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Laporan Bulanan Rekapitulasi Laboratorium Di Puskesmas Dan Jejaringnya Kabupaten /puskesmas Huebunif

The document contains monthly reports from a health center laboratory. It reports the total number of laboratory visits for the current month and cumulatively. It also details the number of laboratory tests conducted, broken down by test type (such as blood type, hemoglobin level, etc.) and results. The number of laboratory visits and tests conducted varied each month.

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Charles bengkiuk
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28 views31 pages

Laporan Bulanan Rekapitulasi Laboratorium Di Puskesmas Dan Jejaringnya Kabupaten /puskesmas Huebunif

The document contains monthly reports from a health center laboratory. It reports the total number of laboratory visits for the current month and cumulatively. It also details the number of laboratory tests conducted, broken down by test type (such as blood type, hemoglobin level, etc.) and results. The number of laboratory visits and tests conducted varied each month.

Uploaded by

Charles bengkiuk
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as XLSX, PDF, TXT or read online on Scribd
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REK

Puskesmas
No Elemen Data Jumlah
L P
I Total Kunjungan Laboratorium :
1 Bulan ini 3 13
2 Kumulatif s.d. bulan lalu 0 0
II Peminta Tes Laboratorium : 3 13
1 Poli umum 3 1
2 KIA 0 12
3 Rawat inap 0 0
4 Unit gawat darurat 0 0
5 Lain-lain (sebutkan) 0 0
III Jumlah Pemeriksaan Laboratorium : 2 15
801 Golongan darah : 2 5
1 A 0 1
2 O 0 1
3 B 0 0
4 AB 2 3
5 Rhesus + 0 0
6 Rhesus - 0 0
802 Hb : 0 5
a. 12 -17 gr /dl 0 0
b. 11 -16 gr /dl 0 5
803 Leukosit : 0 0
a. 4,0 - 6,2 103/μl 0 0
b. 6,0 - 17,5 103/μl 0 0
804 Eritrosit : 0 0
a. 4,0 - 6,2 106/μl 0 0
b. < 4,0 106/μl 0 0
c. > 6,2 106/μl 0 0
805 Trombosit : 0 0
a. 150 - 450 103/μl 0 0
b. < 150 103/μl 0 0
c. > 450 103/μl 0 0
806 Hematokrit / Hct : 0 0
a. 31 - 47 % 0 0
Puskesmas
No Elemen Data Jumlah
L P
I Total Kunjungan Laboratorium :
1 Bulan ini 6 17
2 Kumulatif s.d. bulan lalu 3 13
II Peminta Tes Laboratorium : 6 17
1 Poli umum 6 6
2 KIA 0 11
3 Rawat inap 0 0
4 Unit gawat darurat 0 0
5 Lain-lain (sebutkan) 0 0
III Jumlah Pemeriksaan Laboratorium : 0 20
801 Golongan darah : 0 6
1 A 0 1
2 O 0 2
3 B 0 0
4 AB 0 3
5 Rhesus + 0 0
6 Rhesus - 0 0
802 Hb : 0 8
a. 12 -17 gr /dl 0 1
b. 11 -16 gr /dl 0 7
803 Leukosit : 0 0
a. 4,0 - 6,2 103/μl 0 0
b. 6,0 - 17,5 103/μl 0 0
804 Eritrosit : 0 0
a. 4,0 - 6,2 106/μl 0 0
b. < 4,0 106/μl 0 0
c. > 6,2 106/μl 0 0
805 Trombosit : 0 0
a. 150 - 450 103/μl 0 0
b. < 150 103/μl 0 0
c. > 450 103/μl 0 0
806 Hematokrit / Hct : 0 0
a. 31 - 47 % 0 0
Puskesmas
No Elemen Data Jumlah
L P
I Total Kunjungan Laboratorium :
1 Bulan ini 4 9
2 Kumulatif s.d. bulan lalu 9 20
II Peminta Tes Laboratorium : 4 9
1 Poli umum 4 2
2 KIA 0 7
3 Rawat inap 0 0
4 Unit gawat darurat 0 0
5 Lain-lain (sebutkan) 0 0
III Jumlah Pemeriksaan Laboratorium : 1 10
801 Golongan darah : 1 2
1 A 0 1
2 O 0 0
3 B 1 0
4 AB 0 1
5 Rhesus + 0 0
6 Rhesus - 0 0
802 Hb : 0 3
a. 12 -17 gr /dl 0 0
b. 11 -16 gr /dl 0 3
803 Leukosit : 0 0
a. 4,0 - 6,2 103/μl 0 0
b. 6,0 - 17,5 103/μl 0 0
804 Eritrosit : 0 0
a. 4,0 - 6,2 106/μl 0 0
b. < 4,0 106/μl 0 0
c. > 6,2 106/μl 0 0
805 Trombosit : 0 0
a. 150 - 450 103/μl 0 0
b. < 150 103/μl 0 0
c. > 450 103/μl 0 0
806 Hematokrit / Hct : 0 0
a. 31 - 47 % 0 0
Puskesmas
No Elemen Data Jumlah
L P
I Total Kunjungan Laboratorium :
1 Bulan ini 1 17
2 Kumulatif s.d. bulan lalu 13 29
II Peminta Tes Laboratorium : 1 17
1 Poli umum 1 3
2 KIA 0 14
3 Rawat inap 0 0
4 Unit gawat darurat 0 0
5 Lain-lain (sebutkan) 0 0
III Jumlah Pemeriksaan Laboratorium : 3 25
801 Golongan darah : 1 3
1 A 0 0
2 O 0 0
3 B 1 0
4 AB 0 3
5 Rhesus + 0 0
6 Rhesus - 0 0
802 Hb : 0 7
a. 12 -17 gr /dl 0 0
b. 11 -16 gr /dl 0 7
803 Leukosit : 0 0
a. 4,0 - 6,2 103/μl 0 0
b. 6,0 - 17,5 103/μl 0 0
804 Eritrosit : 0 0
a. 4,0 - 6,2 106/μl 0 0
b. < 4,0 106/μl 0 0
c. > 6,2 106/μl 0 0
805 Trombosit : 0 0
a. 150 - 450 103/μl 0 0
b. < 150 103/μl 0 0
c. > 450 103/μl 0 0
806 Hematokrit / Hct : 0 0
a. 31 - 47 % 0 0
Puskesmas
No Elemen Data Jumlah
L P
I Total Kunjungan Laboratorium :
1 Bulan ini 0 5
2 Kumulatif s.d. bulan lalu 14 46
II Peminta Tes Laboratorium : 0 5
1 Poli umum 0 0
2 KIA 0 5
3 Rawat inap 0 0
4 Unit gawat darurat 0 0
5 Lain-lain (sebutkan) 0 0
III Jumlah Pemeriksaan Laboratorium : 0 7
801 Golongan darah : 0 0
1 A 0 0
2 O 0 0
3 B 0 0
4 AB 0 0
5 Rhesus + 0 0
6 Rhesus - 0 0
802 Hb : 0 4
a. 12 -17 gr /dl 0 0
b. 11 -16 gr /dl 0 4
803 Leukosit : 0 0
a. 4,0 - 6,2 103/μl 0 0
b. 6,0 - 17,5 103/μl 0 0
804 Eritrosit : 0 0
a. 4,0 - 6,2 106/μl 0 0
b. < 4,0 106/μl 0 0
c. > 6,2 106/μl 0 0
805 Trombosit : 0 0
a. 150 - 450 103/μl 0 0
b. < 150 103/μl 0 0
c. > 450 103/μl 0 0
806 Hematokrit / Hct : 0 0
a. 31 - 47 % 0 0
Puskesmas
No Elemen Data Jumlah
L P
I Total Kunjungan Laboratorium :
1 Bulan ini 0 0
2 Kumulatif s.d. bulan lalu 14 51
II Peminta Tes Laboratorium : 0 0
1 Poli umum 0 0
2 KIA 0 0
3 Rawat inap 0 0
4 Unit gawat darurat 0 0
5 Lain-lain (sebutkan) 0 0
III Jumlah Pemeriksaan Laboratorium : 0 0
801 Golongan darah : 0 0
1 A 0 0
2 O 0 0
3 B 0 0
4 AB 0 0
5 Rhesus + 0 0
6 Rhesus - 0 0
802 Hb : 0 0
a. 12 -17 gr /dl 0 0
b. 11 -16 gr /dl 0 0
803 Leukosit : 0 0
a. 4,0 - 6,2 103/μl 0 0
b. 6,0 - 17,5 103/μl 0 0
804 Eritrosit : 0 0
a. 4,0 - 6,2 106/μl 0 0
b. < 4,0 106/μl 0 0
c. > 6,2 106/μl 0 0
805 Trombosit : 0 0
a. 150 - 450 103/μl 0 0
b. < 150 103/μl 0 0
c. > 450 103/μl 0 0
806 Hematokrit / Hct : 0 0
a. 31 - 47 % 0 0
Puskesmas
No Elemen Data Jumlah
L P
I Total Kunjungan Laboratorium :
1 Bulan ini 0 7
2 Kumulatif s.d. bulan lalu 14 51
II Peminta Tes Laboratorium : 0 7
1 Poli umum 0 0
2 KIA 0 7
3 Rawat inap 0 0
4 Unit gawat darurat 0 0
5 Lain-lain (sebutkan) 0 0
III Jumlah Pemeriksaan Laboratorium : 0 7
801 Golongan darah : 0 0
1 A 0 0
2 O 0 0
3 B 0 0
4 AB 0 0
5 Rhesus + 0 0
6 Rhesus - 0 0
802 Hb : 0 5
a. 12 -17 gr /dl 0 0
b. 11 -16 gr /dl 0 5
803 Leukosit : 0 0
a. 4,0 - 6,2 103/μl 0 0
b. 6,0 - 17,5 103/μl 0 0
804 Eritrosit : 0 0
a. 4,0 - 6,2 106/μl 0 0
b. < 4,0 106/μl 0 0
c. > 6,2 106/μl 0 0
805 Trombosit : 0 0
a. 150 - 450 103/μl 0 0
b. < 150 103/μl 0 0
c. > 450 103/μl 0 0
806 Hematokrit / Hct : 0 0
a. 31 - 47 % 0 0
LAPORAN BULANAN
REKAPITULASI LABORATORIUM DI PUSKESMAS DAN JEJARINGNYA
KABUPATEN /PUSKESMAS HUEBUNIF

Puskesmas Pustu Tanini Pustu Hueknutu Pustu Oelnaineno Poskesdes Nefoneke Pustu Kauniki Pustu O
No Elemen Data Jumlah Hasil Jumlah Hasil Jumlah Hasil Jumlah Hasil Jumlah Hasil Jumlah Hasil Jumlah
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
I Total Kunjungan Laboratorium :
1 Bulan ini 1 0 0 0 0 4 0 0 0 3 0 0 0 6 0 0 0 1 0 0 0 3 0 0 0
2 Kumulatif s.d. bulan lalu 14 58 0 0 0 16 0 0 0 8 0 0 0 4 0 0 0 4 0 0 0 24 0 0 0
II Peminta Tes Laboratorium : 1 0 0 0 0 4 0 0 0 3 0 0 0 6 0 0 0 1 0 0 0 3 0 0 0
1 Poli umum 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
2 KIA 0 0 0 0 0 4 0 0 0 3 0 0 0 6 0 0 0 1 0 0 0 3 0 0 0
3 Rawat inap 0 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 Unit gawat darurat 0 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 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
III Jumlah Pemeriksaan Laboratorium : 1 0 0 0 0 4 0 0 0 3 0 0 0 6 0 0 0 1 0 0 0 3 0 0 0
801 Golongan darah : 0 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 A 0 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 O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 B 0 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 AB 0 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 Rhesus + 0 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 Rhesus - 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
802 Hb : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 12 -17 gr /dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. 11 -16 gr /dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
803 Leukosit : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 4,0 - 6,2 103/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. 6,0 - 17,5 103/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
804 Eritrosit : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 4,0 - 6,2 106/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 4,0 106/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. > 6,2 106/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
805 Trombosit : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 150 - 450 103/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 150 103/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. > 450 103/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
806 Hematokrit / Hct : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 31 - 47 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 31 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. > 47 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
807 LED : 0 0 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 mm/jam 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
808 Hitung jenis leukosit : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. Eosinofil : 1 - 4 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Basofil : 0 -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
c. Stab :1 - 5 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. Segmen : 38 - 71 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. Monosit : 2 - 10 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f. Limposit : 25 - 50 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
809 Ureum : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a.10 - 50 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 10 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. > 50 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
810 Kreatinin : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 0,6 - 1,3 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 0,6 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. > 1,3 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
811 Asam urat : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 2,4 - 7,0 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 2,4 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. > 7,0 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
812 Cholesterol : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. < 200 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. > 200 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
813 Trigliserida : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. < 200 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. > 200 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
814 HDL : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. ≥ 45 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 45 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
815 LDL : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. ≤ 130 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. > 130 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
816 SGOT : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. < 38 U/L 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 32 U/L 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
817 SGPT : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. < 38 U/L 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 32 U/L 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
818 Gula Darah : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. Gula Darah Puasa : 70 - 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Gula darah 2 j PP : < 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. Gula Darah Sewaktu : < 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
819 Widal : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. Salmonela typhi O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Salmonela typhi H : ≤ 1/80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. Salmonela para typhi AO : ≥ 1/160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. Salmonela para typhi BO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
820 HBsAg : 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
nilai rujukan : non reaktif 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
821 Malaria : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. P. 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
b. P. Falcifarum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. P. Malariae 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. P. Ovale 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. P. 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
822 Sputum 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
a. Positif 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Negatif 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
823 Urine lengkap : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. Berat jenis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. pH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. Protein 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. Glukosa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. Keton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f. Bilirubin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. Urobilinogen 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
h. Nitrit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
i. Eritrosit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
j. Lekosit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
k. Sedimen : Lekosit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Eritrosit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epitel 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kristal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Bakteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lain - lain 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
824 Faeces lengkap : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. Makroskopis : Warna 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Konsistensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Darah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lendir 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Mikroskopis : Lekosit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epitel 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Bakteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Sisa Makanan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Telur Cacing 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Amoeba 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
HCG 0 0 0 0 0 4 0 0 0 3 0 0 0 6 0 0 0 1 0 0 0 3 0 0 0

Mengetahui Huebunif, 03 Septem


Kepala Puskesmas Huebunif Yang Melapor

Antonius Naisumu, SKM Paskalis S. Jemarut,


Nip. 19680715 199103 1 013 Nip. 19810325 2006
AN BULANAN
M DI PUSKESMAS DAN JEJARINGNYA
USKESMAS HUEBUNIF

Pustu Oekolo TOTAL


Jumlah Hasil Jumlah Hasil
P L P L P L P

2 0 0 1 19 0 0
6 0 0 14 120 0 0
2 0 0 1 19 0 0
0 0 0 1 0 0 0
2 0 0 0 19 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
2 0 0 1 19 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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 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 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 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 0 0 0 19 0 0

Huebunif, 03 September 2018


Yang Melapor

Paskalis S. Jemarut, S.Kep


Nip. 19810325 200604 1 012
LAPORAN BULANAN
REKAPITULASI LABORATORIUM DI PUSKESMAS DAN JEJARINGNYA
KABUPATEN /PUSKESMAS HUEBUNIF

Puskesmas Pustu Tanini Pustu Hueknutu Pustu Oelnaineno Poskesdes Nefoneke Pustu Kauniki Pustu O
No Elemen Data Jumlah Hasil Jumlah Hasil Jumlah Hasil Jumlah Hasil Jumlah Hasil Jumlah Hasil Jumlah
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
I Total Kunjungan Laboratorium :
1 Bulan ini 0 6 0 0 0 2 0 0 0 0 0 0 0 5 0 0 0 2 0 0 0 2 0 0 0
2 Kumulatif s.d. bulan lalu 15 58 0 0 0 20 0 0 0 11 0 0 0 10 0 0 0 5 0 0 0 27 0 0 0
II Peminta Tes Laboratorium : 0 6 0 0 0 2 0 0 0 0 0 0 0 5 0 0 0 2 0 0 0 2 0 0 0
1 Poli umum 0 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 KIA 0 6 0 0 0 2 0 0 0 0 0 0 0 5 0 0 0 2 0 0 0 2 0 0 0
3 Rawat inap 0 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 Unit gawat darurat 0 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 Lain-lain (sebutkan) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
III Jumlah Pemeriksaan Laboratorium : 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
801 Golongan darah : 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 A 0 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 O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 B 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 AB 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Rhesus + 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Rhesus - 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
802 Hb : 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 12 -17 gr /dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. 11 -16 gr /dl 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
803 Leukosit : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 4,0 - 6,2 103/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. 6,0 - 17,5 103/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
804 Eritrosit : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 4,0 - 6,2 106/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 4,0 106/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. > 6,2 106/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
805 Trombosit : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 150 - 450 103/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 150 103/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. > 450 103/μl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
806 Hematokrit / Hct : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 31 - 47 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 31 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. > 47 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
807 LED : 0 0 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 mm/jam 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
808 Hitung jenis leukosit : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. Eosinofil : 1 - 4 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Basofil : 0 -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
c. Stab :1 - 5 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. Segmen : 38 - 71 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. Monosit : 2 - 10 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f. Limposit : 25 - 50 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
809 Ureum : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a.10 - 50 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 10 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. > 50 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

810 Kreatinin : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 0,6 - 1,3 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 0,6 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. > 1,3 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
811 Asam urat : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. 2,4 - 7,0 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 2,4 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. > 7,0 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
812 Cholesterol : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. < 200 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. > 200 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
813 Trigliserida : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. < 200 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. > 200 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
814 HDL : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. ≥ 45 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 45 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
815 LDL : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. ≤ 130 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. > 130 mg/dl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
816 SGOT : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. < 38 U/L 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 32 U/L 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
817 SGPT : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. < 38 U/L 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. < 32 U/L 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
818 Gula Darah : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. Gula Darah Puasa : 70 - 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Gula darah 2 j PP : < 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. Gula Darah Sewaktu : < 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
819 Widal : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. Salmonela typhi O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Salmonela typhi H : ≤ 1/80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. Salmonela para typhi AO : ≥ 1/160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. Salmonela para typhi BO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
820 HBsAg : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
nilai rujukan : non reaktif 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
821 Malaria : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. P. 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
b. P. Falcifarum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. P. Malariae 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. P. Ovale 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. P. 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
822 Sputum 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
a. Positif 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Negatif 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
823 Urine lengkap : 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. Berat jenis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. pH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
c. Protein 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
d. Glukosa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
e. Keton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
f. Bilirubin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
g. Urobilinogen 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
h. Nitrit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
i. Eritrosit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
j. Lekosit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
k. Sedimen : Lekosit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Eritrosit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epitel 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kristal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Bakteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lain - lain 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
824 Faeces lengkap : 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
a. Makroskopis : Warna 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Konsistensi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Darah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lendir 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
b. Mikroskopis : Lekosit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Epitel 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Bakteri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Sisa Makanan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Telur Cacing 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Amoeba 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
HCG 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui Huebunif, 04 Oktob


a/n. Kepala Puskesmas Huebunif Yang Melapor
Bidan Koordinator

Martha A.W. Kononis, Amd.Keb Paskalis S. Jemarut,


19770412 200501 2 016 Nip. 19810325 2006
ORAN BULANAN
RIUM DI PUSKESMAS DAN JEJARINGNYA
/PUSKESMAS HUEBUNIF

Pustu Oekolo TOTAL


Jumlah Hasil Jumlah Hasil
P L P L P L P

3 0 0 0 20 0 0
8 0 0 15 139 0 0
3 0 0 0 20 0 0
0 0 0 0 0 0 0
3 0 0 0 20 0 0
0 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 0 0
0 0 0 0 6 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 2 0 0
0 0 0 0 1 0 0
0 0 0 0 2 0 0
0 0 0 0 1 0 0
0 0 0 0 3 0 0
0 0 0 0 0 0 0
0 0 0 0 3 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 3 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 3 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

Huebunif, 04 Oktober 2018


Yang Melapor
Paskalis S. Jemarut, S.Kep
Nip. 19810325 200604 1 012
Puskesmas
No Elemen Data Jumlah
L P
I Total Kunjungan Laboratorium :
1 Bulan ini 0 0
2 Kumulatif s.d. bulan lalu 0 0
II Peminta Tes Laboratorium : 0 0
1 Poli umum 0 0
2 KIA 0 0
3 Rawat inap 0 0
4 Unit gawat darurat 0 0
5 Lain-lain (sebutkan) 0 0
III Jumlah Pemeriksaan Laboratorium : 0 0
801 Golongan darah : 0 0
1 A 0 0
2 O 0 0
3 B 0 0
4 AB 0 0
5 Rhesus + 0 0
6 Rhesus - 0 0
802 Hb : 0 0
a. 12 -17 gr /dl 0 0
b. 11 -16 gr /dl 0 0
803 Leukosit : 0 0
a. 4,0 - 6,2 103/μl 0 0
b. 6,0 - 17,5 103/μl 0 0
804 Eritrosit : 0 0
a. 4,0 - 6,2 106/μl 0 0
b. < 4,0 106/μl 0 0
c. > 6,2 106/μl 0 0
805 Trombosit : 0 0
a. 150 - 450 103/μl 0 0
b. < 150 103/μl 0 0
c. > 450 103/μl 0 0
806 Hematokrit / Hct : 0 0
a. 31 - 47 % 0 0
Puskesmas
No Elemen Data Jumlah
L P
I Total Kunjungan Laboratorium :
1 Bulan ini 0 0
2 Kumulatif s.d. bulan lalu 0 0
II Peminta Tes Laboratorium : 0 0
1 Poli umum 0 0
2 KIA 0 0
3 Rawat inap 0 0
4 Unit gawat darurat 0 0
5 Lain-lain (sebutkan) 0 0
III Jumlah Pemeriksaan Laboratorium : 0 0
801 Golongan darah : 0 0
1 A 0 0
2 O 0 0
3 B 0 0
4 AB 0 0
5 Rhesus + 0 0
6 Rhesus - 0 0
802 Hb : 0 0
a. 12 -17 gr /dl 0 0
b. 11 -16 gr /dl 0 0
803 Leukosit : 0 0
a. 4,0 - 6,2 103/μl 0 0
b. 6,0 - 17,5 103/μl 0 0
804 Eritrosit : 0 0
a. 4,0 - 6,2 106/μl 0 0
b. < 4,0 106/μl 0 0
c. > 6,2 106/μl 0 0
805 Trombosit : 0 0
a. 150 - 450 103/μl 0 0
b. < 150 103/μl 0 0
c. > 450 103/μl 0 0
806 Hematokrit / Hct : 0 0
a. 31 - 47 % 0 0
Puskesmas
No Elemen Data Jumlah
L P
I Total Kunjungan Laboratorium :
1 Bulan ini 0 0
2 Kumulatif s.d. bulan lalu 0 0
II Peminta Tes Laboratorium : 0 0
1 Poli umum 0 0
2 KIA 0 0
3 Rawat inap 0 0
4 Unit gawat darurat 0 0
5 Lain-lain (sebutkan) 0 0
III Jumlah Pemeriksaan Laboratorium : 0 0
801 Golongan darah : 0 0
1 A 0 0
2 O 0 0
3 B 0 0
4 AB 0 0
5 Rhesus + 0 0
6 Rhesus - 0 0
802 Hb : 0 0
a. 12 -17 gr /dl 0 0
b. 11 -16 gr /dl 0 0
803 Leukosit : 0 0
a. 4,0 - 6,2 103/μl 0 0
b. 6,0 - 17,5 103/μl 0 0
804 Eritrosit : 0 0
a. 4,0 - 6,2 106/μl 0 0
b. < 4,0 106/μl 0 0
c. > 6,2 106/μl 0 0
805 Trombosit : 0 0
a. 150 - 450 103/μl 0 0
b. < 150 103/μl 0 0
c. > 450 103/μl 0 0
806 Hematokrit / Hct : 0 0
a. 31 - 47 % 0 0
Pusk/Desa……….
No Elemen Data Jumlah
L P
I Total Kunjungan Laboratorium :
1 Bulan ini 15 74
2 Kumulatif s.d. bulan lalu 0 0
II Peminta Tes Laboratorium : 15 74
1 Poli umum 15 12
2 KIA 0 62
3 Rawat inap 0 0
4 Unit gawat darurat 0 0
5 Lain-lain (sebutkan) 0 0
III Jumlah Pemeriksaan Laboratorium : 7 96
801 Golongan darah : 4 22
1 A 0 3
2 O 0 3
3 B 2 2
4 AB 2 11
5 Rhesus + 0 2
6 Rhesus - 0 1
802 Hb : 0 35
a. 12 -17 gr /dl 0 1
b. 11 -16 gr /dl 0 34
803 Leukosit : 0 0
a. 4,0 - 6,2 103/μl 0 0
b. 6,0 - 17,5 103/μl 0 0
804 Eritrosit : 0 0
a. 4,0 - 6,2 106/μl 0 0
b. < 4,0 106/μl 0 0
c. > 6,2 106/μl 0 0
805 Trombosit : 0 0
a. 150 - 450 103/μl 0 0
b. < 150 103/μl 0 0
c. > 450 103/μl 0 0
806 Hematokrit / Hct : 0 0
a. 31 - 47 % 0 0

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