Kartu Sehat UKS Boys2 (1)
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Identitas Nama : ___________________________________ L/P Tanggal Lahir : ___________________________________ Nama Orang Tua/Wali : ___________________________________ Alamat : ___________________________________ Anak ke- : ________ dari ______________ Riwayat Kesehatan Riwayat Penyakit Dahulu/ Riwayat Alergi : ________________________________________________________ Riwayat Imunisasi Polio BCG DPT Hepatitis B Campak Status Gizi Tanggal: Berat Badan Tinggi Badan Status Gizi Kartu
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Transcript of Kartu Sehat UKS Boys2 (1)
Identitas
Nama : ___________________________________ L/P
Tanggal Lahir : ___________________________________
Nama Orang Tua/Wali : ___________________________________
Alamat : ___________________________________
Anak ke- : ________ dari ______________
Riwayat KesehatanRiwayat Penyakit Dahulu/ Riwayat Alergi :
________________________________________________________
Riwayat ImunisasiPolio
BCG
DPT
Hepatitis B
Campak
Status Gizi
Tanggal:Berat BadanTinggi Badan
Status Gizi
Kartu Sehatk
Identitas
Nama : ___________________________________ L/P
Tanggal Lahir : ___________________________________
Nama Orang Tua/Wali : ___________________________________
Alamat : ___________________________________
Anak ke- : ________ dari ______________
Riwayat KesehatanRiwayat Penyakit Dahulu/ Riwayat Alergi :
________________________________________________________
Riwayat ImunisasiPolio
BCG
DPT
Hepatitis B
Campak
Status Gizi
Profil Kesehatan Gigi
Tanggal:Berat BadanTinggi Badan
Status Gizi
Year/month Month -3 SD -2 SD -1 SD Median 1 SD 2 SD 3 SD
Simplified field tables
weight-for-age BOYSBirth to 5 years (z-scores)
0 : 0 0 2.1 2.5 2.9 3.3 3.9 4.4 5.00 : 1 1 2.9 3.4 3.9 4.5 5.1 5.8 6.60 : 2 2 3.8 4.3 4.9 5.6 6.3 7.1 8.00 : 3 3 4.4 5.0 5.7 6.4 7.2 8.0 9.00 : 4 4 4.9 5.6 6.2 7.0 7.8 8.7 9.70 : 5 5 5.3 6.0 6.7 7.5 8.4 9.3 10.40 : 6 6 5.7 6.4 7.1 7.9 8.8 9.8 10.90 : 7 7 5.9 6.7 7.6 8.3 9.2 10.3 11.40 : 8 8 6.2 6.9 7.7 8.6 9.6 10.7 11.90 : 9 9 6.4 7.1 8.0 8.9 9.9 11.0 12.30 : 10 10 6.6 7.4 8.2 9.2 10.2 11.4 12.70 : 11 11 6.8 7.6 8.4 9.4 10.5 11.7 13.01 : 0 12 6.9 7.7 8.6 9.6 10.8 12.0 13.31 : 1 13 7.1 7.9 8.8 9.9 11.0 12.3 13.71 : 2 14 7.2 8.1 9.0 10.1 11.3 12.6 141 : 3 15 7.4 8.3 9.2 10.3 11.5 12.8 14.31 : 4 16 7.5 8.4 9.4 10.5 11.7 13.1 14.61 : 5 17 7.7 8.6 9.6 10.7 12.0 13.4 14.91 : 6 18 7.8 8.8 9.8 10.9 12.2 13.7 15.31 : 7 19 8.0 8.9 10.0 11.1 12.5 13.9 15.61 : 8 20 8.1 9.1 10.1 11.3 12.7 14.2 15.91 : 9 21 8.2 9.2 10.3 11.5 12.9 14.5 16.21 : 10 22 8.4 9.4 10.5 11.8 13.2 14.7 16.51 : 11 23 8.5 9.5 10.7 12.0 13.4 15.0 16.82 : 0 24 8.6 9.7 10.8 12.2 13.6 15.3 17.12 : 1 25 8.8 9.8 11.0 12.4 13.9 15.5 17.52 : 2 26 8.9 10.0 11.2 12.5 14.1 15.8 17.82 : 3 27 9.0 10.1 11.3 12.7 14.3 16.1 18.12 : 4 28 9.1 10.2 11.5 12.9 14.5 16.3 18.42 : 5 29 9.2 10.4 11.7 13.1 14.8 16.6 18.72 : 6 30 9.4 10.5 11.8 13.3 15.0 16.9 19.02 : 7 31 9.5 10.7 12.0 13.5 15.2 17.1 19.32 : 8 32 9.6 10.8 12.1 13.7 15.4 17.4 19.62 : 9 33 9.7 10.9 12.3 13.8 15.6 17.6 19.92 : 10 34 9.8 11.0 12.4 14.0 15.8 17.8 20.22 : 11 35 9.9 11.2 12.6 14.2 16.0 18.1 20.43 : 0 36 10.0 11.3 12.7 14.3 16.2 18.3 20.73 : 1 37 10.1 11.4 12.9 14.5 16.4 18.6 21.03 : 2 38 10.2 11.5 13.0 14.7 16.6 18.8 21.33 : 3 39 10.3 11.6 13.1 14.8 16.8 19.0 21.63 : 4 40 10.4 11.8 13.3 15.0 17.0 19.3 21.93 : 5 41 10.5 11.9 13.4 15,2 17.2 19.5 22.13 : 6 42 10.6 12.0 13.6 15.3 17.4 19.7 22.43 : 7 43 10.7 12.1 13.7 15.5 17.6 20.0 22.73 : 8 44 10.8 12.2 13.8 15.7 17.8 20.2 23.03 : 9 45 10.9 12.4 14.0 15.8 18.0 20.5 23.33 : 10 46 11.0 12.5 14.1 16.0 18.2 20.7 23.63 : 11 47 11.1 12.6 14.3 16.2 18.4 20.9 23.94 : 0 48 11.2 12.7 14.4 16.3 18.6 21.2 24.24 : 1 49 11.3 12.8 14.5 16.5 18.8 21.4 24.54 : 2 50 11.4 12.9 14.7 16.7 19.0 21.7 24.84 : 3 51 11.5 13.1 14.8 16.8 19.2 21.9 25.14 : 4 52 11.6 13.2 15.0 17.0 19.4 22.2 25.44 : 5 53 11.7 13.3 15.1 17.2 19.6 22.4 25.74 : 6 54 11.8 13.4 15.2 17.3 19.8 22.7 26.04 : 7 55 11.9 13.5 15.4 17.5 20.0 22.9 26.34 : 8 56 12.0 13.6 15.5 17.7 20.2 23.2 26.64 : 9 57 12.1 13.7 15.6 17.8 20.4 23.4 26.94 : 10 58 12.2 13.8 15.8 18.0 20.6 23.7 27.24 : 11 59 12.3 14.0 15.9 18.2 20.8 23.9 27.65 : 0 60 12.4 14.1 16.0 18.3 21.0 24.2 27.9
WHO Child Growth Standars
Kartu Sehatk
Erupsi Parsial
Tambalan Logam
X Missing
Sisa Akar
Tambalan Nonlogam
Caries Belum Erupsi
Tanggal:
Pemeriksaan Gigi:
Saran:
Daftar Berat Badan dibanding Usia anak Laki-laki (0-5thn) menurut: Z-Score (WHO)
UE
PE
Profil Kesehatan Gigi
Year/month Month -3 SD -2 SD -1 SD Median 1 SD 2 SD 3 SD
Erupsi Parsial
Tambalan Logam
X Missing
Sisa Akar
Tambalan Nonlogam
Caries Belum Erupsi
Tanggal:
Pemeriksaan Gigi:
Saran:
Simplified field tables
weight-for-age BOYSBirth to 5 years (z-scores)
0 : 0 0 2.1 2.5 2.9 3.3 3.9 4.4 5.00 : 1 1 2.9 3.4 3.9 4.5 5.1 5.8 6.60 : 2 2 3.8 4.3 4.9 5.6 6.3 7.1 8.00 : 3 3 4.4 5.0 5.7 6.4 7.2 8.0 9.00 : 4 4 4.9 5.6 6.2 7.0 7.8 8.7 9.70 : 5 5 5.3 6.0 6.7 7.5 8.4 9.3 10.40 : 6 6 5.7 6.4 7.1 7.9 8.8 9.8 10.90 : 7 7 5.9 6.7 7.6 8.3 9.2 10.3 11.40 : 8 8 6.2 6.9 7.7 8.6 9.6 10.7 11.90 : 9 9 6.4 7.1 8.0 8.9 9.9 11.0 12.30 : 10 10 6.6 7.4 8.2 9.2 10.2 11.4 12.70 : 11 11 6.8 7.6 8.4 9.4 10.5 11.7 13.01 : 0 12 6.9 7.7 8.6 9.6 10.8 12.0 13.31 : 1 13 7.1 7.9 8.8 9.9 11.0 12.3 13.71 : 2 14 7.2 8.1 9.0 10.1 11.3 12.6 141 : 3 15 7.4 8.3 9.2 10.3 11.5 12.8 14.31 : 4 16 7.5 8.4 9.4 10.5 11.7 13.1 14.61 : 5 17 7.7 8.6 9.6 10.7 12.0 13.4 14.91 : 6 18 7.8 8.8 9.8 10.9 12.2 13.7 15.31 : 7 19 8.0 8.9 10.0 11.1 12.5 13.9 15.61 : 8 20 8.1 9.1 10.1 11.3 12.7 14.2 15.91 : 9 21 8.2 9.2 10.3 11.5 12.9 14.5 16.21 : 10 22 8.4 9.4 10.5 11.8 13.2 14.7 16.51 : 11 23 8.5 9.5 10.7 12.0 13.4 15.0 16.82 : 0 24 8.6 9.7 10.8 12.2 13.6 15.3 17.12 : 1 25 8.8 9.8 11.0 12.4 13.9 15.5 17.52 : 2 26 8.9 10.0 11.2 12.5 14.1 15.8 17.82 : 3 27 9.0 10.1 11.3 12.7 14.3 16.1 18.12 : 4 28 9.1 10.2 11.5 12.9 14.5 16.3 18.42 : 5 29 9.2 10.4 11.7 13.1 14.8 16.6 18.72 : 6 30 9.4 10.5 11.8 13.3 15.0 16.9 19.02 : 7 31 9.5 10.7 12.0 13.5 15.2 17.1 19.32 : 8 32 9.6 10.8 12.1 13.7 15.4 17.4 19.62 : 9 33 9.7 10.9 12.3 13.8 15.6 17.6 19.92 : 10 34 9.8 11.0 12.4 14.0 15.8 17.8 20.22 : 11 35 9.9 11.2 12.6 14.2 16.0 18.1 20.43 : 0 36 10.0 11.3 12.7 14.3 16.2 18.3 20.73 : 1 37 10.1 11.4 12.9 14.5 16.4 18.6 21.03 : 2 38 10.2 11.5 13.0 14.7 16.6 18.8 21.33 : 3 39 10.3 11.6 13.1 14.8 16.8 19.0 21.63 : 4 40 10.4 11.8 13.3 15.0 17.0 19.3 21.93 : 5 41 10.5 11.9 13.4 15,2 17.2 19.5 22.13 : 6 42 10.6 12.0 13.6 15.3 17.4 19.7 22.43 : 7 43 10.7 12.1 13.7 15.5 17.6 20.0 22.73 : 8 44 10.8 12.2 13.8 15.7 17.8 20.2 23.03 : 9 45 10.9 12.4 14.0 15.8 18.0 20.5 23.33 : 10 46 11.0 12.5 14.1 16.0 18.2 20.7 23.63 : 11 47 11.1 12.6 14.3 16.2 18.4 20.9 23.94 : 0 48 11.2 12.7 14.4 16.3 18.6 21.2 24.24 : 1 49 11.3 12.8 14.5 16.5 18.8 21.4 24.54 : 2 50 11.4 12.9 14.7 16.7 19.0 21.7 24.84 : 3 51 11.5 13.1 14.8 16.8 19.2 21.9 25.14 : 4 52 11.6 13.2 15.0 17.0 19.4 22.2 25.44 : 5 53 11.7 13.3 15.1 17.2 19.6 22.4 25.74 : 6 54 11.8 13.4 15.2 17.3 19.8 22.7 26.04 : 7 55 11.9 13.5 15.4 17.5 20.0 22.9 26.34 : 8 56 12.0 13.6 15.5 17.7 20.2 23.2 26.64 : 9 57 12.1 13.7 15.6 17.8 20.4 23.4 26.94 : 10 58 12.2 13.8 15.8 18.0 20.6 23.7 27.24 : 11 59 12.3 14.0 15.9 18.2 20.8 23.9 27.65 : 0 60 12.4 14.1 16.0 18.3 21.0 24.2 27.9
WHO Child Growth StandarsDaftar Berat Badan dibanding Usia anak Laki-laki (0-5thn) menurut: Z-Score (WHO)
UE
PE
