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DINAS KESEHATAN KABUPATEN MANOKWARI SELATAN

PUSKESMAS RANSIKI
ALAMAT : Jln. Sujarwo Condronegoro, SH No.

Distrik Ransiki

KWITANSI
NO
Untuk Pembayaran

: Biaya Uang Saku Petugas Yang Melakukan Kegiatan Pengobatan di Pos


Minum Obat pada Masyarakat di Wilayah Kerja Puskesmas Ransiki Distrik
Ransiki.

1. Kampung Nuhuwei Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
dr. Keys Meraudje
Ronald Mandosir
Sartina Rumbiak
Hery Sumbung
Nelly Marani
Deasy Rumbonde

Pos Minum Obat


Pustu Nuhuwei
SD Nuhuwei

Cost

Paraf

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

2. Kampung Susmorof Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
Yunus Warami
Yakobus Towansiba
Elsa Wina Titus
Deasy Rumbonde
Maya Sermumes
Yulius Mokiri

Pos Minum Obat


Pustu Susmorof
SD Susmorof

Cost

Paraf

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

3. Kampung Yamboi Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
Fiti Marlia
Maya Sermumes
Beni Saiba
dr. Paulinus Sayori
Yunus Warami
Yulius Mokiri

Pos Minum Obat

Balai Kampung
Yamboi

Cost

Paraf

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

4. Kampung Mambrema Total 2 PMO


N
o

Nama Petugas

Pos Minum Obat

Cost

Paraf

1.
2.
3.
4.
5.
6.

dr. Keys Meraudje


Ruth Yeninar
Selviana Rumander
Vicky Sawasemariay
Yulia Mandacan
Yakobus Towansiba

Balai Kampung
Mambrema

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

5. Kampung Wamcei Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
dr. Keys Meraudje
Ade Grace Airori
Lina Inden
Yakobus Towansiba
Nelcy urbinas
Fince Suabey

Pos Minum Obat

Balai Kampung
Wamcei

Cost

Paraf

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

6. SMP N. Ransiki Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
dr. Keys Meraudje
Fiti Marlina
Sartina Rumbiak
Yantrina Inyomusi
Hery Sumbung
Edwin Ronald Mandosir

Pos Minum Obat

Cost

SMP N Ransiki

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

Pos Minum Obat

Cost

SMP YPK Lahroi

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

Pos Minum Obat

Cost

Paraf

7. SMP YPK Lahroi Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
dr. Paulinus Sayori
Maya Sermumes
Martina Iba
Sasmi Dewi Jayanti
Anita Kaidan
Dwi Ayu

Paraf

8. SD Cenderawasi Abreso Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
Mimi Inden
Fince Suabey
Ribka Krey
Yeni Novi
Vicky Sawasemariay
Nelcy Urbinas

SD Cendrawasi
Abreso

Paraf

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

9. SD Impres Ransiki Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
Ade Grace Airori
Edwin Mandosir
Nelly Nouwoneyk
Selviana Rumander
Yakobus Towansiba
Agetha Mundipkoman

Pos Minum Obat

SD Impres 30 Ransiki

Cost
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

Paraf

10. SD YPK Ransiki Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
Yulia Mandacan
Norma Rahmawati
Yunus Warami
Sulastri
Mira Saiba
Bani Marini

Pos Minum Obat

Cost

SD YPK Ransiki

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

Pos Minum Obat

Cost

SD Impres Sabri

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

Pos Minum Obat

Cost

Paraf

11. SD Impres Sabri Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
Septinus Corneles Rumbiak
Ermiyanti
Novi Istia
Elsa Wina Titus
Asmiati
Moh. Taufik Hidayat

Paraf

12. Kampung Hamawi Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
Yulia Mandacan
Norma Rahmawati
Yunus Warami
Sulastri
Mira Saiba
dr. Paulinus Sayori

Balai Kampung
Hamawi

Paraf

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

13. Kampung Tobou Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
Mimi Inden
Fince Suabey
Maya Sermumes
Yeni Novi
Vicky Sawasemariay
Nelcy Urbinas

Pos Minum Obat

SD Tobou

Cost

Paraf

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

14. Kampung Ransiki Total 10 PMO


N
o
1.
2.
3
4
5
6
7
8
9
10
11
12
13
14

Nama Petugas
dr. Paulinus Sayori
Maya Sermumes
Martina Iba
Sasmi Dewi Jayanti
Anita Kaidan
Dwi Ayu
Ade Grace Airori
Ermiyanti
Novi Istia
Yantrina Inyomusi
Asmiati
Moh. Taufik Hidayat
Ade Grace Airori
Edwin Mandosir

Pos Minum Obat

Balai Kampung
Ransiki

Posyandu Anggrek

Posyandu Gracia

Cost
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

Paraf

15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30

Septinus Corneles Rumbiak


Selviana Rumander
Yakobus Towansiba
Agetha Mundipkoman
dr. Keys Meraudje
Beni Saiba
Sartina Rumbiak
Junita A.H Beroperai
Nelly Marani
Yunus Warani
Mimi Inden
Fince Suabey
Nelcy Urbinas
Yeni Novi
Beni Marini
Fransina Imbiri

Posyandu Melati

Pasar Kenangan
Ransiki

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

15. Kampung Bamaha Total 2 PMO


N
o
1.
2.
3.
4.
5.
6.

Nama Petugas
Yulia Mandacan
Norma Rahmawati
Yunus Warami
Sulastri
Mira Saiba
Fransina

Pos Minum Obat

Balai Kampung
Bamaha

Cost

Paraf

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

16. Kampung Kobrey Total 3 PMO


N
o
1.
2.
3.
4.
5.
6.
7.
8.
9.

Nama Petugas
dr. Keys Meraudje
Fiti Marlina
Sartina Rumbiak
Yantrina Inyomusi
Hery Sumbung
Edwin Ronald Mandosir
Novi Istia
dr. Paulinus Sayori
Maya Sermumes

Pos Minum Obat

Balai Kampung
Kobrey

Kobrey Lokasi

Cost

Paraf

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

17. Kampung Abreso Total 12 PMO


N
o
1.
2.
3
4
5
6
7
8
9
10
11
12
13
14

Nama Petugas
dr. Paulinus Sayori
Maya Sermumes
Martina Iba
Sasmi Dewi Jayanti
Vicky Sawasemariay
Dwi Ayu
Ruth Yeninar
Ermiyanti
Novi Istia
Elsa Wina Titus
Sulastri
Moh. Taufik Hidayat
Ade Grace Airori
Edwin Mandosir

Pos Minum Obat

Ransiki Pante

Wariki

Posyandu Raipawi

Cost
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

Paraf

15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30

Nelly Nouwoneyk
Selviana Rumander
Yakobus Towansiba
Agetha Mundipkoman
dr. Keys Meraudje
Nelly Marani
Sartina Rumbiak
Yantrina Inyomusi
Hery Sumbung
Deasy Rumbonde
Mimi Inden
Fince Suabey
Nelcy Urbinas
Yeni Novi
Esron Inden
Yulius Mokiri

No
31

Nama Petugas

.
32
.
33
.
34
.
55
.
36
.

Balai Kampung
Abreso

Kampung Ambon

Pos Minum Obat

Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Cost

Yulia Mandacan

Rp 150.000

Norma Rahmawati

Rp 150.000

Junita A.H Beroperai

Rp 150.000

Paraf

Yamboi
Sulastri

Rp 150.000

Mira Saiba

Rp 150.000

Fransina

Rp 150.000

18. Kampung Sabri Total 6 PMO


N
o
1.
2.
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18

Nama Petugas
Mimi Inden
Yeni Novi
Fince Suabey
Erens Kaidan
Ruth Yeninar
Sartina Rumbiak
Septinus Corneles Rumbiak
Ermiyanti
Novi Istia
Elsa Wina Titus
Sulastri
Moh. Taufik Hidayat
Nelly Marani
Edwin Mandosir
dr. Paulinus Sayori
Yunus Warami
Beni Saiba
Mira Saiba

Pos Minum Obat

Balai Kampung Sabri

Rumah Kepala
Kampung

Kampung Manam

Cost
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000
Rp 150.000

Paraf