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Polio Immunization Data Report

The document is a data sheet for the implementation of a polio vaccination sub-district program in Aceh Utara, Aceh province, Indonesia. It lists 282 total targets for vaccination across several age groups at various health posts in Seumirah village. It also records the initial stock of vaccines (7 vials) and droppers (7) available.

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Ayesha Fajira
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22 views134 pages

Polio Immunization Data Report

The document is a data sheet for the implementation of a polio vaccination sub-district program in Aceh Utara, Aceh province, Indonesia. It lists 282 total targets for vaccination across several age groups at various health posts in Seumirah village. It also records the initial stock of vaccines (7 vials) and droppers (7) available.

Uploaded by

Ayesha Fajira
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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DATA DASAR PELAKSANAAN SUB PIN POLIO

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH

(Mohon isi pada kolom yang berwarna kuning)


SASARAN VAKSIN DAN DROPPER
No Nama Pos Pelayanan Desa/Kelurahan SASARAN PER KELOMPOK UMUR STOK AWAL STOK AWAL
Total Sasaran VAKSIN (VIAL) DROPPER
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn
a b b c d e f g h
1 Posyandu Anyelir 1 Seumirah 98 98 2 2
2 Posyandu Anyelir 2 Seumirah 70 70 2 2
3 posyandu Anyelir 3 Seumirah 69 69 2 2
4 Posyandu Anyelir 4 Seumirah 45 45 1 1
5 -
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158 -
159 -
160 - 7
Total 282 - - 282 7
LAPORAN HARIAN PELAKSANAAN SUB PIN POLIO (HARI KE-1)

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Harian Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan Jumlah sisa vial
Jumlah Cakupan Harian Cakupan Harian Jumlah Cakupan Harian Total Sasaran dibawa terbuka/terpakai vaksin rusak
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 73 74.5% - 0.0% - 0.0% 98 73 74.5% 2 2 0 0
2 Posyandu Anyelir 2 Seumirah 70 55 78.6% - 0.0% - 0.0% 70 55 78.6% 2 2 0
3 posyandu Anyelir 3 Seumirah 69 56 81.2% - 0.0% - 0.0% 69 56 81.2% 2 2 0
4 Posyandu Anyelir 4 Seumirah 45 38 84.4% - 0.0% - 0.0% 45 38 84.4% 1 1 0
5 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
6 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
7 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
8 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
9 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
10 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
11 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
12 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
13 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
14 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
15 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
16 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
17 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
18 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
19 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
20 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
21 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
22 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
23 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
24 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
25 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
26 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
27 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
28 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
29 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
30 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
31 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
32 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
33 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
34 0 0 - 0.0% - 0.0% - 0.0% - 0.0% 0
35 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
36 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
37 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
38 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
39 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
40 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
41 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
42 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
43 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
44 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
45 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
46 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
47 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
48 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
49 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
50 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
51 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
52 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
53 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
54 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
55 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
56 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
57 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
58 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
59 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
60 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
61 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
62 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
63 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
64 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
65 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
66 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
67 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
68 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
69 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
70 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
71 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
72 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
73 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
74 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
75 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
76 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
77 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
78 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
79 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
80 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
81 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
82 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
83 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
84 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
85 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
86 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
87 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
88 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
89 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
90 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
91 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
92 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
93 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
94 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
95 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
96 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
97 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
98 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
99 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
100 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
101 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
102 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
103 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
104 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
105 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
106 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
107 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
108 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
109 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
110 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
111 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
112 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
113 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
114 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
115 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
116 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
117 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
118 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
119 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
120 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
121 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
122 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
123 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
124 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
125 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
126 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
127 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
128 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
129 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
130 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
131 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
132 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
133 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
134 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
135 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
136 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
137 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
138 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
139 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
140 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
141 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
142 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
143 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
144 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
145 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
146 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
147 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
148 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
149 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
150 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
151 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
152 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
153 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
154 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
155 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
156 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
157 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
158 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
159 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
160 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
Total 282 222 78.7% - - 0.0% - - 0.0% 282 222 78.7% 7 7 - -
Jumlah dropper
terpakai

r
2
2
2
1
7
LAPORAN HARIAN PELAKSANAAN SUB PIN POLIO (HARI KE-2)

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Harian Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan Jumlah sisa vial
Jumlah Cakupan Harian Cakupan Harian Jumlah Cakupan Harian Total Sasaran dibawa terbuka/terpakai vaksin rusak
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 50 51.0% - 0.0% - 0.0% 98 50 51.0% 4 4 0 0
2 Posyandu Anyelir 2 Seumirah 70 0.0% - 0.0% - 0.0% 70 - 0.0% 0
3 posyandu Anyelir 3 Seumirah 69 0.0% - 0.0% - 0.0% 69 - 0.0% 0
4 Posyandu Anyelir 4 Seumirah 45 0.0% - 0.0% - 0.0% 45 - 0.0% 0
5 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
6 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
7 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
8 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
9 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
10 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
11 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
12 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
13 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
14 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
15 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
16 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
17 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
18 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
19 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
20 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
21 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
22 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
23 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
24 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
25 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
26 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
27 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
28 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
29 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
30 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
31 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
32 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
33 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
34 0 0 - 0.0% - 0.0% - 0.0% - 0.0% 0
35 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
36 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
37 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
38 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
39 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
40 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
41 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
42 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
43 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
44 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
45 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
46 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
47 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
48 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
49 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
50 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
51 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
52 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
53 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
54 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
55 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
56 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
57 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
58 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
59 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
60 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
61 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
62 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
63 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
64 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
65 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
66 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
67 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
68 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
69 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
70 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
71 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
72 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
73 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
74 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
75 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
76 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
77 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
78 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
79 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
80 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
81 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
82 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
83 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
84 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
85 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
86 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
87 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
88 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
89 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
90 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
91 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
92 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
93 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
94 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
95 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
96 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
97 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
98 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
99 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
100 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
101 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
102 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
103 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
104 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
105 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
106 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
107 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
108 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
109 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
110 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
111 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
112 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
113 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
114 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
115 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
116 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
117 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
118 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
119 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
120 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
121 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
122 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
123 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
124 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
125 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
126 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
127 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
128 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
129 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
130 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
131 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
132 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
133 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
134 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
135 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
136 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
137 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
138 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
139 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
140 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
141 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
142 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
143 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
144 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
145 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
146 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
147 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
148 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
149 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
150 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
151 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
152 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
153 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
154 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
155 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
156 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
157 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
158 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
159 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
160 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
Total 282 50 17.7% - - 0.0% - - 0.0% 282 50 17.7% 4 4 - -
Jumlah dropper
terpakai

r
-
LAPORAN HARIAN PELAKSANAAN SUB PIN POLIO (HARI KE-3)

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Harian Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan Jumlah sisa vial
Jumlah Cakupan Harian Cakupan Harian Jumlah Cakupan Harian Total Sasaran dibawa terbuka/terpakai vaksin rusak
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 50 51.0% - 0.0% - 0.0% 98 50 51.0% 4 4 0 0
2 Posyandu Anyelir 2 Seumirah 70 0.0% - 0.0% - 0.0% 70 - 0.0% 0
3 posyandu Anyelir 3 Seumirah 69 0.0% - 0.0% - 0.0% 69 - 0.0% 0
4 Posyandu Anyelir 4 Seumirah 45 0.0% - 0.0% - 0.0% 45 - 0.0% 0
5 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
6 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
7 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
8 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
9 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
10 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
11 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
12 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
13 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
14 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
15 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
16 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
17 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
18 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
19 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
20 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
21 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
22 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
23 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
24 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
25 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
26 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
27 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
28 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
29 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
30 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
31 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
32 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
33 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
34 0 0 - 0.0% - 0.0% - 0.0% - 0.0% 0
35 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
36 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
37 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
38 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
39 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
40 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
41 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
42 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
43 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
44 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
45 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
46 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
47 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
48 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
49 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
50 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
51 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
52 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
53 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
54 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
55 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
56 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
57 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
58 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
59 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
60 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
61 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
62 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
63 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
64 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
65 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
66 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
67 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
68 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
69 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
70 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
71 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
72 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
73 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
74 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
75 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
76 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
77 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
78 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
79 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
80 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
81 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
82 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
83 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
84 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
85 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
86 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
87 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
88 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
89 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
90 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
91 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
92 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
93 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
94 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
95 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
96 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
97 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
98 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
99 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
100 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
101 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
102 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
103 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
104 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
105 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
106 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
107 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
108 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
109 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
110 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
111 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
112 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
113 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
114 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
115 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
116 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
117 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
118 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
119 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
120 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
121 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
122 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
123 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
124 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
125 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
126 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
127 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
128 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
129 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
130 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
131 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
132 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
133 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
134 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
135 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
136 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
137 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
138 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
139 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
140 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
141 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
142 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
143 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
144 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
145 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
146 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
147 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
148 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
149 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
150 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
151 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
152 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
153 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
154 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
155 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
156 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
157 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
158 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
159 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
160 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
Total 282 50 17.7% - - 0.0% - - 0.0% 282 50 17.7% 4 4 - -
Jumlah dropper
terpakai

r
-
LAPORAN HARIAN PELAKSANAAN SUB PIN POLIO (HARI KE-4)

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Harian Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan Jumlah sisa vial
Jumlah Cakupan Harian Cakupan Harian Jumlah Cakupan Harian Total Sasaran dibawa terbuka/terpakai vaksin rusak
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 50 51.0% - 0.0% - 0.0% 98 50 51.0% 4 4 0 0
2 Posyandu Anyelir 2 Seumirah 70 0.0% - 0.0% - 0.0% 70 - 0.0% 0
3 posyandu Anyelir 3 Seumirah 69 0.0% - 0.0% - 0.0% 69 - 0.0% 0
4 Posyandu Anyelir 4 Seumirah 45 0.0% - 0.0% - 0.0% 45 - 0.0% 0
5 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
6 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
7 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
8 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
9 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
10 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
11 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
12 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
13 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
14 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
15 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
16 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
17 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
18 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
19 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
20 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
21 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
22 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
23 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
24 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
25 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
26 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
27 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
28 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
29 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
30 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
31 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
32 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
33 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
34 0 0 - 0.0% - 0.0% - 0.0% - 0.0% 0
35 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
36 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
37 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
38 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
39 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
40 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
41 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
42 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
43 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
44 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
45 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
46 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
47 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
48 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
49 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
50 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
51 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
52 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
53 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
54 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
55 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
56 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
57 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
58 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
59 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
60 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
61 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
62 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
63 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
64 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
65 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
66 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
67 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
68 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
69 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
70 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
71 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
72 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
73 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
74 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
75 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
76 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
77 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
78 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
79 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
80 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
81 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
82 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
83 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
84 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
85 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
86 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
87 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
88 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
89 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
90 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
91 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
92 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
93 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
94 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
95 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
96 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
97 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
98 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
99 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
100 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
101 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
102 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
103 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
104 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
105 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
106 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
107 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
108 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
109 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
110 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
111 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
112 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
113 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
114 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
115 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
116 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
117 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
118 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
119 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
120 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
121 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
122 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
123 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
124 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
125 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
126 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
127 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
128 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
129 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
130 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
131 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
132 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
133 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
134 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
135 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
136 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
137 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
138 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
139 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
140 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
141 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
142 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
143 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
144 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
145 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
146 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
147 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
148 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
149 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
150 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
151 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
152 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
153 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
154 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
155 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
156 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
157 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
158 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
159 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
160 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
Total 282 50 17.7% - - 0.0% - - 0.0% 282 50 17.7% 4 4 - -
Jumlah dropper
terpakai

r
-
LAPORAN HARIAN PELAKSANAAN SUB PIN POLIO (HARI KE-5)

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Harian Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan Jumlah sisa vial
Jumlah Cakupan Harian Cakupan Harian Jumlah Cakupan Harian Total Sasaran dibawa terbuka/terpakai vaksin rusak
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 50 51.0% - 0.0% - 0.0% 98 50 51.0% 4 4 0 0
2 Posyandu Anyelir 2 Seumirah 70 0.0% - 0.0% - 0.0% 70 - 0.0% 0
3 posyandu Anyelir 3 Seumirah 69 0.0% - 0.0% - 0.0% 69 - 0.0% 0
4 Posyandu Anyelir 4 Seumirah 45 0.0% - 0.0% - 0.0% 45 - 0.0% 0
5 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
6 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
7 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
8 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
9 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
10 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
11 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
12 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
13 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
14 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
15 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
16 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
17 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
18 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
19 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
20 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
21 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
22 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
23 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
24 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
25 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
26 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
27 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
28 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
29 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
30 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
31 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
32 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
33 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
34 0 0 - 0.0% - 0.0% - 0.0% - 0.0% 0
35 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
36 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
37 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
38 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
39 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
40 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
41 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
42 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
43 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
44 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
45 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
46 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
47 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
48 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
49 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
50 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
51 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
52 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
53 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
54 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
55 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
56 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
57 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
58 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
59 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
60 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
61 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
62 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
63 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
64 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
65 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
66 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
67 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
68 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
69 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
70 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
71 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
72 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
73 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
74 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
75 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
76 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
77 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
78 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
79 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
80 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
81 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
82 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
83 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
84 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
85 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
86 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
87 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
88 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
89 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
90 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
91 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
92 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
93 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
94 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
95 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
96 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
97 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
98 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
99 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
100 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
101 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
102 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
103 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
104 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
105 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
106 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
107 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
108 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
109 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
110 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
111 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
112 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
113 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
114 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
115 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
116 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
117 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
118 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
119 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
120 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
121 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
122 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
123 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
124 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
125 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
126 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
127 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
128 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
129 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
130 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
131 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
132 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
133 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
134 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
135 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
136 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
137 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
138 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
139 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
140 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
141 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
142 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
143 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
144 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
145 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
146 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
147 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
148 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
149 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
150 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
151 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
152 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
153 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
154 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
155 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
156 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
157 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
158 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
159 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
160 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
Total 282 50 17.7% - - 0.0% - - 0.0% 282 50 17.7% 4 4 - -
Jumlah dropper
terpakai

r
-
LAPORAN HARIAN PELAKSANAAN SUB PIN POLIO (HARI KE-6)

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Harian Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan Jumlah sisa vial
Jumlah Cakupan Harian Cakupan Harian Jumlah Cakupan Harian Total Sasaran dibawa terbuka/terpakai vaksin rusak
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 50 51.0% - 0.0% - 0.0% 98 50 51.0% 4 4 0 0
2 Posyandu Anyelir 2 Seumirah 70 0.0% - 0.0% - 0.0% 70 - 0.0% 0
3 posyandu Anyelir 3 Seumirah 69 0.0% - 0.0% - 0.0% 69 - 0.0% 0
4 Posyandu Anyelir 4 Seumirah 45 0.0% - 0.0% - 0.0% 45 - 0.0% 0
5 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
6 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
7 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
8 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
9 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
10 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
11 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
12 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
13 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
14 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
15 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
16 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
17 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
18 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
19 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
20 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
21 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
22 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
23 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
24 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
25 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
26 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
27 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
28 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
29 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
30 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
31 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
32 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
33 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
34 0 0 - 0.0% - 0.0% - 0.0% - 0.0% 0
35 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
36 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
37 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
38 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
39 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
40 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
41 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
42 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
43 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
44 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
45 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
46 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
47 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
48 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
49 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
50 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
51 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
52 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
53 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
54 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
55 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
56 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
57 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
58 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
59 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
60 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
61 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
62 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
63 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
64 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
65 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
66 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
67 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
68 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
69 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
70 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
71 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
72 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
73 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
74 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
75 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
76 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
77 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
78 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
79 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
80 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
81 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
82 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
83 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
84 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
85 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
86 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
87 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
88 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
89 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
90 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
91 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
92 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
93 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
94 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
95 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
96 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
97 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
98 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
99 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
100 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
101 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
102 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
103 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
104 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
105 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
106 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
107 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
108 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
109 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
110 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
111 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
112 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
113 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
114 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
115 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
116 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
117 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
118 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
119 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
120 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
121 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
122 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
123 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
124 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
125 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
126 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
127 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
128 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
129 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
130 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
131 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
132 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
133 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
134 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
135 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
136 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
137 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
138 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
139 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
140 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
141 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
142 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
143 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
144 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
145 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
146 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
147 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
148 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
149 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
150 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
151 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
152 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
153 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
154 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
155 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
156 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
157 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
158 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
159 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
160 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
Total 282 50 17.7% - - 0.0% - - 0.0% 282 50 17.7% 4 4 - -
Jumlah dropper
terpakai

r
-
LAPORAN HARIAN PELAKSANAAN SUB PIN POLIO (HARI KE-7)

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Harian Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan Jumlah sisa vial
Jumlah Cakupan Harian Cakupan Harian Jumlah Cakupan Harian Total Sasaran dibawa terbuka/terpakai vaksin rusak
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 50 51.0% - 0.0% - 0.0% 98 50 51.0% 4 4 0 0
2 Posyandu Anyelir 2 Seumirah 70 0.0% - 0.0% - 0.0% 70 - 0.0% 0
3 posyandu Anyelir 3 Seumirah 69 0.0% - 0.0% - 0.0% 69 - 0.0% 0
4 Posyandu Anyelir 4 Seumirah 45 0.0% - 0.0% - 0.0% 45 - 0.0% 0
5 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
6 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
7 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
8 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
9 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
10 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
11 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
12 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
13 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
14 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
15 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
16 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
17 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
18 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
19 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
20 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
21 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
22 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
23 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
24 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
25 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
26 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
27 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
28 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
29 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
30 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
31 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
32 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
33 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
34 0 0 - 0.0% - 0.0% - 0.0% - 0.0% 0
35 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
36 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
37 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
38 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
39 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
40 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
41 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
42 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
43 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
44 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
45 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
46 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
47 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
48 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
49 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
50 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
51 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
52 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
53 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
54 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
55 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
56 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
57 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
58 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
59 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
60 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
61 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
62 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
63 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
64 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
65 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
66 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
67 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
68 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
69 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
70 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
71 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
72 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
73 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
74 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
75 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
76 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
77 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
78 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
79 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
80 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
81 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
82 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
83 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
84 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
85 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
86 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
87 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
88 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
89 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
90 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
91 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
92 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
93 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
94 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
95 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
96 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
97 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
98 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
99 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
100 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
101 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
102 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
103 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
104 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
105 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
106 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
107 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
108 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
109 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
110 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
111 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
112 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
113 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
114 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
115 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
116 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
117 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
118 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
119 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
120 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
121 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
122 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
123 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
124 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
125 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
126 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
127 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
128 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
129 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
130 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
131 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
132 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
133 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
134 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
135 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
136 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
137 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
138 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
139 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
140 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
141 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
142 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
143 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
144 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
145 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
146 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
147 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
148 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
149 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
150 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
151 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
152 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
153 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
154 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
155 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
156 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
157 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
158 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
159 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
160 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
Total 282 50 17.7% - - 0.0% - - 0.0% 282 50 17.7% 4 4 - -
Jumlah dropper
terpakai

r
-
LAPORAN HARIAN PELAKSANAAN SUB PIN POLIO (SWEEPING HARI KE-1)

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Harian Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan Jumlah sisa vial
Jumlah Cakupan Harian Cakupan Harian Jumlah Cakupan Harian Total Sasaran dibawa terbuka/terpakai vaksin rusak
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 50 51.0% - 0.0% - 0.0% 98 50 51.0% 4 4 0 0
2 Posyandu Anyelir 2 Seumirah 70 0.0% - 0.0% - 0.0% 70 - 0.0% 0
3 posyandu Anyelir 3 Seumirah 69 0.0% - 0.0% - 0.0% 69 - 0.0% 0
4 Posyandu Anyelir 4 Seumirah 45 0.0% - 0.0% - 0.0% 45 - 0.0% 0
5 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
6 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
7 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
8 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
9 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
10 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
11 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
12 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
13 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
14 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
15 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
16 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
17 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
18 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
19 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
20 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
21 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
22 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
23 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
24 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
25 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
26 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
27 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
28 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
29 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
30 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
31 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
32 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
33 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
34 0 0 - 0.0% - 0.0% - 0.0% - 0.0% 0
35 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
36 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
37 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
38 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
39 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
40 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
41 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
42 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
43 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
44 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
45 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
46 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
47 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
48 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
49 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
50 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
51 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
52 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
53 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
54 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
55 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
56 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
57 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
58 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
59 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
60 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
61 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
62 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
63 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
64 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
65 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
66 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
67 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
68 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
69 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
70 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
71 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
72 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
73 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
74 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
75 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
76 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
77 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
78 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
79 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
80 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
81 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
82 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
83 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
84 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
85 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
86 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
87 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
88 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
89 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
90 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
91 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
92 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
93 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
94 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
95 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
96 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
97 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
98 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
99 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
100 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
101 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
102 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
103 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
104 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
105 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
106 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
107 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
108 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
109 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
110 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
111 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
112 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
113 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
114 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
115 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
116 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
117 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
118 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
119 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
120 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
121 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
122 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
123 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
124 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
125 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
126 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
127 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
128 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
129 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
130 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
131 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
132 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
133 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
134 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
135 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
136 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
137 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
138 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
139 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
140 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
141 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
142 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
143 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
144 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
145 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
146 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
147 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
148 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
149 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
150 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
151 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
152 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
153 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
154 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
155 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
156 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
157 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
158 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
159 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
160 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
Total 282 50 17.7% - - 0.0% - - 0.0% 282 50 17.7% 4 4 - -
Jumlah dropper
terpakai

r
-
LAPORAN HARIAN PELAKSANAAN SUB PIN POLIO (SWEEPING HARI KE-2)

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Harian Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan Jumlah sisa vial
Jumlah Cakupan Harian Cakupan Harian Jumlah Cakupan Harian Total Sasaran dibawa terbuka/terpakai vaksin rusak
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 50 51.0% - 0.0% - 0.0% 98 50 51.0% 4 4 0 0
2 Posyandu Anyelir 2 Seumirah 70 0.0% - 0.0% - 0.0% 70 - 0.0% 0
3 posyandu Anyelir 3 Seumirah 69 0.0% - 0.0% - 0.0% 69 - 0.0% 0
4 Posyandu Anyelir 4 Seumirah 45 0.0% - 0.0% - 0.0% 45 - 0.0% 0
5 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
6 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
7 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
8 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
9 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
10 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
11 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
12 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
13 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
14 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
15 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
16 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
17 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
18 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
19 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
20 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
21 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
22 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
23 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
24 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
25 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
26 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
27 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
28 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
29 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
30 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
31 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
32 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
33 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
34 0 0 - 0.0% - 0.0% - 0.0% - 0.0% 0
35 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
36 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
37 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
38 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
39 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
40 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
41 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
42 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
43 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
44 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
45 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
46 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
47 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
48 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
49 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
50 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
51 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
52 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
53 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
54 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
55 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
56 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
57 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
58 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
59 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
60 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
61 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
62 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
63 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
64 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
65 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
66 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
67 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
68 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
69 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
70 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
71 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
72 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
73 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
74 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
75 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
76 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
77 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
78 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
79 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
80 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
81 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
82 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
83 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
84 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
85 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
86 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
87 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
88 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
89 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
90 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
91 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
92 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
93 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
94 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
95 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
96 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
97 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
98 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
99 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
100 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
101 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
102 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
103 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
104 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
105 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
106 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
107 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
108 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
109 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
110 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
111 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
112 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
113 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
114 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
115 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
116 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
117 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
118 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
119 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
120 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
121 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
122 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
123 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
124 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
125 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
126 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
127 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
128 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
129 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
130 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
131 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
132 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
133 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
134 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
135 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
136 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
137 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
138 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
139 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
140 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
141 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
142 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
143 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
144 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
145 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
146 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
147 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
148 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
149 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
150 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
151 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
152 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
153 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
154 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
155 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
156 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
157 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
158 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
159 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
160 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
Total 282 50 17.7% - - 0.0% - - 0.0% 282 50 17.7% 4 4 - -
Jumlah dropper
terpakai

r
-
LAPORAN HARIAN PELAKSANAAN SUB PIN POLIO (SWEEPING HARI KE-3)

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Harian Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan Jumlah sisa vial
Jumlah Cakupan Harian Cakupan Harian Jumlah Cakupan Harian Total Sasaran dibawa terbuka/terpakai vaksin rusak
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 50 51.0% - 0.0% - 0.0% 98 50 51.0% 4 4 0 0
2 Posyandu Anyelir 2 Seumirah 70 0.0% - 0.0% - 0.0% 70 - 0.0% 0
3 posyandu Anyelir 3 Seumirah 69 0.0% - 0.0% - 0.0% 69 - 0.0% 0
4 Posyandu Anyelir 4 Seumirah 45 0.0% - 0.0% - 0.0% 45 - 0.0% 0
5 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
6 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
7 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
8 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
9 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
10 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
11 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
12 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
13 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
14 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
15 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
16 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
17 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
18 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
19 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
20 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
21 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
22 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
23 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
24 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
25 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
26 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
27 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
28 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
29 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
30 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
31 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
32 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
33 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
34 0 0 - 0.0% - 0.0% - 0.0% - 0.0% 0
35 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
36 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
37 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
38 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
39 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
40 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
41 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
42 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
43 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
44 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
45 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
46 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
47 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
48 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
49 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
50 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
51 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
52 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
53 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
54 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
55 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
56 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
57 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
58 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
59 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
60 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
61 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
62 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
63 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
64 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
65 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
66 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
67 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
68 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
69 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
70 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
71 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
72 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
73 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
74 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
75 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
76 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
77 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
78 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
79 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
80 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
81 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
82 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
83 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
84 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
85 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
86 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
87 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
88 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
89 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
90 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
91 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
92 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
93 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
94 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
95 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
96 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
97 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
98 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
99 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
100 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
101 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
102 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
103 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
104 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
105 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
106 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
107 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
108 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
109 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
110 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
111 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
112 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
113 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
114 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
115 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
116 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
117 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
118 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
119 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
120 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
121 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
122 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
123 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
124 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
125 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
126 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
127 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
128 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
129 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
130 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
131 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
132 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
133 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
134 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
135 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
136 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
137 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
138 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
139 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
140 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
141 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
142 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
143 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
144 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
145 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
146 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
147 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
148 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
149 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
150 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
151 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
152 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
153 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
154 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
155 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
156 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
157 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
158 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
159 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
160 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
Total 282 50 17.7% - - 0.0% - - 0.0% 282 50 17.7% 4 4 - -
Jumlah dropper
terpakai

r
-
LAPORAN HARIAN PELAKSANAAN SUB PIN POLIO (SWEEPING HARI KE-4)

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Harian Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan Jumlah sisa vial
Jumlah Cakupan Harian Cakupan Harian Jumlah Cakupan Harian Total Sasaran dibawa terbuka/terpakai vaksin rusak
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 50 51.0% - 0.0% - 0.0% 98 50 51.0% 4 4 0 0
2 Posyandu Anyelir 2 Seumirah 70 0.0% - 0.0% - 0.0% 70 - 0.0% 0
3 posyandu Anyelir 3 Seumirah 69 0.0% - 0.0% - 0.0% 69 - 0.0% 0
4 Posyandu Anyelir 4 Seumirah 45 0.0% - 0.0% - 0.0% 45 - 0.0% 0
5 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
6 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
7 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
8 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
9 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
10 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
11 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
12 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
13 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
14 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
15 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
16 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
17 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
18 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
19 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
20 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
21 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
22 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
23 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
24 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
25 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
26 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
27 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
28 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
29 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
30 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
31 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
32 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
33 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
34 0 0 - 0.0% - 0.0% - 0.0% - 0.0% 0
35 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
36 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
37 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
38 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
39 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
40 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
41 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
42 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
43 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
44 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
45 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
46 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
47 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
48 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
49 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
50 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
51 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
52 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
53 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
54 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
55 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
56 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
57 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
58 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
59 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
60 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
61 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
62 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
63 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
64 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
65 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
66 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
67 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
68 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
69 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
70 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
71 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
72 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
73 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
74 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
75 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
76 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
77 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
78 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
79 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
80 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
81 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
82 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
83 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
84 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
85 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
86 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
87 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
88 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
89 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
90 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
91 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
92 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
93 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
94 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
95 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
96 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
97 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
98 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
99 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
100 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
101 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
102 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
103 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
104 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
105 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
106 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
107 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
108 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
109 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
110 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
111 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
112 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
113 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
114 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
115 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
116 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
117 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
118 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
119 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
120 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
121 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
122 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
123 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
124 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
125 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
126 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
127 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
128 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
129 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
130 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
131 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
132 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
133 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
134 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
135 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
136 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
137 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
138 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
139 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
140 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
141 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
142 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
143 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
144 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
145 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
146 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
147 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
148 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
149 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
150 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
151 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
152 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
153 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
154 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
155 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
156 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
157 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
158 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
159 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
160 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
Total 282 50 17.7% - - 0.0% - - 0.0% 282 50 17.7% 4 4 - -
Jumlah dropper
terpakai

r
-
LAPORAN HARIAN PELAKSANAAN SUB PIN POLIO (HARI KE-5 SWEEPING )

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Harian Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan Jumlah sisa vial
Jumlah Cakupan Harian Cakupan Harian Jumlah Cakupan Harian Total Sasaran dibawa terbuka/terpakai vaksin rusak
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 50 51.0% - 0.0% - 0.0% 98 50 51.0% 4 4 0 0
2 Posyandu Anyelir 2 Seumirah 70 0.0% - 0.0% - 0.0% 70 - 0.0% 0
3 posyandu Anyelir 3 Seumirah 69 0.0% - 0.0% - 0.0% 69 - 0.0% 0
4 Posyandu Anyelir 4 Seumirah 45 0.0% - 0.0% - 0.0% 45 - 0.0% 0
5 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
6 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
7 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
8 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
9 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
10 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
11 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
12 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
13 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
14 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
15 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
16 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
17 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
18 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
19 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
20 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
21 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
22 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
23 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
24 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
25 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
26 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
27 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
28 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
29 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
30 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
31 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
32 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
33 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
34 0 0 - 0.0% - 0.0% - 0.0% - 0.0% 0
35 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
36 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
37 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
38 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
39 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
40 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
41 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
42 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
43 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
44 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
45 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
46 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
47 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
48 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
49 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
50 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
51 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
52 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
53 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
54 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
55 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
56 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
57 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
58 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
59 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
60 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
61 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
62 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
63 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
64 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
65 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
66 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
67 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
68 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
69 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
70 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
71 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
72 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
73 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
74 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
75 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
76 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
77 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
78 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
79 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
80 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
81 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
82 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
83 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
84 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
85 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
86 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
87 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
88 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
89 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
90 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
91 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
92 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
93 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
94 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
95 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
96 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
97 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
98 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
99 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
100 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
101 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
102 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
103 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
104 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
105 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
106 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
107 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
108 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
109 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
110 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
111 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
112 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
113 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
114 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
115 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
116 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
117 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
118 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
119 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
120 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
121 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
122 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
123 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
124 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
125 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
126 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
127 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
128 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
129 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
130 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
131 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
132 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
133 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
134 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
135 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
136 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
137 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
138 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
139 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
140 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
141 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
142 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
143 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
144 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
145 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
146 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
147 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
148 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
149 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
150 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
151 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
152 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
153 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
154 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
155 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
156 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
157 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
158 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
159 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
160 0 0 - 0.0% - 0.0% - 0.0% - - 0.0% 0
Total 282 50 17.7% - - 0.0% - - 0.0% 282 50 17.7% 4 4 - -
Jumlah dropper
terpakai

r
4
4
LAPORAN KUMULATIF PELAKSANAAN SUB PIN POLIO

Puskesmas : UPTD PUSKESMAS NISAM ANTARA


Kabupaten/ Kota : ACEH UTARA
Provinsi : ACEH
Laporan tanggal :
(Mohon isi pada kolom yang berwarna kuning)
SASARAN DAN CAKUPAN IMUNISASI
Usia 0-59 bulan Usia 5 - <7 thn Usia 7- 12 thn Total Cakupan Kumulatif Jumlah vial vaksin Jumlah vial vaksin Jumlah vial
No Nama Pos Pelayanan Desa/Kelurahan dibawa terbuka/terpakai vaksin rusak Jumlah sisa vial
Jumlah Cakupan Kumulatif Cakupan Kumulatif Jumlah Cakupan Kumulatif Total Sasaran
Jumlah sasaran Absolut %
sasaran Absolut % Absolut % sasaran Absolut %
a b b c d e f g h i j k l m n o p q q
1 Posyandu Anyelir 1 Seumirah 98 623 635.7% - - 0.0% - - 0.0% 98 623 635.7% 46 46 0 0
2 Posyandu Anyelir 2 Seumirah 70 55 78.6% - - 0.0% - - 0.0% 70 55 78.6% 2 2 0 0
3 posyandu Anyelir 3 Seumirah 69 56 81.2% - - 0.0% - - 0.0% 69 56 81.2% 2 2 0 0
4 Posyandu Anyelir 4 Seumirah 45 38 84.4% - - 0.0% - - 0.0% 45 38 84.4% 1 1 0 0
5 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
6 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
7 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
8 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
9 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
10 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
11 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
12 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
13 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
14 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
15 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
16 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
17 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
18 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
19 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
20 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
21 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
22 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
23 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
24 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
25 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
26 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
27 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 0 0 0
29 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
30 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
31 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
32 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
33 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
34 0 0 - - 0.0% - - 0.0% - - 0.0% - 0.0% 0 0 0 0
35 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
36 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
37 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
38 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
39 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
40 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
41 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
42 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
43 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
44 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
45 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
46 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
47 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
48 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
49 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
50 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
51 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
52 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
53 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
54 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
55 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
56 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
57 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
58 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
59 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
60 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
61 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
62 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
63 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
64 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
65 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
66 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
67 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
68 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
69 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
70 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
71 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
72 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
73 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
74 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
75 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
76 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
77 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
78 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
79 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
80 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
81 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
82 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
83 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
84 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
85 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
86 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
87 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
88 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
89 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
90 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
91 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
92 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
93 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
94 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
95 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
96 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
97 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
98 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
99 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
100 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
101 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
102 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
103 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
104 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
105 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
106 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
107 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
108 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
109 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
110 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
111 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
112 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
113 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
114 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
115 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
116 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
117 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
118 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
119 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
120 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
121 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
122 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
123 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
124 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
125 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
126 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
127 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
128 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
129 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
130 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
131 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
132 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
133 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
134 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
135 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
136 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
137 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
138 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
139 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
140 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
141 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
142 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
143 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
144 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
145 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
146 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
147 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
148 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
149 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
150 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
151 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
152 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
153 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
154 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
155 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
156 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
157 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
158 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
159 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
160 0 0 - - 0.0% - - 0.0% - - 0.0% - - 0.0% 0 0 0 0
Total 282 772 273.8% - - 0.0% - - 0.0% 282 772 273.8% 51 51 - -
Jumlah stok awal Jumlah dropper Jumlah sisa
dropper terpakai dropper

r s t
2 6 -4
2 2 0
2 2 0
Err:509 1 Err:509
1 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 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
Err:509

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