LAPORAN PROLANIS

PUSKESMAS BOLIYOHUTO
BULAN JUNI TAHUN 2017

PEMANTAUAN KESEHATAN
DAFTAR DOSIS TINDAK
NO NAMA PESERTA KET
OBAT OBAT KOLES Hb1C IMT GDS TD BB LANJUT

1 2 5 6 7 8 9 10 11 12 13 14

METFORMIN 1X1
Yasin Buka
1 GLUCODEX 1X1 120/90 60/167
0001405093206

BISOPROLOL 1X1
Samsinar
2 180/100 64/154
0001075579029

AMLODIPIN 1X1
Sailah
3 140/80 58/146
0000958060034

AMLODIPIN 1X1
Nurhayati
4 130/80 60/157
0000958099173

AMLODIPIN 1X1
Sumar
5 120/80 47/145
0001234947003

AMLODIPIN 1X1
Patmi
6 150/80 60/169
0000958146963

AMLODIPIN 1X1
Imam Mahmud
7 140/80 72/162
0000958577534
 Imam Mahmud
7 140/80 72/162
0000958577534

1 2 5 6 7 8 9 10 11 12 13 14

AMLODIPIN 1X1
Salaton
8 140/80 55/145
0001234946733

AMLODIPIN 1X1
Sarjono
9 130/80 43/157
0000958299085

AMLODIPIN 1X1
Mujiah
10 160/80 68/162
0001234946351

AMLODIPIN 1X1
Poni
11 METFORMIN 1X1 154 130/70 60/158
0000958581753
GLUCODEX 1X1
AMLODIPIN 1X1
Tukirah
12 140/80 54/156
0000958542862

AMLODIPIN 1X1
Suyanti
13 120/80 48/148
0000958136455

AMLODIPIN 1X1
Ica
14 140/80 52/146
0001075580155

AMLODIPIN 1X1
Hartini Dena
15 130/80 58/155
0000958896189

AMLODIPIN 1X1
Sutarwiyati
16 130/80 65/158
0000958068426
 Sutarwiyati
16 130/80 65/158
0000958068426

1 2 5 6 7 8 9 10 11 12 13 14

AMLODIPIN 1X1
Rukaiyah
17 120/80 52/153
0001235601044

GLUCODEX 1X1
Indasah
18 407 120/70 54/165
0001234946125

AMLODIPIN 1X1
Ariani Hatiku
19 130/80 69/146
000210778402

AMLODIPIN 1X1
Jinem
20 130/80 47/155
0001237178529

AMLODIPIN 1X1
Umar Tute
21 130/80 106/172
000139474372

AMLODIPIN 1X1
Rahasia Modjo
22 130/80 60/154
0000139474383

AMLODIPIN 1X1
Since Didipu
23 GLUCODEX 1X1 322 140/80 57/161
0000139591214

AMLODIPIN 1X1
Aisa Kune
24 140/80 58/152
0000957190408
 AMLODIPIN 1X1
Niko pane
25 GLUCODEX 2X2 140/80 70/171
0000957797076

1 2 5 6 7 8 9 10 11 12 13 14

AMLODIPIN 1X1
Eri Husuna
26 CAPTOPRIL 1X1 140/80 62/155
0000959010592

AMLODIPIN 1X1
Habiba Husuna
27 130/90 60/150
0001234849522

AMLODIPIN 1X1
Salami Datau
28 330 140/80 64/147
0000958023336

AMLODIPIN 1X1
Hadidjah M. Taidi
29 130/80 57/162
0001793845451

AMLODIPIN 1X1
Hasni Lapantu
30 140/80 57/158
0000958042135

CAPTOPRIL 2X1
Erni Hasim
31 GLUCODEX 2X1 325 140/60 62/156
0001235601819

GLUCODEX 1X1
Satumi
32 301 140/80 58/156
000139474337

AMLODIPIN 1X1
Siltje T. Moray
33 130/80 55/156
0000139591102
 Siltje T. Moray
33 130/80 55/156
0000139591102

GLUCODEX 2X1
Maimun Yusuf
34 140/80 71/156
0000139583204

1 2 5 6 7 8 9 10 11 12 13 14

CAPTOPRIL 2X1
Hawa K. Mopatu
35 130/70 46/146
0001075568106

CAPTOPRIL 2X1
Kasmini
36 120/70 40/156
0001235600651

AMLODIPIN 1X1
Ismail Nasiru
37 183 140/80 60/170
0000139458058

AMLODIPIN 1X1
Ahmad Hadi
38 150 130/80 51/165
0001075574485

AMLODIPIN 1X1
Siti Jariyah
39 130/80 69/145
0000958806595

CAPTOPRIL 2X1
Maryam Kinga
40 150/90 42/145
0000958993121

AMLODIPIN 1X1
Martha Nento
41 130/80 50/146
0001386690996

METFORMIN 2X1
Sumarwin
42 300 140/80 66/157
0000139592529
 Sumarwin
42 LISINOPRIL 1X1 300 140/80 66/157
0000139592529

AMLODIPIN 1X1
Srikah
43 130/80 61/155
0001237164682

1 2 5 6 7 8 9 10 11 12 13 14

CAPTOPRIL 2X1
Yasin U. Olii
44 METFORMIN 2X1 140/80 60/160
0000139589379
AMLODIPIN 1X1
CAPTOPRIL 1X1
Suwarni Ismail
45 160/90 63/157
0000958888776

AMLODIPIN 1X1
Sumina
46 130/80 60/155
0001075574496

AMLODIPIN 1X1
Sartin Rifai
47 130/80 69/158
0001235601189

AMLODIPIN 1X1
Karsum Hilala
48 130/80 52/158
0001484307696

AMLODIPIN 1X1
Darjo
49 120/70 51/155
0001075579233

CAPTOPRIL 3X1
Agus S. Rojikan
50 AMLODIPIN 1X1 140/90 70/170
0000139436752
 Karsum Daud
51 120/70 55/155
0000957329728

AMLODIPIN 1X1
Karmi
52 299 150/90 41/155
0000139470197

1 2 5 6 7 8 9 10 11 12 13 14

AMLODIPIN 1X1
Nolva Ikano
53 130/70 64/156
0001237179014

AMLODIPIN 1X1
Jemini
54 130/80 46/155
0001075580223

AMLODIPIN 1X1
Amelia Lawendatu
55 140/80 57/153
0000958581876

GLUCODEX 1X1
Hadija Djaini
56 245 130/70 55/157
0000958530093

METFORMIN 2X1
Maryati
57 231 130/80 46/157
0002231701964

AMLODIPIN 1X1
Wiwik
58 CAPTOPRIL 2X1 200/110 41/157
0001075579435

AMLODIPIN 1X1
Sumiyati
59 160/80 41/158
0001973198777
 Sumiyati
59 160/80 41/158
0001973198777

AMLODIPIN 1X1
Umi Kalsum
60 140/80 45/156
0001075579244

AMLODIPIN 1X1
Hajira Datau
61 160/90 62/155
0000957937511

1 2 5 6 7 8 9 10 11 12 13 14

AMLODIPIN 1X1
Asmin Rifai
62 170/90 66/153
000197317529

AMLODIPIN 1X1
63 Dani Zakaria 110/70 67/170

CARBAMAZEPIN 1X1
Darmuti
64 PHENOBARBITAL 30 MG 1X1 110/70 48/157
0000958100218

METFORMIN 2X1
Hartati Polomulo
65 279 130/80 47/159
0000957772541

AMLODIPIN 1X1
Amina Hasan
66 160/90 57/159
0001973204594

AMLODIPIN 1X1
Rohana Alwi
67 160/90 66/162
0000958339901

AMLODIPIN 10 MG 1X1

Samsudin Abdul
 VALSARTAN 80 MG 1X1
FUROSEMID 40 MG 1X1
Samsudin Abdul
68 SPIRONOLACTON 25 MG 1X1 130/80 60/160
0000958583327
BISOPROLOL 5 MG 1X1/2
ISDN 5 MG 3X1
CPG 75 MG 1X1
s
 DAFTAR PASIEN PROLANIS PUSKESMAS BOLIYOHUTO
BPJS KESEHATAN KANWIL GORONTALO
BULAN JULI 2017

NO NAMA JK BB TB ALAMAT NO.KARTU BPJS DIAGNOSA TERAPI NOMOR HP

Diabetes Metformin
1 Yasin Buka L 167 Dulohupa 0001405093206
Melitus Glucodex

2 Samsinar P 154 Sid. Selatan 0001075579029 Hypertensi Bisoprolol

3 Sailah P 146 Sid. Selatan 0000958060034 Hypertensi amlodipin

4 Nurhayati P 157 Sid. Selatan 0000958099173 Hypertensi Amlodipin

5 Sumar P 145 Sid. Selatan 0001234947003 Hypertensi amlodipin

6 Patmi P 169 Sid. Selatan 0000958146963 Hypertensi amlodipin

7 Imam Mahmud L 162 Sidomulyo 0000958577534 Hypertensi amlodipin

8 Salaton P 145 Sid. Selatan 0001234946733 Hypertensi amlodipin

9 Sarjono L 157 Sid. Selatan 0000958299085 Hypertensi amlodipin

10 Mujiah P 162 Sid. Selatan 0001234946351 Hypertensi amlodipin

amlodipin
Poni Hypertensi
11 P 158 Sid. Selatan 0000958581753 metformin
Diabetes Melitus
Glucodex

Tukirah
12 P 156 Sid. Selatan 0000958542862 Hypertensi amlodipin

Suyanti
13 P 148 Sid. Selatan 0000958136455 Hypertensi amlodipin

Ica
14 P 146 Sid. Selatan 0001075580155 Hypertensi amlodipin

Hartini Dena
15 P 155 Sid. Selatan 0000958896189 Hypertensi amlodipin

16 Sutarwiyati P 158 Sid. Selatan 0000958068426 Hypertensi amlodipin

17 Rukaiyah P 153 Sid. Selatan 0001235601044 Hypertensi amlodipin

Diabetes
18 Indasah P 165 Sid. Selatan 0001234946125 Glucodex
Melitus

19 Ariani Hatiku P 146 Sidomulyo 000210778402 Hypertensi amlodipin

Jinem
20 P 155 Sidomulyo 0001237178529 Hypertensi amlodipin

21 Umar Tute L 172 Bandung Rejo 000139474372 Hypertensi amlodipin

22 Rahasia Modjo P 154 Bandung Rejo 0000139474383 Hypertensi amlodipin

Hypertensi amlodipin
23 Since Didipu P 161 Iloheluma 000139591214
Diabetes Melitus Glucodex

amlodipin
24 Aisa Kune P 152 Iloheluma 957190408 Hypertensi

Hypertensi amlodipin
25 Niko pane P 171 Parungi 0000957797076
Diabetes Melitus Glucodex
 Eri Husuna amlodipin
26 P 155 Parungi 0000959010592 Hypertensi
Captopril

27 Habiba Husuna P 150 Parungi 0001234849522 Hypertensi amlodipin

Hypertensi amlodipin
28 Salami Datau P 147 Parungi 0000958023336
Diabetes Melitus metformin

29 Hadidjah M. Taidi P 162 Parungi 0001793845451 Hypertensi amlodipin

30 Hasni Lapantu P 158 Parungi 0000958042135 Hypertensi amlodipin

Erni Hasim Hypertensi Captopril

31 P 156 Motoduto 0001235601819
Diabetes Melitus Glucodex

32 Satumi P 156 Monggolito 000139474337 Diabetes Melitus Glucodex

33 Siltje Telmy Moray P 156 Diloniyohu 0000139591102 Hypertensi amlodipin

34 Maimun Yusuf P 156 Iloheluma 0000139583204 Diabetes Melitus Glucodex

35 Hawa K. Mopatu P 146 Parungi 0001075568106 Hypertensi Captopril

36 Kasmini P 156 Monggolito 0001235600651 Hypertensi Captopril

37 Ismail Nasiru L 170 Iloheluma 0000139458058 Hypertensi amlodipin

38 Ahmad Hadi L 165 Sidodadi 0001075574485 Hypertensi amlodipin

39 Siti Jariyah P 145 Monggolito 0000958806595 Hypertensi amlodipin

40 Maryam Kinga P 145 Parungi 0000958993121 Hypertensi Captopril

41 Martha Nento P 146 Parungi 0001386690996 Hypertensi amlodipin

Metformin
42 Sumarwin L 157 Sidomulyo 0000139592529 Diabetes Melitus
Lisinopril

43 Srikah P 155 Sidomulyo 0001237164682 Hypertensi Amlodipin

 Captopril
Hypertensi
44 Yasin U. Olii L 160 Parungi 0000139589379 Metformin
Diabetes Melitus
Amlodipin

45 Suwarni Ismail P 157 Parungi 0000958888776 Hypertensi Captopril

46 Sumina P 155 Sidodadi 0001075574496 Hypertensi Amlodipin

47 Sartin Rifai P 158 Monggolito 0001235601189 Hypertensi Amlodipin

48 Karsum Hilala P 158 Parungi 0001484307696 Hypertensi Amlodipin

49 Darjo L 155 Sid. Selatan 0001075579233 Hypertensi Amlodipin

Captopril
50 Agus S. Rojikan L 170 Sid. Selatan 0000139436752 Hypertensi
Amlodipin

51 Karsum Daud P 155 Motoduto 0000957329728 - -

52 Karmi P 155 Sidomulyo 0000139470197 Hypertensi Amlodipin

53 Nolva Ikano P 156 Sidomulyo 0001237179014 Hypertensi Amlodipin

54 Jemini P 155 Sid. Selatan 0001075580223 Hypertensi Amlodipin

55 Amelia Lawendatu P 153 Sidomulyo 0000958581876 Hypertensi Amlodipin

56 Hadija Djaini P 157 Tolite 0000958530093 Diabetes Melitus Glucodex

57 Maryati P 157 0002231701964 Diabetes Melitus Metformin

Amlodipin
58 Wiwik P 157 Sid. Selatan 0001075579435 Hypertensi
Captopril

59 Sumiyati P 158 0001973198777 Hypertensi Amlodipin

60 Umi Kalsum P 156 Sid. Selatan 0001075579244 Hypertensi Amlodipin

61 Hajira Datau P 155 0000957937511 Hypertensi Amlodipin

62 Asmin Rifai P 157 000197317529 Hypertensi Amlodipin

63 Dani Zakaria L 157 0001973203659 Hypertensi Amlodipin

 Carbamazepine
64 Darmuti P 157 Sid. Selatan 0000958100218 Epilepsi Phenobarbital
30mg

65 Hartati Polomulo P 157 0000957772541 Diabetes Melitus Metformin

66 Amina Hasan P 159 0001973204594 Hypertensi Amlodipin

67 Rohana Alwi P 162 0000958339901 Hypertensi Amlodipin

Amlodipin
Valsartan
furosemid
68 Samsudin Abdul L 160 0000958583327 Hypertensi Spironolacton
bisoprolol
ISDN
CPG
 LAPORAN PROLANIS
PUSKESMAS BOLIYOHUTO
BULAN OKTOBER TAHUN 2018

TANDA TANGAN PEMANTAUAN KESEHATAN

DAFTAR DOSIS TINDAK
NO NAMA PESERTA PENGAMBILAN KET
KEHADIRAN OBAT OBAT KOLES Hb1C IMT GDS TD BB LANJUT
OBAT
1 2 3 4 5 6 7 8 9 10 11 12 13 14

Metformin 500mg 1x1

Yasin Buka
1 Glucodex 80mg 1x1
0001405093206

Bisoprolol 5 mg 1x1
Samsinar
2
0001075579029

Amlodipin 5 mg 1x1
Sailah
3
0000958060034

Amlodipin 10 mg 1x1
Nurhayati
4
0000958099173

Amlodipin 10 mg 1x1
Sumar
5
0001234947003

Amlodipin 10 mg 1x1
Patmi
6
0000958146963

Amlodipin 10 mg 1x1
Imam Mahmud
7
0000958577534
 Imam Mahmud
7
0000958577534

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Amlodipin 10 mg 1x1
Salaton
8
0001234946733

Amlodipin 10 mg 1x1
Sarjono
9
0000958299085

Amlodipin 10 mg 1x1
Mujiah
10
0001234946351

Amlodipin 10 mg 1x1
Poni
11 Metformin 500 mg 1x1
0000958581753
Glucodex 80 mg 1x1
Amlodipin 10mg 1x1
Tukirah
12
0000958542862

Amlodipin 5 mg 1x1
Suyanti
13
0000958136455

Amlodipin 10 mg 1x1
Ica
14
0001075580155

Amlodipin 10 mg 1x1
Hartini Dena
15
0000958896189

Amlodipin 10 mg 1x1
Sutarwiyati
16
0000958068426
 Sutarwiyati
16
0000958068426

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Amlodipin 5 mg 1x1
Rukaiyah
17
0001235601044

Glucodex 80 mg 1x1
Indasah
18 Metformin 500 mg 2x1
0001234946125

Amlodipin 10 mg 1x1
Ariani Hatiku
19
000210778402

Amlodipin 10 mg 1x1
Jinem
20
0001237178529

Amlodipin 10 mg 1x1
Umar Tute
21
000139474372

Amlodipin 10 mg 1x1
Since Didipu
22 Glucodex 80 mg 1x1
0000139591214

Amlodipin 10 mg 1x1
Aisa Kune
23
0000957190408

Amlodipin 10 mg 1x1
Niko pane
24 Glucodex 80 mg 2x2
0000957797076
 Amlodipin 10 mg 1x1
Eri Husuna
25 Captopril 25 mg 1x1
0000959010592

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Amlodipin 10 mg 1x1
Habiba Husuna
26
0001234849522

Amlodipin 10 mg 1x1
Salami Datau
27
0000958023336

Amlodipin 5 mg 1x1
Hadidjah M. Taidi
28
0001793845451

Amlodipin 10 mg 1x1
Hasni Lapantu
29
0000958042135

Captopril 25 mg 2x1
Erni Hasim
30 Glucodex 80 mg 2x1
0001235601819

Captopril 25 mg 2x1
Hawa K. Mopatu
31
0001075568106

Captopril 25 mg 2x1
Kasmini
32
0001235600651

Amlodipin 5 mg 1x1
Ahmad Hadi
33
0001075574485
 Ahmad Hadi
33
0001075574485

Amlodipin 10 mg 1x1
Siti Jariyah
34
0000958806595

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Captopril 25 mg 2x1
Maryam Kinga
35
0000958993121

Amlodipin 10 mg 1x1
Martha Nento
36
0001386690996

Amlodipin 5 mg 1x1
Srikah
37
0001237164682

Captopril 25 mg 1x1
Suwarni Ismail
38
0000958888776

Amlodipin 5 mg 1x1
Sumina
39
0001075574496

Amlodipin 1x1
Darjo
40
0001075579233

Amlodipin 10 mg 1x1
Agus S. Rojikan
41 Captopril 25 mg 3x1
0000139436752

Karsum Daud
42
0000957329728
 Karsum Daud
42
0000957329728

Amlodipin 10 mg 1x1
Karmi
43
0000139470197

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Amlodipin 5 mg 1x1
Nolva Ikano
44
0001237179014

Amlodipin 5 mg 1x1
Jemini
45
0001075580223

Amlodipin 5 mg 1x1
Amelia Lawendatu
46
0000958581876

Metformin 500 mg 2x1

Maryati
47
0002231701964

Amlodipin 10 mg 1x1
Wiwik
48 Captopril 25 mg 2x1
0001075579435

Amlodipin 10 mg 1x1
Sumiyati
49
0001973198777

Amlodipin 5 mg 1x1
Umi Kalsum
50
0001075579244
 Amlodipin 10 mg 1x1
Hajira Datau
51
0000957937511

Amlodipin 10 mg 1x1
Asmin Rifai
52
0001973175219

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Amlodipin 5 mg 1x1
Dani Zakaria
53
0001973203659

Carbamezepin 20 mg 1x1
Darmuti
54 Phenobarbital 30 mg 1x1
0000958100218

Metformin 500mg 2x1

Hartati Polomulo
55
0000957772541

Amlodipin 10 mg 1x1
Amina Hasan
56
0001973204594

Amlodipin 10 mg 1x1
Rohana Alwi
57
0000958339901

Amlodipin 10 mg 1x1
Valsartan 80 mg 1x1
Furosemid 40 mg 1x1
Samsudin Abdul
58
0000958583327
 Samsudin Abdul
58 Spironolacton 25 mg 1x1
0000958583327
Bisoprolol 5 mg 1x1/2
Isosorbid Dinitrat 5 m 3x1
Clopidogrel 75 mg 1x1
Amlodipin 10 mg 1x1
Ismail Nasiru
59
0000139458058

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Amlodipin 10 mg 1x1
Mastin Mantulangi
60
0000958323453

Metformin 500 mg 2x1

Wasih
61 Amlodipin 5 mg 1x1
0002237602083

Amlodipin 1x1
Risna Mantali
62
0001234867217

Amlodipin 5 Mg 1x1
Kasum Pakaya
63
0000957607558

Amlodipin 10mg 1x1

Napisa Konie
64
0001973208205

Amlodipin 1x1
Tukinah
65
0000958558217
 Tukinah
65
0000958558217

Amlodipin 10 mg 1x1
Siti Aminah
66
0002272656756

Amlodipin 10 mg 1x1
Nani Antu
67
0001973207283

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Captopril 25 mg 2x1
Suhaya
68
0000958554729

Amlodipin 10 mg 1x1
Olis Didipu
69
0001075571098

Metformin 500mg 2x1

Yulin Mopili
70
0000958566947

Metformin 500mg 2x1

Ale
71
0000958566104

Metformin 500mg 2x1

Wirna Buka
72
0000958620701
 Metformin 500mg 2x1
Rahmawati Yusuf
73
000097842189

Metformin 500mg 2x1

Suwarsi
74 Amlodipin 10 Mg 1x1
0000958062947

Metformin 500mg 2x1

Tukimin Nawawi
75
00001973204291

1 2 3 4 5 6 7 8 9 10 11 12 13 14

glikuidone 30 g 2x1

Abd. Gani Mauraja Furosemid 40 mg 1x1

76
0001235601483 Spironolacton 25 mg 1x1

Candesartan 8 g 1x1

Sariyah
77
000075569333

Neri Ali
78
0000959000387

Mustapa Tamadi
79
0000957606772

80 Satumi
80 Satumi

Saminah
81
0001481034126

82 Hajara Lamala

Noveramid 22 IU 3X1
Sumartini
83 Lovemir 22 IU 1x1
0001234947014
Micardis 89Mg 1x1
1 2 3 4 5 6 7 8 9 10 11 12 13 14
s