LAPORAN BULANAN
KESEHATAN REPRODUKSI
(LB KUSUB & KR) 
BULAN  : NOVEMBER                      Tahun   : 2013
PEOPINSI                                                             :
jawa Timur       Jumlah  Sp OG
PUSKESMAS                                                       :
Pujon                                  Dokter                  1
Jumlah
Polindes yang ada /lapor               :9/9                                        Bidan                     18
Jumlah yang
melaksanakan PAP SMEAR                : -                                                            PKM      : 7
Jml Desa                                                              :
10                                                         Pustu    : 2
Jml Posyandu                                                    :
74                                                         Desa      : 9
                                                                                                                                                Polindes               : -
Jml Penduduk                                                   :
64.917                                 D3           : 17
Jumlah
PUSPUS dengan istri (Yang belum KB)     :
12.345                 D4/S1/S2             `: 1/-/-
Umur < 20
tahun                                              :
                                                              Perawat               : 14
Umur > 35
tahun                                              :                                                               D3           : 14
Anak
terkecil < 2 Tahun                                 :                                                               SPK        : -
Anak > 3
Orang                                                 :                                                               S1           : -1
                                                                                                                                                Lain-lain               : -
I.                   
HASIL KEGIATAN PELAYANAN
 
  
No 
 | 
  
Kegiatan 
 | 
  
Unit Pemerintah 
 | 
  
Unit swasta 
 | 
  
Jumlah 
 | 
 
  
Pasca bersalin 
 | 
  
Pasca Keguguran 
 | 
  
KB Baru 
 | 
  
Psca bersalin 
 | 
  
Pasca keguguran 
 | 
  
KB Baru 
 | 
  
  
 | 
 
  
1 
 | 
  
Pelayanan Aseptor KB Baru 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
4 
 | 
  
  
 | 
  
4 
 | 
 
  
  
 | 
  
-IUD 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
-MOP 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
-MOW 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
-IMPLANT 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
-Suntik 
 | 
  
  
 | 
  
  
 | 
  
64 
 | 
  
  
 | 
  
  
 | 
  
23 
 | 
  
87 
 | 
 
  
  
 | 
  
-Pil 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
1 
 | 
  
1 
 | 
 
  
  
 | 
  
-Kondom 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
JUMLAH 
 | 
  
  
 | 
  
  
 | 
  
64 
 | 
  
  
 | 
  
  
 | 
  
28 
 | 
  
92 
 | 
 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
2 
 | 
  
Peserta KB Aktif 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
-iud 
 | 
  
1137 
 | 
  
  
 | 
  
1137 
 | 
 
  
  
 | 
  
-mop 
 | 
  
39 
 | 
  
  
 | 
  
39 
 | 
 
  
  
 | 
  
-mow 
 | 
  
185 
 | 
  
  
 | 
  
185 
 | 
 
  
  
 | 
  
-implant 
 | 
  
950 
 | 
  
  
 | 
  
950 
 | 
 
  
  
 | 
  
-suntik 
 | 
  
6322 
 | 
  
  
 | 
  
6322 
 | 
 
  
  
 | 
  
-pil 
 | 
  
546 
 | 
  
  
 | 
  
546 
 | 
 
  
  
 | 
  
-kondom 
 | 
  
3 
 | 
  
  
 | 
  
3 
 | 
 
  
  
 | 
  
JUMLAH 
 | 
  
9182 
 | 
  
  
 | 
  
9182 
 | 
 
  
3 
 | 
  
Peserta UB Aktif di bina (Sesuai regester Pembinaan medis UB) 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
-iud 
 | 
  
3 
 | 
  
  
 | 
  
3 
 | 
 
  
  
 | 
  
-mop 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
-mow 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
-implant 
 | 
  
198 
 | 
  
  
 | 
  
198 
 | 
 
  
  
 | 
  
-suntik 
 | 
  
281 
 | 
  
  
 | 
  
281 
 | 
 
  
  
 | 
  
-pil 
 | 
  
23 
 | 
  
  
 | 
  
23 
 | 
 
  
  
 | 
  
-kondom 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
JUMLAH 
 | 
  
505 
 | 
  
  
 | 
  
505 
 | 
 
 
  
No 
 | 
  
KEGIATAN 
 | 
  
UNIT PEMERINTAH 
 | 
  
UNIT SWASTA 
 | 
  
JML 
 | 
 
  
8 
 | 
  
Jumlah orang yang mengalami : 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
-         
  Efek Samping 
 | 
  
82 
 | 
  
66 
 | 
  
128 
 | 
 
  
  
 | 
  
-         
  Komplikasi 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
JUMLAH 
 | 
  
82 
 | 
  
66 
 | 
  
128 
 | 
 
  
9 
 | 
  
Jumlah Kasus Yang di AMP-KB 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
-         
  Kegagalan  
 | 
  
0 
 | 
  
0 
 | 
  
0 
 | 
 
  
  
 | 
  
-         
  komplikasi 
 | 
  
0 
 | 
  
0 
 | 
  
0 
 | 
 
  
  
 | 
  
JUMLAH 
 | 
  
0 
 | 
  
0 
 | 
  
0 
 | 
 
  
10 
 | 
  
PMTC 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
Polindes /Pustu 
 | 
  
9/2 
 | 
  
2 
 | 
  
13 
 | 
 
  
  
 | 
  
-         
  Menjadi jejaring PMTCT 
 | 
  
9/2 
 | 
  
2 
 | 
  
13 
 | 
 
  
  
 | 
  
-         
  Ibu hamil yang ANC 
 | 
  
109 
 | 
  
0 
 | 
  
- 
 | 
 
  
  
 | 
  
-         
  Melakukan Konseling PMTCT (90%) 
 | 
  
0 
 | 
  
0 
 | 
  
1 
 | 
 
  
  
 | 
  
-         
  Ibu hamil yang dikonseling HIV (20%) 
 | 
  
0 
 | 
  
0 
 | 
  
0 
 | 
 
  
  
 | 
  
-         
  Ibu hamil yang test HIV (15%) 
 | 
  
0 
 | 
  
0 
 | 
  
0 
 | 
 
  
  
 | 
  
JUMLAH 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
11 
 | 
  
PKRE 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
-Jumlah Polindes 
 | 
  
9 
 | 
  
  
 | 
  
9 
 | 
 
  
  
 | 
  
Polindes melakukan PKRE 
 | 
  
11 
 | 
  
2 
 | 
  
13 
 | 
 
  
  
 | 
  
-Polindes dengan PKRK 
 | 
  
10 
 | 
  
  
 | 
  
10 
 | 
 
DATA ALOKON DI PUSKESMAS
 
  
No 
 | 
  
URAIAN 
 | 
  
OBAT 
 | 
  
  
 | 
  
ALAT 
 | 
  
  
 | 
  
  
 | 
  
JUMLAH 
 | 
  
  
 | 
 
  
PIL 
 | 
  
SUNTIK 
 | 
  
IUD 
 | 
  
IMP 
 | 
  
KDM 
 | 
  
OBAT 
 | 
  
ALAT 
 | 
 
  
13 
 | 
  
Stok Awal 
-         
  Sisa bulan lalu 
-         
  - Penerimaan 
-Penggunaan 
-stok akhir 
-sisa 
 | 
  
  
700 
- 
100 
600 
600 
 | 
  
  
150 
- 
100 
50 
50 
 | 
  
  
131 
- 
- 
131 
131 
 | 
  
  
30 
- 
- 
30 
30 
 | 
  
  
129 
- 
3 
9 
9 
 | 
  
  
850 
0 
200 
650 
650 
 | 
  
  
173 
0 
3 
170 
170 
 | 
 
Mengetahui
Kepala
Puskesmas                                                                                           pengelola
Program
…………………………………..                                                                      ARIES
YUDA PALUPI
NIP :                                                                                                          NIP
; 19800427 2011012007
FORMAT LAPORAN PMT CT
TRIBULAN           :
IV
PUSKESMAS       :
PUJON
TAHUN                 :
2013
 
  
No 
 | 
  
URAIAN 
 | 
  
PUSTU 
 | 
  
POLINDES 
 | 
  
FASKES LAIN 
 | 
  
TOTAL 
 | 
 
  
1. 
 | 
  
Jumlah 
 | 
  
2 
 | 
  
9 
 | 
  
2 
 | 
  
13 
 | 
 
  
2. 
 | 
  
Menjadi Jejaring 
 | 
  
2 
 | 
  
9 
 | 
  
2 
 | 
  
13 
 | 
 
  
3 
 | 
  
Menjadi BUMIL 
 | 
  
  
 | 
  
  
 | 
  
- 
 | 
  
  
 | 
 
  
4 
 | 
  
BUMIL yg di ANC 
 | 
  
  
 | 
  
  
 | 
  
- 
 | 
  
  
 | 
 
  
5 
 | 
  
BUMIL di konseling PMT CT 
 | 
  
- 
 | 
  
  
 | 
  
- 
 | 
  
  
 | 
 
  
6 
 | 
  
Bumil Test HIV 
 | 
  
- 
 | 
  
  
 | 
  
- 
 | 
  
  
 | 
 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
Mengetahui
Kepala
Puskesmas                                                                                           Pengelola
KesPro
…………………………………..                                                               ARIES
YUDA PALUPI
NIP :                                                                                                      NIP
; 19800427 2011012007
LAPORAN PENANGANAN KEKERASAN
TERHADAP PEREMPUAN
PUSKESMAS       : PUJON
BULAN                  : NOVEMBER 2013
 
  
No 
 | 
  
KEGIATAN 
 | 
  
NAMA KORBAN 
 | 
  
UMUR 
 | 
  
KETERANGAN 
 | 
 
  
1 
 | 
  
JUMLAH KASUS 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
2 
 | 
  
CARA PENEMUAN KASUS 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
a 
 | 
  
Diantar Keluarga 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
b 
 | 
  
Datang sendiri 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
c 
 | 
  
Diantar teman 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
d 
 | 
  
Diantar Paman 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
e 
 | 
  
Diantar petugas kecamatan/Polsek 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
3 
 | 
  
JENIS KASUS 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
a 
 | 
  
Penganiayaan 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
Perkosaan 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
Pelecehan Seksual 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
JUMLAH 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
4 
 | 
  
BENTUK PERLAKUAN 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
Dipukuli 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
Ditampar 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
Ditusuk 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
Dibenturkan 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
Lain-lain/dianting 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
Jumlah 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
5 
 | 
  
KASUS YANG DIRUJUK 
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
  
  
 | 
 
Mengetahui
Kepala
Puskesmas                                                                                           Pengelola
KesPro
…………………………………..                                                                  ARIES
YUDA PALUPI
NIP :                                                                                                       NIP
; 19800427 2011012007
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