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LAPORAN HASIL STIMULASI, DETEKSI DAN INTERVEN TUMBUH KEMBANG (SDIDTK) ANAK

Puskesmas :_________________  Bulan

Jumlah Po Jml Posya

:_________________  

INSTRUMEN DATA UMUM

1 Jumlah Balita 2 Jumlah di Deteksi 3 Jumlah Dideteksi 1 kali 4 Jumlah Dideteksi 2 kali atau lebih HASIL PEMERIKSAAN 1

TB/BB

Gemuk Normal Kurus. Kurus ekali 2 LKA

Normal !akrose"al !ikrose"al 3 KPSP 

esuai #$ !era%ukan #!$ Penyim&an%an #P$ 4 TDL

Normal 'uri%a ada %an%%uan 5 TDD

Normal 'uri%a ada %an%%uan 6 KMME with Scribd Master your semester Normal & The New York Times 'uri%a ada %an%%uan

Special offer for students: Only $4.99/month. PEMERIKSAAN ATAS ATAS INDIKASI

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!en%etahui Ke&ala Puskesmas00000000

NP

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SI DINI

yandu

: ____________ 

du )umban%

:____________ 

KELOMPOK UMUR 0-12 bln

13-0 bln 1-!2 bln

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Pen%elola Pro%ram

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P"#$%#&'#



K%'&'*'n

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K'b"+'*%n

 G'"*

P./n#/

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ORMULIR LAPORAN KESEHATAN BAYI

Jumlah 'aku&an !)B!

Jml BB( d% !)B! KN

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11

Jumlah 'aku&an DD)K

Jumlah 'aku&an !)B

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KN !)B! diru-uk

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Jumlah Kematian

Keteran%an  *s"iksia

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ORMULIR P"#$%#&'#



K%'&'*'n



K'b"+'*%n

 G'"*

P./n#/

 '' B''* Jumlah sasaran

No 5rut

Jml anak balita &unya Buku K*

Nama Desa

1

2

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P

3

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Jml. Kun-. *nak Balita sakit

2

6

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Ke&ala Puskesmas

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LAPORAN KESEHATAN ANAK BALITA DAN PRASEKOLAH

B"l'n

T'"n Jumlah 'aku&an !)B

Jumlah 'aku&an DD)K *nak Balita dan Prasekolah

Jml. Kun-. !)B

Jml. Kun-. !)B diru-uk

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8

Jml Kontak 1 DD)K

9

Jml. Kun-. DD)K 2 kali/th

Jml. DD)K diru-uk

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11

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  Jumlah Kematian

Keteran%an Diare

ain;lain

13

14

1

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