Dusun : ……………………………………………………………………………………… NAMA ALAMAT RT/RW HPHT HPL Usia Kehamilan IBU SUAMI TM I TM II 1 2 3 4 5 6 7 8 9 10 11 1 1 NO URUT NO INDEX BUKU KIA STIKER P4K
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KOHORT IBUREGISTER KOHORT IBUDusun : NO URUTNO INDEXNAMAALAMAT RT/RWBUKU KIASTIKER P4KHPHTHPLUsia Kehamilan (Mgg)DETEKSI FAKTOR RESIKOKOMPLIKASIKUNJUNGAN IBUPERTOLONGAN PERSALINAN OLEHKELAHIRANIBU NIFASKETIBUSUAMITM ITM IITM IIIOlehUMUR IBUHAMIL KEJRK KHMLNBB TIII 3
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