14 0 15 4 16 4 16 2 18 5 10 5 13 3 15 3 1 1 9 40 170 210
0 77 0 101 0 0 85 86 0 119 141 93 97 799
3 Balita yang ada (S) : 0 0 45 32 0 0 52 49 0 0 0 0 45 40 47 39 0 0 64 55 67 74 48 45 40 57 408 391 799
0 - 5 bulan 0 0 2 1 0 0 3 2 0 0 0 0 2 1 4 4 0 0 6 2 6 5 3 2 2 8 28 25 53
6 - 11 bulan 0 0 7 3 0 0 2 4 0 0 0 0 4 7 6 3 0 0 4 2 7 8 8 4 9 6 47 37 84
12 - 23 bulan 0 0 12 9 0 0 10 11 0 0 0 0 7 6 10 7 0 0 14 12 14 9 5 9 3 11 75 74 149
24 -59 bulan 0 0 24 19 0 0 37 32 0 0 0 0 32 26 27 25 0 0 40 39 40 52 32 30 26 32 258 255 513
4 Jlh Balita Terdaftar & Punya
KMS/buku KIA (K) :
0 0 45 32 0 0 52 49 0 0 0 0 45 40 47 39 0 0 64 55 67 74 48 45 40 57 408 391 799
0 - 5 bulan 0 0 2 1 0 0 3 2 0 0 0 0 2 1 4 4 0 0 6 2 6 5 3 2 2 8 28 25 53
6 - 11 bulan 0 0 7 3 0 0 2 4 0 0 0 0 4 7 6 3 0 0 4 2 7 8 8 4 9 6 47 37 84
12 - 23 bulan 0 0 12 9 0 0 10 11 0 0 0 0 7 6 10 7 0 0 14 12 14 9 5 9 3 11 75 74 149
24 -59 bulan 0 0 24 19 0 0 37 32 0 0 0 0 32 26 27 25 0 0 40 39 40 52 32 30 26 32 258 255 513

3 Jlh Balita yang Ditimbang (D) : 0 0 28 17 0 0 46 36 0 0 0 0 37 29 24 29 0 0 55 41 56 64 38 39 27 40 311 295 606

0 - 5 bulan 0 0 2 1 0 0 3 2 0 0 0 0 2 1 3 3 0 0 5 1 6 5 3 2 2 7 26 22 48
6 - 11 bulan 0 0 7 1 0 0 2 3 0 0 0 0 2 7 2 2 0 0 4 2 6 8 7 2 7 6 37 31 68
12 - 23 bulan 0 0 9 5 0 0 10 9 0 0 0 0 5 4 7 6 0 0 14 8 12 8 4 8 2 7 63 55 118
24 -59 bulan 0 0 10 10 0 0 31 22 0 0 0 0 28 17 12 18 0 0 32 30 32 43 24 27 16 20 185 187 372
II Hasil penimbangan :
1 Balita yang BB Naik (N) : 0 0 13 8 0 0 8 8 0 0 0 0 16 12 8 12 0 0 29 13 21 25 13 11 20 22 128 111 239
0 - 5 bulan 0 0 1 0 0 0 0 1 0 0 0 0 2 1 1 3 0 0 3 0 2 3 3 2 2 3 14 13 27
6 - 11 bulan 0 0 4 1 0 0 0 1 0 0 0 0 1 4 0 0 0 0 3 1 2 3 3 0 6 3 19 13 32
12 - 23 bulan 0 0 4 1 0 0 3 2 0 0 0 0 3 2 3 2 0 0 9 1 6 4 2 2 2 3 32 17 49
24 -59 bulan 0 0 4 6 0 0 5 4 0 0 0 0 10 5 4 7 0 0 14 11 11 15 5 7 10 13 63 68 131

2 Balita yang tidak naik (T) : 0 0 10 7 0 0 16 11 0 0 0 0 17 14 4 9 0 0 13 17 27 26 15 18 6 9 108 111 219

0 - 5 bulan 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 2 0 0 0 2 1 5 6
6 - 11 bulan 0 0 3 0 0 0 0 1 0 0 0 0 0 2 1 2 0 0 0 0 3 2 0 2 1 1 8 10 18
12 - 23 bulan 0 0 3 3 0 0 3 5 0 0 0 0 2 2 0 3 0 0 3 4 5 3 1 5 0 3 17 28 45
24 -59 bulan 0 0 3 3 0 0 12 5 0 0 0 0 15 10 2 4 0 0 10 13 18 19 14 11 5 3 79 68 147
3 Balita yang tidak naik 2 kali berturut- 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
4 Balita Bawah Garis Merah (BGM) : 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2
0 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2
5
Balita ditimbang bulan ini tidak 0 0 5 2 0 0 19 17 0 0 0 0 4 3 12 8 0 0 13 10 4 13 7 9 1 7 65 69 134
hadir bulan lalu (O) :
0 - 5 bulan 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 2 0 0 0 0 0 0 0 3 1 4
6 - 11 bulan 0 0 0 0 0 0 2 1 0 0 0 0 1 1 1 0 0 0 1 1 0 3 3 0 0 2 8 8 16
12 - 23 bulan 0 0 2 1 0 0 3 2 0 0 0 0 0 0 4 1 0 0 2 3 1 1 1 1 0 1 13 10 23
24 -59 bulan 0 0 3 1 0 0 14 13 0 0 0 0 3 2 6 7 0 0 8 6 3 9 3 8 1 4 41 50 91
6 Balita yang baru hadir bulan ini (B) :
0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 1 4 0 3 1 0 2 10 4 14

0 - 5 bulan 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 1 3 0 0 0 0 2 5 3 8
6 - 11 bulan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 2 0 2
12 - 23 bulan 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
24 -59 bulan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 0 2 1 3
III Status Gizi (Konfirmasi BGM & 2
T /yangGizi
a. Status di identifikasi
berdasarkan bermasalah)
berat
badan menurut tinggi badan :
1 Kurus/Gizi kurang (BB/TB) 0 0 8 5 0 0 15 11 0 0 0 0 13 11 6 8 0 0 16 16 12 15 8 12 13 15 91 93 184
0 - 5 bulan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 2
6 - 11 bulan 0 0 1 0 0 0 0 0 0 0 0 0 1 2 0 0 0 0 0 0 0 0 0 0 2 3 4 5 9
12 - 23 bulan 0 0 3 2 0 0 3 3 0 0 0 0 3 2 3 2 0 0 3 5 3 2 0 2 0 1 18 19 37
24 -59 bulan 0 0 4 3 0 0 12 8 0 0 0 0 9 7 3 6 0 0 12 11 9 13 8 10 11 10 68 68 136
2 Sangat Kurus/Gizi buruk : (BB/TB)
a. Baru : 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
b. Kumulatif sampai bulan ini : 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
3 Gizi Lebih (B+) 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
4 Gizi Baik (B) 0 0 20 12 0 0 31 25 0 0 0 0 24 18 18 21 0 0 39 25 44 49 30 27 14 25 220 202 422
0 - 5 bulan 0 0 2 1 0 0 3 2 0 0 0 0 2 1 3 3 0 0 4 1 6 5 3 2 2 6 25 21 46
6 - 11 bulan 0 0 6 1 0 0 2 3 0 0 0 0 1 5 2 2 0 0 4 2 6 8 7 2 5 3 33 26 59
12 - 23 bulan 0 0 6 3 0 0 7 6 0 0 0 0 2 2 4 4 0 0 11 3 9 6 4 6 2 6 45 36 81
24 -59 bulan 0 0 6 7 0 0 19 14 0 0 0 0 19 10 9 12 0 0 20 19 23 30 16 17 5 10 117 119 236
b. Status Gizi berdasarkan indikator
Tinggi Badan menurut
Umur(TB/U) :

1 Pendek (TB/U) 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
2 Sangat Pendek (TB/U) 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
3 Normal 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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

4 Tinggi 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
IV
Penanganan Gizi Kurang dan Gizi
Buruk
1 Gizi Kurang yang ditangani 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
a. Konseling/Penyuluhan saja 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
b. Diberi PMT Pemulihan 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
2 Gizi Buruk yang mendapat
0 0 0
perawatan
Baru : 0 0 0
a. Rawat Inap 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
b. Rawat Jalan 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
Lama : 0 0 0
a. Rawat Inap 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
b. Rawat Jalan 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
3 Kasus Gizi Buruk Yang Meninggal : 0 0 0
Bulan ini : 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
Kumulatif s/d bulan lalu 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

V Pemberian ASI Eksklusif (0-6)

1 Eksklusif (√) 0 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 0 0 1 1 0 1 1 0 1 1 6 4 10
2 Tidak Eksklusi (X) 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 1 0 0 3 4 7
3 Tidak hadir (A) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 1 1 2 4 6

Mengetahui
Kepala Puskesmas Oinlasi Pelapor

Nance D Fanggidae,A.Md Gz
NIP.19800911 200012 2 003
Yustina Bria, A. Md Kep
NIP. 19670622 199703 2 007
Marsalina Selan, A.Md Gz
NRPTT: -
 HALAMAN 1
LAPORAN BULAN : APRIL 2019
REKAPITULASI LAPORAN PENIMBANGAN
F/III/GIZI PUSKESMAS
PUSKESMAS : OINLASI JUMLAH PENDUDUK : 19.727 JIWA
KECAMATAN : AMANATUN SELATAN JUMLAH POSYANDU : 45

JUMLAH DESA : 13

JML BALITA YG ADA JML BALITA YG TERDAFTAR JML BALITA YG NAIK BERAT BADAN
DESA POSYANDU KADER
PENDUDUK

(S) & MEMPUNYAI KMS ( K ) BULAN INI ( N )

NOMOR

DESA
Ada Aktif 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN
Ada Lapor Ada Lapor
L P L P L P L P L P L p L P L P L P L P L P L P L P L P

1 OINLASI 2.351 1 1 4 3 0 20 0 15 4 7 11 7 13 18 41 39 4 7 11 7 13 18 41 39 1 2 4 2 4 3 13 10
2 KOKOI 1.409 1 1 3 2 2 13 2 8 4 2 5 0 4 7 21 22 4 2 5 0 4 7 21 22 1 0 2 0 2 2 6 7
3 FATULUNU 1.307 1 1 3 2 5 10 0 0 1 6 1 0 6 8 16 10 1 6 1 0 6 8 16 10 1 5 0 0 0 0 3 4

4 NUNLEU 2.398 1 1 4 4 6 14 4 11 12 8 12 12 20 32 84 73 12 8 12 12 20 32 84 73 1 1 1 1 5 8 22 13
5 KUALEU 2.117 1 1 3 0 0 15 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6 FENUN 2.009 1 1 4 0 4 16 1 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 FAE 980 1 1 4 4 4 16 3 12 3 1 5 10 8 12 26 18 3 1 5 10 8 12 26 18 0 0 2 6 4 6 13 9

8 ANIN 1.285 1 1 4 4 2 18 1 14 2 7 10 6 17 10 33 41 2 7 10 6 17 10 33 41 1 4 2 0 6 2 8 11
9 TOI 1.213 1 1 3 3 5 10 2 8 5 2 6 1 13 3 33 25 5 2 6 1 13 3 33 25 1 1 1 0 0 0 4 2
10 NIFULEO 1.193 1 1 4 3 3 12 0 0 5 2 3 2 15 7 33 32 5 2 3 2 15 7 33 32 5 1 2 1 7 3 13 13
11 SUNU 1.310 1 1 4 4 4 16 4 16 7 6 12 11 13 15 30 34 7 6 12 11 13 15 30 34 4 3 6 3 7 9 10 14
12 LANU 1.028 1 1 3 3 3 12 3 12 0 1 7 3 6 10 31 30 0 1 7 3 6 10 31 30 0 1 2 3 0 4 16 14
13 NETUTNANA 1.127 1 1 2 2 2 8 2 8 4 5 4 9 11 12 18 40 4 5 4 9 11 12 18 40 0 0 2 3 4 1 5 9

40 180 22 118 47 47 76 61 126 134 366 364 47 47 76 61 126 134 366 364 15 18 24 19 39 38 113 106
JUMLAH 19.727 13 13 45 34
220 140 1221 1221 372
 BALITA DENGAN GIZI LEBIH/TINGGI BALITA DENGAN GIZI BAIK/NORMAL BALITA DENGAN GIZI KURANG/PENDEK BALITA DENGAN GIZI BURUK/SANGAT PENDEK
NOMOR

(TB/U) (TB/U) (TB/U) (TB/U)

0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN
L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P
1 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
2 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
3 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
4 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
5 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
6 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
7 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 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
9 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
10 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
11 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
12 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
13 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 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
 HALAMAN 2
LAPORAN BULAN : APRIL 2019

REKAPITULASI LAPORAN PENIMBANGAN

F/III/GIZI PUSKESMAS

JML BALITA YG TIDAK NAIK BERAT JML BALITA YG DI TIMBANG BULAN INI JML BALITA YG BARU HADIR JML BALITA YG DI TIMBANG
NOMOR

BADANNYA BULAN INI ( T ) TAPI TIDAK BULAN LALU ( O ) BULAN INI ( B ) BULAN INI ( D )
DESA
0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN

L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P

1 OINLASI 1 1 1 2 1 0 10 3 1 3 2 1 5 9 7 14 0 1 0 0 0 0 0 0 3 7 7 5 10 12 30 27
2 KOKOI 2 1 1 0 2 4 5 8 0 0 1 0 0 1 5 4 1 1 0 0 0 0 0 0 4 2 4 0 4 7 16 19
3 FATULUNU 0 0 0 0 1 1 6 1 0 0 0 0 1 2 2 1 0 0 0 0 0 0 0 0 1 5 0 0 2 3 11 6
4 NUNLEU 1 1 1 4 3 1 4 9 3 0 2 3 2 4 13 6 2 0 0 0 0 0 0 0 7 2 4 8 10 13 39 28
5 KUALEU 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
6 FENUN 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
7 FAE 0 1 2 2 2 3 5 2 0 0 0 2 1 1 3 4 2 0 0 0 0 0 0 1 2 1 4 10 7 10 21 16
8 ANIN 0 1 2 1 0 3 5 6 0 0 0 2 2 0 1 4 1 0 0 0 0 0 0 1 2 5 4 3 8 5 14 22
9 TOI 0 0 3 1 2 1 8 8 1 1 2 0 6 1 10 6 1 0 0 0 0 0 0 0 3 2 6 1 8 2 22 16
10 NIFULEO 0 1 1 1 2 1 5 6 0 0 0 0 4 1 7 3 0 0 0 0 0 0 0 0 5 2 3 2 13 5 25 22
11 SUNU 1 2 1 1 2 4 8 8 0 0 2 3 1 0 3 5 1 0 0 0 0 0 0 0 6 5 9 7 10 13 21 27
12 LANU 0 0 3 0 3 4 7 8 0 0 0 0 0 0 4 2 0 0 0 0 0 0 0 1 0 1 5 3 3 8 27 25
13 NETUTNANA 2 5 1 1 3 6 5 12 1 0 1 2 2 2 2 4 1 0 0 0 0 0 0 1 4 5 4 6 9 9 12 26
7 13 16 13 21 28 68 71 6 4 10 13 24 21 57 53 9 2 0 0 0 0 0 4 37 37 50 45 84 87 238 234
JUMLAH
237 188 15 812
 BALITA DENGAN GIZI SANGAT KURUS BARU BALITA DENGAN GIZI BURUK LAMA BALITA DIBAWAH GARIS MERAH BALITA TIDAK NAIK BB 2 KALI
NOMOR

(∆.Br,BB/TB) (∆.Lm,BB/TB) (Δ.Br + Δ.Lm) (2T)

DESA
0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN
L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P
1 OINLASI 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
2 KOKOI 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
3 FATULUNU 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
4 NUNLEU 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
5 KUALEU 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
6 FENUN 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
7 FAE 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 ANIN 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
9 TOI 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
10 NIFULEO 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
11 SUNU 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
12 LANU 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
13 NETUTNANA 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 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
JUMLAH
0 0 0
 HALAMAN 3
LAPORAN BULAN : APRIL 2019

REKAPITULASI LAPORAN PENIMBANGAN

F/III/GIZI PUSKESMAS

JML BALITA YG TIDAK HADIR DI BALITA DENGAN GIZI LEBIH BALITA DENGAN GIZI BAIK BALITA DENGAN GIZI KURANG/KURUS JML PEMBERIAN

ORALIT
NOMOR

PENIMBANGAN BULAN INI ( - ) ( BB/TB ) ( BB/TB ) (BB/TB)

DESA
0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN 0-5 BLN 6-11 BLN 12-23 BLN 24-60 BLN
US

A
K

T
NG

LI
BU

BA
L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P

1 OINLASI 1 0 4 2 3 6 11 12 0 0 0 0 0 0 0 0 3 4 6 5 6 8 20 17 0 3 1 0 4 4 10 10
2 KOKOI 0 0 1 0 0 0 5 3 0 0 0 0 0 0 0 0 4 2 4 0 3 5 11 13 0 0 0 0 1 2 5 6
3 FATULUNU 0 1 1 0 4 5 5 4 0 0 0 0 0 0 0 0 1 5 0 0 2 2 7 4 0 0 0 0 0 1 4 2
4 NUNLEU 5 6 8 4 10 19 45 45 0 0 0 0 0 0 0 0 7 2 3 7 9 10 27 22 0 0 1 1 1 3 12 6
5 KUALEU 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
6 FENUN 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
7 FAE 1 0 1 0 1 2 5 2 0 0 0 0 0 0 0 0 2 1 4 8 6 7 16 12 0 0 0 2 1 3 5 4
8 ANIN 0 2 6 3 9 5 19 19 0 0 0 0 0 0 0 0 2 5 4 3 6 3 9 16 0 0 0 0 2 2 5 6
9 TOI 2 0 0 0 5 1 11 9 0 0 0 0 0 0 0 0 3 2 5 1 5 2 15 10 0 0 1 0 3 0 7 6
10 NIFULEO 0 0 0 0 2 2 8 10 0 0 0 0 0 0 0 0 3 1 3 1 9 3 15 15 2 1 0 1 4 2 10 7
11 SUNU 1 1 3 4 3 2 9 7 0 0 0 0 0 0 0 0 6 5 8 6 6 7 13 16 0 0 1 1 4 6 8 11
12 LANU 0 0 2 0 3 2 4 5 0 0 0 0 0 0 0 0 0 1 5 3 3 5 18 16 0 0 0 0 0 3 9 9
13 NETUTNANA 0 0 0 3 2 3 6 14 0 0 0 0 0 0 0 0 4 4 4 5 6 6 8 20 0 1 0 1 3 3 4 6

10 10 26 16 42 47 128 130 0 0 0 0 0 0 0 0 35 32 46 39 61 58 159 161 2 5 4 6 23 29 79 73

JUMLAH 0 0
409 0 591 221
 HALAMAN : 6
LAPORAN BULAN : APRIL 2019

REKAPITULASI LAPORAN PENIMBANGAN

F/III/GIZI PUSKESMAS

DISTRIBUSI VITAMIN A BALITA Vit.A ASI EKSLUSIF PENGUKURAN KAPSUL YODIUM

DISTRIBUSI FE
BUFAS LILA
NOMOR

BAYI ( 6-11 BLN ) ANAK ( 12-60 BLN ) SASARAN SASARAN DISTRIBUSI

DESA AE TDK AE ALPA
SASARAN REALISASI SASARAN REALISASI WUS BUMIL

Realisasi

BUFAS
Sasaran
(0-6 bln

SD

SD
IL

IL
S

S
Fe 1 Fe 3

M
AK

AK
U

U
BU

BU
W

W
L P L P L P L P L P L P L P L P < 23,5 >23,5 <23,5 >23,5

AN

AN
1 OINLASI 0 0 0 0 0 0 0 0 0 0 0 0 0 2 3 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0
2 KOKOI 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0
3 FATULUNU 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0
4 NUNLEU 0 0 0 0 0 0 0 0 0 0 0 0 0 4 3 1 1 1 1 2 1 0 0 0 0 0 0 0 0 0 0
5 KUALEU 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
6 FENUN 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 1 0 1 2 0 0 0 0 0 0 0 0 0 0 0 0
7 FAE 0 0 0 0 0 0 0 0 0 0 0 0 0 3 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0
8 ANIN 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0
9 TOI 0 0 0 0 0 0 0 0 0 0 0 0 0 3 2 1 1 0 0 2 1 0 0 0 0 0 0 0 0 0 0
10 NIFULEO 0 0 0 0 0 0 0 0 0 0 0 0 0 4 2 1 1 1 1 2 0 0 0 0 0 0 0 0 0 0 0
11 SUNU 0 0 0 0 0 0 0 0 0 0 0 0 0 3 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0
12 LANU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 NETUTNANA 0 0 0 0 0 0 0 0 0 0 0 0 0 3 1 1 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 29 21 11 6 7 8 11 7 0 0 0 0 0 0 0 0 0 0
JUMLAH
0 0 0 0 0 0 50 17 15 18 0 0 0 0
 0 LAPORAN BULAN : APRIL 2019
REKAPITULASI LAPORAN PENIMBANGAN
F/III/GIZI PUSKESMAS

JUMLAH KASUS GIZI BURUK DAN GIZI BURUK DENGAN KELAINAN KLINIS
MARASMUS MARASMUS-KWASHIORKOR B G M
NOMOR
KWASHIORKOR
DESA
0-5 BLN 6-11 BL 12-23 BL 24-60 BL 0-5 BLN 6-11 BLN 12-23 BL 24-60 BL 0-5 BLN 6-11 BLN 12-23 BL 24-60 BL 0-5 BLN 6-11 BLN 12-23 BL 24-60 BL

L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P L P

1 OINLASI 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
2 KOKOI 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
3 FATULUNU 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

4 NUNLEU 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
KUALEU
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
5
6 FENUN 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
7 FAE 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 ANIN 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
9 TOI 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
10 NIFULEO 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
11 SUNU 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
12 LANU 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
13 NETUTNANA 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 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
JUMLAH
0 0 0
MENGETAHUI Oinlasi, 06 MEI 2019
KEPALA PUSKESMAS OINLASI Petugas Gizi Puskesmas
1 KMS ( lbr ) 0 0 0 0
2 ORALIT (bks) 0 0 0 0 YUSTINA BRIA,A.Md Kep Marsalina Selan,A.Md Gz
3 VIT. A BIRU 0 0 0 0 NIP.196706221992032007 NrPTT. -
4 VIT A MERAH 0 0 0 0
5 TABLET BESI 0 0 0 0
6 KAPSUL YODIUM 0 0 0 0
 LAPORAN BULANAN
REKAPITULASI HASIL PENIMBANGAN BAYI BALITA
PUSKESMAS OINLASI BULAN APRIL 2019

Desa Oinlasi Desa Kokoi Desa Fatulunu Desa Nunleu Desa Kualeu Desa Fenun Desa Fae Desa Anin Desa Toi Desa Nifuleo Desa Sunu Desa Lanu Desa Netutnana Total
No Elemen Data
L P L P L P L P L P L P L P L P L P L P L P L P L P L P L+P
I Jumlah Posyandu :
a. Ada 4 3 3 4 3 4 4 4 3 4 4 3 2 45
b. Lapor 3 2 2 4 0 0 4 4 3 3 4 3 2 34

II Jumlah Kader :
a. Ada 0 20 2 13 5 10 6 14 0 15 4 16 4 16 2 18 5 10 5 12 4 16 3 12 1 9 41 181 222
b. Aktif 0 20 2 13 5 10 6 14 0 15 4 16 4 16 2 18 5 10 5 13 3 15 3 1 1 9 40 170 210
140 65 48 253 0 0 83 126 88 99 128 88 103 1,221
3 Balita yang ada (S) : 69 71 34 31 24 24 128 125 0 0 0 0 42 41 62 64 57 31 56 43 62 66 44 44 37 66 615 606 1221
0 - 5 bulan 4 7 4 2 1 6 12 8 0 0 0 0 3 1 2 7 5 2 5 2 7 6 0 1 4 5 47 47 94
6 - 11 bulan 11 7 5 0 1 0 12 12 0 0 0 0 5 10 10 6 6 1 3 2 12 11 7 3 4 9 76 61 137
12 - 23 bulan 13 18 4 7 6 8 20 32 0 0 0 0 8 12 17 10 13 3 15 7 13 15 6 10 11 12 126 134 260
24 -59 bulan 41 39 21 22 16 10 84 73 0 0 0 0 26 18 33 41 33 25 33 32 30 34 31 30 18 40 366 364 730
4 Jlh Balita Terdaftar & Punya
KMS/buku KIA (K) :
69 71 34 31 24 24 128 125 0 0 0 0 42 41 62 64 57 31 56 43 62 66 44 44 37 66 615 606 1221
0 - 5 bulan 4 7 4 2 1 6 12 8 0 0 0 0 3 1 2 7 5 2 5 2 7 6 0 1 4 5 47 47 94
6 - 11 bulan 11 7 5 0 1 0 12 12 0 0 0 0 5 10 10 6 6 1 3 2 12 11 7 3 4 9 76 61 137
12 - 23 bulan 13 18 4 7 6 8 20 32 0 0 0 0 8 12 17 10 13 3 15 7 13 15 6 10 11 12 126 134 260
24 -59 bulan 41 39 21 22 16 10 84 73 0 0 0 0 26 18 33 41 33 25 33 32 30 34 31 30 18 40 366 364 730

3 Jlh Balita yang Ditimbang (D) : 50 51 28 28 14 14 60 51 0 0 0 0 34 37 28 35 39 21 46 31 46 52 35 37 29 46 409 403 812

0 - 5 bulan 3 7 4 2 1 5 7 2 0 0 0 0 2 1 2 5 3 2 5 2 6 5 0 1 4 5 37 37 74
6 - 11 bulan 7 5 4 0 0 0 4 8 0 0 0 0 4 10 4 3 6 1 3 2 9 7 5 3 4 6 50 45 95
12 - 23 bulan 10 12 4 7 2 3 10 13 0 0 0 0 7 10 8 5 8 2 13 5 10 13 3 8 9 9 84 87 171
24 -59 bulan 30 27 16 19 11 6 39 28 0 0 0 0 21 16 14 22 22 16 25 22 21 27 27 25 12 26 238 234 472
II Hasil penimbangan :
1 Balita yang BB Naik (N) : 22 17 11 9 4 9 29 23 0 0 0 0 19 21 17 17 6 3 27 18 27 29 18 22 11 13 191 181 372
0 - 5 bulan 1 2 1 0 1 5 1 1 0 0 0 0 0 0 1 4 1 1 5 1 4 3 0 1 0 0 15 18 33
6 - 11 bulan 4 2 2 0 0 0 1 1 0 0 0 0 2 6 2 0 1 0 2 1 6 3 2 3 2 3 24 19 43
12 - 23 bulan 4 3 2 2 0 0 5 8 0 0 0 0 4 6 6 2 0 0 7 3 7 9 0 4 4 1 39 38 77
24 -59 bulan 13 10 6 7 3 4 22 13 0 0 0 0 13 9 8 11 4 2 13 13 10 14 16 14 5 9 113 106 219

2 Balita yang tidak naik (T) : 13 6 10 13 7 2 9 15 0 0 0 0 9 8 7 11 13 10 8 9 12 15 13 12 11 24 112 125 237

0 - 5 bulan 1 1 2 1 0 0 1 1 0 0 0 0 0 1 0 1 0 0 0 1 1 2 0 0 2 5 7 13 20
6 - 11 bulan 1 2 1 0 0 0 1 4 0 0 0 0 2 2 2 1 3 1 1 1 1 1 3 0 1 1 16 13 29
12 - 23 bulan 1 0 2 4 1 1 3 1 0 0 0 0 2 3 0 3 2 1 2 1 2 4 3 4 3 6 21 28 49
24 -59 bulan 10 3 5 8 6 1 4 9 0 0 0 0 5 2 5 6 8 8 5 6 8 8 7 8 5 12 68 71 139
3 Balita yang tidak naik 2 kali berturut- 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
4 Balita Bawah Garis Merah (BGM) : 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
5
Balita ditimbang bulan ini tidak 15 27 6 5 3 3 20 13 0 0 0 0 4 7 3 6 19 8 11 4 6 8 4 2 6 8 97 91 188
hadir bulan lalu (O) :
0 - 5 bulan 1 3 0 0 0 0 3 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 6 4 10
6 - 11 bulan 2 1 1 0 0 0 2 3 0 0 0 0 0 2 0 2 2 0 0 0 2 3 0 0 1 2 10 13 23
12 - 23 bulan 5 9 0 1 1 2 2 4 0 0 0 0 1 1 2 0 6 1 4 1 1 0 0 0 2 2 24 21 45
24 -59 bulan 7 14 5 4 2 1 13 6 0 0 0 0 3 4 1 4 10 6 7 3 3 5 4 2 2 4 57 53 110
6 Balita yang baru hadir bulan ini (B) :
0 1 1 1 0 0 2 0 0 0 0 0 2 1 1 1 1 0 0 0 1 0 0 1 1 1 9 6 15

0 - 5 bulan 0 1 1 1 0 0 2 0 0 0 0 0 2 0 1 0 1 0 0 0 1 0 0 0 1 0 9 2 11
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 1 0 4 4
III Status Gizi (Konfirmasi BGM & 2
T /yangGizi
a. Status di identifikasi
berdasarkan bermasalah)
berat
badan menurut tinggi badan :
1 Kurus/Gizi kurang (BB/TB) 15 17 6 8 4 3 14 10 0 0 0 0 6 9 7 8 11 6 16 11 13 18 9 12 7 11 108 113 221
0 - 5 bulan 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 0 0 0 0 1 2 5 7
6 - 11 bulan 1 0 0 0 0 0 1 1 0 0 0 0 0 2 0 0 1 0 0 1 1 1 0 0 0 1 4 6 10
12 - 23 bulan 4 4 1 2 0 1 1 3 0 0 0 0 1 3 2 2 3 0 4 2 4 6 0 3 3 3 23 29 52
24 -59 bulan 10 10 5 6 4 2 12 6 0 0 0 0 5 4 5 6 7 6 10 7 8 11 9 9 4 6 79 73 152
2 Sangat Kurus/Gizi buruk : (BB/TB)
a. Baru : 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
b. Kumulatif sampai bulan ini : 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
3 Gizi Lebih (B+) 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
4 Gizi Baik (B) 35 34 22 20 10 11 46 41 0 0 0 0 28 28 21 27 28 15 30 20 33 34 26 25 22 35 301 290 591
0 - 5 bulan 3 4 4 2 1 5 7 2 0 0 0 0 2 1 2 5 3 2 3 1 6 5 0 1 4 4 35 32 67
6 - 11 bulan 6 5 4 0 0 0 3 7 0 0 0 0 4 8 4 3 5 1 3 1 8 6 5 3 4 5 46 39 85
12 - 23 bulan 6 8 3 5 2 2 9 10 0 0 0 0 6 7 6 3 5 2 9 3 6 7 3 5 6 6 61 58 119
24 -59 bulan 20 17 11 13 7 4 27 22 0 0 0 0 16 12 9 16 15 10 15 15 13 16 18 16 8 20 159 161 320
b. Status Gizi berdasarkan indikator
Tinggi Badan menurut
Umur(TB/U) :

1 Pendek (TB/U) 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
2 Sangat Pendek (TB/U) 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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
3 Normal 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 - 5 bulan 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
6 - 11 bulan 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
12 - 23 bulan 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
24 -59 bulan 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

4 Tinggi 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
IV
Penanganan Gizi Kurang dan Gizi
Buruk
1 Gizi Kurang yang ditangani 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
a. Konseling/Penyuluhan saja 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
b. Diberi PMT Pemulihan 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
2 Gizi Buruk yang mendapat
0 0 0
perawatan
Baru : 0 0 0
a. Rawat Inap 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
b. Rawat Jalan 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
Lama : 0 0 0
a. Rawat Inap 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
b. Rawat Jalan 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
3 Kasus Gizi Buruk Yang Meninggal : 0 0 0
Bulan ini : 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
Kumulatif s/d bulan lalu 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

V Pemberian ASI Eksklusif (0-6)

1 Eksklusif (√) 1 1 1 0 1 0 1 1 0 0 0 0 1 0 1 0 1 1 1 1 1 1 0 1 1 0 10 6 16
2 Tidak Eksklusi (X) 0 1 0 0 0 1 1 1 0 0 0 0 1 1 1 1 0 0 1 1 1 0 0 0 1 0 6 6 12
3 Tidak hadir (A) 1 1 1 1 0 1 2 1 0 0 0 0 1 0 0 1 2 1 2 0 1 0 0 0 1 1 11 7 18

Mengetahui
Kepala Puskesmas Oinlasi Pelapor

Yustina Bria, A. Md Kep Marsalina Selan, A.Md Gz

NIP. 19670622 199703 2 007 NRPTT: -
 LAPORAN BULANAN
REKAPITULASI BAYI BALITA DI PUSKESMAS DAN JEJARINGNYA
OINLASI BULAN APRIL 2019

Desa
Desa Oinlasi Desa Kokoi Desa Fatulunu Desa Nunleu Desa Kualeu Desa Fenun Desa Fae Desa Anin Desa Toi Desa Nifuleo Desa Sunu Desa Lanu Total
No Elemen Data Netutnana
L P L P L P L P L P L P L P L P L P L P L P L P L P L P L+P
I Total Kunjungan Bayi/Balita ke Puskesmas : 21 18 16 27 16 9 15 59 10 12 20 23 26 16 29 32 9 2 25 21 12 26 24 24 9 12 232 281 513
0 - 7 hr 0 1 1 1 0 0 0 0 2 0 1 3 1 1 0 1 0 0 0 0 0 1 0 0 0 0 5 8 13
8 - 28 hr 0 2 3 2 1 0 0 0 0 0 3 0 0 0 1 0 0 0 0 0 0 1 0 0 2 5 10 10 20
29 - <1 thn 1 0 0 1 0 1 0 0 0 0 1 0 0 1 0 1 0 0 1 0 0 1 0 1 0 1 3 7 10
1 - < 5 thn 20
42 15 12 23 15 8 15 59 8 12 15 20 25 14 28 30 9 2 24 21 12 23 24 23 7 6 214 256 470
II Kategori Penduduk : 1 1 2 2 0 0 1 2 1 0 1 0 1 1 2 3 1 0 2 0 1 1 1 1 0 0 14 4 18
1 Keluarga miskin 1 1 2 2 0 0 1 2 1 0 1 0 1 1 2 3 1 0 2 0 1 1 1 1 0 0 14 2 16
2 Bukan keluarga miskin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2
III Pelayanan Bayi dan Balita 3 4 2 2 1 0 2 2 0 1 2 2 1 1 3 5 0 1 2 0 2 0 1 0 1 2 20 20 40
1 Vit.A Biru (6-11 bulan) 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
2 Vit A Merah (12-59 bulan) 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
3 MTBM (0 < 2 bln) 1 2 1 1 0 0 0 0 0 0 0 1 0 0 1 2 0 0 1 0 1 0 0 0 0 0 5 6 11
4 MTBS (2 bln - 5 thn) 2 2 1 1 1 0 2 2 0 1 2 1 1 1 2 3 0 1 1 0 1 0 1 0 1 2 15 14 29
IV Diagnosa Penyakit
Dilaporkan melalui lamp.ICD10 sesuai kasus yg ada
saja
V Kondisi Bayi 21 18 16 27 16 9 15 59 10 12 20 23 26 16 29 32 9 2 25 21 12 26 24 24 9 12 232 281 513
a Sehat 20 15 12 23 15 8 15 59 8 12 15 20 25 14 28 30 9 2 24 21 12 23 24 23 7 6 214 256 470
b Tidak Sehat 1 3 4 4 1 1 0 0 2 0 5 3 1 2 1 2 0 0 1 0 0 3 0 1 2 6 18 25 43
c Meninggal 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
VI Rujuk 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
Puskesmas 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
Rumah sakit 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
Faskes lainnya 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
VII Penyebab Kematian :
a. Bayi : 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
- Pneumoni 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
- Diare 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
- Kelainan Saluran Pencernaan 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
- Tetanus Neonatorum 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
- Dll 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
 LAPORAN BULANAN
REKAPITULASI BAYI BALITA DI PUSKESMAS DAN JEJARINGNYA
OINLASI BULAN APRIL 2019

Desa
Desa Oinlasi Desa Kokoi Desa Fatulunu Desa Nunleu Desa Kualeu Desa Fenun Desa Fae Desa Anin Desa Toi Desa Nifuleo Desa Sunu Desa Lanu Total
No Elemen Data Netutnana
L P L P L P L P L P L P L P L P L P L P L P L P L P L P L+P
b. Balita : 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
- Pneumoni 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
- Diare 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
- Malaria 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
- Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
- Dll 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
VIII Dilakukan Deteksi Tumbuh Kembang : 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
a. Ya 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
b. Tidak 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
IX Asal Pasien: 50 18 16 27 16 9 15 59 10 12 20 23 26 16 29 32 9 2 25 21 12 26 24 24 9 12 232 281 513
1 Datang sendiri 50 18 16 27 16 9 15 59 10 12 20 23 26 16 29 32 9 2 25 21 12 26 24 24 9 12 232 281 513
2 Rujukan 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
3 Kiriman kader 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
Pelapor

Mengetahui
Kepala Puskesmas Oinlasi Marsalina Selan, A.Md.Gz
NRPTT:

Yustina Bria, A. Md Kep

NIP. 19670622 199203 2 007

Cat : Kolom jumlah Puskesmas bisa ditambahkan atau dikurangi sesuai kondisi di Kab.
 LAPORAN BULANAN
REKAPITULASI KONSULTASI GIZI
PUSKESMAS OINLASI BULAN APRIL 2019

Desa Desa Desa Desa Desa Desa Desa Desa Desa Desa
Desa Fae Desa Anin Desa Toi Netutnan TOTAL
No Elemen Data Oinlasi. Kokoi Fatulunu Nunleu Kualeu Fenun Nifuleo Sunu Lanu a
L P L P L P L P L P L P L P L P L P L P L P L P L P L P L+P
I Total Kunjungan Poli Gizi :
1 Bulan ini 0 5 1 4 0 1 0 6 0 3 0 4 0 0 0 3 0 2 0 1 0 2 0 1 0 1 1 33 34
2 Kumulatif s.d. bulan lalu

II Pelayanan : 6 12 6 12 0 4 2 14 0 6 2 12 0 0 6 8 0 2 2 2 0 4 0 2 0 2 14 80 94
1 Konseling 3 6 3 6 0 2 1 7 0 2 1 6 0 0 3 4 0 0 1 1 0 2 0 1 0 1 2 38 40
a. Bumil 0 5 0 3 0 2 0 6 0 3 0 4 0 0 0 2 0 2 0 1 0 2 0 1 0 1 0 32 32
b. Menyusui 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
c. Baduta 1 0 1 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 4 2 6
d. Balita 2 1 2 1 0 0 1 1 0 1 0 2 0 0 2 1 0 0 1 0 0 0 0 0 0 0 8 7 15
2 Diet 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
a. DM 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
b. Hipertensi 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
c. Ginjal 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
d. Jantung 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
e. TBC 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
f. HIV/AIDS 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
g. Dll 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
III Asal Pasien : 0 5 1 4 0 1 0 6 0 3 0 4 0 0 0 3 0 2 0 1 0 2 0 1 0 0 1 32 33
1 Datang sendiri 0 5 1 4 0 1 0 6 0 3 0 4 0 0 0 3 0 2 0 1 0 2 0 1 0 0 1 32 33
2 Rujukan 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
3 Kiriman kader 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

Yang melapor
Mengetahui Petugas Gizi Puskesmas
Kepala Puskesmas Oinlasi

Yustina Bria, A. Md Kep Marsalina Selan, A.Md.Gz

NIP.19670622 199703 2 007 NRPTT:
Cat : Kolom jumlah Puskesmas bisa ditambahkan atau dikurangi sesuai kondisi di Kab.