Format Laporan Pemantauan PPDM PPHT

Pada Tanggal 09 april 2017

BULAN APRIL 2017
Jenis Tgl Mulai Diagnosa TEK. DARAH
No. Nama No. Kartu P/I/S/A Alamat No. Hp IMT CHOL CHOL
Kelamin Terdaftar GDP GDPP GDS HBA1C TOTAL
(Kg/m2) CHOL HDL TRIGLISE SISTOLE
LDL RIDA
1 RONI FAHAMSYAH 0001884289904 L PONDOK W08233205313/11/201DM 55/165 260 120
2 SOEWITO 0000114227526 L KENCONG 08233753713/11/201DM 65/165 248 130
3 SHANHAJI 0000114549085 L KENCONG 08214095013/11/201DM 55/165 285 120
4 SUDARIANTO 0002196119698 L JOMBANG08533531427/11/201DM 42/148 256 120
5 EMI 0000114426281 P KRATON 08523489927/11/201HIPERTENS 59/165 160
6 NUR HADI 0000114426279 L KRATON 08523489927/11/201HIPERTENS 52/165 140
7 SUCIATI 0001884290321 P JOMBANG08233205325/12/201KOLESTERO 59/152 130
8 KUSMAWATI 0000113427292 P KRATON 08523354625/12/201HIPERTENS 75/156 160
9 WIJI SANTOSO 0000114521747 L KENCONG 08133583825/12/201KOLESTERO 70/165 110
10 ISTINI 0001106432076 P KENCONG 08139126025/12/201KOLESTERO 55/150 140
TEK. DARAH

DIASTOLE

80
80
80
80
100
90
80
100
70
90