LAPORAN BULANAN HASIL IMUNISASI RUTIN BAYI PUSKESMAS

Puskesmas: WANING
Kabupaten/Kota: MANGGARAI BARAT
Provinsi: Nusa Tenggara Timur
Bulan: JANUARI
TAHUN: 2021

BAYI BARU LAHIR SURVIVING INFANT HB0 (<24 JAM) HB0 (1-7 HARI) TOTAL HB0 BCG
NO DESA /
KELURAHAN
L P JML L P JML
#L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33
1 WANING 11 11 22 10 11 21 2 18.2 0 0.0 2 9.1 0 0.0 0 0.0 0 0.0 2 18.2 0 0.0 2 9.1 0 0.0 1 9.1 1 4.5 0
2 TEHONG 10 10 20 10 10 20 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 5.0 0 0.0 1 10.0 1 5.0 0 0.0 0 0.0 0 0.0 0
3 PATENG LESU 7 7 14 7 7 14 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 0.0 0 0.0 0 0.0 0 0.0 0
4 MOMOL 15 15 30 14 15 29 2 13.3 1 6.7 3 10.0 0 0.0 0 0.0 0 0.0 2 13.3 1 6.7 3 10.0 2 13.3 0 0.0 2 6.7 2
5 NDOSO 11 11 22 10 11 15 0 0.0 0 0.0 0 0.0 2 18.2 1 9.1 3 13.6 2 18.2 1 9.1 3 13.6 0 0.0 1 9.1 1 4.5 0
6 LUMUT 17 18 35 17 18 35 0 0.0 0 0.0 0 0.0 3 17.6 5 27.8 8 22.9 3 17.6 5 27.8 8 22.9 1 5.9 3 16.7 4 11.4 1
8 WAE BUKA 8 8 16 7 8 15 0 0.0 0 0.0 0 0.0 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 0 0.0 0 0.0 0 0.0 0

RPROVINSI 79 80 159 75 80 149 4 5.1 1 1.3 5 3.1 7 8.9 7 8.8 14 8.8 11 13.9 8 10.0 19 11.9 3 3.8 5 6.3 8 5.0 3
 HASIL IMUNISASI BAYI

POLIO1 DPT/HB-Hib (1) POLIO2 DPT/HB-Hib (2) POLIO3 DPT/HB-Hib (3) POL

% #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L %

34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70
0.0 1 9.1 1 4.5 2 20.0 1 9.1 3 14.3 2 20.0 1 9.1 3 14.3 3 30.0 0 0.0 3 14.3 3 30.0 0 0.0 3 14.3 1 10.0 1 9.1 2 9.5 1 10.0
0.0 0 0.0 0 0.0 1 10.0 4 40.0 5 25.0 1 10.0 4 40.0 5 25.0 0 0.0 2 20.0 2 10.0 0 0.0 2 20.0 2 10.0 3 30.0 1 10.0 4 20.0 3 30.0
0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 0 0.0 0 0.0 0 0.0
13.3 0 0.0 2 6.7 0 0.0 2 13.3 2 6.9 0 0.0 2 13.3 2 6.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 6.7 1 3.4 0 0.0
0.0 1 9.1 1 4.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 30.0 1 9.1 4 26.7 3 30.0 1 9.1 4 26.7 0 0.0 1 9.1 1 6.7 0 0.0
5.9 3 16.7 4 11.4 3 17.6 4 22.2 7 20.0 3 17.6 4 22.2 7 20.0 0 0.0 2 11.1 2 5.7 0 0.0 2 11.1 2 5.7 2 11.8 1 5.6 3 8.6 2 11.8
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 1 12.5 1 6.7 0 0.0 1 12.5 1 6.7 0 0.0 1 12.5 1 6.7 0 0.0

3.8 5 6.3 8 5.0 6 8.0 12 15.0 18 12.1 6 8.0 12 15.0 18 12.1 6 8.0 7 8.8 13 8.7 6 8.0 7 8.8 13 8.7 6 8.0 6 7.5 12 8.1 6 8.0
 HASIL IMU

POLIO4 IPV CAMPAK RUBELLA (MR) TOTAL CAMPAK IMUNISASI LENGKAP SASARAN BATITA DPT/HB/Hib

L P JML
#P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML %
71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107
1 9.1 2 9.5 0 0.0 0 0.0 0 0.0 4 40.0 2 18.2 6 28.6 4 40.0 2 18.2 6 28.6 0 0.0 0 0.0 0 0.0 22 23 44 0 0.0 1 4.4 1 2.3
1 10.0 4 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 21 22 43 1 4.8 0 0.0 1 2.3
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 0.0 0 0.0 0 0.0 0 0.0 14 17 32 1 6.9 0 0.0 1 3.1
1 6.7 1 3.4 0 0.0 0 0.0 0 0.0 0 0.0 3 20.0 3 10.3 0 0.0 3 20.0 3 10.3 0 0.0 0 0.0 0 0.0 23 22 45 3 12.9 1 4.6 4 8.9
1 9.1 1 6.7 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 6.7 1 10.0 0 0.0 1 6.7 0 0.0 0 0.0 0 0.0 23 17 40 0 0.0 2 11.5 2 5.0
1 5.6 3 8.6 0 0.0 0 0.0 0 0.0 3 17.6 1 5.6 4 11.4 3 17.6 1 5.6 4 11.4 0 0.0 0 0.0 0 0.0 14 16 30 3 21.5 3 18.9 6 20.1
1 12.5 1 6.7 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 0.0 0 0.0 12 12 24 0 0.0 0 0.0 0 0.0

6 7.5 12 8.1 0 0.0 0 0.0 0 0.0 8 10.7 6 7.5 14 9.4 8 10.7 6 7.5 14 9.4 0 0.0 0 0.0 0 0.0 129 129 258 8 6.2 7 5.4 15 5.8
HASIL IMUNISASI BATITA

CAMPAK RUBELLA (MR) TOTAL CAMPAK

#L % #P % # JML % #L % #P % # JML %
108 109 110 111 112 113 114 115 116 117 118 119
2 9.1 0 0.0 2 4.5 2 9.1 0 0.0 2 4.5
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 0.0 0 0.0
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
0 0.0 1 5.8 1 2.5 0 0.0 1 5.8 1 2.5
2 14.3 1 6.3 3 10.1 2 14.3 1 6.3 3 10.1
0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0

4 3.1 2 1.6 6 2.3 4 3.1 2 1.6 6 2.3

LAPORAN RUTIN
LAPORAN HASIL IMUNISASI RUTIN BAYI PUSKESMAS (KUMULATIF)

Puskesmas: WANING

Kabupaten/Kota: MANGGARAI BARAT

Provinsi: Nusa Tenggara Timur

Bulan: JANUARI Format 2.a.9).

TAHUN: 2021
PENCAPAIAN HASIL BAYI S/D JANUARI (%) DROP OUT (DO) (%) PENCAPAIAN HASIL BATITA S/D JANUARI (%)

BAYI BARU LAHIR SURVIVING INFANT HB0 (<24 JAM) HB0 (1-7 HARI) TOTAL HB0 BCG POLIO1 DPT/HB-Hib (1) POLIO2 DPT/HB-Hib (2) POLIO3 DPT/HB-Hib (3) POLIO4 IPV CAMPAK RUBELLA (MR) IMUNISASI LENGKAP DPT-HB-Hib (1)-(3) DPT-HB-Hib (1)-CAMPAK POLIO 1-4 SASARAN BATITA DPT/HB/Hib CAMPAK
DESA / RUBELLA (MR)
NO KELURAHAN
L P JML L P JML %L %L %L %P % %L %P % %L %P %
#L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % #L % #P % # JML % %P % JML %P % JML %L %P % JML JML JML JML
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110

22 23 44
1 WANING 11 11 22 10 11 21 2 18.2 0 0.0 2 9.1 0 0.0 0 0.0 0 0.0 2 18.2 1 0.0 2 9.1 0 0.0 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 2 20.0 1 9.1 3 14.3 2 20.0 1 9.1 3 14.3 3 30.0 0 0.0 3 14.3 3 30.0 0 0.0 3 14.3 1 10.0 1 9.1 2 9.5 1 10.0 1 9.1 2 9.5 0 0.0 0 0.0 0 0.0 4 40.0 2 18.2 6 28.6 0 0.0 0 0.0 0 0.0 50.0 0.0 33.3 #REF! #REF! #REF! #DIV/0! 0.0 -100.0 0.0 4.4 2.3 9.1 0.0 4.5
21 22 43
2 TEHONG 10 10 20 10 10 20 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 1 5.0 0 0.0 0 10.0 1 5.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 4 40.0 5 25.0 1 10.0 4 40.0 5 25.0 0 0.0 2 20.0 2 10.0 0 0.0 2 20.0 2 10.0 3 30.0 1 10.0 4 20.0 3 30.0 1 10.0 4 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 -200.0 75.0 20.0 #REF! #REF! #REF! #DIV/0! #DIV/0! #DIV/0! 4.8 0.0 2.3 0.0 0.0 0.0
14 17 32
3 PATENG LESU 7 7 14 7 7 14 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 0 0.0 1 14.3 1 7.1 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 0.0 0 0.0 0 0.0 0 0.0 0 0.0 #DIV/0! 100.0 100.0 #REF! #REF! #REF! #DIV/0! #DIV/0! #DIV/0! 6.9 0.0 3.1 0.0 0.0 0.0
23 22 45
4 MOMOL 15 15 30 14 15 29 2 13.3 1 6.7 3 10.0 0 0.0 0 0.0 0 0.0 2 13.3 0 6.7 3 10.0 2 13.3 0 0.0 2 6.7 2 13.3 0 0.0 2 6.7 0 0.0 2 13.3 2 6.9 0 0.0 2 13.3 2 6.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 6.7 1 3.4 0 0.0 1 6.7 1 3.4 0 0.0 0 0.0 0 0.0 0 0.0 3 20.0 3 10.3 0 0.0 0 0.0 0 0.0 #DIV/0! 50.0 50.0 #REF! #REF! #REF! 100.0 #DIV/0! 50.0 12.9 4.6 8.9 0.0 0.0 0.0
23 17 40
5 NDOSO 11 11 22 10 11 15 0 0.0 0 0.0 0 0.0 2 18.2 1 9.1 3 13.6 2 18.2 1 9.1 3 13.6 0 0.0 1 9.1 1 4.5 0 0.0 1 9.1 1 4.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 30.0 1 9.1 4 26.7 3 30.0 1 9.1 4 26.7 0 0.0 1 9.1 1 6.7 0 0.0 1 9.1 1 6.7 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 1 6.7 0 0.0 0 0.0 0 0.0 #DIV/0! #DIV/0! #DIV/0! #REF! #REF! #REF! #DIV/0! 0.0 0.0 0.0 11.5 5.0 0.0 5.8 2.5
14 16 30
6 LUMUT 17 18 35 17 18 35 0 0.0 0 0.0 0 0.0 3 17.6 5 27.8 8 22.9 3 17.6 3 27.8 8 22.9 1 5.9 3 16.7 4 11.4 1 5.9 3 16.7 4 11.4 3 17.6 4 22.2 7 20.0 3 17.6 4 22.2 7 20.0 0 0.0 2 11.1 2 5.7 0 0.0 2 11.1 2 5.7 2 11.8 1 5.6 3 8.6 2 11.8 1 5.6 3 8.6 0 0.0 0 0.0 0 0.0 3 17.6 1 5.6 4 11.4 0 0.0 0 0.0 0 0.0 33.3 75.0 57.1 #REF! #REF! #REF! -100.0 66.7 25.0 21.5 18.9 20.1 14.3 6.3 10.1
12 12 24
8 WAE BUKA 8 8 16 7 8 15 0 0.0 0 0.0 0 0.0 2 25.0 0 0.0 2 12.5 2 25.0 0 0.0 2 12.5 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 0.0 0 0.0 0 0.0 1 12.5 1 6.7 0 0.0 1 12.5 1 6.7 0 0.0 1 12.5 1 6.7 0 0.0 1 12.5 1 6.7 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 #DIV/0! #DIV/0! #DIV/0! #REF! #REF! #REF! #DIV/0! #DIV/0! #DIV/0! 0.0 0.0 0.0 0.0 0.0 0.0

129 129 258

RPROVINSI 79 80 159 75 80 149 4 5.1 1 1.3 5 3.1 7 8.9 7 8.8 14 8.8 11 13.9 5 6.3 19 11.9 3 3.8 5 6.3 8 5.0 3 3.8 5 6.3 8 5.0 6 8.0 12 15.0 18 12.1 6 8.0 12 15.0 18 12.1 6 8.0 7 8.8 13 8.7 6 8.0 7 8.8 13 8.7 6 8.0 6 7.5 12 8.1 6 8.0 6 7.5 12 8.1 0 0.0 0 0.0 0 0.0 8 10.7 6 7.5 14 9.4 0 0.0 0 0.0 0 0.0 0.0 50.0 33.3 #REF! #REF! #REF! -100.0 -20.0 -50.0 6.2 5.4 5.8 0.0 0.0 0.0
LAPORAN KUMULATIF
 LAPORAN KASUS CAMPAK
BULAN : JANUARI
TAHUN: 2021

PUSKESMAS : WANING
KABUPATEN : MANGGARAI BARAT

Alamat
Lengkap Vaksin Campak
Nama (Desa/
Umur/Sex Tgl Timbul Tgl diambil Hasil Sampel Keadaan Akir Keterangan Kasus
Nama Sebelum Sakit Diberi
No. Epid No. Epid Orang RT/RW)
Anak Vit.A Y/T
Tua Tahu/
Berapa
L P Tdk Demam Rash Darah Urin Darah Urin Hidup Mati Rutin KLB
kali
Tahu
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui Waning, 31 Januari 2021

Kepala UPTD Puskesmas Waning Pengelola Imunisasi

Ferdinandus Suwardi Egidius Suranko

NIP. 19750227 199903 1 003 NIP. 19860901 201903 1 006
 LAPORAN KEJADIAN IKUTAN PASKA IMUNISASI (KIPI)

KABUPATEN MANGGARAI BARAT

PROPINSI NTT
BULAN/TAHUN JANUARI 2021
I D E N T I T A S GEJALA YANG DIALAMI
Jenis Jenis No Batch Jenis No Batch Pemberi Tempat Tanggal
No Lain Sebutkan
Nama Anak Kelamin Tgl Lahir Umur Nama Ortu Alamat Vaksin Exp Date Vaksin Exp Date Imunisasi Pelayanan Imunisasi Demam Bengkak Merah Muntah
1 Vaksin 1 2 Vaksin 2 Imunisasi
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
1 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
3 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
5 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
7 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
9 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
11 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
13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Waning, 31 Januari 2021

Kepala Puskesmas Waning

Ferdinandus Suwardi
NIP. 19750227 199903 1 003
ABSENSI LAPORAN BULANAN DESA

Puskesmas: WANING Kabupaten/Kota: MANGGARAI BARAT Provinsi: Nusa Tenggara Timur Tahun: 2021
Bulan (dalam angka): 1 (<== isilah bulan ini dalam angka (misalnya Bulan Juni: 6) untuk mengetahui % kumulatif laporan masuk dan ketepatan waktu per desa s/d bulan ini)

Isilah tanggal laporan diterima dengan cara: ketik "hr/bl/thn; contohnya: 01/01/19 untuk 1 Januari 2019.

DESA / KELURAHAN Jan Feb Mar Apr Mei Jun Jul Agu Sep Okt Nov Des
No Laporan % Kumulatif Laporan Tepat % Kumulatif
Batas waktu 26/01/21 Masuk Laporan Masuk Waktu Ketepatan waktu
laporan ===>
1 WANING 26/01/21 1 100.0% 1 100.0%
2 TEHONG 26/01/21 1 100.0% 1 100.0%
3 PATENG LESU 26/01/21 1 100.0% 1 100.0%
4 MOMOL 26/01/21 1 100.0% 1 100.0%
5 NDOSO 26/01/21 1 100.0% 1 100.0%
6 LUMUT 26/01/21 1 100.0% 1 100.0%
7 WAE BUKA 26/01/21 1 100.0% 1 100.0%
7 # Laporan masuk 7 0 0 0 0 0 0 0 0 0 0 0 7 8.3%
# Laporan tepat
waktu 7 0 0 0 0 0 0 0 0 0 0 0 7 100.0%
# Laporan yang
diharapkan 7 7 7 7 7 7 7 7 7 7 7 7 84
RPROVINSI

% Laporan masuk 100.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
% Ketepatan waktu 100.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
% Kumulatif laporan
masuk 100.0% 50.0% 33.3% 25.0% 20.0% 16.7% 14.3% 12.5% 11.1% 10.0% 9.1% 8.3%
% Kumulatif
ketepatan waktu 100.0% 50.0% 33.3% 25.0% 20.0% 16.7% 14.3% 12.5% 11.1% 10.0% 9.1% 8.3%
CATATAN (Tulislah jumlah laporan yang masuk tapi belum terisi lengkap):
LAPORAN RILL HASIL IMUNISASI
Puskesmas: Waning
Kabupaten/Kota: Manggarai Barat
Provinsi: NTT
Bulan: Januari 2021

HB0 HB0 BCG POLIO1 DPT/HB-Hib POLIO2 DPT/HB-Hib POLIO3 DPT/HB-Hib POLIO4 IPV CAMPAK RUBELLA IMUNISASI DPT/HB/Hib CAMPAK RUBELLA
NO DESA / (<24 JAM) (1-7 HARI) (1) (2) (3) (MR) LENGKAP (MR)
KELURAHAN
#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 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
1 WANING 2 0 0 0 0 1 0 1 2 1 2 1 3 0 3 0 1 1 1 1 0 0 4 2 0 0 0 1 2 0
2 TEHONG 0 0 0 1 0 0 0 0 1 4 1 4 0 2 0 2 3 1 3 1 0 0 0 0 0 0 1 0 0 0
3 PATENG LESU 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0
4 MOMOL 2 1 0 0 2 0 2 0 0 2 0 2 0 0 0 0 0 1 0 1 0 0 0 3 0 0 3 1 0 0
5 NDOSO 0 0 2 1 0 1 0 1 0 0 0 0 3 1 3 1 0 1 0 1 0 0 1 0 0 0 0 2 0 1
6 LUMUT 0 0 3 5 1 3 1 3 3 4 3 4 0 2 0 2 2 1 2 1 0 0 3 1 0 0 3 3 2 1
8 WAE BUKA 0 0 2 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0

RPROVINSI 4 1 7 7 3 5 3 5 6 12 6 12 6 7 6 7 6 6 6 6 0 0 8 6 0 0 8 7 4 2
LAPORAN RILL
LAPORAN BULANAN HASIL IMUNISASI T IBU HAMIL DAN WUS PUSKESMAS
Puskesmas: WANING
Kabupaten/Kota: MANGGARAI BARAT
Provinsi: Nusa Tenggara Timur Bulan: Januari 2021

JUMLAH TOTAL DAN PERSENTASE TT2+

JUMLAH DAN PERSENTASE IBU HAMIL DIIMUNISASI JUMLAH DAN PERSENTASE WUS TIDAK HAMIL DIIMUNISASI
WUS (HAMIL+TIDAK HAMIL) DIIMUNISASI TT BUMIL

DESA / SASARAN
NO
KELURAHAN SASARAN WUS
BUMIL
Td1 Td2 Td3 Td4 Td5 TIDAK
Td1 Td2 Td3 Td4 Td5 Td1 Td2 Td3 Td4 Td5 Td 2 +
HAMIL

# # % # % # % # % # % # # % # % # % # % # % # % # % # % # % # % # %
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36
1 WANING 24 4 16.5 0 0.0 0 0.0 0 0.0 0 0.0 329 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 1.1 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
2 TEHONG 22 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 303 0 0.0 0 0.0 0 0.0 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 PATENG LESU 15 3 19.5 0 0.0 0 0.0 0 0.0 0 0.0 159 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 1.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
4 MOMOL 33 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 198 0 0.0 0 0.0 0 0.0 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 NDOSO 24 4 16.5 0 0.0 0 0.0 0 0.0 0 0.0 323 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 4 1.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
6 LUMUT 39 1 2.6 3 7.8 0 0.0 0 0.0 0 0.0 311 0 0.0 0 0.0 8 2.6 0 0.0 0 0.0 1 0.3 3 0.9 8 2.3 0 0.0 0 0.0 0 0.0
7 WAE BUKA 18 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 245 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0

RPROVINSI 175 12 6.9 3 1.7 0 0.0 0 0.0 0 0.0 1867 0 0.0 0 0.0 8 0.4 0 0.0 0 0.0 12 0.6 3 0.1 8 0.4 0 0.0 0 0.0 0 0.0
Isilah tempat/tanggal/tahun
dan Nama serta NIP Kepala Puskesmas
atau Dinkes
LAPORAN TT