SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS

(KASUS BARU)
Propinsi : Sulawesi Tengah Tahun
Kab/Kota : Banggai Laut Bulan
Puskesmas : Lantibung Jml. Kunjungan
Golongan Umur
No Jenis Penyakit Total
0-7 hr 8-28 hr <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70+
L P L P L P L P L P L P L P L P L P L P L P L P L
1 Kolera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Diare 0 0 0 0 2 3 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 5
3 Diare Berdarah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TBC Paru BTA (+) 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
6 Tersangka TBC Paru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Kusta PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Kusta MB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Difteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Batuk Rejan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Hepatitis Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Malaria Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Malaria Vivax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Malaria Falciparum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Malaria Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Pnemonia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Sifilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Gonorhoe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Influensa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
Diabetes Melitus 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah Puskesmas Pembantu yang ada bulan lap : Mengetahui
Jumlah Puskesmas Pembantu yang melapor bulan lap : (.............%) Pengelola Surveilans
Jumlah Puskesmas Pembantu melapor tepat waktu : (.............%)
Jumlah Puskesmas yang ada bulan lap :
Jumlah Puskesmas melapor lap : (.............%)
Jumlah Puskesmas melapor tepat waktu : (.............%) (Moh. Jaspari Totondeng, SKM)
 SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS
(KASUS BARU)

Propinsi : Sulawesi Tengah Tahun

Kab/Kota : Banggai Laut Bulan
Puskesmas : Lantibung Jml. Kunjungan
Golongan Umur
No Jenis Penyakit Total
0-7 hr 8-28 hr <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70+
L P L P L P L P L P L P L P L P L P L P L P L P L
1 Kolera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Diare 0 0 0 0 0 0 1 2 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 3
3 Diare Berdarah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TBC Paru BTA (+) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Tersangka TBC Paru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
7 Kusta PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Kusta MB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Difteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Batuk Rejan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Hepatitis Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Malaria Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Malaria Vivax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Malaria Falciparum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Malaria Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Pnemonia 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
21 Sifilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Gonorhoe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Influensa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 2 0 1 0 0 0 0 1
27 Diabetes Melitus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
Jumlah Puskesmas Pembantu yang ada bulan lap : Mengetahui
Jumlah Puskesmas Pembantu yang melapor bulan lap : (.............%) Pengelola Surveilans
Jumlah Puskesmas Pembantu melapor tepat waktu : (.............%)
Jumlah Puskesmas yang ada bulan lap :
Jumlah Puskesmas melapor lap : (.............%)
Jumlah Puskesmas melapor tepat waktu : (.............%) (Moh. Jaspari Totondeng, SKM)
 SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS
(KASUS BARU)

Propinsi : Sulawesi Tengah Tahun

Kab/Kota : Banggai Laut Bulan
Puskesmas : Lantibung Jml. Kunjungan
Golongan Umur
No Jenis Penyakit Total
0-7 hr 8-28 hr <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70+
L P L P L P L P L P L P L P L P L P L P L P L P L
1 Kolera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Diare 0 0 0 0 2 0 1 1 0 1 0 0 0 0 0 2 0 0 0 0 0 0 0 0 3
3 Diare Berdarah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TBC Paru BTA (+) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
6 Tersangka TBC Paru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
7 Kusta PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Kusta MB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Difteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Batuk Rejan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Hepatitis Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Malaria Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Malaria Vivax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Malaria Falciparum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Malaria Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Pnemonia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Sifilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Gonorhoe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Influensa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 3 0 0 0 2 1 0 2
27 Diabetes Melitus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah Puskesmas Pembantu yang ada bulan lap : Mengetahui
Jumlah Puskesmas Pembantu yang melapor bulan lap : (.............%) Pengelola Surveilans
Jumlah Puskesmas Pembantu melapor tepat waktu : (.............%)
Jumlah Puskesmas yang ada bulan lap :
Jumlah Puskesmas melapor lap : (.............%)
Jumlah Puskesmas melapor tepat waktu : (.............%) (Moh. Jaspari Totondeng, SKM)
 SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS
(KASUS BARU)

Propinsi : Sulawesi Tengah Tahun

Kab/Kota : Banggai Laut Bulan
Puskesmas : Lantibung Jml. Kunjungan
Golongan Umur
No Jenis Penyakit Total
0-7 hr 8-28 hr <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70+
L P L P L P L P L P L P L P L P L P L P L P L P L
1 Kolera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Diare 0 0 0 0 0 3 1 2 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 4
3 Diare Berdarah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TBC Paru BTA (+) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Tersangka TBC Paru 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
7 Kusta PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Kusta MB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Difteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Batuk Rejan 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 2 0 0 0 0 0 1 0 5
12 Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Hepatitis Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Malaria Klinis 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1
15 Malaria Vivax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Malaria Falciparum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Malaria Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Pnemonia 0 0 0 0 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
21 Sifilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Gonorhoe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Influensa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 7 0 0 2 3 0 1 4
27 Diabetes Melitus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 0 0 0 0 0 2
Jumlah Puskesmas Pembantu yang ada bulan lap : Mengetahui
Jumlah Puskesmas Pembantu yang melapor bulan lap : (.............%) Pengelola Surveilans
Jumlah Puskesmas Pembantu melapor tepat waktu : (.............%)
Jumlah Puskesmas yang ada bulan lap :
Jumlah Puskesmas melapor lap : (.............%)
Jumlah Puskesmas melapor tepat waktu : (.............%) (Moh. Jaspari Totondeng, SKM)
 SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS
(KASUS BARU)

Propinsi : Sulawesi Tengah Tahun

Kab/Kota : Banggai Laut Bulan
Puskesmas : Lantibung Jml. Kunjungan :
Golongan Umur
No Jenis Penyakit Total
0-7 hr 8-28 hr <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70+
L P L P L P L P L P L P L P L P L P L P L P L P L
1 Kolera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Diare 0 0 0 0 1 2 2 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 5
3 Diare Berdarah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TBC Paru BTA (+) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
6 Tersangka TBC Paru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 1 1 0 2 1 0 1 5
7 Kusta PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Kusta MB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Difteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Batuk Rejan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Hepatitis Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Malaria Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Malaria Vivax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Malaria Falciparum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Malaria Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Pnemonia 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
21 Sifilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Gonorhoe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Influensa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 1 3 0 1 1 0 0 0 3
27 Diabetes Melitus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0
Jumlah Puskesmas Pembantu yang ada bulan lap : Mengetahui
Jumlah Puskesmas Pembantu yang melapor bulan lap : (.............%) Pengelola Surveilans
Jumlah Puskesmas Pembantu melapor tepat waktu : (.............%)
Jumlah Puskesmas yang ada bulan lap :
Jumlah Puskesmas melapor lap : (.............%)
Jumlah Puskesmas melapor tepat waktu : (.............%) (Moh. Jaspari Totondeng, SKM)
 SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS
(KASUS BARU)

Propinsi : Sulawesi Tengah Tahun

Kab/Kota : Banggai Laut Bulan
Puskesmas : Lantibung Jml. Kunjungan :
Golongan Umur
No Jenis Penyakit Total
0-7 hr 8-28 hr <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70+
L P L P L P L P L P L P L P L P L P L P L P L P L
1 Kolera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Diare 0 0 0 0 1 1 1 1 0 0 0 1 0 0 1 1 0 0 0 2 0 0 0 0 3
3 Diare Berdarah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TBC Paru BTA (+) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Tersangka TBC Paru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 2 1 1 0 0 0 1 1 0 7
7 Kusta PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Kusta MB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Difteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Batuk Rejan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Hepatitis Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Malaria Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
15 Malaria Vivax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Malaria Falciparum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Malaria Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Pnemonia 0 0 0 0 1 1 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
21 Sifilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Gonorhoe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Influensa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 4 4 6 0 2 0 2 1 0 7
27 Diabetes Melitus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1
Jumlah Puskesmas Pembantu yang ada bulan lap : Mengetahui
Jumlah Puskesmas Pembantu yang melapor bulan lap : (.............%) Pengelola Surveilans
Jumlah Puskesmas Pembantu melapor tepat waktu : (.............%)
Jumlah Puskesmas yang ada bulan lap :
Jumlah Puskesmas melapor lap : (.............%)
Jumlah Puskesmas melapor tepat waktu : (.............%) (Moh. Jaspari Totondeng, SKM)
 SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS
(KASUS BARU)

Propinsi : Sulawesi Tengah Tahun

Kab/Kota : Banggai Laut Bulan
Puskesmas : Lantibung Jml. Kunjungan
Golongan Umur
No Jenis Penyakit Total
0-7 hr 8-28 hr <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70+
L P L P L P L P L P L P L P L P L P L P L P L P L
1 Kolera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Diare 0 0 0 0 1 1 4 3 0 1 0 0 0 0 0 2 0 0 0 0 0 0 0 0 5
3 Diare Berdarah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TBC Paru BTA (+) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Tersangka TBC Paru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 2 0 0 0 4
7 Kusta PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Kusta MB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Difteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Batuk Rejan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Hepatitis Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Malaria Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Malaria Vivax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Malaria Falciparum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Malaria Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Pnemonia 0 0 0 0 1 1 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
21 Sifilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Gonorhoe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Influensa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 2 2 3 0 0 3 1 1 6
27 Diabetes Melitus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0
Jumlah Puskesmas Pembantu yang ada bulan lap : Mengetahui
Jumlah Puskesmas Pembantu yang melapor bulan lap : (.............%) Pengelola Surveilans
Jumlah Puskesmas Pembantu melapor tepat waktu : (.............%)
Jumlah Puskesmas yang ada bulan lap :
Jumlah Puskesmas melapor lap : (.............%)
Jumlah Puskesmas melapor tepat waktu : (.............%) (Moh. Jaspari Totondeng, SKM)
 SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS
(KASUS BARU)

Propinsi : Sulawesi Tengah Tahun

Kab/Kota : Banggai Laut Bulan
Puskesmas : Lantibung Jml. Kunjungan :
No Jenis Penyakit Total
0-7 hr 8-28 hr <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70+
L P L P L P L P L P L P L P L P L P L P L P L P L
1 Kolera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Diare 0 0 0 0 2 3 5 4 2 0 0 0 0 0 1 3 0 0 0 0 0 0 0 0 10
3 Diare Berdarah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TBC Paru BTA (+) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Tersangka TBC Paru 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 0 0 0 0 0 0 0 0 2
7 Kusta PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Kusta MB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Difteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Batuk Rejan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Hepatitis Klinis 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 1
14 Malaria Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
15 Malaria Vivax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Malaria Falciparum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Malaria Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Pnemonia 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
21 Sifilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Gonorhoe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Influensa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 2 0 0 0 0 1 0 0 2
27 Diabetes Melitus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
Jumlah Puskesmas Pembantu yang ada bulan lap : Mengetahui
Jumlah Puskesmas Pembantu yang melapor bulan lap : (.............%) Pengelola Surveilans
Jumlah Puskesmas Pembantu melapor tepat waktu : (.............%)
Jumlah Puskesmas yang ada bulan lap :
Jumlah Puskesmas melapor lap : (.............%)
Jumlah Puskesmas melapor tepat waktu : (.............%) (Moh. Jaspari Totondeng, SKM)
 SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS
(KASUS BARU)

Propinsi : Sulawesi Tengah Tahun

Kab/Kota : Banggai Laut Bulan
Puskesmas : Lantibung Jml. Kunjungan :
No Jenis Penyakit Total
0-7 hr 8-28 hr <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70+
L P L P L P L P L P L P L P L P L P L P L P L P L
1 Kolera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Diare 0 0 0 0 1 2 4 8 1 1 0 0 0 1 2 1 0 0 0 1 0 0 0 0 8
3 Diare Berdarah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TBC Paru BTA (+) 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1
6 Tersangka TBC Paru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0
7 Kusta PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Kusta MB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Difteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Batuk Rejan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Hepatitis Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Malaria Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Malaria Vivax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Malaria Falciparum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Malaria Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Pnemonia 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
21 Sifilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Gonorhoe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Influensa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 4 0 2 1 1 0 0 1
27 Diabetes Melitus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0
Jumlah Puskesmas Pembantu yang ada bulan lap : Mengetahui
Jumlah Puskesmas Pembantu yang melapor bulan lap : (.............%) Pengelola Surveilans
Jumlah Puskesmas Pembantu melapor tepat waktu : (.............%)
Jumlah Puskesmas yang ada bulan lap :
Jumlah Puskesmas melapor lap : (.............%)
Jumlah Puskesmas melapor tepat waktu : (.............%) (Moh. Jaspari Totondeng, SKM)
 SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS
(KASUS BARU)

Propinsi : Sulawesi Tengah Tahun

Kab/Kota : Banggai Laut Bulan
Puskesmas : Lantibung Jml. Kunjungan :

No Jenis Penyakit Total

0-7 hr 8-28 hr <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70+
L P L P L P L P L P L P L P L P L P L P L P L P L
1 Kolera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Diare 0 0 0 0 0 0 4 3 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 4
3 Diare Berdarah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TBC Paru BTA (+) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Tersangka TBC Paru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Kusta PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Kusta MB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Difteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Batuk Rejan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Hepatitis Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Malaria Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Malaria Vivax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Malaria Falciparum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Malaria Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Pnemonia 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
21 Sifilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Gonorhoe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Influensa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 2 0 5 1 3 1
27 Diabetes Melitus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Jumlah Puskesmas Pembantu yang ada bulan lap : Mengetahui

Jumlah Puskesmas Pembantu yang melapor bulan lap : (.............%) Pengelola Surveilans
Jumlah Puskesmas Pembantu melapor tepat waktu : (.............%)
Jumlah Puskesmas yang ada bulan lap :
Jumlah Puskesmas melapor lap : (.............%)
Jumlah Puskesmas melapor tepat waktu : (.............%) (Moh. Jaspari Totondeng, SKM)
 SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS
(KASUS BARU)

Propinsi : Sulawesi Tengah Tahun

Kab/Kota : Banggai Laut Bulan
Puskesmas : Lantibung Jml. Kunjungan :
No Jenis Penyakit Total
0-7 hr 8-28 hr <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70+
L P L P L P L P L P L P L P L P L P L P L P L P L
1 Kolera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Diare 0 0 0 0 0 0 1 1 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 2
3 Diare Berdarah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TBC Paru BTA (+) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Tersangka TBC Paru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Kusta PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Kusta MB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Difteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Batuk Rejan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Hepatitis Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Malaria Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
15 Malaria Vivax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Malaria Falciparum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Malaria Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Pnemonia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Sifilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Gonorhoe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Influensa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 1 0 1 0 2
27 Diabetes Melitus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 1 0 1 0
Jumlah Puskesmas Pembantu yang ada bulan lap : Mengetahui
Jumlah Puskesmas Pembantu yang melapor bulan lap : (.............%) Pengelola Surveilans
Jumlah Puskesmas Pembantu melapor tepat waktu : (.............%)
Jumlah Puskesmas yang ada bulan lap :
Jumlah Puskesmas melapor lap : (.............%)
Jumlah Puskesmas melapor tepat waktu : (.............%) (Moh. Jaspari Totondeng, SKM)
 SURVEILANS TERPADU PENYAKIT BERBASIS PUSKESMAS
(KASUS BARU)

Propinsi : Sulawesi Tengah Tahun

Kab/Kota : Banggai Laut Bulan
Puskesmas : Lantibung Jml. Kunjungan :
No Jenis Penyakit Total
0-7 hr 8-28 hr <1 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 70+
L P L P L P L P L P L P L P L P L P L P L P L P L
1 Kolera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Diare 0 0 0 0 0 3 2 5 1 2 0 1 0 0 1 2 1 1 0 2 0 1 0 0 5
3 Diare Berdarah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Tifus Perut Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 TBC Paru BTA (+) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
6 Tersangka TBC Paru 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1
7 Kusta PB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Kusta MB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Campak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Difteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Batuk Rejan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Hepatitis Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Malaria Klinis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
15 Malaria Vivax 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Malaria Falciparum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Malaria Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Demam Berdarah Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Demam Dengue 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Pnemonia 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
21 Sifilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Gonorhoe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Frambusia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Filariasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Influensa 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1
26 Hipertensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3 0 1 1 1 0 0 2
27 Diabetes Melitus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 1 0 0 0 1
Jumlah Puskesmas Pembantu yang ada bulan lap : Mengetahui
Jumlah Puskesmas Pembantu yang melapor bulan lap : (.............%) Pengelola Surveilans
Jumlah Puskesmas Pembantu melapor tepat waktu : (.............%)
Jumlah Puskesmas yang ada bulan lap :
Jumlah Puskesmas melapor lap : (.............%)
Jumlah Puskesmas melapor tepat waktu : (.............%) (Moh. Jaspari Totondeng, SKM)
 : 2019
: Januari
jungan : 78
Jumlah
Total
Kasus Kunjungan
P Lama+Baru
0 0 #REF!
5 10 #REF!
0 0 #REF!
0 0 #REF!
0 1 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 0 #REF!
0 1 #REF!
1 1 #REF!
eilans

deng, SKM)
 : 2019
: FEBRUARI
jungan : 187
Jumlah
Total
Kasus Kunjungan
P Lama+Baru
0 0 0
3 6 16
0 0 0
0 0 0
0 0 1
1 1 1
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 1 1
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
5 6 7
0 1 2
eilans

deng, SKM)
 : 2019
: Maret
jungan : 186
Jumlah
Total
Kasus Kunjungan
P Lama+Baru
0 0 0
4 7 23
0 0 0
0 0 0
1 1 2
0 1 2
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 1
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
7 9 16
0 0 2
eilans

deng, SKM)
 : 2019
: April
jungan : 163
Jumlah
Total
Kasus Kunjungan
P Lama+Baru
0 0 0
5 9 32
0 0 0
0 0 0
0 0 24
1 2 104
0 0 0
0 0 0
0 0 0
0 0 0
0 5 5
0 0 0
0 0 0
1 2 2
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
2 4 5
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
13 17 33
1 3 5
eilans

deng, SKM)
 : 2018
: Mei
jungan : 162
Jumlah
Total
Kasus Kunjungan
P Lama+Baru
0 0 0
4 9 41
0 0 0
0 0 0
0 1 24
4 9 104
0 0 0
0 0 0
0 0 0
0 0 0
0 0 5
0 0 0
0 0 0
0 0 2
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
1 3 8
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
6 9 42
1 1 6
eilans

deng, SKM)
 : 2019
: Juni
jungan : 217
Jumlah
Total
Kasus Kunjungan
P Lama+Baru
0 0 0
6 9 50
0 0 0
0 0 0
0 0 24
4 11 104
0 0 0
0 0 0
0 0 0
0 0 0
0 0 5
0 0 0
0 0 0
1 1 3
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
2 5 13
0 0 0
0 0 0
0 0 0
2 2 2
0 0 0
14 21 63
1 2 8
eilans

deng, SKM)
 : 2019
: Juli
jungan : 246
Jumlah
Total
Kasus Kunjungan
P Lama+Baru
0 0 0
7 12 62
0 0 0
0 0 0
0 0 24
1 5 104
0 0 0
0 0 0
0 0 0
0 0 0
0 0 5
0 0 0
0 0 0
0 0 3
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
3 6 19
0 0 0
0 0 0
0 0 0
0 0 2
0 0 0
12 18 81
2 2 10
eilans

deng, SKM)
 : 2018
: Agustus
unjungan : 206
Jumlah
Total
Kasus Kunjungan
P Lama+Baru
0 0 0
10 20 82
0 0 0
0 0 0
0 0 24
1 3 107
0 0 0
0 0 0
0 0 0
0 0 0
0 0 5
0 0 0
1 2 2
0 1 4
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
2 4 23
0 0 0
0 0 0
0 0 0
0 0 2
0 0 0
7 9 90
1 1 11
eilans

deng, SKM)
 : 2019
: September
unjungan : 306
Jumlah
Total
Kasus Kunjungan
P Lama+Baru
0 0 0
14 22 104
0 0 0
0 0 0
1 2 26
1 1 108
0 0 0
0 0 0
0 0 0
0 0 0
0 0 5
0 0 0
0 0 2
0 0 4
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
1 3 26
0 0 0
0 0 0
0 0 0
0 0 2
0 0 0
9 10 100
1 1 12
eilans

deng, SKM)
 : 2019
: Oktober
unjungan : 140
Jumlah
Total
Kasus Kunjungan
P Lama+Baru
0 0 0
4 8 112
0 0 0
0 0 0
0 0 26
0 0 108
0 0 0
0 0 0
0 0 0
0 0 0
0 0 5
0 0 0
0 0 2
0 0 4
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 2 28
0 0 0
0 0 0
0 0 0
0 0 2
0 0 0
 12 13 113
0 0 12

eilans

deng, SKM)
 : 2019
: November
unjungan : 186
Jumlah
Total
Kasus Kunjungan
P Lama+Baru
0 0 0
2 4 116
0 0 0
0 0 0
0 0 26
0 0 108
0 0 0
0 0 0
0 0 0
0 0 0
0 0 5
0 0 0
0 0 2
0 1 5
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 28
0 0 0
0 0 0
0 0 0
0 0 2
0 0 0
4 6 119
4 4 16
eilans

deng, SKM)
 : 2019
: Desember
unjungan : 235
Jumlah
Total
Kasus Kunjungan
P Lama+Baru
0 0 0
17 22 138
0 0 0
0 0 0
0 1 27
1 2 110
0 0 0
0 0 0
0 0 0
0 0 0
0 0 5
0 0 0
0 0 2
0 1 6
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 1 29
0 0 0
0 0 0
0 0 0
0 0 2
1 2 2
5 7 126
3 4 20
eilans

deng, SKM)