Book1.xlsx

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FORMAT : C-1 (Rutin atau KLB)

LAPORAN KASUS CAMPAK Kabupaten Puskesmas

: LEBONG : TES

No Umur/Sex Vaksin CampakTgl timbul Tgl diambil Hasil Spesimen Klasifikasi Final Diberi Keadaa Tidak/ Bukan Epid Alamat Lengkap Spesimen Spesimen Nama AnakNama Orang Tua Vit A n Akhir Campak Tidak Campak/R Kasus/ (Desa/RT/RW) L PBrp Kali DarahUrine Y / T Rubella (H/M) LabEpidKlinis Tahu DemamRash Darah Urine ubella KLB 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

NIHIL

Tes, 30 SEPTEMBER 2018 Pimpinan Puskesmas

Apriyani, SKM Nip. 19800404 200312 2 007

LAPORAN INTEGRITAS AFP, CAMPAK, DAN TETANUS NEONATORUM

NIHIL

Total

Mengetahui Kepala Puskesmas Perawatan Tes

Pengelola P2 Campak

Apriyani, SKM Nip. 19800404 200312 2 007

Krismawati, Amd. Kep Nip. 19870306 200804 2 001

Tidak

Rumah Sakit

Lain-lain

Ramuan

Alkohol

Tidak Imunisasi

TT1

TT2+

Dukun

Bidan

Dokter

11 Periksa Hamil keImunisasiPerawatan Tali Pusat Rawat

Meninggal

Total Kasus

Imunisasi

Total Kasusu

Imunisasi

Total Kasus

Imunisasi

Total Kasus

Imunisasi

TES TABA ANYAR TURAN TIGING MUBAI MANAI BLAU TURAN LALANG TIK JENIAK

Total Kasus

1 2 3 4 5 6 7 8

Total Kasus

Desa

Imunisasi

No

AFP

<1

Jumlah Kasus Campak Bulan KLB 1 - th 5 - 9 th 10 14 th > 15 th Total

Jumlah Kasus

: LEBONG : TES

Imunisasi

Kabupaten Puskesmas

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