FORMAT PENCATATAN DAN PELAPORAN KESEHATAN LANJUT USIA DI PUSKESMAS

POSYANDU
BULAN
TAHUN

Pengobatan
Konseling Jumlah Lansia
Jml Lansia Posyandu / Posbindu yang
Pemberda Jumlah Panti Strata Posyandu / Posbindu Lansia Jumlah Lansia
dgn kelainan Penyuluh Lansia mendapatkan
No NAMA yaan Wredha yang di Home Ket.
Diobati Dirujuk an Perawatan jangka
B L S Lansia dibina Care
Panjang (Long
L P Jumlah Aktif Pratama Madya Purnama Mandiri Term Care)

1 2 21 22 23 24 24 25 26 27 28 29 30 31 32 33 34 35

Mengetahui Kepala Puskesmas, BIDES RAMBAH,

dr.RANDI MAREDO AMDANI APERITA LINRI, A.Md.Keb

NIP:19860326201902100
1 NIP.198701212017052001
 DAFTAR HADIR LANSIA
POSYANDU :
BULAN :
NO NAMA UMUR JK ALAMAT BPJS NIK TD TB BB KGD KOL TTD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

PEMENGANG PROGRAM LANSIA TAPUS, 2024

BIDES,

NOVA PITRIANI APERITA LINRI

 DATA LANSIA JORONG RAMBAH TAHUN 2022
NO NAMA L/P NIK TGL LAHIR ALAMAT
1 MASTIDAR P 1308074501530002 69 5/1/1953 RAMBAH
2 SAPRIMAN L 1308170109490002 73 1/9/1949 RAMBAH
3 RANI P 1308175001610001 61 10/1/1961 RAMBAH
4 RUKIAH P 1308074107590019 63 1/7/1959 RAMBAH
5 AHMAD JUSNI L 1308070201480002 74 2/1/1948 RAMBAH
6 SUDIRMAN L 1308072807570001 65 28-07-1957 RAMBAH
7 DEDI HARIANTO L 13080 67 RAMBAH
8 AJISMAN L 1308070703570001 65 7/3/1957 RAMBAH
9 ZAINAB P 1308075101600003 62 11/1/1960 RAMBAH
10 EMMA WATI P 1308077460359002 63 6/3/1959 RAMBAH
11 MASRIDA P 1308076207520001 70 22-07-1952 RAMBAH
12 ASMADI L 1308051007610001 61 10/7/1961 RAMBAH
13 MASRELAWATI P 1308054703610001 61 7/3/1961 RAMBAH
14 ROSTINA P 1308074106600001 62 1/6/1960 RAMBAH
15 RAMLI L 1308070105610003 61 1/5/1961 RAMBAH
16 ERMI P 1308074207600001 62 2/7/1960 RAMBAH
17 ASMIDA P 1308075608610001 61 6/8/1961 RAMBAH
18 MASRIA P 1308075706620001 60 17-06-1962 RAMBAH
19 MARWAN L. L 1308070103620001 60 1/3/1962 RAMBAH
20 RAMSI L 1308071211550001 67 11/12/1955 RAMBAH
21 SALMIAH P 1308071451256602 66 5/12/1956 RAMBAH
22 ROHANI P 1308075005560003 64 10/5/1956 RAMBAH
23 NURAINI P 1308175705540002 68 7/15/1954 RAMBAH
24 YULFAHRI L 1308072404520001 70 24-04-1952 RAMBAH
25 SALMAINI P 1308074106560003 66 1/6/1956 RAMBAH
26 YATMI P 1308075806520002 70 8/6/1952 RAMBAH
27 ASRI L 1308071255500001 65 12/5/1955 RAMBAH
28 SUMIARNI P 1308074307570003 63 3/7/1957 RAMBAH
29 ALIMAN L 1308070805580001 68 7/5/1954 RAMBAH
30 NURASIAH NST P 1308074204600003 62 20-04-1960 RAMBAH
31 MURNI ELIS P 1308074606630001 63 6/6/1959 RAMBAH
32 AFRIZAL L 1308070107620010 61 1/7/1962 RAMBAH
33 DELFITA HANNUM P 1308074405750001 60 4/5/1962 RAMBAH
34 NISAR 13080 RAMBAH
35 SURHAIDA P 1308076303580002 64 23-03-1958 RAMBAH
36 YUSRI L 1308070302600002 62 3/2/1960 RAMBAH
37 ERI MAWARDI P 1308171508560001 64 15-08-1956 RAMBAH
38 KHAIRUDDIN L 1308071507690001 61 15-07-1961 RAMBAH
39 ASNELI 13080 RAMBAH
40 DARMIAH P 1308070112460002 74 1/12/1946 RAMBAH
41 ASMA WATI P 1308075906590001 71 9/6/1951 RAMBAH
42 YENI ESMA P 1308074801520001 70 8/1/1952 RAMBAH
43 ALI UMAR L 1308070612510001 71 6/12/1951 RAMBAH
44 SARIANI P 1308077112380003 84 11/2/1938 RAMBAH
45 AHMADIN L 1308070609520001 70 6/9/1952 RAMBAH
46 SAMRUSNI L 1308070902500001 70 9/2/1952 RAMBAH
47 NURAINA P 1308074107530017 69 10/7/1953 RAMBAH
48 SAMSIAR P 1308074507480002 74 5/7/1948 RAMBAH
49 MALINAR P 1308076504440001 76 5/4/1944 RAMBAH
50 BA'ANG L 1308073111500008 72 31-11-1950 RAMBAH
51 MASDAINAR P 1308074102480001 68 1/2/1954 RAMBAH
52 AMREL 13080 73 RAMBAH
53 ROSMIDA 13080 71 RAMBAH
54 SANJOIMAH P 1308075805580001 65 8/5/1957 RAMBAH
55 RAMLI PASARIBU L 1308070303500001 62 3/3/1960 RAMBAH
56 RAHMI P 1308071211550001 85 21-01-1937 RAMBAH
57 ESNA WATI P 1308074311550001 71 31-01-1951 RAMBAH
58 NUR AMAH P 13080 70 RAMBAH
59 AHMADIN L 1308070609520001 70 6/9/1952 RAMBAH
60 MUSTIANA P 1308075204390001` 83 20-04-1939 RAMBAH
61 SANGKOT.L L 1308072101610001 61 10/1/1961 RAMBAH
62 ZAINUDDIN L 1308070311620001 60 3/11/1962 RAMBAH
63 ASMA WATI P 1308074602620002 60 6/2/1962 RAMBAH
64 WATTINI P 1308074709560001 66 7/9/1956 BERSAMA INDAH
65 MASNUN P 1308076010580002 63 20-10-1958 BERSAMA INDAH
66 SATIMAH P 1308075407600005 60 14-07-1960 BERSAMA INDAH
67 KONDAR L 1308070503590002 67 5/3/1954 JANJI MANAHAN
68 ROSLIANA P 1308075602600001 60 16-02-1960 JANJI MANAHAN
69 HAMJAH L 1308072509580001 63 25-09-1958 JANJI MANAHAN
70 NURHALIMAH P 1308074206600001 61 2/6/1960 JANJI MANAHAN
71 SOLIH PULUNGAN L 1308070611520001 69 6/11/1952 JANJI MANAHAN
72 MARAHOT L 1308070506650002 63 5/6/1965 JANJI MANAHAN
73 SAMA POHAN P 1308074706570001 65 7/6/1957 JANJI MANAHAN
74 AMININ HSB L 1308071407610001 60 14-07-1961 JANJI MANAHAN
75 RAMLAN P. L 1308071076109002 61 1/7/1961 JANJI MANAHAN
76 MUHAMMAD L 1308071211520001 68 12/11/1952 JANJI MANAHAN
77 ROBIAH P 1308075012550003 65 10/12/1955 JANJI MANAHAN
78 NUR MAYA P 1308077112500014 60 31-12-1960 JANJI MANAHAN
79 JORLIAN P 1308075507560012 66 5/7/1956 JANJI MANAHAN
80 MASLINA P 1308075210570001 65 2/10/1957 JANJI MANAHAN
81 MASLIAN P 1308077011520001 70 10/11/1952 JANJI MANAHAN
82 PITTA P 1308075204480001 74 20-10-1958 BERSAMA INDAH
83 ZAHARA P 1308075003400001 82 10/3/1940 BERSAMA INDAH
84 MASHANIAH P 1308176003450002 76 5/6/1952 BERSAMA INDAH
85 JURAIDA P 1308076506520002 70 25-06-1952 JANJI MANAHAN
86 SALAMA P 1308075312400002 82 13-12-1940 JANJI MANAHAN
87 HARUAYA L 1308071604510001 71 16-04-1951 JANJI MANAHAN
88 ALI HASAN RAMBE L 1308071206620001 60 12/6/1962 SIPIONGOT
89 TAJUDDIN L 1308071212610002 61 12/12/1961 SIPIONGOT
90 ABD.BANGUN L 1308071010620001 60 10/10/1962 BERSAMA INDAH
91 PARLAUNGAN L 1308073112620002 60 31-12-1962 BERSAMA INDAH

DATA LANSIA JORONG RAMBAH TAHUN 2022

UMUR
NO NAMA L/P NIK TGL LAHIR ALAMAT
>60 THN
1 ALI AKBAR L 1308072004620001 60 20/4/1962 PADANG BALAI
2 PAHRUDDIN L 1308071501580001 64 15/1/1959 PADANG BALAI
3 CHALIJAH P 1308074709480001 72 7/9/1940 PADANG BALAI
4 DARMINA P 1308175203450002 82 13/3/1946 PADANG BALAI
5 MANSUR L 1308070403380001 83 4/3/1938 PADANG BALAI
6 MASDAWANI P 1308076101600004 81 21/4/1940 PADANG BALAI
7 SITI KHADIJAH P 1308074101600004 63 1/10/1960 PADANG BALAI
8 SUDIRMAN NST L 1308071205590002 63 12/5/1959 PADANG BALAI
9 ARNITA P '1308074312590001 63 3//12/1959 PADANG BALAI
10 SURYANI P 1308076605600001 62 26/5/1960 PADANG BALAI
11 YULIZAR MANSUR L 1308070606810003 61 8/5/1961 PADANG BALAI
12 MARIATI P 1308070608510002 61 16/8/1961 PADANG BALAI
13 BAYANG SANI P 1308074612620001 60 6/12/1962 PADANG BALAI
14 YUSAFRIN L 1308071111620003 60 11/11/1962 PADANG BALAI
15 MEGAT NST L 1308072003620002 60 23/3/1962 PADANG BALAI
16 AFSAH P 1308074809550001 67 8/9/1955 PADANG BALAI
17 ZULKARNAIN L 1308072704600001 62 27/4/1960 PADANG BALAI
18 YUHANIS L 1308076908610000 61 29/8/1961 PADANG BALAI
19 YUSMIAR P 1308070908026001 62 8/2/1960 PADANG BALAI
20 SAMSIAR P 1308074205540001 68 2/6/1954 PADANG BALAI
21 SAPRUDDIN L 1308070105590001 63 1/5/1959 PADANG BALAI
22 EDI SALYUSRA L 1308070308600001 62 3/8/1960 PADANG BALAI
23 ASNI P 1308074112590003 63 1/12/1959 PADANG BALAI
24 YUSRIL L 1308171306570001 64 13/6/1957 PADANG BALAI
25 ERMA APRIDA P 1308074503610001 60 5/3/1961 PADANG BALAI
26 SARI PADA NAULI P 1308172308580002 63 23/6/1958 PADANG BALAI
27 MASNIDA P 1308074307570002 64 3/7/1957 PADANG BALAI
28 DARMELINA P 1308075101570001 64 11/1/1957 PADANG BALAI
29 ROSMAWATI P 1308074803590001 62 8/3/1959 PADANG BALAI
30 KOIMAH P 1308075607520001 69 16/7/1952 PADANG BALAI
31 AHMAD NASIR L 1308070485300001 68 4/8/1953 PADANG BALAI
32 AGUSTI P 1308070205570002 64 2/5/1957 PADANG BALAI
33 DARMAWAN P 1308072308590001 62 10/8/1959 PADANG BALAI
34 SITI ROHANI P 1308075011560002 60 10/11/1956 PADANG BALAI
35 YUL AMRI L 1308072107600003 61 21/7/1960 PADANG BALAI
36 SAPARUDDIN L 1308070105550001 60 1/5/1955 PADANG BALAI
37 YUNIDAR P 1308076109590001 65 21/9/1956 PADANG BALAI
38 MASMI P 1308176000540001 65 20/4/1954 PADANG BALAI
39 DAHLIANA P 1308074708580002 63 7/8/1958 PADANG BALAI
40 SAMRIL L 1308073000060001 62 30/4/1960 PADANG BALAI
41 AJUANA P 1308075511470001 76 15/11/1947 PADANG BALAI
42 ZULKIFLI L 1308071608520001 70 16/8/1952 PADANG BALAI
43 SAUDAH P 1308175908350001 87 19/5/1935 PADANG BALAI
44 RUSTAM BTR L 1308072009450001 76 20/9/1945 PADANG BALAI
45 PAUSA P 1308076112490001 70 1/12/1949 PADANG BALAI
46 NUR MIMSAH P 71 PADANG BALAI
47 RASAD L 1308074107460011 75 1/7/1946 PADANG BALAI
48 ZABEDAH P 1308074705440001 78 7/5/1944 PADANG BALAI
49 MASTAJURI L 1308072206600001 61 22/6/1960 PADANG BALAI