12 Rekapitulasi Panimbo Jadi

DAFTAR HASIL REKAPITULASI FAKTOR RESIKO LINGKUNGAN
RUMAH
NO
FAKTOR RESIKO 1 2 3 4 5 6 7
A FAKTOR RESIKO DEMAM

BERDARAH
Observasi
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
JUMLAH FAKTOR RISIKO 0 0 0 0 0 0 0
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 1 1 1 1 1 1 1
4 Observasi/Pertanyaan 0 0 0 0 0 0 0
5 Observasi 1 1 1 1 1 1 1
6 Observasi 0 0 0 0 0 0 0
7 Observasi 0 0 0 0 0 0 0
JUMLAH FAKTOR RISIKO FLU 2 2 2 2 2 2 2
BURUNG
1 1 1 1 1 1 1
C FAKTOR RESIKO DIARE
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
1 1 1 1 1 1 1
JUMLAH FAKTOR RISIKO DIARE
1 1 1 1 1 1 1
D FAKTOR RESIKO PENYAKIT

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi 1 1 1 1 1 1 1
PENYAKIT LEPTOSPIROSIS
1 1 1 1 1 1 1
E FAKTOR RESIKO PENYAKIT

KUSTA
RUMAH
NO
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0
F FAKTOR RESIKO PENYAKIT

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
G FAKTOR RISIKO TB PARU
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 1 1 0 0
2 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 1 1 1 1 0 0 0
f 1 0 1 1 0 1 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
JUMLAH FAKTOR RISIKO TB 2 1 2 3 1 1 0
PARU
1 1 1 1 1 1 0
H FAKTOR RISIKO KEMATIAN

IBU
1 Gejala dan tanda ibu hamil
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
2 Gejala dan tanda ibu nifas 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
RUMAH
NO
b 0 0 0 0 0 0 0
c 1 1 0 1 1 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 1 1 0 1 0 0 0
h 0 0 0 0 1 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
1 1 0 1 1 0 0
I FAKTOR RISIKO KEMATIAN

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0
J FAKTOR RISIKO GIZI

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 1 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 1 0 0
JUMLAH FAKTOR GIZI BURUK
0 0 0 0 1 0 0
K FAKTOR RISIKO KESEHATAN

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 1 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
RUMAH
NO
7 1 1 0 1 1 0 0
8 0 0 0 0 0 0 0
PERILAKU YG
K.2. MENUNJUKKAN TANDA
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
1 1 0 1 1 1 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 1 1 1 1 1 1 1
5 1 1 1 1 1 1 1
6 0 0 0 0 0 0 0
JUMLAH OBSERVASI FAKTOR 2 2 2 2 2 2 2
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
RUMAH
NO
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
ULASI FAKTOR RESIKO LINGKUNGAN
RUMAH
JUMLAH
8 9 10
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
0 0 0 0 0
2 2 2
1 1 1
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
1 1 1
1 1 1
0
0
1 1 1 10 1
1 1 1 10 1
2 2 2
1 1 1
0
RUMAH
JUMLAH
8 9 10
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 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 4 1
1 1 0 6 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 0
1 1 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
RUMAH
JUMLAH
8 9 10
0 0 0 0 0
0 0 0 4 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 0 0 4 1
0 0 0 1 1
0 0 0 0 0
1 0 0
1 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
RUMAH
JUMLAH
8 9 10
1 0 0 5 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
1 0 0
1 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
1 1 1 10 1
0 0 0 0 0
2 2 2
1 1 1
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
RUMAH
JUMLAH
8 9 10
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
RUMAH
NO

BERDARAH
Observasi
1 0 0 1 1 0 0 1
2 0 0 0 0 0 0 0
DEMAM BERDARAH
0 0 1 1 0 0 1
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 0 0 1 0 1 1 1
5 Observasi 0 0 1 0 1 1 1
6 Observasi 0 1 1 0 1 1 1
7 Observasi 0 1 0 0 0 0 0
BURUNG
0 1 1 0 1 1 1
1 0 0 0 0 0 0 1
2 0 1 1 0 1 0 0
3 Observasi
0 0 0 0 0 0 0
1 1 1 1 1 1 1
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
2 3 3 2 3 2 3
1 1 1 1 1 1 1

LEPTOSPIROSIS
1 1 1 1 0 0 1 1
2 Observasi 0 0 0 0 0 0 0
1 1 1 0 0 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 1 0 1 0 1 1 1
d 0 0 0 0 0 0 0
e 1 1 1 1 1 1 1
f 1 1 1 1 0 1 1
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
PARU
1 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 1 0 0 1 0 0
KEMATIAN IBU
0 1 0 0 1 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 1 1 1 1 1 1 1
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 1
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
DBD FLU BURUNG DIARE
5 8 10
1 0 1 5 1
0 0 0 0 0
1 0 1
1 0 1 5
0 0 0 0 0
0 0 0 0 0
1 1 1 7 1
0 0 1 6 1
1 1 1 7 1
1 0 1 7 1
0 0 0 1 1
3 2 4
1 1 1 8
0
0 0 0 1 1
0 0 0 3 1
0 0 0 0
0 0 1 8 1
0 0 0 0 0
0 0 1 0 0
1 1 1 10 1
1 1 3
1 1 1 10
0
0
1 1 1 8 1
1 1 0 2 1
2 2 1
1 1 1 8
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
1 0 1 7 1
0 0 0 0 0
1 1 1 10 1
0 0 1 7 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
2 1 3
1 1 1 10
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 1
0 0 0
0 0 0 2
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
0 0 0 0 0
1 1 1
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
JUMLAH RUMAH DENGAN FAKTOR RESIKO
LEPTO KUSTA ANTRAX TB PARU AKI AKB GIBUR KESWA LINGK

8 0 0 10 2 0 0 0 10
RUMAH
NO

BERDARAH
Observasi
1 1 0 0 0 0 0 0
2 0 0 0 0 1 0 0
DEMAM BERDARAH
1 0 0 0 1 0 0
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 1 0 0
2 0 1 0 0 0 0 1
3 Observasi 1 1 0 1 0 0 0
5 Observasi 1 0 0 0 0 0 0
6 Observasi 1 0 0 0 0 0 0
7 Observasi 0 1 0 1 0 0 0
BURUNG
1 1 0 1 1 0 1
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 1 1 1 1 1
0 0 1 1 1 1 1

LEPTOSPIROSIS
1 1 1 1 1 1 1 0
2 Observasi 1 1 1 1 1 1 1
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 1 0 1 0 1 1 1
f 0 1 1 1 0 1 1
g 0 1 1 1 1 1 1
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
PARU
1 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 1 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
0 0 0 1 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 1 1 1 1 1 1 1
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
3 5 8
0 1 0 2 1
0 0 0 1 1
0 1 0
0 1 0 3
0 0 0 1 1
0 0 0 2 1
0 0 0 3 1
0 0 0 0 0
0 0 0 1 1
0 0 0 1 1
0 0 0 2 1
0 0 0
0 0 0 5
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 8 1
1 1 1
1 1 1 8
0
0
1 1 1 9 1
1 1 1 10 1
2 2 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 8 1
0 1 0 6 1
1 1 0 8 1
0 0 0 0 0
0 0 0 0 0
2 3 1
1 1 1 10
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 1
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
0 0 0 0 0
1 1 1
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 10 1 0 0 0 10
RUMAH
NO

BERDARAH
Observasi
1 1 0 0 0 0 0 1
2 0 0 0 0 0 0 0
DEMAM BERDARAH
1 0 0 0 0 0 1
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 1 0 0 0 0 0
3 Observasi 0 1 0 0 0 0 0
5 Observasi 0 1 0 0 0 0 0
6 Observasi 0 1 0 0 0 0 0
7 Observasi 0 0 0 0 0 0 0
BURUNG
0 1 0 0 0 0 0
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
1 1 1 1 1 0 0
0 0 0 0 0 0 0
4 Observasi
0 0 0 0 0 0 0
0 0 1 0 0 0 1
2 2 3 2 2 1 2
1 1 1 1 1 1 1

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi 1 1 1 1 1 1 1
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 0 0 1 0 0 1 0
b 0 0 1 0 0 1 0
c 0 1 1 1 0 1 1
d 0 0 0 0 0 0 0
e 0 0 1 0 0 0 1
f 0 0 0 1 1 1 1
g 0 0 0 0 0 0 0
h 0 0 0 1 0 0 0
i 0 0 0 0 0 0 0
PARU
0 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 0 0
2 0 0 1 0 1 0 0
3 0 0 0 0 0 0 0
4 1 1 1 1 1 1 1
5 0 0 0 0 0 0 0
6 0 0 1 0 0 1 0
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
4 1 9
1 1 0 4 1
0 0 0 0 0
1 1 0
1 1 0 4
0 0 0 0 0
0 0 0 1 1
0 0 0 1 1
0 0 0 1 1
0 0 0 1 1
0 0 0 1 1
0 0 0 0 0
0 0 0
0 0 0 1
0
0 0 0 0 0
0 0 0 0 0
1 1 0 7 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 0 9 1
2 2 0
1 1 0 9
0
0
1 1 1 10 1
1 1 1 10 1
2 2 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
1 0 0 3 1
1 0 0 3 1
0 1 1 7 1
0 0 0 0 0
0 0 0 2 1
0 0 0 4 1
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
2 1 1
1 1 1 9
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 1 1 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 1
0 0 1 1
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 1 2 1
0 1 1
0 1 1 2
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
1 0 0 3 1
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
1 0 0 3 1
3 1 1
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 9 1 0 2 0 10
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
4 Observasi/Pertanyaan
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
2 Gejala dan tanda ibu nifas
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
RUMAH
NO

BERDARAH
Observasi
1 0 1 0 0 0 0 0
2 0 0 0 0 0 0 0
DEMAM BERDARAH
0 1 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 0 1 1 0 0 0 1
5 Observasi 1 1 1 0 1 1 1
6 Observasi 1 1 1 0 1 0 1
7 Observasi 0 1 1 0 0 0 1
BURUNG
1 1 1 0 1 1 1
1 1 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 1 0
4 Observasi
0 0 0 0 0 0 0
1 1 1 0 0 1 0
3 2 2 1 1 3 1
1 1 1 1 1 1 1

LEPTOSPIROSIS
1 1 1 1 0 1 1 0
2 Observasi 1 1 1 0 0 1 0
1 1 1 0 1 1 0

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 0 0 0 0 1 1 0
b 0 1 0 0 1 1 0
c 1 1 0 0 1 0 0
d 0 0 0 0 0 0 0
e 1 1 0 1 1 1 1
f 0 1 0 1 1 1 1
g 1 1 1 1 1 1 1
h 1 1 1 1 1 1 1
i 0 0 0 0 0 0 0
PARU
1 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 1 1 1 1 1 1 1
5 0 0 0 0 0 0 0
6 0 1 0 0 1 1 0
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 1 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 1 1 1 1 1 1 1
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
3 9 10
0 1 1 3 1
0 0 0 0 0
0 1 1
0 1 1 3
0 0 0 0 0
0 0 0 0 0
1 1 1 6 1
0 0 1 1 1
1 1 1 9 1
1 0 1 7 1
1 1 0 5 1
4 3 4
1 1 1 9
0
0 0 0 1 1
1 0 0 1 1
0 0 0 0 0
1 1 1 4 1
0 0 0 0 0
1 1 1 0 0
1 1 1 10 1
4 3 3
1 1 1 10
0
0
1 1 1 8 1
1 0 0 5 1
2 1 1
1 1 1 8
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
1 1 0 4 1
1 1 0 5 1
1 1 1 6 1
0 0 0 0 0
1 1 1 9 1
1 0 1 7 1
1 1 1 10 1
1 1 1 10 1
0 0 0 0 0
7 6 5
1 1 1 10
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
1 0 0 1 1
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
1 1 0 5 1
3 2 1
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1

8 0 0 10 0 0 0 0 10
Pelaksana : Damhid
RUMAH
NO

BERDARAH
Observasi
1 0 0 0 1 0 1 0
2 0 1 0 0 0 0 0
DEMAM BERDARAH
0 1 0 1 0 1 0
B FAKTOR RESIKO FLU

BURUNG
1 0 1 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 1 1 1 1 1 1 1
5 Observasi 1 1 1 1 1 1 1
6 Observasi 1 1 1 1 1 1 1
7 Observasi 0 0 0 0 0 0 0
BURUNG
1 1 1 1 1 1 1
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
4 Observasi
0 0 0 0 0 0 0
1 1 1 1 1 1 1
1 1 1 1 1 1 1
1 1 1 1 1 1 1

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi 0 0 1 1 1 1 1
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 0 0 0 1 1 1 0
b 0 0 0 1 1 1 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 1 0 1 1 1
g 0 0 0 0 0 0 0
h 0 1 0 0 1 1 1
i 0 0 0 0 0 0 0
PARU
0 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 1 1 1 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
1 1 1 0 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 1 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 1 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 1 1 1 1
LINGKUNGAN
0 0 0 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
5 10 10
0 1 1 4 1
0 0 0 1 1
0 1 1
0 1 1 5
0 0 0 1 1
0 0 0 0 0
1 1 1 10 1
1 1 1 10 1
1 1 1 10 1
1 1 1 10 1
0 0 0 0 0
4 4 4
1 1 1 10
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
1 1 1
1 1 1 10
0
0
1 1 1 10 1
1 1 1 8 1
2 2 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0 1 1 5 1
1 1 0 5 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 0 5 1
0 0 0 0 0
0 1 1 6 1
0 0 0 0 0
1 4 2
1 1 1 9
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 3 1
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 3
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0
0 0 0 1
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 0 5 1
0 1 0
0 1 0 5
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 9 3 1 0 0 5
Pelaksana : Subaeah
RUMAH
NO

BERDARAH
Observasi
1 1 1 1 1 1 1 1
2 0 0 0 0 0 0 0
DEMAM BERDARAH
1 1 1 1 1 1 1
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 1 1 1 1 1 1 1
5 Observasi 0 0 0 0 0 0 0
6 Observasi 1 1 1 1 1 1 1
7 Observasi 0 0 0 0 0 0 0
BURUNG
1 1 1 1 1 1 1
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi 1 1 1 1 1 1 1
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 1 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 1 1 0 1 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
PARU
0 1 1 1 0 1 0

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 1 1 1 1 1 1 1
5 0 0 0 0 0 0 0
6 1 1 1 1 1 1 1
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
10 10 0
1 1 1 10 1
0 0 0 0 0
1 1 1
1 1 1 10
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
2 2 2
1 1 1 10
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
1 1 1 10 1
1 1 1 10 1
2 2 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 3 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 4
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
1 1 1 10 1
2 2 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 4 0 0 0 0 10
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
RUMAH
NO

BERDARAH
Observasi
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 1 1 1 1 0 1 1
5 Observasi 1 1 1 1 0 1 1
6 Observasi 1 1 1 1 0 1 1
7 Observasi 1 1 1 1 0 1 1
BURUNG
1 1 1 1 0 1 1
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
1 1 1 1 1 0 1
1 1 1 1 1 0 1

LEPTOSPIROSIS
1 1 1 1 1 0 1 1
2 Observasi 1 1 1 1 1 1 1
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 1 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 1 0 0 0 0
d 0 1 0 0 0 0 0
2 Faktor Risiko
a 1 0 0 0 0 0 1
b 1 0 0 0 0 0 1
c 1 1 1 1 0 1 1
d 0 0 0 0 0 0 0
e 1 1 1 1 1 1 1
f 0 1 1 1 1 1 1
g 0 0 0 0 0 0 0
h 1 0 0 0 0 0 1
i 0 0 0 0 0 0 0
PARU
1 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 1 0 0 1
4 1 0 0 1 0 0 1
5 0 0 0 0 0 0 1
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
1 0 0 1 0 0 1

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 1
6 0 0 0 0 0 0 0
7 1 0 0 0 0 0 1
8 1 0 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 1
14 0 0 0 0 0 0 0
KESEHATAN JIWA
1 0 0 0 0 0 1
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 1
3 0 0 0 0 0 0 0
4 1 1 1 1 1 1 1
5 0 0 0 0 0 0 0
6 1 0 0 0 0 0 1
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 1 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 9 9
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 9 1
1 1 1 9 1
1 1 1 9 1
1 1 1 9 1
1 1 1 9 1
5 5 5
1 1 1 9
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 9 1
1 1 1
1 1 1 9
0
0
1 0 1 8 1
1 1 1 10 1
2 1 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 1 1
0 1 0 1 1
0 0 0 1 1
0 0 0 1 1
0
1 0 0 3 1
1 0 0 3 1
0 1 1 8 1
0 0 0 0 0
1 1 1 10 1
1 1 1 9 1
0 0 0 0 0
1 0 0 3 1
0 0 0 0 0
5 4 3
1 1 1 10
0
0
1
0 0 0 0 0
0 1 0 1 1
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 0
0 1 0 1
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 1
0 0 0 3 1
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 3
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 2 1
0 0 0 1 1
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 0 2 1
0 0 0 0 0
0 1 0
0 1 0 3
0
0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
0 0 0 2 1
1 1 1
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 10 1 3 0 3 10
RUMAH
NO

BERDARAH
Observasi
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 0 0 0 0 0 0 0
5 Observasi 1 1 1 1 1 1 1
6 Observasi 1 1 1 1 1 1 1
7 Observasi 0 0 0 0 0 0 0
BURUNG
1 1 1 1 1 1 1
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
0 0 0 0 0 0 0
1 1 1 1 1 1 1
4 Observasi
0 0 0 0 0 0 0
1 1 1 1 1 1 1
3 3 3 3 3 3 3
1 1 1 1 1 1 1

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi 1 1 1 1 1 1 1
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 1 1 1 1 1 1 1
b 1 1 1 1 1 1 1
c 1 1 1 1 1 1 1
d 0 0 0 0 0 0 0
e 1 1 1 1 1 1 1
f 1 1 1 1 1 1 1
g 0 0 0 0 0 0 0
h 1 1 1 1 1 1 1
i 0 0 0 0 0 0 0
PARU
1 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 1 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
0 0 0 1 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 1 0 0 0
0 0 0 1 0 0 0
0 0 0 1 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 0 0
2 1 1 1 1 1 1 1
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 1 1 1 1 1 1 1
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 8 10
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 0 0 8 1
1 0 0 8 1
0 0 0 0 0
2 0 0
1 0 0 8
0
0 0 0 0 0
0 0 0 0 0
0 0 0
1 1 0 9 1
0 0 0 0 0
1 1 1 10 1
1 1 1 10 1
3 3 2
1 1 1 10
0
0
1 1 1 10 1
1 1 1 10 1
2 2 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
1 1 1 10 1
1 1 1 10 1
1 1 1 10 1
0 0 0 0 0
1 1 1 10 1
1 1 1 10 1
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
6 6 6
1 1 1 10
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 1 0 2 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 1 0
0 1 0 2
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0
0 0 0 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
1 1 1 10 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
2 2 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 10 2 0 1 0 10
RUMAH
NO

BERDARAH
Observasi
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 0 0 0 0 0 0 0
5 Observasi 1 1 1 1 1 1 1
6 Observasi 1 1 1 1 1 1 1
7 Observasi 1 1 1 1 0 1 0
BURUNG
1 1 1 1 1 1 1
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
0 0 0 0 0 0 0
1 1 1 1 1 1 1
4 Observasi
0 0 0 0 0 0 0
1 1 1 1 1 1 1
3 3 3 3 3 3 3
1 1 1 1 1 1 1

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi 1 1 1 1 1 1 1
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 1 1 1 1 1 1 1
b 1 1 1 1 1 1 1
c 1 1 1 1 1 1 1
d 0 0 0 0 0 0 0
e 1 1 1 1 1 1 1
f 1 1 1 1 1 1 1
g 1 1 1 1 1 1 1
h 1 1 1 1 1 1 1
i 0 0 0 0 0 0 0
PARU
1 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 1 1 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
0 0 0 0 1 1 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 1 1 1 1 1 1 1
2 1 1 1 1 1 1 1
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 1 1 1 1 1 1 1
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 8 10
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 0 0 8 1
1 0 0 8 1
1 0 0 8 1
1 0 0 6 1
4 0 0
1 0 0 8
0
0 0 0 0 0
0 0 0 0 0
0 0 0
1 1 0 9 1
0 0 0 0 0
1 1 1 10 1
1 1 1 10 1
3 3 2
1 1 1 10
0
0
1 1 1 10 1
1 1 1 10 1
2 2 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
1 1 1 10 1
1 1 1 10 1
1 1 1 10 1
0 0 0 0 0
1 1 1 10 1
1 1 1 10 1
1 1 1 10 1
1 1 1 10 1
0 0 0 0 0
7 7 7
1 1 1 10
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 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 2
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
1 1 1 10 1
1 1 1 10 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
3 3 3
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 10 2 0 0 0 10
RUMAH
NO

BERDARAH
Observasi
1 0 0 0 0 1 1 0
2 0 1 0 0 1 1 0
DEMAM BERDARAH
0 1 0 0 1 1 0
B FAKTOR RESIKO FLU

BURUNG
1 0 1 0 0 1 1 0
2 0 0 0 0 0 0 0
3 Observasi 0 1 0 1 1 0 0
5 Observasi 0 0 0 0 0 0 0
6 Observasi 0 0 0 0 0 0 0
7 Observasi 0 0 0 0 1 0 0
BURUNG
0 1 0 1 1 1 0
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
0 0 0 0 0 0 0
1 1 1 1 1 1 1
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
1 1 1 1 1 1 1
1 1 1 1 1 1 1

LEPTOSPIROSIS
1 0 0 1 0 1 0 0
2 Observasi 1 1 1 1 1 1 1
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 1 1 1 1 1 1 1
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 1 1 0 1 0 0 1
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 1 1 0
PARU
1 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 1 0 1 0 0
0 0 1 0 1 0 0
0 0 1 0 1 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 1 1 1 1 0
6 0 0 0 0 0 0 0
7 0 0 0 1 0 1 0
8 0 0 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 1 0 0 0 0 0 0
5 1 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
1 0 1 1 1 1 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 1 1 1 1 1 1 1
5 1 1 1 1 1 1 1
6 0 0 0 0 0 0 0
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 1 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
5 5 9
0 0 1 3 1
1 0 0 4 1
1 0 1
1 0 1 5
1 0 0 4 1
0 0 0 0 0
0 0 0 3 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
1 0 0
1 0 0 5
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 1 1 9 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 1
0 1 1 9
0
0
0 0 0 2 1
1 1 1 10 1
1 1 1
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
0 0 0 0 0
0 0 1 5 1
0 0 0 0 0
0 0 0 0 0
0 0 1 3 1
1 1 3
1 1 1 10
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 1
0 0 0
0 0 0 2
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 0 0 5 1
0 0 0 0 0
1 0 0 3 1
1 0 0 1 1
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
3 0 0
1 0 0 6
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
1 1 1 10 1
0 0 0 0 0
2 2 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 10 0 0 2 6 10
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
RUMAH
NO

BERDARAH
Observasi
1 0 1 0 0 0 0 0
2 0 0 0 0 0 0 0
DEMAM BERDARAH
0 1 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 1 1 0 0 1 0 0
5 Observasi 0 0 0 0 0 0 0
6 Observasi 0 0 0 0 0 0 0
7 Observasi 0 1 0 0 0 0 0
BURUNG
1 1 0 0 1 0 0
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
1 1 0 0 1 0 1
1 1 0 0 1 0 1

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi 1 1 1 1 1 1 1
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 0 0 0 0 1 0 0
b 0 0 0 0 1 0 0
c 0 1 0 1 1 0 1
d 0 0 0 0 0 0 0
e 0 1 0 0 1 0 1
f 0 0 0 0 0 1 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
PARU
0 1 0 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 1 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 1 0 0 0
KEMATIAN IBU
0 0 0 1 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 1 0 0
2 1 1 0 0 1 0 1
3 0 0 0 0 0 0 0
4 1 1 1 1 1 1 1
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
1 5 7
0 0 0 1 1
0 0 0 0 0
0 0 0
0 0 0 1
0 0 0 0 0
0 0 0 0 0
1 1 0 5 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 0 3 1
2 2 0
1 1 0 5
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 7 1
1 1 1
1 1 1 7
0
0
1 1 1 10 1
1 1 1 10 1
2 2 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
1 1 1 4 1
1 1 0 3 1
1 1 1 7 1
0 0 0 0 0
1 1 1 6 1
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
4 4 3
1 1 1 8
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0
0 0 0 1
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 1 1
1 1 1 7 1
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
0 0 0 0 0
2 2 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 8 1 0 0 0 10
RUMAH
NO

BERDARAH
Observasi
1 0 1 0 0 0 0 0
2 0 0 0 0 0 0 0
DEMAM BERDARAH
0 1 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 1 1 1 1 1 0 1
5 Observasi 1 1 1 1 1 0 1
6 Observasi 0 0 0 0 0 0 0
7 Observasi 1 1 0 1 0 0 1
BURUNG
1 1 1 1 1 0 1
1 0 0 0 0 0 0 0
2 0 0 0 1 0 1 0
3 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
4 Observasi
0 0 0 0 0 0 0
1 1 1 1 1 1 1
2 2 2 3 2 3 2
1 1 1 1 1 1 1

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi 1 1 1 1 1 1 1
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 0 1 0 0 0 0 0
b 0 1 1 0 0 0 0
c 0 1 1 1 0 0 1
d 0 0 0 0 0 0 0
e 1 1 1 1 1 1 1
f 0 0 1 1 1 1 1
g 0 1 1 1 0 0 1
h 0 1 1 0 0 0 0
i 0 0 0 0 0 0 0
PARU
1 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 1 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
1 0 0 0 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 1 0
0 0 0 0 0 1 0
0 0 0 0 0 1 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 1 0 0 0 0 0
6 1 0 0 0 0 0 0
7 0 1 0 0 0 0 0
8 0 1 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
1 1 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 1 0 0 0 0 0
2 1 1 1 1 1 1 1
3 0 0 0 0 0 0 0
4 1 1 1 1 1 1 1
5 0 0 0 0 0 0 0
6 1 1 1 1 0 1 1
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 1
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
1
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
1 9 10
0 0 0 1 1
0 0 0 0 0
0 0 0
0 0 0 1
0 0 0 0 0
0 0 0 0 0
1 1 1 9 1
1 1 1 9 1
1 1 1 9 1
0 0 0 0 0
1 1 1 7 1
4 4 4
1 1 1 9
0
0 0 0 0 0
0 0 0 2 1
0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
1 1 1 10 1
2 2 2
1 1 1 10
0
0
1 1 1 10 1
1 1 1 10 1
2 2 2
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
1 0 0 1 1
1 0 0 1 1
1 0 0 1 1
1 0 0 1 1
0
0 0 0 1 1
0 0 0 2 1
1 1 1 7 1
0 0 0 0 0
1 1 1 10 1
1 1 1 8 1
1 1 1 7 1
0 0 0 2 1
0 0 0 0 0
8 4 4
1 1 1 10
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 1
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0
0 0 0 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 1 1
0 0 0 1 1
0 0 0 1 1
0 0 0 1 1
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 2
0
0
0 0 0 1 1
1 1 1 10 1
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
1 1 1 9 1
3 3 3
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
1 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 10 1 0 1 2 10
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
DBD FLU BURU DIARE LEPTO KUSTA ANTRAX TB PARU AKI

RT 1 0 10 10 10 0 0 8 5
RT 2 5 8 10 8 0 0 10 2
RT 3 3 5 8 10 0 0 10 1
RT 4 4 1 9 10 0 0 9 1
RT 5 0 0 0 0 0 0 0 0
RT 6 0 0 0 0 0 0 0 0
RW 1 12 24 37 38 0 0 37 9
RT 1 3 9 10 8 0 0 10 0
RT 1.2 (b) 0 0 0 0 0 0 0 0
RT 2 5 10 10 10 0 0 9 3
RT 3 10 10 0 10 0 0 4 0
RT 4 0 0 0 0 0 0 0 0
RT 5 0 0 0 0 0 0 0 0
RW 2 18 29 20 28 0 0 23 3
RT 1 0 9 9 10 0 0 10 1
RT 2 0 8 10 10 0 0 10 2
RT 2.3(b) 0 0 0 0 0 0 0 0
RT 3 0 8 10 10 0 0 10 2
RT 4 5 5 9 10 0 0 10 0
RT 5 0 0 0 0 0 0 0 0
RW 3 5 30 38 40 0 0 40 5
RT 1 1 5 7 10 0 0 8 1
RT 2 1 9 10 10 0 0 10 1
RT 8 0 0 0 0 0 0 0 0
RW 4 2 14 17 20 0 0 18 2
RT 1 0 10 10 10 0 0 10 1
RT 2 3 10 10 10 0 0 10 0
RT 3 4 10 10 10 0 0 10 1
RT 4 7 9 0 10 0 0 10 0
RT 5 8 10 0 10 0 0 10 0
RW 5 22 49 30 50 0 0 50 2
59 146 142 176 0 0 168 21
TOR RESIKO
AKB GIBUR KESWA LINGK

0 1 6 10
0 0 0 10
0 0 0 10
0 2 0 10
0 0 0 0
0 0 0 0
0 3 6 40
0 0 0 10
0 0 0 0
1 0 0 5
0 0 0 10
0 0 0 0
0 0 0 0
1 0 0 25
3 0 3 10
0 1 0 10
0 0 0 0
0 0 0 10
0 2 6 10
0 0 0 0
3 3 9 40
0 0 0 10
0 1 2 10
0 0 0 0
0 1 2 20
0 0 6 10
0 1 3 10
0 0 7 10
0 0 0 10
0 0 0 10
0 1 16 50
4 8 33 175
JUMLAH RUMAH DENGAN FAKTOR RESIKO DESA PANIMBO
Dusun DBD FLU BURUNG DIARE LEPTO KUSTA ANTRAX TB PARU AKI AKB GIBUR KESWA LINGK
RW 1 12 24 37 38 0 0 37 9 0 3 6 40
RW 2 18 29 20 28 0 0 23 3 1 0 0 25
RW 3 5 30 38 40 0 0 40 5 3 3 9 40
RW 4 2 14 17 20 0 0 18 2 0 1 2 20
RW 5 22 49 30 50 0 0 50 2 0 1 16 50
59 146 142 176 0 0 168 21 4 8 33 175
Pelaksana : Muslimin
RUMAH
NO

BERDARAH
Observasi
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 1 1 1 1 1 1 1
5 Observasi 1 1 1 1 1 1 1
6 Observasi 1 1 1 1 1 1 1
7 Observasi 1 1 1 1 1 1 1
BURUNG
1 1 1 1 1 1 1
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
4 Observasi
0 0 0 0 0 0 0
1 1 1 1 1 1 1
2 2 2 2 2 2 2
1 1 1 1 1 1 1

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi 0 0 0 0 0 0 0
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 1 1 1 1
c 0 0 0 1 1 1 1
d 0 0 0 0 0 0 0
e 1 1 1 1 1 1 1
f 0 0 0 1 0 0 1
g 0 0 0 0 0 0 0
h 0 0 0 0 1 1 1
i 0 0 0 0 0 0 0
PARU
1 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 1 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 1 0 1 0 0
8 0 0 0 0 0 1 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
0 1 1 0 1 1 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 1 1 1 1 1 1 1
4 1 0 0 1 1 1 1
5 0 0 0 0 0 0 0
6 0 0 0 1 1 1 1
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 10 10
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
1 1 1 10 1
1 1 1 10 1
1 1 1 10 1
1 1 1 10 1
5 5 5
1 1 1 10
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
1 1 1 10 1
2 2 2
1 1 1 10
0
0
1 1 1 10 1
0 0 0 0 0
1 1 1
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0 0
0 1 1 6 1
0 1 1 6 1
0 0 0 0 0
1 1 1 10 1
0 0 1 3 1
0 0 0 0 0
1 1 1 6 1
0 0 0 0 0
2 4 5
1 1 1 10
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 1 1 1
0 0 0 0 0
0 0 0 0 0
0 0 1 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 2
0 0 1 1
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 0 1 4 1
1 0 0 2 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
2 0 1
1 0 1 6
0
0
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
1 1 1 8 1
0 0 0 0 0
0 1 1 6 1
2 3 3
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 1 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 10 1 0 0 6 10
Pelaksana : Sukardi
RUMAH
NO

BERDARAH
Observasi
1 1 0 1 1 0 0 0
2 0 0 0 0 0 0 0
DEMAM BERDARAH
1 0 1 1 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 1 1 1 1 1 1 1
5 Observasi 1 1 1 1 1 1 1
6 Observasi 1 1 1 1 0 0 1
7 Observasi 0 1 1 1 1 1 1
BURUNG
1 1 1 1 1 1 1
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0
4 Observasi
0 0 0 0 0 0 0
1 1 1 1 1 1 1
2 2 2 2 2 2 2
1 1 1 1 1 1 1

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi 0 0 0 0 0 0 0
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 1 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 1
d 0 0 0 0 0 0 1
2 Faktor Risiko
a 1 1 1 1 1 0 1
b 1 1 1 1 1 1 1
c 1 1 0 1 0 0 1
d 1 0 0 0 0 0 1
e 1 1 1 1 0 0 1
f 1 1 1 1 1 1 1
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
PARU
1 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 0 0 0 0
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 1 0 0 0 0 0 0
1 0 0 0 0 0 0
1 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 1 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 1 0 0 0 0 0 0
8 1 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
1 0 1 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 0 0
2 1 1 1 1 1 1 1
3 0 0 0 0 0 0 0
4 1 1 1 1 1 1 1
5 1 0 0 0 0 0 1
6 1 1 1 1 1 1 1
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
3 10 10
0 0 0 3 1
0 0 0 0 0
0 0 0
0 0 0 3
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
1 1 1 10 1
1 1 1 10 1
0 1 1 7 1
1 1 0 8 1
4 5 4
1 1 1 10
0
0 0 0 0 0
0 0 0 0 0
0 0 1
0 0 0 0 0
0 0 1 0 0
1 1 1 1 1
1 1 1 10 1
2 2 4
1 1 1 10
0
0
1 1 1 10 1
0 0 0 0 0
1 1 1
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 1 1
0 0 0 0 0
0 1 0 2 1
0 0 0 1 1
0
1 1 1 9 1
1 1 1 10 1
1 1 1 7 1
0 0 0 2 1
0 0 1 6 1
1 0 1 9 1
0 0 0 0 0
0 1 0 1 1
0 0 0 0 0
4 5 5
1 1 1 10
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0
0 0 0 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 1 2 1
0 0 0 0 0
0 0 1 1 1
0 0 0 0 0
0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 2
0 0 1 3
0
0
0 0 0 0 0
1 1 1 10 1
0 0 0 0 0
1 1 1 10 1
0 0 0 2 1
1 1 1 10 1
3 3 3
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 10 0 0 1 3 10
Pelaksana : Umi Masruroh
RUMAH
NO

BERDARAH
Observasi
1 0 0 0 0 0 1 0
2 0 0 0 0 0 0 0
DEMAM BERDARAH
0 0 0 0 0 1 0
B FAKTOR RESIKO FLU

BURUNG
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 Observasi 1 1 1 1 1 1 1
5 Observasi 1 1 1 1 1 1 1
6 Observasi 1 1 1 1 1 1 1
7 Observasi 1 1 1 1 1 1 1
BURUNG
1 1 1 1 1 1 1
1 0 0 0 0 0 0 0
2 0 0 0 0 0 1 0
3 Observasi
0 1 1 0 0 0 0
0 0 0 0 0 0 0
4 Observasi
1 0 1 0 1 1 0
1 1 1 1 1 1 1
3 3 4 2 3 4 2
1 1 1 1 1 1 1

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi 0 0 0 0 0 0 0
1 1 1 1 1 1 1

KUSTA
KUSTA
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
2 Faktor Risiko
a 0 1 1 1 1 1 0
b 1 1 1 1 1 1 1
c 1 1 1 1 0 1 1
d 0 0 0 0 0 0 0
e 1 1 1 1 1 1 1
f 0 0 0 1 0 0 1
g 0 0 0 0 0 1 0
h 0 0 0 0 0 1 1
i 0 0 0 0 0 0 0
PARU
1 1 1 1 1 1 1

IBU
berisiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0

berisiko
3 Faktor Risiko
a 0 0 0 0 0 0 0
b 0 0 0 0 0 0 0
c 0 0 0 0 0 0 0
d 0 0 0 0 0 0 0
e 0 0 0 0 0 0 0
f 0 0 0 0 0 0 0
g 0 0 0 1 0 0 0
h 0 0 0 0 0 0 0
i 0 0 0 1 0 0 0
KEMATIAN IBU
0 0 0 1 0 0 0

BAYI
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 1 1 0 1 1 0
6 0 1 0 1 0 0 0
7 0 0 0 0 0 0 0
8 0 1 0 0 0 0 0
PERILAKU YANG
GANGGUAN JIWA
PERILAKU YANG
GANGGUAN JIWA
1 0 0 0 0 0 1 0
2 0 0 0 0 0 1 0
3 0 0 0 0 0 1 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 1 0
6 0 0 0 0 0 0 0
7 0 0 1 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 1 0 0 1 0
10 0 0 0 0 0 1 0
11 0 0 0 0 0 0 0
12 0 0 0 0 0 0 0
13 0 0 0 0 0 0 0
14 0 0 0 0 0 0 0
KESEHATAN JIWA
0 1 1 1 1 1 0
L OBSERVASI FAKTOR
LINGKUNGAN
1 0 0 0 0 0 1 0
2 1 1 1 1 1 1 1
3 0 1 1 0 0 0 0
4 1 1 1 1 1 1 1
5 0 0 0 0 0 0 0
6 1 1 1 1 1 1 1
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
4 10 10
1 1 1 4 1
1 0 0 1 1
2 1 1
1 1 1 4
0 0 0 0 0
0 0 0 0 0
1 1 1 10 1
1 1 1 10 1
1 1 1 10 1
1 1 0 9 1
1 1 1 10 1
5 5 4
1 1 1 10
0
0 0 0 0 0
0 0 0 1 1
0 0 0 2 1
0 0 0 0 0
1 0 0 5 1
1 1 1 10 1
1 1 1 10 1
3 2 2
1 1 1 10
0
0
1 1 1 10 1
0 0 0 0 0
1 1 1
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0
0 1 1 7 1
0 1 1 9 1
1 0 1 8 1
0 0 0 0 0
1 1 1 10 1
1 1 1 5 1
0 0 0 1 1
0 1 1 4 1
0 0 0 0 0
3 5 6
1 1 1 10
0
0
0
0 0 0 0 0
0 0 0 0 0
0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 1 1
0 0 0
0 0 0 1
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0
0 0 1 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 0 5 1
0 0 0 2 1
0 0 0 0 0
0 0 0 1 1
0
0
0
0 0 1 2 1
0 0 0 1 1
0 0 0 1 1
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 1 1
0 0 0 0 0
0 0 0 2 1
0 0 0 1 1
0 0 1 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 3
0 1 1 7
0
0
0 0 0 1 1
1 1 1 10 1
0 0 0 2 1
1 1 1 10 1
0 0 0 0 0
0 1 1 9 1
2 3 3
1 1 1 10
0
0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

10 0 0 10 1 0 0 7 10
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1 1 1 1 1 1
2
DEMAM BERDARAH
1 0 1 1 1 0 1
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
4 Observasi/Pertanyaan 1 1 1 1 1 1
5 Observasi 1 1 1 1 1
6 Observasi
7 Observasi
BURUNG
1 1 1 1 1 1 1
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi
1 1 1 1 1 1 1

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e 1 1 1 1 1 1
f 1 1 1 1 1 1 1
g
h
i
PARU
1 1 1 1 1 1 1

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2 1 1 1 1 1
3
4 1 1 1 1 1 1 1
5
6
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
7 9 0
1 1 7 1
0 0
1 1 0
1 1 0 7
0 0
0 0
0 0
1 1 8 1
5 1
0 0
0 0
1 0 1
1 0 1 9
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
1 1 1 10 1
0 0
1 1 1
1 1 1 10
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
1 7 1
1 1 1 10 1
0 0
0 0
0 0
2 1 1
1 1 1 10
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
1 1 7 1
0 0
1 1 1 10 1
0 0
0 0
2 1 2
1 1 1 10
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

10 0 0 10 0 0 0 0 10
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1 1 1 1 1 1 1
2
DEMAM BERDARAH
1 0 1 1 1 1 1
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
4 Observasi/Pertanyaan 1 1 1 1 1 1
5 Observasi 1 1 1 1 1 1 1
6 Observasi
7 Observasi
BURUNG
1 1 1 1 1 1 1
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1 1 1 1 1 1 1 1
2 Observasi
1 1 1 1 1 1 1

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e 1 1 1 1 1 1 1
f 1 1 1 1 1 1 1
g
h
i 1 1 1 1 1
PARU
1 1 1 1 1 1 1

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2 1 1 1 1 1 1 1
3
4 1 1 1 1 1 1 1
5
6
LINGKUNGAN
1 1 1 1 1 1 1
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
8 10 0
1 1 8 1
0 0
1 1 0
1 1 0 8
0 0
0 0
0 0
1 1 1 9 1
1 1 9 1
0 0
0 0
2 2 1
1 1 1 10
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
1 1 1 10 1
0 0
1 1 1
1 1 1 10
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
1 1 1 10 1
1 1 1 10 1
0 0
0 0
5 1
2 2 2
1 1 1 10
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
1 1 1 10 1
0 0
1 1 1 10 1
0 0
0 0
2 2 2
1 1 1 10
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

10 0 0 10 0 0 0 0 10
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0
Pelaksana :
RUMAH
NO

BERDARAH
Observasi
1
2
DEMAM BERDARAH
0 0 0 0 0 0 0
B FAKTOR RESIKO FLU

BURUNG
1
2
3 Observasi
5 Observasi
6 Observasi
7 Observasi
BURUNG
0 0 0 0 0 0 0
1
2
3 Observasi
4 Observasi
0 0 0 0 0 0 0
0 0 0 0 0 0 0

LEPTOSPIROSIS
1
2 Observasi
0 0 0 0 0 0 0

KUSTA
KUSTA
1
2
PENYAKIT KUSTA
0 0 0 0 0 0 0

ANTRAX
3 0 0 0 0 0 0 0
PENYAKIT ANTRAX
0 0 0 0 0 0 0
1 Gejala dan Tanda
a
b
c
d
2 Faktor Risiko
a
b
c
d
e
f
g
h
i
PARU
0 0 0 0 0 0 0

IBU
berisiko
a
b
berisiko
3 Faktor Risiko
a
b
c
d
e
f
g
h
i
KEMATIAN IBU
0 0 0 0 0 0 0

BAYI
1
2
3
4
5
6
7
KEMATIAN BAYI
0 0 0 0 0 0 0

BURUK
1
2
3
4
5
0 0 0 0 0 0 0
0 0 0 0 0 0 0

JIWA
K.1. RISIKO MASALAH

PSIKOSOSIAL
1
2
3
4
5
6
7
8
PERILAKU YG
GANGGUAN JIWA
PERILAKU YG
GANGGUAN JIWA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
KESEHATAN JIWA
0 0 0 0 0 0 0
L OBSERVASI FAKTOR
LINGKUNGAN
1
2
3
4
5
6
LINGKUNGAN
0 0 0 0 0 0 0
M MASALAH KESEHATAN
KASUS
1
2
3
4
5
6
7
8
9
10
JUMLAH 0 0 0 0 0 0 0
UNGAN
JUMLAH JUMLAH
JUMLAH
8 9 10
0 0 0
0 0
0 0
0 0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0 0
0 0 0 0
0
0 0
0 0
0 0 0 0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0
0 0 0 0
0
0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0

0 0 0 0 0 0 0 0 0

12 Rekapitulasi Panimbo Jadi

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12 Rekapitulasi Panimbo Jadi

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DAFTAR HASIL REKAPITULASI FAKTOR RESIKO LINGKUNGAN

A FAKTOR RESIKO DEMAM

B FAKTOR RESIKO FLU

D FAKTOR RESIKO PENYAKIT

E FAKTOR RESIKO PENYAKIT

F FAKTOR RESIKO PENYAKIT

H FAKTOR RISIKO KEMATIAN

2 Gejala dan tanda ibu nifas 0 0 0 0 0 0 0

I FAKTOR RISIKO KEMATIAN

J FAKTOR RISIKO GIZI

K FAKTOR RISIKO KESEHATAN

K.1. RISIKO MASALAH

A FAKTOR RESIKO DEMAM

B FAKTOR RESIKO FLU

D FAKTOR RESIKO PENYAKIT

E FAKTOR RESIKO PENYAKIT

F FAKTOR RESIKO PENYAKIT

H FAKTOR RISIKO KEMATIAN

2 Gejala dan tanda ibu nifas 0 0 0 0 0 0 0

I FAKTOR RISIKO KEMATIAN

J FAKTOR RISIKO GIZI

K FAKTOR RISIKO KESEHATAN

K.1. RISIKO MASALAH

LEPTO KUSTA ANTRAX TB PARU AKI AKB GIBUR KESWA LINGK

A FAKTOR RESIKO DEMAM

B FAKTOR RESIKO FLU

D FAKTOR RESIKO PENYAKIT

E FAKTOR RESIKO PENYAKIT

F FAKTOR RESIKO PENYAKIT

H FAKTOR RISIKO KEMATIAN

2 Gejala dan tanda ibu nifas 0 0 0 0 0 0 0

I FAKTOR RISIKO KEMATIAN

J FAKTOR RISIKO GIZI

K FAKTOR RISIKO KESEHATAN

K.1. RISIKO MASALAH

LEPTO KUSTA ANTRAX TB PARU AKI AKB GIBUR KESWA LINGK

A FAKTOR RESIKO DEMAM

B FAKTOR RESIKO FLU

D FAKTOR RESIKO PENYAKIT

E FAKTOR RESIKO PENYAKIT

F FAKTOR RESIKO PENYAKIT

H FAKTOR RISIKO KEMATIAN

2 Gejala dan tanda ibu nifas 0 0 0 0 0 0 0

I FAKTOR RISIKO KEMATIAN

J FAKTOR RISIKO GIZI

K FAKTOR RISIKO KESEHATAN

K.1. RISIKO MASALAH

LEPTO KUSTA ANTRAX TB PARU AKI AKB GIBUR KESWA LINGK

A FAKTOR RESIKO DEMAM

B FAKTOR RESIKO FLU

D FAKTOR RESIKO PENYAKIT

E FAKTOR RESIKO PENYAKIT

F FAKTOR RESIKO PENYAKIT

H FAKTOR RISIKO KEMATIAN

I FAKTOR RISIKO KEMATIAN

J FAKTOR RISIKO GIZI

K FAKTOR RISIKO KESEHATAN

K.1. RISIKO MASALAH

LEPTO KUSTA ANTRAX TB PARU AKI AKB GIBUR KESWA LINGK

A FAKTOR RESIKO DEMAM

B FAKTOR RESIKO FLU

D FAKTOR RESIKO PENYAKIT

E FAKTOR RESIKO PENYAKIT

F FAKTOR RESIKO PENYAKIT