Form Rekap Keluarga Sehat

DATA KELUARGA SEHAT TAHUN 2016
RW : .......................... Puskesmas
Dusun : .......................... Kecamatan
Desa : .......................... Kabupaten
INPUT OUTPUT
I. PENGENALAN TEMPAT
RT : 1
RT : 2
RT : 3 INDEKS KELUARG
RT : 4
RT : 5
RT : 6
II. KETERANGAN KELUARGA
RT : 1
RT :
RT :
RT :
III. KETERANGAN PENGUMPUL DATA
RT : 1
RT :
RT :
RT :
IV. KETERANGAN ANGGOTA KELUARGA
RT : 1
RT :
RT :
RT :
V. KETERANGAN INDIVIDU
RT : 1
RT :
RT :
RT :
TAHUN 2016
uskesmas ..........................
:
ecamatan ..........................
:
abupaten ..........................
:
OUTPUT
NDEKS KELUARGA SEHAT

BACK
NO PROV KAB KEC PUSKESMAS DESA/KEL RT RW
1 35 09
2 35 09
3 35 09
4 35 09
5 35 09
6 35 09
7 35 09
8 35 09
9 35 09
10 35 09
11 35 09
12 35 09
13 35 09
14 35 09
15 35 09
16 35 09
17 35 09
18 35 09
19 35 09
20 35 09
21 35 09
22 35 09
23 35 09
24 35 09
25 35 09
26 35 09
27 35 09
28 35 09
29 35 09
30 35 09
31 35 09
32 35 09
33 35 09
34 35 09
35 35 09
36 35 09
37 35 09
38 35 09
39 35 09
40 35 09
41 35 09
42 35 09
43 35 09
44 35 09
45 35 09
46 35 09
47 35 09
48 35 09
49 35 09
50 35 09
51 35 09
52 35 09
53 35 09
54 35 09
55 35 09
56 35 09
57 35 09
58 35 09
59 35 09
60 35 09
61 35 09
62 35 09
63 35 09
64 35 09
65 35 09
66 35 09
67 35 09
68 35 09
69 35 09
70 35 09
71 35 09
72 35 09
73 35 09
74 35 09
75 35 09
76 35 09
77 35 09
78 35 09
79 35 09
80 35 09
81 35 09
82 35 09
83 35 09
84 35 09
85 35 09
86 35 09
87 35 09
88 35 09
89 35 09
90 35 09
91 35 09
92 35 09
93 35 09
94 35 09
95 35 09
96 35 09
97 35 09
98 35 09
99 35 09
100 35 09
BACK
NO URUT BANGUNAN NO URUT ALAMAT RUMAH Column1
RUMAH KELUARGA
BLOK II
BLOK II
BLOK II
BACK
NO PROV KAB KEC PUSKESMAS DESA/KEL RT RW
1 35 09 Balung Balung kulon Balung Kidul 003 004

2 35 09 115 BALUNG balung lor 002 003
3 35 09 11 fdsfds 002 003
4 35 09
5 35 09
6 35 09
7 35 09
8 35 09
9 35 09
10 35 09
11 35 09
12 35 09
13 35 09
14 35 09
15 35 09
16 35 09
17 35 09
18 35 09
19 35 09
20 35 09
21 35 09
22 35 09
23 35 09
24 35 09
25 35 09
26 35 09
27 35 09
28 35 09
29 35 09
30 35 09
31 35 09
32 35 09
33 35 09
34 35 09
35 35 09
36 35 09
37 35 09
38 35 09
39 35 09
40 35 09
41 35 09
42 35 09
43 35 09
44 35 09
45 35 09
46 35 09
47 35 09
48 35 09
49 35 09
50 35 09
51 35 09
52 35 09
53 35 09
54 35 09
55 35 09
56 35 09
57 35 09
58 35 09
59 35 09
60 35 09
61 35 09
62 35 09
63 35 09
64 35 09
65 35 09
66 35 09
67 35 09
68 35 09
69 35 09
70 35 09
71 35 09
72 35 09
73 35 09
74 35 09
75 35 09
76 35 09
77 35 09
78 35 09
79 35 09
80 35 09
81 35 09
82 35 09
83 35 09
84 35 09
85 35 09
86 35 09
87 35 09
88 35 09
89 35 09
90 35 09
91 35 09
92 35 09
93 35 09
94 35 09
95 35 09
96 35 09
97 35 09
98 35 09
99 35 09
100 35 09
101 35 09
102 35 09
103 35 09
104 35 09
105 35 09
106 35 09
107 35 09
108 35 09
109 35 09
110 35 09
111 35 09
112 35 09
113 35 09
114 35 09
115 35 09
116 35 09
117 35 09
118 35 09
119 35 09
120 35 09
121 35 09
122 35 09
123 35 09
124 35 09
125 35 09
126 35 09
127 35 09
128 35 09
129 35 09
130 35 09
131 35 09
132 35 09
133 35 09
134 35 09
135 35 09
136 35 09
137 35 09
138 35 09
139 35 09
140 35 09
141 35 09
142 35 09
143 35 09
144 35 09
145 35 09
146 35 09
147 35 09
148 35 09
149 35 09
150 35 09
151 35 09
152 35 09
153 35 09
154 35 09
155 35 09
156 35 09
157 35 09
158 35 09
159 35 09
160 35 09
161 35 09
162 35 09
163 35 09
164 35 09
165 35 09
166 35 09
167 35 09
168 35 09
169 35 09
170 35 09
171 35 09
172 35 09
173 35 09
174 35 09
175 35 09
176 35 09
177 35 09
178 35 09
179 35 09
180 35 09
181 35 09
182 35 09
183 35 09
184 35 09
185 35 09
186 35 09
187 35 09
188 35 09
189 35 09
190 35 09
191 35 09
192 35 09
193 35 09
194 35 09
195 35 09
196 35 09
197 35 09
198 35 09
199 35 09
200 35 09
201 35 09
202 35 09
203 35 09
204 35 09
205 35 09
206 35 09
207 35 09
208 35 09
209 35 09
210 35 09
211 35 09
212 35 09
213 35 09
214 35 09
215 35 09
216 35 09
217 35 09
218 35 09
219 35 09
220 35 09
221 35 09
222 35 09
223 35 09
224 35 09
225 35 09
226 35 09
227 35 09
228 35 09
229 35 09
230 35 09
231 35 09
232 35 09
233 35 09
234 35 09
235 35 09
236 35 09
237 35 09
238 35 09
239 35 09
240 35 09
241 35 09
242 35 09
243 35 09
244 35 09
245 35 09
246 35 09
247 35 09
248 35 09
249 35 09
250 35 09
251 35 09
252 35 09
253 35 09
254 35 09
255 35 09
256 35 09
257 35 09
258 35 09
259 35 09
260 35 09
261 35 09
262 35 09
263 35 09
264 35 09
265 35 09
266 35 09
267 35 09
268 35 09
269 35 09
270 35 09
271 35 09
272 35 09
273 35 09
274 35 09
275 35 09
276 35 09
277 35 09
278 35 09
279 35 09
280 35 09
281 35 09
282 35 09
283 35 09
284 35 09
285 35 09
286 35 09
287 35 09
288 35 09
289 35 09
290 35 09
291 35 09
292 35 09
293 35 09
294 35 09
295 35 09
296 35 09
297 35 09
298 35 09
299 35 09
300 35 09
301 35 09
302 35 09
303 35 09
304 35 09
305 35 09
306 35 09
307 35 09
308 35 09
309 35 09
310 35 09
311 35 09
312 35 09
313 35 09
314 35 09
315 35 09
316 35 09
317 35 09
318 35 09
319 35 09
320 35 09
321 35 09
322 35 09
323 35 09
324 35 09
325 35 09
326 35 09
327 35 09
328 35 09
329 35 09
330 35 09
331 35 09
332 35 09
333 35 09
334 35 09
335 35 09
336 35 09
337 35 09
338 35 09
339 35 09
340 35 09
341 35 09
342 35 09
343 35 09
344 35 09
345 35 09
346 35 09
347 35 09
348 35 09
349 35 09
350 35 09
351 35 09
352 35 09
353 35 09
354 35 09
355 35 09
356 35 09
357 35 09
358 35 09
359 35 09
360 35 09
361 35 09
362 35 09
363 35 09
364 35 09
365 35 09
366 35 09
367 35 09
368 35 09
369 35 09
370 35 09
371 35 09
372 35 09
373 35 09
374 35 09
375 35 09
376 35 09
377 35 09
378 35 09
379 35 09
380 35 09
381 35 09
382 35 09
383 35 09
384 35 09
385 35 09
386 35 09
387 35 09
388 35 09
389 35 09
390 35 09
391 35 09
392 35 09
393 35 09
394 35 09
395 35 09
396 35 09
397 35 09
398 35 09
399 35 09
400 35 09
401 35 09
402 35 09
403 35 09
404 35 09
405 35 09
406 35 09
407 35 09
408 35 09
409 35 09
410 35 09
411 35 09
412 35 09
413 35 09
414 35 09
415 35 09
416 35 09
417 35 09
418 35 09
419 35 09
420 35 09
421 35 09
422 35 09
423 35 09
424 35 09
425 35 09
426 35 09
427 35 09
428 35 09
429 35 09
430 35 09
431 35 09
432 35 09
433 35 09
434 35 09
435 35 09
436 35 09
437 35 09
438 35 09
439 35 09
440 35 09
441 35 09
442 35 09
443 35 09
444 35 09
445 35 09
446 35 09
447 35 09
448 35 09
449 35 09
450 35 09
451 35 09
452 35 09
453 35 09
454 35 09
455 35 09
456 35 09
457 35 09
458 35 09
459 35 09
460 35 09
461 35 09
462 35 09
463 35 09
464 35 09
465 35 09
466 35 09
467 35 09
468 35 09
469 35 09
470 35 09
471 35 09
472 35 09
473 35 09
474 35 09
475 35 09
476 35 09
477 35 09
478 35 09
479 35 09
480 35 09
481 35 09
482 35 09
483 35 09
484 35 09
485 35 09
486 35 09
487 35 09
488 35 09
489 35 09
490 35 09
491 35 09
492 35 09
493 35 09
494 35 09
495 35 09
496 35 09
497 35 09
498 35 09
499 35 09
500 35 09
BACK
NO URUT BANGUNAN NO URUT ALAMAT RUMAH Column1
RUMAH KELUARGA
025 002 dasdsad BLOK II

001 001 Jl sriwijaya BLOK II
001 012 Jln Raya BLOK II
Jum Anggota
Jum Anggota Jum Anggota Keluarga
No Nama KK Keluarga
Keluarga Dewasa (≥15thn)
diwawancara
1 2a 2b 2c
BLOK I 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
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
Jum Anggota Jum Anggota Jum Anggota Ketersediaan Sarana Jenis Sumber
Keluarga Usia (10- Keluarga Usia (12- Keluarga Usia (0- Air Bersih (Bila 1--> P.4, Air Terlindung
54thn) 59bln) 11bln) Bila 2--> P.5)
2d 2e 2f 3 4
Anggota Keluarga
Ketersediaan Keteraturan Minum
pernah didiagnosis Gx Keberadaan
Jamban Keluarga Jenis Jamban Obat Gangguan Jiwa
Jiwa Berat Anggota Keluarga
(Bila 1--> P.6, Saniter (Bila 1--> B.III,
(Bila 1--> P.8, yang dipasung
Bila 2--> P.7) Bila 2--> B.III)
Bila 2--> P.9)
5 6 7 8 9
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
Jum Anggota
Jum Anggota Jum Anggota Keluarga
No Nama KK Keluarga
Keluarga Dewasa (≥15thn)
diwawancara
1 2a 2b 2c
1 Dian
2 Hadi
3 Rara
4 Isti
5 Fitri
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
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
Jum Anggota Jum Anggota Jum Anggota Ketersediaan Sarana Jenis Sumber
Keluarga Usia (10- Keluarga Usia (12- Keluarga Usia (0- Air Bersih (Bila 1--> P.4, Air Terlindung
54thn) 59bln) 11bln) Bila 2--> P.5)
2d 2e 2f 3 4
1 1
1 2
2
2
Anggota Keluarga
Ketersediaan Keteraturan Minum
pernah didiagnosis Gx Keberadaan
Jamban Keluarga Jenis Jamban Obat Gangguan Jiwa
Jiwa Berat Anggota Keluarga
(Bila 1--> P.6, Saniter (Bila 1--> B.III,
(Bila 1--> P.8, yang dipasung
Bila 2--> P.7) Bila 2--> B.III)
Bila 2--> P.9)
5 6 7 8 9
1 1 1 1
1 2 2 1
2 2 2
2 1 2
1 1
1 2
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BLOK III
BACK
Nama Tanggal Pengumpul

No Nama KK Pengumpul Data Nama Supervisor Data
1 2 3
BLOK II 1 0
2 0
3 0
4 0
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
16 0
17 0
18 0
19 0
20 0
21 0
22 0
23 0
24 0
25 0
26 0
27 0
28 0
29 0
30 0
31 0
32 0
33 0
34 0
35 0
36 0
37 0
38 0
39 0
40 0
41 0
42 0
43 0
44 0
45 0
46 0
47 0
48 0
49 0
50 0
51 0
52 0
53 0
54 0
55 0
56 0
57 0
58 0
59 0
60 0
61 0
62 0
63 0
64 0
65 0
66 0
67 0
68 0
69 0
70 0
71 0
72 0
73 0
74 0
75 0
76 0
77 0
78 0
79 0
80 0
81 0
82 0
83 0
84 0
85 0
86 0
87 0
88 0
89 0
90 0
91 0
92 0
93 0
94 0
95 0
96 0
97 0
98 0
99 0
100 0
Column1
BLOK IV
BACK
Nama Tanggal Pengumpul

No Nama KK Pengumpul Data Nama Supervisor Data
1 2 3
BLOK II 1 Dian Balung
2 Hadi 115
3 Rara 11
4 Isti
5 Fitri
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
16 0
17 0
18 0
19 0
20 0
21 0
22 0
23 0
24 0
25 0
26 0
27 0
28 0
29 0
30 0
31 0
32 0
33 0
34 0
35 0
36 0
37 0
38 0
39 0
40 0
41 0
42 0
43 0
44 0
45 0
46 0
47 0
48 0
49 0
50 0
51 0
52 0
53 0
54 0
55 0
56 0
57 0
58 0
59 0
60 0
61 0
62 0
63 0
64 0
65 0
66 0
67 0
68 0
69 0
70 0
71 0
72 0
73 0
74 0
75 0
76 0
77 0
78 0
79 0
80 0
81 0
82 0
83 0
84 0
85 0
86 0
87 0
88 0
89 0
90 0
91 0
92 0
93 0
94 0
95 0
96 0
97 0
98 0
99 0
100 0
101 0
102 0
103 0
104 0
105 0
106 0
107 0
108 0
109 0
110 0
111 0
112 0
113 0
114 0
115 0
116 0
117 0
118 0
119 0
120 0
121 0
122 0
123 0
124 0
125 0
126 0
127 0
128 0
129 0
130 0
131 0
132 0
133 0
134 0
135 0
136 0
137 0
138 0
139 0
140 0
141 0
142 0
143 0
144 0
145 0
146 0
147 0
148 0
149 0
150 0
151 0
152 0
153 0
154 0
155 0
156 0
157 0
158 0
159 0
160 0
161 0
162 0
163 0
164 0
165 0
166 0
167 0
168 0
169 0
170 0
171 0
172 0
173 0
174 0
175 0
176 0
177 0
178 0
179 0
180 0
181 0
182 0
183 0
184 0
185 0
186 0
187 0
188 0
189 0
190 0
191 0
192 0
193 0
194 0
195 0
196 0
197 0
198 0
199 0
200 0
201 0
202 0
203 0
204 0
205 0
206 0
207 0
208 0
209 0
210 0
211 0
212 0
213 0
214 0
215 0
216 0
217 0
218 0
219 0
220 0
221 0
222 0
223 0
224 0
225 0
226 0
227 0
228 0
229 0
230 0
231 0
232 0
233 0
234 0
235 0
236 0
237 0
238 0
239 0
240 0
241 0
242 0
243 0
244 0
245 0
246 0
247 0
248 0
249 0
250 0
251 0
252 0
253 0
254 0
255 0
256 0
257 0
258 0
259 0
260 0
261 0
262 0
263 0
264 0
265 0
266 0
267 0
268 0
269 0
270 0
271 0
272 0
273 0
274 0
275 0
276 0
277 0
278 0
279 0
280 0
281 0
282 0
283 0
284 0
285 0
286 0
287 0
288 0
289 0
290 0
291 0
292 0
293 0
294 0
295 0
296 0
297 0
298 0
299 0
300 0
301 0
302 0
303 0
304 0
305 0
306 0
307 0
308 0
309 0
310 0
311 0
312 0
313 0
314 0
315 0
316 0
317 0
318 0
319 0
320 0
321 0
322 0
323 0
324 0
325 0
326 0
327 0
328 0
329 0
330 0
331 0
332 0
333 0
334 0
335 0
336 0
337 0
338 0
339 0
340 0
341 0
342 0
343 0
344 0
345 0
346 0
347 0
348 0
349 0
350 0
351 0
352 0
353 0
354 0
355 0
356 0
357 0
358 0
359 0
360 0
361 0
362 0
363 0
364 0
365 0
366 0
367 0
368 0
369 0
370 0
371 0
372 0
373 0
374 0
375 0
376 0
377 0
378 0
379 0
380 0
381 0
382 0
383 0
384 0
385 0
386 0
387 0
388 0
389 0
390 0
391 0
392 0
393 0
394 0
395 0
396 0
397 0
398 0
399 0
400 0
401 0
402 0
403 0
404 0
405 0
406 0
407 0
408 0
409 0
410 0
411 0
412 0
413 0
414 0
415 0
416 0
417 0
418 0
419 0
420 0
421 0
422 0
423 0
424 0
425 0
426 0
427 0
428 0
429 0
430 0
431 0
432 0
433 0
434 0
435 0
436 0
437 0
438 0
439 0
440 0
441 0
442 0
443 0
444 0
445 0
446 0
447 0
448 0
449 0
450 0
451 0
452 0
453 0
454 0
455 0
456 0
457 0
458 0
459 0
460 0
461 0
462 0
463 0
464 0
465 0
466 0
467 0
468 0
469 0
470 0
471 0
472 0
473 0
474 0
475 0
476 0
477 0
478 0
479 0
480 0
481 0
482 0
483 0
484 0
485 0
486 0
487 0
488 0
489 0
490 0
491 0
492 0
493 0
494 0
495 0
496 0
497 0
498 0
499 0
500 0
Column1
BLOK IV
Nama KK & Hub Anggota Tgl, Bln, Tahun Lahir Column1
No Nama KK No2 Anggota Keluarga (_ _ / _ _ / _ _ _ _)
Keluarga
1 2 3 4
1 0 1 Dian 01/04/1970 Err:507
2 Ali 02/04/1978 Err:507
3 Sutris 03/04/2000 Err:507
4 Siti 04/04/2005 Err:507
5 Err:507
6 Err:507
2 0 1 Hadi Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
3 0 1 Rara Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
4 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
5 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
6 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
7 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
8 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
9 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
10 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
11 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
12 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
13 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
14 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
15 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
16 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
17 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
18 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
19 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
20 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
21 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
22 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
23 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
24 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
25 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
26 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
27 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
28 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
29 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
30 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
31 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
32 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
33 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
34 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
35 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
36 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
37 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
38 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
39 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
40 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
41 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
42 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
43 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
44 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
45 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
46 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
47 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
48 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
49 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
50 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
51 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
52 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
53 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
54 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
55 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
56 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
57 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
58 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
59 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
60 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
61 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
62 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
63 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
64 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
65 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
66 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
67 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
68 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
69 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
70 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
71 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
72 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
73 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
74 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
75 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
76 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
77 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
78 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
79 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
80 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
81 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
82 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
83 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
84 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
85 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
86 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
87 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
88 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
89 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
90 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
91 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
92 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
93 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
94 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
95 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
96 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
97 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
98 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
99 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
100 0 1 0 Err:507
2 Err:507
3 Err:507
4 Err:507
5 Err:507
6 Err:507
(Khusus Wanita Usia
Jenis Status
Umur 10-54 th) Sedang Agama
Kelamin Perkawinan Hamil?
5 6 7 8 9
Err:507 025 002
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507 001 001
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507 001 012
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
Err:507
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Pendidikan Pekerjaan
Anggota Ket
Anggota Ket
Keluarga usia Keluarga usia
>5thn >10thn
10 11
1 Tdk Pernah Sekolah 1 Tdk Kerja BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
2 Tdk Tamat SD/MI 1 Tdk Kerja BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
3 Tamat SD/MI 1 Tdk Kerja BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
4 Tamat SLTP/MTS 2 Sekolah BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
5 Tamat SLTA/MA 3 PNS/TNI/POLRI/BUMN/BUMD BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
6 Tamat D1/D2/D3 4 Pegawai Swasta BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
7 Tamat PT 5 Wiraswasta/Pedagang/Jasa BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
6 Petani BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
7 Nelayan BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
8 Buruh BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
9 Lainnya BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
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BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
BLOK V
2 Tdk Tamat SD/MI 2 Sekolah BLOK V
2 Tdk Tamat SD/MI 2 Sekolah BLOK V
3 PNS/TNI/POLRI/BUMN/BUMD BLOK V
BLOK V
BLOK V
BLOK V
No Nama KK &
No NIK Tgl Puldat Umur
Urut Anggota Keluarga
1 2 3 4
1 1 Dian 17/07/2016 46tahun,11bulan,17hari
2 Ali 38tahun,11bulan,16hari
3 Sutris 16tahun,11bulan,15hari
4 Siti 11tahun,11bulan,14hari
5 0 117tahun,2bulan,18hari
2 1 Hadi 117tahun,2bulan,18hari
3 1 Rara 117tahun,2bulan,18hari
4 1 0 117tahun,2bulan,18hari
Pernah Minum Obat
Didiagnosis
Kebiasaan Secara Teratur
Kepemilikan Kebiasaan BAB di Menderita TB
Status Merokok Menggunakan (selama 6 bln)
Kartu JKN2 Jamban Paru
Air Bersih (Bila 1--> P.8,
(Bila 1--> P.6, Bila 2--> P.8)
Bila 2--> P.7)
Berlaku Semua Umur Berlaku Anggota Keluarga umur ≥15 thn)

1 2 3 4 5 6
1 1 1 1 1
1 2 1 2
2 1 1
2 2 1 2
2 2 2 2
1 2 1 1
2 2 1 1
1 1
1 1
1
1
Pernah Menderita Batuk Pernah Didiagnosis Bila Ya, Minum Obat Dilakukan
Berdahak ≥2 minggu Menderita Tekanan Darah Tekanan Darah Tinggi Pengukuran Tekanan Hasil
disertai satu atau lebih Tinggi/Hipertensi Secara teratur Darah Pengukuran
gejala (Bila 1--> P.9, (Bila 1--> P.11, (Bila 1--> P.10b, Sistolik (mmHg)
(Bila 1--> P.8, Bila 2--> P.10a) Bila 2--> P.11) Bila 2--> P.11)
Bila 2--> P.8)
7 8 9 10a 10b.1
1 1
1 2 1 140
2 2 1 140
1
1 1
2 1 110
Menggunakan Alkon atau ikut Bersalin di Fasilitas Bayi 0-6 bln hanya
Hasil program KB --> Kesehatan -->
Pengukuran diberi ASI -->
Berlaku AK Wanita Menikah Berlaku Ibu yg
Diastolik Berlaku AK
(10-54th) dan tdk hamil atau AK memiliki AK berumur berumur
(mmHg) 7-23 bln
Laki2 menikah (≥10th) <12 bln
10b.2 11 12 13
1 2
90 2 1
2 1
90 2 2
2 1
2
2
1 2
80 1 1
2 1
2
Bayi 0-11 bln diberikan Dalam 1 bln terakhir
imunisasi lengkap --> dilakukan pemantauan
Berlaku AK berumur 12- pertumbuhan balita -->
23 bln Berlaku AK berumur 2-59 bln
14 15
1 1
1 2
2
1
1 1
1
Menggunakan
Alkon atau
No Nama KK &
No Umur ikut program Status Column1 KES
Urut Anggota Keluarga KB
1 1 Dian 46tahun,11bulan,17hari
1 Y 1 Y
2 T
0 0
0 0
0 0
0 0
2 T 0 T
2 T
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
0 0
0 0
0 0
0 0 0 T
0 0
0 0
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Bersalin di
No Nama KK &
No Umur Fasilitas Status Column1 KES
Urut Anggota Keluarga Kesehatan
2 T 1 Y
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1 Y
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Bayi 0-11 bln
No Nama KK & diberikan
No Umur Status Column1 KES
Urut Anggota Keluarga imunisasi
lengkap
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Bayi 0-6 bln
No Nama KK &
No Umur hanya diberi Status Column1 KES
Urut Anggota Keluarga ASI
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Dalam 1 bln
terakhir
No Nama KK & dilakukan
No Umur pemantauan Status Column1 KES
Urut Anggota Keluarga
pertumbuhan
balita
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1 Y
1 Y
0 0
0 0
Pernah Menderita
Minum Obat
Pernah Didiagnosis Batuk Berdahak ≥2
Secara Teratur
No Nama KK & Umur Menderita TB Paru minggu disertai satu
No (selama 6 bln)
Urut Anggota Keluarga (Bila 1--> P.6, atau lebih gejala
(Bila 1--> P.8,
Bila 2--> P.7) (Bila 1--> P.8,
Bila 2--> P.8) Bila 2--> P.8)
1 1 Dian 46tahun,11bulan,17hari1 1 0
2 Ali 38tahun,11bulan,16hari2 0 1
3 Sutris 16tahun,11bulan,15hari1 1 0
4 Siti 11tahun,11bulan,14hari0 0 0
5 0 117tahun,2bulan,18hari0 0 0
2 1 Hadi 117tahun,2bulan,18hari2 0 2
3 1 Rara 117tahun,2bulan,18hari1 1 0
4 1 0 117tahun,2bulan,18hari0 0 0
Status a Status b Status c JUMLAH KES Jumlah2
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Pernah Didiagnosis Bila Ya, Minum Dilakukan
No Nama KK & Menderita Obat Tekanan
No Umur Pengukuran Tekanan S SISTOLE
Urut Anggota Keluarga Tekanan Darah Darah Tinggi Darah
Tinggi/Hipertensi Secara teratur
1 1 Dian 46tahun,11bulan,17hari1 1 0 0
2 Ali 38tahun,11bulan,16hari2 0 1 TN
3 Sutris 16tahun,11bulan,15hari0 0 0 0
4 Siti 11tahun,11bulan,14hari0 0 0 0
5 0 117tahun,2bulan,18hari0 0 0 0
2 1 Hadi 117tahun,2bulan,18hari2 0 1 TN
3 1 Rara 117tahun,2bulan,18hari0 0 0 0
4 1 0 117tahun,2bulan,18hari0 0 0 0
10 1 0 117tahun,2bulan,18hari0 0 0 0
11 1 0 117tahun,2bulan,18hari0 0 0 0
12 1 0 117tahun,2bulan,18hari0 0 0 0
13 1 0 117tahun,2bulan,18hari0 0 0 0
14 1 0 117tahun,2bulan,18hari0 0 0 0
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16 1 0 117tahun,2bulan,18hari0 0 0 0
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18 1 0 117tahun,2bulan,18hari0 0 0 0
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20 1 0 117tahun,2bulan,18hari0 0 0 0
21 1 0 117tahun,2bulan,18hari0 0 0 0
22 1 0 117tahun,2bulan,18hari0 0 0 0
23 1 0 117tahun,2bulan,18hari0 0 0 0
24 1 0 117tahun,2bulan,18hari0 0 0 0
25 1 0 117tahun,2bulan,18hari0 0 0 0
26 1 0 117tahun,2bulan,18hari0 0 0 0
27 1 0 117tahun,2bulan,18hari0 0 0 0
28 1 0 117tahun,2bulan,18hari0 0 0 0
29 1 0 117tahun,2bulan,18hari0 0 0 0
30 1 0 117tahun,2bulan,18hari0 0 0 0
31 1 0 117tahun,2bulan,18hari0 0 0 0
32 1 0 117tahun,2bulan,18hari0 0 0 0
33 1 0 117tahun,2bulan,18hari0 0 0 0
34 1 0 117tahun,2bulan,18hari0 0 0 0
35 1 0 117tahun,2bulan,18hari0 0 0 0
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37 1 0 117tahun,2bulan,18hari0 0 0 0
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41 1 0 117tahun,2bulan,18hari0 0 0 0
42 1 0 117tahun,2bulan,18hari0 0 0 0
43 1 0 117tahun,2bulan,18hari0 0 0 0
44 1 0 117tahun,2bulan,18hari0 0 0 0
45 1 0 117tahun,2bulan,18hari0 0 0 0
46 1 0 117tahun,2bulan,18hari0 0 0 0
47 1 0 117tahun,2bulan,18hari0 0 0 0
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63 1 0 117tahun,2bulan,18hari0 0 0 0
64 1 0 117tahun,2bulan,18hari0 0 0 0
65 1 0 117tahun,2bulan,18hari0 0 0 0
66 1 0 117tahun,2bulan,18hari0 0 0 0
67 1 0 117tahun,2bulan,18hari0 0 0 0
68 1 0 117tahun,2bulan,18hari0 0 0 0
69 1 0 117tahun,2bulan,18hari0 0 0 0
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100.00 Y
Anggota Keluarga Keteraturan Keberadaan Anggota
No Nama KK pernah didiagnosis Minum Obat Keluarga yang Status a Status b
Gx Jiwa Berat Gangguan Jiwa dipasung
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Status c JUMLAH KES
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No Nama KK & Status
No Umur Status Column1 KES
Urut Anggota Keluarga Merokok
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Ketersediaan Jenis Sumber Air
No Nama KK Status a Status b JUMLAH
Sarana Air Bersih Terlindung
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KES
0
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Ketersediaan Jenis Jamban
No Nama KK Status a Status b JUMLAH
Jamban Keluarga Saniter
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JAMBAN
KES Nilai KK Nilai Ind Jumlah KES TOT
IND
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0 0 Y 15 15 T
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0 0 Y 15 15 T
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Kebiasaan
No Nama KK &
No Umur BAB di Status Column1 KES
Urut Anggota Keluarga Jamban
1 Y 100.00 Y
1 Y
0 0
0 0
0 0
0 0
1 Y 50.00 T
2 T
0 0
0 0
0 0
0 0
2 T 0.00 T
2 T
0 0
0 0
0 0
0 0
1 Y 100.00 Y
1 Y
0 0
0 0
0 0
0 0
2 T 0.00 T
0 0
0 0
0 0
0 0
0 0
1 Y 100.00 Y
1 Y
0 0
0 0
0 0
0 0
0 0 #DIV/0! #DIV/0!
0 0
0 0
0 0
0 0
0 0
0 0 #DIV/0! #DIV/0!
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0 0
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0 0
0 0
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0 0
0 0
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0 0
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0 0 #DIV/0! #DIV/0!
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0 0 #DIV/0! #DIV/0!
0 0
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0 0
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0 0 #DIV/0! #DIV/0!
0 0
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0 0 #DIV/0! #DIV/0!
0 0
0 0
0 0
0 0
0 0
0 0 #DIV/0! #DIV/0!
0 0
0 0
0 0
0 0
0 0
No Nama KK & Kepemilikan
No Umur Status Column1
Urut Anggota Keluarga Kartu JKN
1 1 Dian 46tahun,11bulan,17hari 1 Y 66.67

2 Ali 38tahun,11bulan,16hari 1 Y
3 Sutris 16tahun,11bulan,15hari 2 T
4 Siti 11tahun,11bulan,14hari 0 0
5 0 117tahun,2bulan,18hari 0 0
2 1 Hadi 117tahun,2bulan,18hari 2 T 0.00
2 0 117tahun,2bulan,18hari 2 T
3 1 Rara 117tahun,2bulan,18hari 1 Y 50.00
2 0 117tahun,2bulan,18hari 2 T
4 1 0 117tahun,2bulan,18hari 1 Y 100.00
2 0 117tahun,2bulan,18hari 1 Y
5 1 0 117tahun,2bulan,18hari 0 0 #DIV/0!
KES
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
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#DIV/0!
#DIV/0!
#DIV/0!
Keluarga Bayi mendapat
mengikuti Ibu bersalin imunisasi dasar
No KK DESA/KEL RT RW di faskes
KB lengkap
1 2 3
1 Dian 0 0 0 Y Y Y
2 Hadi 0 0 0 T Y T
3 Rara 0 0 0 T T #DIV/0!
4 Isti 0 0 0 T T #DIV/0!
5 Fitri 0 0 0 T T #DIV/0!
6 0 0 0 0 T T #DIV/0!
7 0 0 0 0 T T #DIV/0!
8 0 0 0 0 T T #DIV/0!
9 0 0 0 0 T T #DIV/0!
10 0 0 0 0 T T #DIV/0!
11 0 0 0 0 T T #DIV/0!
12 0 0 0 0 T T #DIV/0!
13 0 0 0 0 T T #DIV/0!
14 0 0 0 0 T T #DIV/0!
15 0 0 0 0 T T #DIV/0!
16 0 0 0 0 T T #DIV/0!
17 0 0 0 0 T T #DIV/0!
18 0 0 0 0 T T #DIV/0!
19 0 0 0 0 T T #DIV/0!
20 0 0 0 0 T T #DIV/0!
21 0 0 0 0 T T #DIV/0!
22 0 0 0 0 T T #DIV/0!
23 0 0 0 0 T T #DIV/0!
24 0 0 0 0 T T #DIV/0!
25 0 0 0 0 T T #DIV/0!
26 0 0 0 0 T T #DIV/0!
27 0 0 0 0 T T #DIV/0!
28 0 0 0 0 T T #DIV/0!
29 0 0 0 0 T T #DIV/0!
30 0 0 0 0 T T #DIV/0!
31 0 0 0 0 T T #DIV/0!
32 0 0 0 0 T T #DIV/0!
33 0 0 0 0 T T #DIV/0!
34 0 0 0 0 T T #DIV/0!
35 0 0 0 0 T T #DIV/0!
36 0 0 0 0 T T #DIV/0!
37 0 0 0 0 T T #DIV/0!
38 0 0 0 0 T T #DIV/0!
39 0 0 0 0 T T #DIV/0!
40 0 0 0 0 T T #DIV/0!
41 0 0 0 0 T T #DIV/0!
42 0 0 0 0 T T #DIV/0!
43 0 0 0 0 T T #DIV/0!
44 0 0 0 0 T T #DIV/0!
45 0 0 0 0 T T #DIV/0!
46 0 0 0 0 T T #DIV/0!
47 0 0 0 0 T T #DIV/0!
48 0 0 0 0 T T #DIV/0!
49 0 0 0 0 T T #DIV/0!
50 0 0 0 0 T T #DIV/0!
51 0 0 0 0 T T #DIV/0!
52 0 0 0 0 T T #DIV/0!
53 0 0 0 0 T T #DIV/0!
54 0 0 0 0 T T #DIV/0!
55 0 0 0 0 T T #DIV/0!
56 0 0 0 0 T T #DIV/0!
57 0 0 0 0 T T #DIV/0!
58 0 0 0 0 T T #DIV/0!
59 0 0 0 0 T T #DIV/0!
60 0 0 0 0 T T #DIV/0!
61 0 0 0 0 T T #DIV/0!
62 0 0 0 0 T T #DIV/0!
63 0 0 0 0 T T #DIV/0!
64 0 0 0 0 T T #DIV/0!
65 0 0 0 0 T T #DIV/0!
66 0 0 0 0 T T #DIV/0!
67 0 0 0 0 T T #DIV/0!
68 0 0 0 0 T T #DIV/0!
69 0 0 0 0 T T #DIV/0!
70 0 0 0 0 T T #DIV/0!
71 0 0 0 0 T T #DIV/0!
72 0 0 0 0 T T #DIV/0!
73 0 0 0 0 T T #DIV/0!
74 0 0 0 0 T T #DIV/0!
75 0 0 0 0 T T #DIV/0!
76 0 0 0 0 T T #DIV/0!
77 0 0 0 0 T T #DIV/0!
78 0 0 0 0 T T #DIV/0!
79 0 0 0 0 T T #DIV/0!
80 0 0 0 0 T T #DIV/0!
81 0 0 0 0 T T #DIV/0!
82 0 0 0 0 T T #DIV/0!
83 0 0 0 0 T T #DIV/0!
84 0 0 0 0 T T #DIV/0!
85 0 0 0 0 T T #DIV/0!
86 0 0 0 0 T T #DIV/0!
87 0 0 0 0 T T #DIV/0!
88 0 0 0 0 T T #DIV/0!
89 0 0 0 0 T T #DIV/0!
90 0 0 0 0 T T #DIV/0!
91 0 0 0 0 T T #DIV/0!
92 0 0 0 0 T T #DIV/0!
93 0 0 0 0 T T #DIV/0!
94 0 0 0 0 T T #DIV/0!
95 0 0 0 0 T T #DIV/0!
96 0 0 0 0 T T #DIV/0!
97 0 0 0 0 T T #DIV/0!
98 0 0 0 0 T T #DIV/0!
99 0 0 0 0 T T #DIV/0!
100 0 0 0 0 Y Y Y
2.00 3.00 66.67
Bayi diberi ASI Pertumbuhan Penderita TB Penderita Gangguan jiwa Tidak ada
anggota
eksklusif selama balita dipantau Paru berobat hipertensi berat tidak keluarga yg
6 bulan tiap bulan sesuai standar berobat teratur ditelantarkan merokok
4 5 6 7 8 9
Y T T T 0 T
Y #DIV/0! T T 0 Y
#DIV/0! #DIV/0! Y #DIV/0! 0 #DIV/0!
#DIV/0! #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0!
Y Y #DIV/0! Y 0 #DIV/0!
100.00 50.00 33.33 33.33 #DIV/0! 50.00
Keluarga Keluarga Sekeluarga
memiliki/mem
memiliki/memak akai jamban menjadi anggota IKS Kesimpulan
ai air bersih JKN/askes
sehat
10 11 12
0 T T 40.00 Tidak Sehat
0 T Y 25.00 Tidak Sehat
0 T #DIV/0! 0.00 Tidak Sehat
0 T #DIV/0! 0.00 Tidak Sehat
0 #DIV/0! #DIV/0! 0.00 Tidak Sehat
0 #DIV/0! #DIV/0! 100.00 Sehat
#DIV/0! 0.00 25.00 IKS TOTAL
Sehat 1.00 1%
Pra Sehat 0.00 0%
Tidak Sehat 99.00 99%
Jumlah KK 100.00

Form Rekap Keluarga Sehat

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Form Rekap Keluarga Sehat

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DATA KELUARGA SEHAT TAHUN 2016

NDEKS KELUARGA SEHAT

1 35 09 Balung Balung kulon Balung Kidul 003 004

025 002 dasdsad BLOK II

Nama Tanggal Pengumpul

Nama Tanggal Pengumpul

Berlaku Semua Umur Berlaku Anggota Keluarga umur ≥15 thn)

Err:508 Err:508 Err:508 20 Y 66.67

1 1 Dian 46tahun,11bulan,17hari 1 Y 66.67

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