BULAN : ................................................. : ………..

TAHUN : ................................................. : ............

0 - 6 Bln ≥ 6 Bln - < 1 Th 1 - 4 Th

NO DESA JUMLAH PENDUDUK
P M P M P
L P L P L P L P L
1 2 3 4 5 6 7 8 9 10 11 12
1 SIDOMORO 9951 ### ### ### ### ### ### ### ######
2 SINGOSARI 9659 ### ### ### ### ### ### ### ######
3 INDRO 5232 ### ### ### ### ### ### ### ######
4 GENDING 3934 ### ### ### ### ### ### ### ######
5 KARANG KERING 1187 ### ### ### ### ### ### ### ######
6 SEGOROMADU 1558 ### ### ### ### ### ### ### ######
7 TENGGULUNAN 557 ### ### ### ### ### ### ### ######
8 SUKOREJO 1884 ### ### ### ### ### ### ### ######
9 PRAMBANGAN 2163 ### ### ### ### ### ### ### ######
10 GULOMANTUNG 2592 ### ### ### ### ### ### ### ######
11 LUAR WILAYAH 0 ### ### ### ### ### ### ### ######

JUMLAH 38717 0 ### ### ### ### ### ### ######

TANPA DEHIDRASI 0 0 0 0 3 1 0 0 7
JUMLAH PENDERITA
DEHIDRASI RINGAN/SEDANG 0 0 0 0 0 0 0 0 0
DIARE
DEHIDRASI BERAT 0 0 0 0 0 0 0 0 0
ORALIT (36+41)
JUMLAH PENDERITA
INFUSE (40+47)
DIARE MENDAPAT
ZINC (36)
 REKAPITULASI KASUS DIARE DI WILAYAH PUS

FASILITAS PELAYANAN KESEHATAN

1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th > 20 Th JUMLAH
P M P M P M P M P M P M
P L P L P L P L P L P L P L P L P L P L P L P
13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###
### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ###

### ### ### ### ### ### ### ### ### ### ### 3 1 0 0 33 38 0 0 21 29 0 0

7 0 0 5 12 0 0 2 4 0 0 3 1 0 0 33 38 0 0 54 63 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
#REF!
#REF!
#REF!
US DIARE DI WILAYAH PUSKESMAS ...........................

KESEHATAN
Penderita Diare < 5 Th diberi Penderita Diare > Jumlah Pemakaian
Zinc 5 Th diberi Zinc
Oralit RL Oralit
0-6 Bln ≥6Bln-<1Th 1 - 4 Th Oralit RL 0-6 Bln ≥6Bln-<1Th 1-4 Th
36 37 38 39 40 41 42 43 44 45 46
### ### #VALUE! ### ### ### ### ### ### #VALUE! ###
### ### #VALUE! ### ### ### ### ### ### #VALUE! ###
### ### #VALUE! ### ### ### ### ### ### #VALUE! ###
### ### #VALUE! ### ### ### ### ### ### #VALUE! ###
### ### #VALUE! ### ### ### ### ### ### #VALUE! ###
### ### #VALUE! ### ### ### ### ### ### #VALUE! ###
### ### #VALUE! ### ### ### ### ### ### #VALUE! ###
### ### #VALUE! ### ### ### ### ### ### #VALUE! ###
### ### #VALUE! ### ### ### ### ### ### #VALUE! ###
### ### #VALUE! ### ### ### ### ### ### #VALUE! ###
### ### #VALUE! ### ### ### ### ### ### #VALUE! ###

90 0 25 135 0 200 10 220 0 0 0

0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 ### 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
 FORM : 13F

aian

RL

47
###
###
###
###
###
###
###
###
###
###
###

0
0
0
0
0
0
 FASILITAS PELAYANAN KESEHATAN
0 - 6 Bln ≥ 6 Bln - < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th > 20 Th JUMLAH Penderita Diare < 5 Th diberi Penderita Jumlah Pemakaian
NO DESA JUMLAH PENDUDUK Diare > 5 Th
P M P M P M P M P M P M P M P M Zinc diberi Zinc
Oralit RL Oralit RL
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 0-6 ≥6Bln-<1Th
Bln 1-4 Oralit RL ≥6Bln-<1Th
0-6 Bln 1-4 Th
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
1 SIDOMORO 9951 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 1 0 0 0 1 0 0 3 3 0 0 4 7 0 0 5 0 0 10 0 50 0 55 0 0 0 0
2 SINGOSARI 9659 0 0 0 0 1 0 0 0 1 1 0 0 1 1 0 0 1 1 0 0 0 0 0 0 2 4 0 0 6 7 0 0 15 0 5 20 0 50 0 65 0 0 0 0
3 INDRO 5232 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 1 0 0 1 0 0 0 4 2 0 0 7 5 0 0 10 0 5 10 0 50 0 60 0 0 0 0
4 GENDING 3934 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 2 2 0 0 4 4 0 0 10 0 5 10 0 30 0 40 0 0 0 0
5 KARANG KERING 1187 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 1 0 0 2 2 0 0 0 0 0 0 0 20 0 20 0 0 0 0
6 SEGOROMADU 1558 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 1 0 0 2 2 0 0 0 0 0 0 0 20 0 20 0 0 0 0
7 TENGGULUNAN 557 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 0 0 0 1 0 0 0 0 0 0 0 0 5 0 5 0 0 0 0
8 SUKOREJO 1884 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
9 PRAMBANGAN 2163 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
10 GULOMANTUNG 2592 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
11 LUAR WILAYAH 0 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 4 0 0 1 4 0 0 0 0 0 0 0 25 0 25 0 0 0 0

JUMLAH 38717 0 0 0 0 3 0 0 0 1 4 0 0 4 6 0 0 1 3 0 0 1 1 0 0 23 20 0 0 33 34 0 0 40 0 15 50 0 295 0 335 0 0 0 0

TANPA DEHIDRASI 0 0 0 0 3 0 0 0 1 4 0 0 4 6 0 0 1 3 0 0 1 1 0 0 23 20 0 0 33 34 0 0
JUMLAH
DEHIDRASI RINGAN/SEDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PENDERITA DIARE
DEHIDRASI BERAT 0 0 0 0 0 0 0 0 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 ORALIT (36+41) 335

PENDERITA DIARE INFUSE (40+47) 0
MENDAPAT ZINC (36) 65

KET :
P : Penderita
M : Mati Gresik, 03 Februari 2017
TD : Tanpa Dehidrasi Pengelola Program Kepala UPT Puskesmas Gending
DR/: Dehidrasi Ringan/Sedang
DB : Dehidrasi Berat
L : Laki-Laki
Pr : Perempuan ALI SISWANTO, S.Kep.,Ns drg. HELENA SUZANA
NIP.19790507201001 1 010 NIP.19600113198903 2 001
 REKAPITULASI KASUS DIARE DI WILAYAH PUSKESMAS ...........................

BULAN : ................................................. : ………..

TAHUN : ................................................. : ............

FASILITAS PELAYANAN KESEHATAN

0 - 6 Bln ≥ 6 Bln - < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th > 20 Th JUMLAH Penderita Diare < 5 Th diberi Penderita Jumlah Pemakaian
NO DESA JUMLAH PENDUDUK Diare > 5 Th
P M P M P M P M P M P M P M P M Zinc diberi Zinc
Oralit RL Oralit RL
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 0-6 Bln ≥6Bln-<1Th 1 - 4 Th Oralit RL 0-6 Bln ≥6Bln-<1Th 1-4 Th
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
1 SIDOMORO 9951 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 3 0 0 3 5 0 0 10 0 0 20 0 30 0 40 0 0 0 0
2 SINGOSARI 9659 0 0 0 0 0 1 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 2 4 0 0 4 7 0 0 15 0 10 20 0 40 10 35 0 10 0 0
3 INDRO 5232 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 1 0 0 1 0 0 0 1 2 0 0 3 5 0 0 10 0 0 20 0 30 0 30 0 0 0 0
4 GENDING 3934 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 3 0 0 4 4 0 0 5 0 0 5 0 35 1 40 0 0 0 0
5 KARANG KERING 1187 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 0 0 0 1 0 0 0 0 0 0 0 0 5 0 5 0 0 0 0
6 SEGOROMADU 1558 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 2 0 0 0 0 0 0 0 15 0 15 0 0 0 0
7 TENGGULUNAN 557 0 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 0 0 0 1 0 0 0 0 0 0 0 5 0 5 0 0 0 0
8 SUKOREJO 1884 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2 1 0 0 5 0 0 10 0 10 0 15 0 0 0 0
9 PRAMBANGAN 2163 0 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 0 0 0 1 0 0 0 0 0 0 0 5 0 5 0 0 0 0
10 GULOMANTUNG 2592 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 2 1 0 0 5 0 0 10 0 10 0 15 0 0 0 0
11 LUAR WILAYAH 0 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 2 0 0 1 2 0 0 0 0 0 0 0 15 0 15 0 0 0 0
JUMLAH 38717 0 0 0 0 0 1 0 0 6 3 0 0 1 6 0 0 1 1 0 0 2 0 0 0 10 18 0 0 21 29 0 0 50 0 10 85 0 200 10 220 0 0 0 0
TANPA DEHIDRASI 0 0 0 0 0 1 0 0 6 3 0 0 1 6 0 0 1 1 0 0 2 0 0 0 10 18 0 0 21 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH
DEHIDRASI RINGAN/SEDANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PENDERITA DIARE
DEHIDRASI BERAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 ORALIT (36+41) 0
PENDERITA DIARE INFUSE (40+47) 0
MENDAPAT ZINC (36) 95

KET :
P : Penderita
M : Mati Gresik, 02 Maret 2017
TD : Tanpa Dehidrasi Pengelola Program Kepala UPT Puskesmas Gending
DR/: Dehidrasi Ringan/Sedang
DB : Dehidrasi Berat
L : Laki-Laki
Pr : Perempuan ALI SISWANTO, S.Kep.,Ns drg. HELENA SUZANA
NIP.19790507201001 1 010 NIP.19600113198903 2 001
 REKAPITULASI KASUS DIARE DI WILAYAH PUSKESMAS GENDING

BULAN : ................................................. : ………..

TAHUN : ................................................. : ............

FASILITAS PELAYANAN KESEHATAN

0 - 6 Bln ≥ 6 Bln - < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th > 20 Th JUMLAH Penderita Diare < 5 Th diberi Penderita Jumlah Pemakaian
NO DESA JUMLAH PENDUDUK Diare > 5
P M P M P M P M P M P M P M P M Zinc Zinc
Oralit RL Th diberi Oralit RL
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 0-6 Bln ≥6Bln-<1Th 1 - 4 Th Oralit RL 0-6≥6Bln-<1Th
Bln 1-4 Th
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
1 SIDOMORO 9951 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 3 3 0 0 4 5 0 0 5 0 0 10 0 40 0 45 0 0 0 0
2 SINGOSARI 9659 0 0 0 0 1 0 0 0 1 1 0 0 1 0 0 0 1 1 0 0 0 1 0 0 2 3 0 0 6 6 0 0 15 0 10 20 0 45 0 60 0 0 0 0
3 INDRO 5232 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 4 2 0 0 7 5 0 0 10 0 10 10 0 50 0 60 0 0 0 0
4 GENDING 3934 0 0 0 0 1 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 0 1 0 0 2 2 0 0 5 4 0 0 15 0 10 20 0 30 0 45 0 0 0 0
5 KARANG KERING 1187 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
6 SEGOROMADU 1558 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 2 1 0 0 3 1 0 0 0 0 0 0 0 20 0 20 0 0 0 0
7 TENGGULUNAN 557 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 0 0 0 1 0 0 0 0 0 0 0 0 5 0 5 0 0 0 0
8 SUKOREJO 1884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 2 1 0 0 3 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
9 PRAMBANGAN 2163 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
10 GULOMANTUNG 2592 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 1 0 0 2 2 0 0 0 0 0 0 0 20 0 20 0 0 0 0
11 LUAR WILAYAH 0 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 4 0 0 1 4 0 0 0 0 0 0 0 25 0 25 0 0 0 0
JUMLAH 38717 0 0 0 0 2 1 0 0 4 2 0 0 1 0 1 0 2 3 0 0 3 5 0 0 23 19 0 0 35 30 0 0 45 0 30 60 0 280 0 325 0 0 0 0
JUMLAH TANPA DEHIDRASI 0 0 0 0 2 1 0 0 4 2 0 0 1 6 1 0 2 3 0 0 3 5 0 0 23 19 0 0 35 30 0 0
PENDERITA DEHIDRASI RINGAN/SEDA 0 0 0 0 0 0 0 0 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 DEHIDRASI BERAT 0 0 0 0 0 0 0 0 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 ORALIT (36+41) 325
PENDERITA
INFUSE (40+47) 0
DIARE
MENDAPAT ZINC (36) 90
KET :
P : Penderita
M : Mati Gresik, 05 April 2017
TD : Tanpa Dehidrasi Pengelola Program Kepala UPT Puskesmas Gending
DR/: Dehidrasi Ringan/Sedang
DB : Dehidrasi Berat
L : Laki-Laki
Pr : Perempuan ALI SISWANTO, S.Kep.,Ns drg. HELENA SUZANA
NIP.19790507201001 1 010 NIP.19600113198903 2 001
 REKAPITULASI KASUS DIARE DI WILAYAH PUSKESMAS ...........................

BULAN : ................................................. : ………..

TAHUN : ................................................. : ............

FASILITAS PELAYANAN KESEHATAN Penderit

0 - 6 Bln ≥ 6 Bln - < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th > 20 Th JUMLAH Penderita Diare < 5 Th diberi a Diare > Jumlah Pemakaian
NO DESA JUMLAH PENDUDUK
P M P M P M P M P M P M P M P M Zinc 5 Th Zinc
Oralit RL diberi Oralit RL
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 0-6 Bln ≥6Bln-<1Th1 - 4 Th Oralit RL 0-6 Bln≥6Bln-<1Th1-4 Th
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
1 SIDOMORO 9951 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 3 4 0 0 5 4 0 0 5 0 0 10 0 40 0 45 0 0 10 0
2 SINGOSARI 9659 0 0 0 0 0 1 0 0 0 1 0 0 0 1 0 0 0 0 0 0 1 1 0 0 2 5 0 0 3 9 0 0 10 0 10 10 0 50 0 60 0 10 10 0
3 INDRO 5232 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 3 4 0 0 6 5 0 0 5 0 0 10 0 50 0 55 0 0 10 0
4 GENDING 3934 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 2 4 0 0 4 6 0 0 5 0 0 10 0 45 0 50 0 0 10 0
5 KARANG KERING 1187 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 2 0 0 1 2 0 0 0 0 0 0 0 15 0 15 0 0 0 0
6 SEGOROMADU 1558 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 3 0 0 2 4 0 0 0 0 0 0 0 30 0 30 0 0 0 0
7 TENGGULUNAN 557 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 2 0 0 1 2 0 0 0 0 0 0 0 15 0 15 0 0 0 0
8 SUKOREJO 1884 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 2 0 0 1 2 0 0 0 0 0 0 0 15 0 15 0 0 0 0
9 PRAMBANGAN 2163 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 2 0 0 1 2 0 0 0 0 0 0 0 15 0 15 0 0 0 0
10 GULOMANTUNG 2592 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 2 0 0 1 2 0 0 0 0 0 0 0 15 0 15 0 0 0 0
11 LUAR WILAYAH 0 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 6 0 0 1 6 0 0 0 0 0 0 0 35 0 35 0 0 0 0
JUMLAH 38717 0 0 0 0 0 1 0 0 3 1 0 0 3 2 0 0 0 1 0 0 2 3 0 0 18 36 0 0 26 44 0 0 25 0 10 40 0 325 0 350 0 10 40 0
JUMLAH TANPA DEHIDRASI 0 0 0 0 0 1 0 0 3 1 0 0 3 2 0 0 0 1 0 0 2 3 0 0 18 36 0 0 26 44 0 0
PENDERITA DEHIDRASI RINGAN/SEDANG 0 0 0 0 0 0 0 0 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 DEHIDRASI BERAT 0 0 0 0 0 0 0 0 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 ORALIT (36+41) 350
PENDERITA
INFUSE (40+47) 0
DIARE
MENDAPAT ZINC (36) 50
KET :
P : Penderita
M : Mati Gresik, 03 Mei 2017
TD : Tanpa Dehidrasi Pengelola Program Kepala UPT Puskesmas Gending
DR/: Dehidrasi Ringan/Sedang
DB : Dehidrasi Berat
L : Laki-Laki
Pr : Perempuan ALI SISWANTO, S.Kep.,Ns drg. HELENA SUZANA
NIP.19790507201001 1 010 NIP.19600113198903 2 001
 REKAPITULASI KASUS DIARE DI WILAYAH PUSKESMAS ...........................

BULAN : ................................................. : ………..

TAHUN : ................................................. : ............

FASILITAS PELAYANAN KESEHATAN

0 - 6 Bln ≥ 6 Bln - < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th > 20 Th JUMLAH Penderita Diare < 5 Th diberiPenderita Jumlah Pemakaian
NO DESA JUMLAH PENDUDUK Diare > 5
P M P M P M P M P M P M P M P M Zinc Zinc
Oralit RL Th diberi Oralit RL
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 0-6≥6Bln-<1Th
Bln 1-4 Oralit RL 0-6≥6Bln-<1Th
Bln 1-4 Th
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
1 SIDOMORO 9951 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 1 0 0 0 1 0 0 3 3 0 0 4 7 0 0 5 0 0 10 0 50 0 55 0 0 0 0
2 SINGOSARI 9659 0 0 0 0 1 0 0 0 1 1 0 0 1 1 0 0 1 1 0 0 0 0 0 0 2 4 0 0 6 7 0 0 15 0 5 20 0 50 0 65 0 0 0 0
3 INDRO 5232 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 1 0 0 1 0 0 0 4 2 0 0 7 5 0 0 10 0 5 10 0 50 0 60 0 0 0 0
4 GENDING 3934 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 2 2 0 0 4 4 0 0 10 0 5 10 0 30 0 40 0 0 0 0
5 KARANG KERING 1187 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 1 0 0 2 2 0 0 0 0 0 0 0 20 0 20 0 0 0 0
6 SEGOROMADU 1558 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 1 0 0 3 2 0 0 5 0 0 10 0 20 0 25 0 0 0 0
7 TENGGULUNAN 557 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 0 0 0 1 0 0 0 0 0 0 0 0 5 0 5 0 0 0 0
8 SUKOREJO 1884 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
9 PRAMBANGAN 2163 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
10 GULOMANTUNG 2592 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
11 LUAR WILAYAH 0 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 4 0 0 1 4 0 0 0 0 0 0 0 25 0 25 0 0 0 0
JUMLAH 38717 0 0 0 0 3 0 0 0 2 4 0 0 4 6 0 0 1 3 0 0 1 1 0 0 23 20 0 0 34 34 0 0 45 0 15 60 0 295 0 340 0 0 0 0
JUMLAH TANPA DEHIDRASI 0 0 0 0 3 0 0 0 2 4 0 0 4 6 0 0 1 3 0 0 1 1 0 0 23 20 0 0 34 34 0 0
PENDERITA DEHIDRASI RINGAN/SEDANG 0 0 0 0 0 0 0 0 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 DEHIDRASI BERAT 0 0 0 0 0 0 0 0 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 ORALIT (36+41) 340
PENDERITA
INFUSE (40+47) 0
DIARE
MENDAPAT ZINC (36) 75
KET :
P : Penderita
M : Mati Gresik, 05 Juni 2017
TD : Tanpa Dehidrasi Pengelola Program Kepala UPT Puskesmas Gending
DR/: Dehidrasi Ringan/Sedang
DB : Dehidrasi Berat
L : Laki-Laki
Pr : Perempuan ALI SISWANTO, S.Kep.,Ns drg. HELENA SUZANA
NIP.19790507201001 1 010 NIP.19600113198903 2 001
 REKAPITULASI KASUS DIARE DI WILAYAH PUSKESMAS ...........................

BULAN ................................................. : ………..

TAHUN ................................................. : ............

NO DESA JUMLAH PENDUDUK

FASILITAS PELAYANAN KESEHATAN
Penderit
a Diare Jumlah
0 - 6 Bln ≥ 6 Bln - < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th > 20 Th JUMLAH Penderita Diare < 5 Th diberi
> 5 Th Pemakaian
diberi
P M P M P M P M P M P M P M P M Oralit Zinc RL Oralit Zinc
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 0-6 Bln ≥6Bln-<1Th 1 - 4 Th Oralit RL 0-6 Bln ≥6Bln-<1Th 1-4 Th
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
1 SIDOMORO 9951 0 0 0 0 0 1 0 0 1 1 0 0 1 1 0 0 0 1 0 0 1 1 0 0 3 4 0 0 6 9 0 0 15 0 10 20 0 60 0 75 0 0 0
2 SINGOSARI 9659 0 0 0 0 1 0 0 0 1 1 0 0 1 1 0 0 1 1 0 0 1 0 0 0 2 5 0 0 7 8 0 0 15 0 10 20 0 60 0 75 0 0 0
3 INDRO 5232 0 0 0 0 1 0 0 0 1 1 0 0 1 1 0 0 0 1 0 0 1 0 0 0 4 3 0 0 8 6 0 0 15 0 10 20 0 55 0 70 0 0 0
4 GENDING 3934 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 1 0 0 2 2 0 0 4 5 0 0 10 0 10 10 0 35 0 45 0 0 0
5 KARANG KERING 1187 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 1 0 0 2 2 0 0 0 0 0 0 0 20 0 20 0 0 0
6 SEGOROMADU 1558 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 1 0 0 3 2 0 0 5 0 0 10 0 20 0 25 0 0 0
7 TENGGULUNAN 557 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 0 0 0 1 0 0 0 0 0 0 0 0 5 0 5 0 0 0
8 SUKOREJO 1884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 2 1 0 0 3 1 0 0 0 0 0 0 0 20 0 20 0 0 0
9 PRAMBANGAN 2163 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0
10 GULOMANTUNG 2592 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 0 3 1 0 0 0 0 0 10 0 15 0 15 0 0 0
11 LUAR WILAYAH 0 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 4 0 0 1 4 0 0 0 0 0 0 0 25 0 25 0 0 0
JUMLAH 38717 0 0 0 0 3 1 0 0 5 4 0 0 4 6 0 0 1 3 0 0 4 2 0 0 23 23 0 0 40 39 0 0 60 0 40 90 0 330 0 390 0 0 0
JUMLAH PENDERITA
TANPA DEHIDRASI 0 0 0 0 3 1 0 0 5 4 0 0 4 6 0 0 1 3 0 0 4 2 0 0 23 23 0 0 40 39 0 0
DIARE
DEHIDRASI RINGAN/SEDANG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DEHIDRASI BERAT 0 0 0 0 0 0 0 0 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 PENDERITA
ORALIT (36+41) 390
DIARE MENDAPAT
INFUSE (40+47) 0
ZINC (36) 130
KET :
P : Penderita
M : Mati Gresik, 05 Juli 2017
TD : Tanpa Dehidrasi Pengelola Program Kepala UPT Puskesmas Gending
DR/S : Dehidrasi Ringan/Sedang
DB : Dehidrasi Berat
L : Laki-Laki
Pr : Perempuan ALI SISWANTO, S.Kep.,Ns drg. HELENA SUZANA
NIP.19790507201001 1 010 NIP.19600113198903 2 001
 REKAPITULASI KASUS DIARE DI WILAYAH PUSKESMAS ...........................

BULAN ................................................. : ………..

TAHUN ................................................. : ............
..........
 REKAPITULASI KASUS DIARE DI WILAYAH PUSKESMAS ...........................

BULAN :................................................. : ………..

TAHUN :................................................. : ............

FASILITAS PELAYANAN KESEHATAN

0 - 6 Bln ≥ 6 Bln - < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th > 20 Th JUMLAH Penderita Diare < 5 Th diberiPenderita Jumlah Pemakaian
NO DESA JUMLAH PENDUDUK Diare > 5
P M P M P M P M P M P M P M P M Zinc Zinc
Oralit RL Th diberi Oralit RL
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 0-6≥6Bln-<1Th
Bln 1 - Oralit RL 0-6≥6Bln-<1Th
Bln 1-4 Th
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
1 SIDOMORO 9951 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 1 0 0 0 1 0 0 2 3 0 0 3 7 0 0 5 0 0 10 0 45 0 50 0 0 0 0
2 SINGOSARI 9659 0 0 0 0 1 0 0 0 1 1 0 0 1 1 0 0 1 1 0 0 0 0 0 0 2 4 0 0 6 7 0 0 15 0 5 20 0 50 0 65 0 0 0 0
3 INDRO 5232 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 1 0 0 1 0 0 0 3 2 0 0 6 5 0 0 10 0 5 10 0 45 0 55 0 0 0 0
4 GENDING 3934 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 2 2 0 0 4 4 0 0 10 0 5 10 0 30 0 40 0 0 0 0
5 KARANG KERING 1187 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 1 0 0 2 2 0 0 0 0 0 0 0 20 0 20 0 0 0 0
6 SEGOROMADU 1558 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 1 0 0 2 2 0 0 0 0 0 0 0 20 0 20 0 0 0 0
7 TENGGULUNAN 557 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 0 0 0 1 0 0 0 0 0 0 0 0 5 0 5 0 0 0 0
8 SUKOREJO 1884 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
9 PRAMBANGAN 2163 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
10 GULOMANTUNG 2592 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
11 LUAR WILAYAH 0 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 4 0 0 1 4 0 0 0 0 0 0 0 25 0 25 0 0 0 0
JUMLAH 38717 0 0 0 0 3 0 0 0 1 4 0 0 4 6 0 0 1 3 0 0 1 1 0 0 21 20 0 0 31 34 0 0 40 0 15 50 0 285 0 325 0 0 0 0
JUMLAH TANPA DEHIDRASI 0 0 0 0 3 0 0 0 1 4 0 0 4 6 0 0 1 3 0 0 1 1 0 0 21 20 0 0 31 34 0 0
PENDERITA DEHIDRASI RINGAN/SEDANG 0 0 0 0 0 0 0 0 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 DEHIDRASI BERAT 0 0 0 0 0 0 0 0 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
ORALIT (36+41) 325
PENDERITA
INFUSE (40+47) 0
DIARE
ZINC (36) 65
MENDAPAT
KET :
P : Penderita
M : Mati Gresik, 05 September 2017
TD : Tanpa Dehidrasi Pengelola Program Kepala UPT Puskesmas Gending
DR: Dehidrasi Ringan/Sedang
DB: Dehidrasi Berat
L : Laki-Laki
Pr : Perempuan ALI SISWANTO, S.Kep.,Ns drg. HELENA SUZANA
NIP.19790507201001 1 010 NIP.19600113198903 2 001
 REKAPITULASI KASUS DIARE DI WILAYAH PUSKESMAS ...........................

BULAN :................................................. : ………..

TAHUN :................................................. : ............

FASILITAS PELAYANAN KESEHATAN

0 - 6 Bln ≥ 6 Bln - < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th > 20 Th JUMLAH Penderita Diare < 5 Th diberi Penderita Jumlah Pemakaian
NO DESA JUMLAH PENDUDUK Diare > 5
P M P M P M P M P M P M P M P M Zinc Zinc
Oralit RL Th diberi Oralit RL
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 0-6 Bln≥6Bln-<1Th1 - 4 T Oralit RL 0-6≥6Bln-<1Th
Bln 1-4 Th
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
1 SIDOMORO 9951 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 3 3 0 0 5 5 0 0 5 0 0 10 0 45 0 50 0 0 0 0
2 SINGOSARI 9659 0 0 0 0 1 0 0 0 1 1 0 0 1 0 0 0 1 1 0 0 1 1 0 0 2 3 0 0 7 6 0 0 15 0 10 20 0 60 0 75 0 0 0 0
3 INDRO 5232 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 1 1 0 0 2 1 0 0 4 2 0 0 8 5 0 0 10 0 10 10 0 55 0 65 0 0 0 0
4 GENDING 3934 0 0 0 0 1 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 1 1 0 0 2 2 0 0 5 4 0 0 15 0 10 20 0 30 0 45 0 0 0 0
5 KARANG KERING 1187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 2 1 0 0 3 1 0 0 0 0 0 0 0 20 0 20 0 0 0 0
6 SEGOROMADU 1558 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 2 0 0 0 2 1 0 0 5 2 0 0 10 0 0 20 0 25 0 35 0 0 0 0
7 TENGGULUNAN 557 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 2 0 0 0 0 0 0 0 0 10 0 10 0 0 0 0
8 SUKOREJO 1884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 2 1 0 0 4 1 0 0 0 0 0 0 0 25 0 25 0 0 0 0
9 PRAMBANGAN 2163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 2 1 0 0 3 1 0 0 0 0 0 0 0 20 0 20 0 0 0 0
10 GULOMANTUNG 2592 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2 1 0 0 4 3 0 0 10 0 0 20 0 25 0 35 0 0 0 0
11 LUAR WILAYAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 4 0 0 2 4 0 0 0 0 0 0 0 30 0 30 0 0 0 0
JUMLAH 38717 0 0 0 0 2 1 0 0 6 4 0 0 1 0 1 0 2 3 0 0 14 5 0 0 23 19 0 0 48 32 0 0 65 0 30 100 0 345 0 410 0 0 0 0
JUMLAH TANPA DEHIDRASI 0 0 0 0 2 1 0 0 4 2 0 0 1 6 1 0 2 3 0 0 3 5 0 0 23 19 0 0 35 30 0 0
PENDERITA DEHIDRASI RINGAN/SEDANG 0 0 0 0 0 0 0 0 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 DEHIDRASI BERAT 0 0 0 0 0 0 0 0 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 ORALIT (36+41) 410
PENDERITA
INFUSE (40+47) 0
DIARE
MENDAPAT ZINC (36) 130
KET :
P : Penderita
M : Mati Gresik, 05 Oktober 2017
TD : Tanpa Dehidrasi Pengelola Program Kepala UPT Puskesmas Gending
DR/: Dehidrasi Ringan/Sedang
DB : Dehidrasi Berat
L : Laki-Laki
Pr : Perempuan ALI SISWANTO, S.Kep.,Ns drg. HELENA SUZANA
NIP.19790507201001 1 010 NIP.19600113198903 2 001
 REKAPITULASI KASUS DIARE DI WILAYAH PUSKESMAS ...........................

BULAN :................................................. : ………..

TAHUN :................................................. : ............

FASILITAS PELAYANAN KESEHATAN

0 - 6 Bln ≥ 6 Bln - < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th > 20 Th JUMLAH Penderita Diare < 5 Th diberiPenderita Jumlah Pemakaian
NO DESA JUMLAH PENDUDUK Diare > 5
P M P M P M P M P M P M P M P M Zinc Zinc
Oralit RL Th diberi Oralit RL
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 0-6≥6Bln-<1Th
Bln 1 - Oralit RL 0-6≥6Bln-<1Th
Bln 1-4 Th
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### 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47
1 SIDOMORO 9951 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 1 0 0 0 1 0 0 3 3 0 0 4 7 0 0 5 0 0 10 0 50 0 55 0 0 0 0
2 SINGOSARI 9659 0 0 0 0 1 0 0 0 1 1 0 0 1 1 0 0 1 1 0 0 0 1 0 0 2 4 0 0 6 8 0 0 15 0 5 20 0 55 0 70 0 0 0 0
3 INDRO 5232 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 1 0 0 1 0 0 0 4 2 0 0 7 5 0 0 10 0 5 10 0 50 0 60 0 0 0 0
4 GENDING 3934 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 2 2 0 0 4 4 0 0 10 0 5 10 0 30 0 40 0 0 0 0
5 KARANG KERING 1187 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 1 0 0 2 2 0 0 0 0 0 0 0 20 0 20 0 0 0 0
6 SEGOROMADU 1558 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 1 0 0 2 3 0 0 5 0 5 0 0 20 0 25 0 0 0 0
7 TENGGULUNAN 557 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 0 0 0 1 0 0 0 0 0 0 0 0 5 0 5 0 0 0 0
8 SUKOREJO 1884 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 0 3 1 0 0 5 0 0 5 0 15 0 20 0 0 0 0
9 PRAMBANGAN 2163 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 1 0 0 2 1 0 0 0 0 0 0 0 15 0 15 0 0 0 0
10 GULOMANTUNG 2592 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 0 2 2 0 0 5 0 5 0 0 15 0 20 0 0 0 0
11 LUAR WILAYAH 0 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 4 0 0 1 4 0 0 0 0 0 0 0 25 0 25 0 0 0 0
JUMLAH 38717 0 0 0 0 3 2 0 0 2 4 0 0 4 6 0 0 1 3 0 0 1 2 0 0 23 20 0 0 34 37 0 0 55 0 25 55 0 300 0 355 0 0 0 0
JUMLAH TANPA DEHIDRASI 0 0 0 0 3 2 0 0 2 4 0 0 4 6 0 0 1 3 0 0 1 2 0 0 23 20 0 0 34 37 0 0
PENDERITA DEHIDRASI RINGAN/SEDANG 0 0 0 0 0 0 0 0 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 DEHIDRASI BERAT 0 0 0 0 0 0 0 0 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
ORALIT (36+41) 355
PENDERITA
INFUSE (40+47) 0
DIARE
ZINC (36) 80
MENDAPAT
KET :
P : Penderita
M : Mati Gresik, 02 November 2017
TD : Tanpa Dehidrasi Pengelola Program Kepala UPT Puskesmas Gending
DR/: Dehidrasi Ringan/Sedang
DB : Dehidrasi Berat
L : Laki-Laki
Pr : Perempuan ALI SISWANTO, S.Kep.,Ns drg. HELENA SUZANA
NIP.19790507201001 1 010 NIP.19600113198903 2 001
 REKAPITULASI KASUS DIARE DI WILAYAH PUSKESMAS ...........................

BULAN :................................................. : ………..

TAHUN :................................................. : ............
 REKAPITULASI KASUS DIARE DI WILAYAH PUSKESMAS ...........................

BULAN :................................................. : ………..

TAHUN :................................................. : ............

FASILITAS PELAYANAN KESEHATAN

0 - 6 Bln ≥ 6 Bln - < 1 Th 1 - 4 Th 5 - 9 Th 10 - 14 Th 15 - 19 Th > 20 Th JUMLAH Penderita Diare < 5 Th diberi Penderita Diare > Jumlah Pemakaian
NO DESA JUMLAH PENDUDUK
P M P M P M P M P M P M P M P M Zinc 5 Th diberi Zinc
Oralit RL Oralit RL
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 0-6 Bln≥6Bln-<1Th1 - 4 Th Oralit RL 0-6 Bln ≥6Bln-<1Th1-4 Th
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
1 SIDOMORO 9951 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 3 4 0 0 5 4 0 0 5 0 0 10 0 40 0 45 0 0 10 0
2 SINGOSARI 9659 0 0 0 0 0 1 0 0 0 1 0 1 0 1 0 0 0 0 0 0 1 1 0 0 2 5 0 0 3 9 0 1 15 0 10 20 0 50 0 65 0 10 10 0
3 INDRO 5232 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 3 4 0 0 6 5 0 0 5 0 0 10 0 50 0 55 0 0 10 0
4 GENDING 3934 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 2 0 0 0 1 0 0 2 4 0 0 4 8 0 0 5 0 0 10 0 55 0 65 0 0 10 0
5 KARANG KERING 1187 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 2 0 0 1 2 0 0 0 0 0 0 0 15 0 15 0 0 0 0
6 SEGOROMADU 1558 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 3 0 0 2 4 0 0 0 0 0 0 0 30 0 30 0 0 0 0
7 TENGGULUNAN 557 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 2 0 0 1 3 0 0 0 0 0 0 0 20 0 20 0 0 0 0
8 SUKOREJO 1884 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 2 0 0 1 2 0 0 0 0 0 0 0 15 0 15 0 0 0 0
9 PRAMBANGAN 2163 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 2 0 0 1 2 0 0 0 0 0 0 0 15 0 15 0 0 0 0
10 GULOMANTUNG 2592 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 0 1 2 0 1 5 0 0 10 0 15 0 20 0 0 0 0
11 LUAR WILAYAH 0 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 6 0 0 1 6 0 0 0 0 0 0 0 35 0 35 0 0 0 0
JUMLAH 38717 0 0 0 0 0 1 0 0 3 1 0 2 3 2 0 0 0 4 0 0 2 3 0 0 18 36 0 0 26 47 0 2 35 0 10 60 0 340 0 380 0 10 40 0
JUMLAH TANPA DEHIDRASI 0 0 0 0 0 1 0 0 3 1 0 2 3 2 0 0 0 4 0 0 2 3 0 0 18 36 0 0 26 47 0 2
PENDERITA DEHIDRASI RINGAN/SEDANG 0 0 0 0 0 0 0 0 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 DEHIDRASI BERAT 0 0 0 0 0 0 0 0 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 ORALIT (36+41) 375
PENDERITA
INFUSE (40+47) 0
DIARE
MENDAPAT ZINC (36) 70
KET :
P : Penderita
M : Mati Gresik, 05 Januari 2018
TD : Tanpa Dehidrasi Pengelola Program Kepala UPT Puskesmas Gending
DR/: Dehidrasi Ringan/Sedang
DB : Dehidrasi Berat
L : Laki-Laki
Pr : Perempuan ALI SISWANTO, S.Kep.,Ns drg. HELENA SUZANA
NIP.19790507201001 1 010 NIP.19600113198903 2 001