DATA NOMINATIF PEGAWAI

UPT PUSKESMAS MUNDU

MEI 2016
RUANG :
FORM A1 - INDIVIDU - DATA KEADAAN SDM KESEHATAN DI FASYANKES
Kode Unit PEKERJAAN PENDIDIKAN
Kerja Jenis Status
No NIK ID/NIP/NRP NAMA LENGKAP Kelamin Kepegawaian
Kode SDMK Mulai Berakhir Kode Prog. Studi
Fasyankes

1 3329120810660007 19661008 199603 1 002 dr. H. SYAFAAT MULYANTO. MQIH L PNS 3/1/1996 SKR S-2
2 3209126207850003 19850722 201412 2 002 dr. GIKA FAJARIANAH P CPNS 12/1/2014 SKR DOKTER UMUM (PROFESI)
3 3209230706810003 drg. DENY IRAWAN L SUKWAN 2015 SKR DOKTER GIGI
4 3209384502830004 dr.ITO MASITOH P SUKWAN 2016 SKR DIKTER UMUM 9PROFESI)
5 3274055509820005 dr.DINA INDAYANI P SUKWAN 1/25/2016 SKR DOKTER UMUM (PROFESI)
6 3209111007660004 19660710 198703 1 003 UUS SUGEMA L PNS 3/1/1987 SKR S.1 KESEHATAN MASYARAKAT
7 3209124507710006 19710705 199203 2 005 SUMARNI SUMIARTINI P PNS 3/1/1992 SKR D-4 KEBIDANAN
8 3209104911660006 19661109 198603 2 002 JAN JAN ROKHMATUL JANNAH P PNS 3/1/1986 SKR D-3 KEPERAWATAN
9 3209125111670001 19671011 198901 2 004 TUNIYAH P PNS 1/1/1989 SKR SPK
10 3209124102720002 19720201 199203 2 006 LULUK KUSTONIAH P PNS 3/1/1992 SKR D-4 KEBIDANAN
11 3209365610730003 19731016 199503 2 003 SRI RATNA AYU P PNS 3/1/1995 SKR D-I SPPH
12 3209205904750004 19750419 199703 2 001 NURANTI P PNS 3/1/1997 SKR D-I SPAG
13 3209100308620003 19620803 199103 1 003 MUHYIDIN L PNS 3/1/1991 SKR SMA
14 3209124511730004 19731105 200112 2 001 IMROATUL AZIZAH P PNS 10/1/1994 SKR D-4 KEBIDANAN
15 3209126407750006 19750724 200112 2 002 DEDEK KUSNIATI P PNS 10/1/1994 SKR D-4 KEBIDANAN
16 3209126412740002 19741224 200701 2 005 ROHAYATI P PNS 1/1/2007 SKR D-1 KEBIDANAN
17 3209185905760001 19760519 200701 2 007 IDAH LAENI P PNS 1/1/2007 SKR D-3 KEBIDANAN
18 3209125209830006 19800611 200801 2 006 YULY YUNITA P PNS 1/1/2008 SKR S-1 KEPERAWATAN
19 3209361106730002 19730611 200801 1 006 NANANG SUPARMAN L PNS 1/1/2008 SKR D-3 KEPERAWATAN
20 3209210203800014 19800302 200801 1 006 KARTONO L PNS 1/1/2008 SKR D-3 KEPERAWATAN
21 3209125605780014 19780816 200801 2 008 SRI YANAH RAHAYU P PNS 1/1/2008 SKR D-3 KEPERAWATAN
22 3209152406830002 19830624 200604 1 005 YUSUP L PNS 4/1/2006 SKR SMF
23 3209105026800001 19681210 199003 2 006 ATIN HERYATI P PNS 3/1/1990 SKR D-3 KEBIDANAN
24 3212216204770006 19770422 200801 2 005 ERVINA SUSILAWATI P PNS 11/1/1996 SKR D-4 KEBIDANAN
25 3209126807800012 10.4.047.1704 EMI NURHIKMAH P PTT PUSAT 10/14/2004 SKR D-3 KEBIDANAN
26 3209125608830006 10.4.047.710 IKA MERDEKAWATI P PTT PUSAT 7/1/2006 SKR D-3 KEBIDANAN
27 3209125909850004 10.4.048.14328 RANI SORAYA P PTT PUSAT 12/31/2007 SKR D-3 KEBIDANAN
28 3209196112840008 10.4.047.11767 DEWI DAMAYANTI P PTT PUSAT 6/1/2007 SKR D-3 KEBIDANAN
29 3209126209890003 10.4.030.107 RIZKI RIFATUL NISA P PTT PUSAT 7/1/2011 SKR D-3 KEBIDANAN
30 3209125011790004 873.32.08.09.0115 YENI RAHMAWATI P PTT PROV 8/1/2009 SKR D-3 KEBIDANAN
31 3209215304880005 873.32.08.11.0609 RETNO SULIESTYA NING AYU P PTT PROV 5/1/2011 SKR D-3 KEBIDANAN
32 3209174203906354 873.32.07.11.0611 RIRIN TRI UTAMI P PTT PROV 5/1/2011 SKR D-3 KEBIDANAN
33 3274034106850013 873.32.08.09.0081 HARNI JUNAENI P PTT PROV 8/1/2009 SKR D-3 KEBIDANAN
34 3209124805790001 SUNENGSIH P KONTRK DINAS 1/1/2006 SKR D-3 KEPERAWATAN
35 3209126405800004 CIPI SUCIAWATI P SUKWAN 12/20/2004 SKR D-3 KEPERAWATAN
36 3209144303820006 TETY HERAWATI P SUKWAN 8/1/2006 SKR D-3 KEPERAWATAN
37 3209120401810001 MOH. YASIN L SUKWAN 11/28/2006 SKR S-1 KEPERAWATAN
38 3209125506890005 YUNITA INTAN WULANDARI P SUKWAN 9/20/2013 SKR D-3 KEPERAWATAN
39 3209120108720009 MADI L SUKWAN 11/2/1998 SKR SD
40 3209124702830006 HANIPAH P SUKWAN 9/1/2001 SKR SMK
41 3209121006790008 BAHRUDIN L SUKWAN 12/2/2004 SKR SMA
42 3209136404870002 SULISTYORINI P SUKWAN 10/3/2011 SKR S-1 FARMASI
43 3274044207890001 MIRA SUSILAWATI P SUKWAN 9/6/2011 SKR D-3 KEBIDANAN
44 3209124302910008 DEVI IRA SARI P SUKWAN 9/30/2011 SKR D-3 KEBIDANAN
45 3209246409890003 SHEINA MUTIARA MAYLISA P SUKWAN 10/10/2011 SKR D-3 KEBIDANAN
46 320940510690002 AYU KHAERUNNISA P SUKWAN 10/17/2010 SKR D-3 KEBIDANAN
47 3209185110880004 FATIMAH P SUKWAN 11/1/2011 SKR D-3 KEBIDANAN
48 3209125203910013 SITI AISAH P SUKWAN 8/25/2012 SKR D-3 KEBIDANAN
49 3209026612890005 RIZKYA AMALIA P SUKWAN 6/28/2012 SKR D-3 KEBIDANAN
50 AHMAD RIYANTO L SUKWAN 12/27/2013 SKR SMA
51 3209386911930002 TIARA MAHARANI P SUKWAN 10/2/2014 SKR D-3 ANALIS KESEHATAN
52 3209126603930001 FRITA MARVIANA P SUKWAN 10/22/2014 SKR D-3 KEBIDANAN
53 1605024806910002 YULENI P SUKWAN 11/2/2014 SKR S-1 KEPERAWATAN
54 3210076103910001 EKA RUKMAWATI P SUKWAN 10/20/2014 SKR D-3 KEBIDANAN
55 3329125901920006 NITA SULISTYANINGSIH P SUKWAN 10/20/2014 SKR D-3 KEBIDANAN
56 3209154712930005 NURUL ATIKAH P SUKWAN 12/8/2014 SKR D-3 KEBIDANAN
57 3274035812810014 WULAN PUJIHASTUTI P SUKWAN 3/2/2015 SKR APOTEKER/S-1 FARMASI
58 3274034812930006 DEASY ROSDYANA DEWI P SUKWAN 2/2/2015 SKR D-3 KEBIDANAN
59 3329090311910002 ARI SUBANDI L SUKWAN 1/5/2015 SKR D-3 KEPERAWATAN GIGI
60 3209345412930001 ROSILAWATI P SUKWAN 2/2/2015 SKR D-3 KEBIDANAN
61 3209305606920003 EKA FAJARWATI P SUKWAN 3/1/2015 SKR D-3 KEBIDANAN
62 3209126209930008 KIKI SRI REJEKI P SUKWAN 3/2/2015 SKR D-3 KEPERAWATAN
63 3209126104910017 IKE NURJANAH P SUKWAN 3/3/2015 SKR D-3 KEBIDANAN
64 3209124204930003 INTAN NUR ROKHMAWATI P SUKWAN 4/3/2015 SKR D-3 KEBIDANAN
65 3212234605920004 WIWIN WIDIANINGSIH P SUKWAN 5/4/2015 SKR D-3 KEBIDANAN
66 3329166307910006 TITIN P SUKWAN 6/8/2015 SKR D-3 KEBIDANAN
67 3209124406903990 ANITA ANGGRAENI P SUKWAN 9/21/2015 SKR D-3 KEBIDANAN
68 3209124906910010 MELISA P SUKWAN 9/21/2015 SKR D-3 KEBIDANAN
69 3274055305890007 LISNA LISKA RAMADANI P SUKWAN 10/5/2015 SKR D-3 KEBIDANAN
70 6201010803790001 AGUS SUPRIYADI L SUKWAN 11/17/2015 SKR SMA
71 3209126303940006 RETNO LESTARI P SUKWAN 12/2/2015 SKR D-3 KEBIDANAN
72 3209125210930010 NITA HARDIANTI P SUKWAN 12/2/2015 SKR D-3 KEPERAWATAN
73 3274033202940010 ELVIAN HERAWAN L SUKWAN 11/30/2015 SKR S-1 ILMU GIZI
74 3209165506970017 HESTI UMIYATIN P SUKWAN 12/12/2015 SKR SMK
75 3212206911930001 ENDAH LIR WULAN P SUKWAN 1/4/2016 SKR D-3 KEBIDANAN
76 3209195912910003 DESSY ARIFIYANTI P SUKWAN 2/2/2016 SKR D-3 KEBIDANAN
77 3209046203940007 FITRI ANDAYANI P SUKWAN 2/2/2016 SKR D-3 KEPERAWATAN GIGI
78 3209404306930001 FITRI WAHYUNI P SUKWAN 2/2/2016 SKR D-3 KEPERAWATAN GIGI
79 3209121809770004 AGUS HAMID L SUKWAN 1/2/2016 SKR SLTA
80 3274042512790001 AHMAD SOLEH L SUKWAN 1/2/2016 SKR SLTA
81 3209100512910007 MUSTAMID L SUKWAN 1/2/2016 SKR SLTA
82 MOHAMMAD TOHA L SUKWAN 1/23/2016 SKR SLTA
83 3209125004910010 DAHYATI P SUKWAN 3/1/2016 SKR D-3 KEPERAWATAN
84 3209036512930000 WIDIA AYU LESTARI P SUKWAN 3/1/2016 SKR S-1 KEPERAWATAN
85 3209056701930008 SUSI SETIAWATI P SUKWAN 3/1/2016 SKR D-3 KEBIDANAN
86 3209104102920022 EUIS RAHMAWATI P SUKWAN 3/14/2016 SKR D-3 KEBIDANAN
87 3209386707880005 SITI AISAH P SUKWAN 3/14/2016 SKR S-1 KEPERAWATAN/NERS
88 3209125610930008 WIWIN WIDIASTUTI P SUKWAN 3/14/2016 SKR D-3 KEBIDANAN
89 3209250307890001 TORIDIN L SUKWAN 4/1/2016 SKR D-3 KEPERAWATAN
90 3209125906930002 LELYTA RAHMAWATI P SUKWAN 4/26/2016 SKR D-3 KEBIDANAN
91 3209120611960006 NUR SETIANA P SUKWAN 5/1/2016 SKR SMF
92 3209216507930003 AAN NIRA P SUKWAN 5/1/2016 SKR D-3 FARMASI
93
PENDIDIKAN

Tahun Kode Sekolah /

Lulus Perguruan Tinggi

1999
2010

2007
2013
2012
2012 A.00351
1993 009868
1987
2015 A.2275
1994
1995
1983
2015 A.2272
2015 A.2264
1994
2000
2013
1996
2001
1999
2002
2010 E.0011088
2013 A.0611
2004 19006
2006
2007
2006
2010
2007
2009
2010
2007
2002
2002
2005
2005
2013
1987
2001
1997
2008
2010
2011
2010
2011
2011
2012
2010 A.001713

2014
2014 B.0465
2014
2012
2013
2014
2014
2014 B.0461
2014
2014
2013
2014
2014 017/AIHC.I/2014
2014
2014 A.002694
2014 018/AIHC.I/2014
2012
2013
2011
1997
2015
2015
2015
2015
2014
2015
2015
2015
1996
1997
2010
2005
2014
2015
2014 AF.15713
2013 AC.22398
2012 A.002169
2015
2011
2014
2015
2015
 DATA NOMINATIF PEGAWAI
UPT PUSKESMAS MUNDU
MEI 2016
RUANG :
FORM A4 - INDIVIDU - DATA REGISTRASI DAN PERIJINAN TENAGA KESEHATAN
Kode Unit REGISTRASI
Kerja Jenis Status
NIK ID/NIP/NRP NAMA LENGKAP Th
Kelamin Kepegawaian
No.STR Penerbitan Jenis Profesi
Fasyankes STR
3329120810660007 19661008 199603 1 002 dr. H. SYAFAAT MULYANTO. MQIH L PNS Dokter
3209126207850003 19850722 201412 2 002 dr. GIKA FAJARIANAH HADIKUSUMAH P CPNS 332110021-5112253 Dokter
3209230706810003 drg. DENY IRAWAN L SUKWAN Dokter
3209384502830004 dr.ITO MASITOH P SUKWAN Dokter
3274055509820005 dr.DINA INDAYANI P SUKWAN Dokter
3209111007660004 19660710 198703 1 003 UUS SUGEMA L PNS 131251112-0109432 Sanitasi
3209124507710006 19710705 199203 2 005 SUMARNI SUMIARTINI P PNS 130252115-0880023 1/16/2015 Bidan
3209104911660006 19661109 198603 2 002 JAN JAN ROKHMATUL JANNAH P PNS Dalam Proses Pembuatan Perawat
3209125111670001 19671011 198901 2 004 TUNIYAH P PNS Dalam Proses Pembuatan Perawat
3209124102720002 19720201 199203 2 006 LULUK KUSTONIAH P PNS 130252115-0880085 1/16/2015 Bidan
3209365610730003 19731016 199503 2 003 SRI RATNA AYU P PNS Sanitasi
3209205904750004 19750419 199703 2 001 NURANTI P PNS Pelaksana Gizi
3209100308620003 19620803 199103 1 003 MUHYIDIN L PNS Pelaksana
 PERIJINAN

No. Surat Ijin Praktek Tgl Penerbitan SIP

449/SIP-DU-135/YF/Dinkes/VI/2015 0/06/2015

449/SIKB-1381/YF/DINKES/VI/2012 6/8/2012

449/SIKB-142/YF/DINKES/VI/2012 6/8/2012
DATA NOMINATIF PEGAWAI
UPT PUSKESMAS MUNDU
KEADAAN BULAN FEBRUARY 2016

NO NAMA TEMPAT/TANGGAL LAHIR NIP/NR.PTT

1 2 3 4
1 dr. H. SYAFAAT MULYANTO. MQIH PEKALONGAN/ 08 OKTOBER 1966 19661008 199603 1 002
2 dr. GIKA FAJARIANAH ACEH TENGAH/ 22 JULI 1985 19850722 201412 2 002
3 drg. DENY IRAWAN CIREBON/ 07 JUNI 1981
4 dr.ITO MASITOH CIREBON/ 05 FEBRUARI 1983
5 dr.DINA INDAYANI MEDAN/ 15 SEPTEMBER 1982
6 UUS SUGEMA KUNINGAN/ 10 JULI 1966 19660710 198703 1 003
7 SUMARNI SUMIARTINI CIREBON/ 05 JULI 1971 19710705 199203 2 005
8 JAN JAN ROKHMATUL JANNAH CIREBON/ 09 NOPEMBER 1966 19661109 198603 2 002
9 TUNIYAH INDRAMAYU/ 11 NOPEMBER 1967 19671011 198901 2 004
10 LULUK KUSTONIAH MOJOKERTO/01 FEBRUARI 1972 19720201 199203 2 006
11 SRI RATNA AYU CIREBON/ 16 OKTOBER 1973 19731016 199503 2 003
12 NURANTI BANTUL/ 19 APRIL 1975 19750419 199703 2 001
13 MUHYIDIN CIREBON/ 03 AGUSTUS 1962 19620803 199103 1 003
14 IMROATUL AZIZAH CIREBON/ 05 NOMPEMBER 1973 19731105 200112 2 001
15 DEDEK KUSNIATI CIREBON/ 24 JULI 1975 19750724 200112 2 002
16 ROHAYATI SUMEDANG/ 24 DESEMBER 1974 19741224 200701 2 005
17 IDAH LAENI CIREBON/ 19 MEI 1976 19760519 200701 2 007
18 YULY YUNITA CIREBON/ 11 JUNI 1980 19800611 200801 2 006
19 NANANG SUPARMAN CIREBON/ 11 JUNI 1973 19730611 200801 1 006
20 KARTONO CIREBON/ 02 MARET 1980 19800302 200801 1 006
21 SRI YANAH RAHAYU CIREBON/ 16 AGUSTUS 1978 19780816 200801 2 008
22 YUSUP CIREBON/ 24 JUNI 1983 19830624 200604 1 005
23 ATIN HERYATI CIREBON/ 10/12/1968 19681210 199003 2 006
24 ERVINA SUSILAWATI CIREBON/ 22/04/1977 19770422 200801 2 005
25 EMI NURHIKMAH JAKARTA/ 28 JULI 1980 10.4.047.1704
26 IKA MERDEKAWATI ARJAWINANGUN/ 16 AGUSTUS 1983 10.4.047.710
27 RANI SORAYA CIREBON/ 19 SEPTEMBER 1985 10.4.048.14328
28 DEWI DAMAYANTI CIREBON/ 21 DESEMBER 1984 10.4.047.11767
29 RIZKI RIFATUL NISA CIREBON/ 22 SEPTEMBER 1989 10.4.030107
30 YENI RAHMAWATI CIREBON/ 10 NOPEMBER 1979 873.32.08.09.0115
31 RETNO SULIESTYA NING AYU CIREBON/ 13 APRIL 1988 873.32.08.11.0609
32 RIRIN TRI UTAMI CIREBON/ 02 MARET 1990 873.32.08
33 HARNI JUNAENI CIREBON/ 01 JUNI 1985 873.32.08.09.0081
34 SUNENGSIH CIREBON/ 08 MEI 1979
35 CIPI SUCIAWATI CIREBON/ 24 MEI 1980
36 TETY HERAWATI CIREBON, 03 MARET 1982
37 MOH. YASIN INDRAMAYU/ 04 JANUARI 1981
38 YUNITA INTAN WULANDARI CIREBON/ 15 JUNI 1989
39 MADI CIREBON/ 11/06/1971
40 HANIPAH CIREBON/ 07/07/1983
41 BAHRUDIN CIREBON/ 10/06/1979
42 SULISTYORINI CIREBON/ 24/04/1987
43 MIRA SUSILAWATI CIREBON/ 12/07/1991
44 DEVI IRA SARI CIREBON/ 05/02/1992
45 SHEINA MUTIARA MAYLISA CIREBON/ 24/09/1989
46 AYU KHAERUNNISA CIREBON/ 11/06/1990
47 FATIMAH CIREBON/ 08/10/1988
48 SITI AISAH CIREBON/ 12/03/1991
49 RIZKYA AMALIA CILEDUG/ 26/12/1989
50 AHMAD RIYANTO CIREBON/ 13/01/1982
51 TIARA MAHARANI INDRAMAYU/ 29/11/1993
52 FRITA MARVIANA CIREBON/ 26/03/1993
53 YULENI CIREBON/ 08/06/1991
54 EKA RUKMAWATI MAJALENGKA/ 21/03/1991
55 NITA SULISTYANINGSIH BREBES/ 19/01/1992
56 NURUL ATIKAH CIREBON/ 07/12/1993
57 WULAN PUJIHASTUTI CIREBON/ 18/12/1981
58 DEASY ROSDYANA DEWI CIREBON/ 08/12/1993
59 ARI SUBANDI BREBES/ 03/11/1991
60 ROSILAWATI CIREBON/ 14/12/1993
61 EKA FAJARWATI CIREBON/ 16/06/1992
62 KIKI SRI REJEKI CIREBON/ 22/09/1993
63 IKE NURJANAH CIREBON/ 21/04/1991
64 INTAN NUR ROKHMAWATI CIREBON/ 02/04/1993
65 WIWIN WIDIANINGSIH INDRAMAYU/ 06/05/1992
66 TITIN BREBES/ 23/07/1991
67 ANITA ANGGRAENI CIREBOB/ 04/06/1990
68 MELISA CIREBON/ 09/06/1992
69 LISNA LISKA RAMADANI CIREBON/ 13/05/1989
70 AGUS SUPRIYADI CIREBON/ 08/03/1979
71 RETNO LESTARI CIREBON/ 23/03/1994
72 NITA HARDIANTI CIREBON/ 12/10/1993
73 ELVIAN HERAWAN CIREBON/ 22/02/1994
74 TRIYANI MAYASARI CIREBON/ 20/05/1992
75 HESTI UMIYATIN CIREBON, 15/09/1997
76 ENDAH LIR WULAN INDRAMAYU, 29/11/1993
77 DESSY ARIFIYANTI CIREBON, 19/12/1991
78 FITRI ANDAYANI CIREBON, 22/03/1994
79 FITRI WAHYUNI CIREBON, 03/06/1994
80 AGUS HAMID CIREBON, 03/06/1995
81 AHMAD SOLEH CIREBON, 03/06/1996
82 MUSTAMID CIREBON, 03/06/1997
83
84
85
86
87
 STR SIP NIK NPWP

3329120810660007 67.719.238.7-426.000
3209126207850003 36.545.850.4-426.001

131251112-0109432 3209111007660004 58.648.569.0-426.000

3209124507710006 58.648.580.7-426.000
3209104911660006 14.322.611.6-426.001
3209125111670001 24.449.719.3-426.000
3209124102720002 58.648.571.6-426.000
3209365610730003 58.648.572.4-426.000
3209205904750004 58.648.573.2-426.000
3209100308620003 24.166.220.4-426.000
320912451173000 58.648.575.7-426.000
3209126407750006 58.648.574.0-426.000
3209126412740002 58.648.579.9-426.000
1301521140805300 3209185905760001 58.647.404.1-426.000
3209125209830006 58.648.581.5-426.000
3209361106730002 58.648.312.5-426.000
3209210203800014 58.648.582.3-426.000
3209125605780014 58.648.577.3-426.000
3209152406830002 54.618.688.3-426.000

3209126807800012 66.441.143.6-426.000
3209125608830006 44.320.005.0-426.000
3209125909850004 49.554.678.0-426.001
3209196112840008 35.847.110.0-426.000
3209126209890003 66.464.591.8-426.000
3209125011790004 45.247.273.3-426.000
3209215304880005 36.564.079.6-426.000
3209174203906354 36570

3209120401810001 05.804.397.7-426.000
1302521150965363 3209246409890003 70.636.725.7-426.000

1302521120507780 3210076103910001 72.986.990.9-438.000

3209124406903990
1302521130697863 3209124906910010
322011010805.Bdn 3274055305890007 74.326.543.1-426.000

3209126303940006
 PANGKAT
NOMOR
NO HP KARPEG PANGKAT GOL TMT.GOL

5 6 7
081223339968 PEMBINA IV.A 10/1/2003
081321199221 PENATA MUDA TK I III.B 12/1/2014

SUKWAN
SUKWAN
08122213738 E.552714 PENATA TK I III. D 4/1/2013
08122354116 G.020041 PENATA TK I III.D 10/1/2014
D.330251 PENATA TK I III.D
081320632142 F.007828 PENATA III.C 4/1/2008
081324678672 F.050832 PENATA III.C 10/1/2012
081223840070 G.243502 PENATA MUDA TK I III.B 4/1/2013
087829900549 G.358503 PENATA MUDA III.A 4/1/2013
082117558603 E.781194 PENATA MUDA III.A 10/1/2013
08122186145 L.019840 PENGATUR III.A 10/1/2014
081395616326 L.019841 PENGATUR III.A 10/1/2014
082127742993 N.315108 PENGATUR MUDA II.C 4/1/2011
082129010021 N.315013 PENATA MUDA III.A 4/1/2014
081220770568 N.621558 PENATA MUDA III.A 10/1/2014
081909891177 N.622695 PENATA MUDA III.A 10/1/2015
082119289852 N.622689 PENGATUR MUDA TKII.D 4/1/2012
085295874424 N.621587 PENATA MUDA III.A 4/1/2015
087728895543 N.155393 PENGATUR MUDA II.C 4/1/2015
PENATA MUDA TK I III.B
N.622306 PENATA MUDA III.A 10/1/2014
081313224203 PTT
08971555277 PTT
082127357911 PTT
082221018900 PTT
085315606332 PTT
081395655577 PTT
085316137063 PTT
PTT
PTT
PTT
SUKWAN
SUKWAN
085295952060 SUKWAN
SUKWAN
SUKWAN
 SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
082221521509 SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
081320738732 SUKWAN
087730372727 SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
087883338752 SUKWAN
SUKWAN
082117510575 SUKWAN
SUKWAN
089618310414 SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
SUKWAN
 DIKLAT TAHUN
TMT TAHUN PENJENJAN
JABATAN PENDIDIKAN TERAKHIR
JABATAN LULUS DIKLAT
GAN

8 9 10 11 12 13
KEPALA PUSKESMAS S-2 1999 SPAMA 2005
DOKTER UMUM 12/1/2014 DOKTER UMUM (PROFESI) 2010
DOKTER GIGI 7/1/2015 DOKTER GIGI
DOKTER UMUM DIKTER UMUM 9PROFESI) 2007
DOKTER UMUM 1/25/2016 DOKTER UMUM (PROFESI) 2013
SANITARIAN PENYELIA 4/1/2013 S.1 KESEHATAN MASYARAKAT 2012
BIDAN PENYELIA 10/1/2014 D-4 KEBIDANAN 2012
PERAWAT PENYELIA 4/1/2016
PERAWAT PENYELIA 4/1/2008 SPK 1987
BIDAN PENYELIA 10/1/2012 D-3 KEBIDANAN 2009
SANITARIAM PELAKSANA LANJUTAN 4/1/2013 D-I SPPH 1994
PELAKSANA GIZI 4/1/2013 D-I SPAG 1995
PELAKSANA 10/1/2013 SMA 1983
BIDAN PELAKSANA LANJUTAN 10/1/2014 D-3 KEBIDANAN 2010
BIDAN PELAKSANA LANJUTAN 10/1/2014 D-3 KEBIDANAN 2010
PERAWAT PELAKSANA 10/1/2014 D-1 KEBIDANAN 1994
PERAWAT PELAKSANA LANJUTAN 4/2/2014 D-3 KEBIDANAN 2000
PERAWAT PELAKSANA 10/1/2014 S-1 KEPERAWATAN 2013
PERAWAT PELAKSANA LANJUTAN 10/1/2015 D-3 KEPERAWATAN 1996
PERAWAT PELAKSANA 4/1/2012 D-3 KEPERAWATAN 2001
PERAWAT PELAKSANA LANJUTAN 4/1/2015 D-3 KEPERAWATAN 1999
FUNGSIONAL UMUM 4/1/2015 SMF 2002
BIDAN 7/1/2005 D-3 KEBIDANAN 2010
BIDAN 1/1/2008 D-4 KEBIDANAN 2013
BIDAN DESA SINARANCANG 7/1/2005 D-3 KEBIDANAN 2005
BIDAN DESA CITEMU 7/1/2006 D-3 KEBIDANAN 2006
BIDAN DESA MUNDUMESIGIT 6/1/2009 D-3 KEBIDANAN 2007
BIDAN DESA PAMENGKANG 6/1/2007 D-3 KEBIDANAN 2006
BIDAN DESA PENPEN 7/1/2011 D-3 KEBIDANAN 2010
BIDAN PONED 8/1/2009 D-3 KEBIDANAN 2007
BIDAN PONED 5/1/2011 D-3 KEBIDANAN 2009
BIDAN PONED 5/1/2011 D-3 KEBIDANAN 2010
BIDAN PONED 8/1/2009 D-3 KEBIDANAN 2007
PERAWAT 1/1/2006 D-3 KEPERAWATAN 2002
PERAWAT 12/20/2004 D-3 KEPERAWATAN 2002
PERAWAT 8/1/2006 D-3 KEPERAWATAN 2005
PERAWAT 11/28/2006 S-1 KEPERAWATAN 2005
PERAWAT 9/20/2013 D-3 KEPERAWATAN 2013
CLEANING SERVICE 11/2/1998 SD 1987
PENDAFTARAN 9/1/2001 SMK 2001
PENDAFTARAN 12/2/2004 SMA 1997
PENGELOLA OBAT 10/3/2011 S-1 FARMASI 2008
BIDAN PONED 9/6/2011 D-3 KEBIDANAN 2010
BIDAN PONED 9/30/2011 D-3 KEBIDANAN 2011
BIDAN PONED 10/10/2011 D-3 KEBIDANAN 2010
BIDAN PONED 10/17/2010 D-3 KEBIDANAN 2011
BIDAN PONED 11/1/2011 D-3 KEBIDANAN 2011
BIDAN PONED 8/25/2012 D-3 KEBIDANAN 2012
BIDAN DESA WARUDUWUR 8/1/2013 D-3 KEBIDANAN 2011
DRIVER 12/27/2013 SMA
ANALIS 10/2/2014 D-3 ANALIS KESEHATAN 2014
BIDAN PONED 10/22/2014 D-3 KEBIDANAN 2014
PERAWAT 11/2/2014 S-1 KEPERAWATAN 2014
BIDAN 10/20/2014 D-3 KEBIDANAN 2012
BIDAN 10/20/2014 D-3 KEBIDANAN 2013
BIDAN 12/8/2014 D-3 KEBIDANAN 2014
PENGELOLA OBAT 3/2/2015 APOTEKER/S-1 FARMASI 2014
BIDAN 2/2/2015 D-3 KEBIDANAN 2014
PERAWAT GIGI 1/5/2015 D-3 KEPERAWATAN GIGI 2014
BIDAN PONED 2/2/2015 D-3 KEBIDANAN 2014
BIDAN 3/1/2015 D-3 KEBIDANAN 2013
PERAWAT 3/2/2015 D-3 KEPERAWATAN 2014
BIDAN 3/3/2015 D-3 KEBIDANAN 2014
BIDAN 4/3/2015 D-3 KEBIDANAN 2014
BIDAN 5/4/2015 D-3 KEBIDANAN 2014
BIDAN 6/8/2015 D-3 KEBIDANAN 2014
BIDAN 9/21/2015 D-3 KEBIDANAN 2012
BIDAN 9/21/2015 D-3 KEBIDANAN 213
BIDAN 10/5/2015 D-3 KEBIDANAN 2011
PEMBANTU TU 11/17/2015 SMA 1997
BIDAN 12/2/2015 D-3 KEBIDANAN 2015
PERAWAT 12/2/2015 D-3 KEPERAWATAN 2015
AHLI GIZI 11/30/2015 S-1 ILMU GIZI 2015
BIDAN 12/18/2015 D-3 KEBIDANAN 2012
ASISTEN APOTEKER 12/15/2015 SMK 2015
BIDAN 1/4/2016 D-3 KEBIDANAN 2014
BIDAN 2/2/2016 D-3 KEBIDANAN 2015
PERAWAT GIGI 2/2/2016 D-3 KEPERAWATAN GIGI 2015
PERAWAT GIGI 2/2/2016 D-3 KEPERAWATAN GIGI 2015
SECURITY 1/2/2016 SLTA
SECURITY 1/2/2016 SLTA
SECURITY 1/2/2016 SLTA
 KEPEGAWAIAN MASA KERJA
TMT
JENIS MENJADI KET
STATUS KEPEG KEPEG PEGAWAI TAHUN BULAN

14 15 16 17 18 19
PNS PNS 3/1/1996 19 9
CPNS CPNS 12/1/2014 1 0
SUKWAN
SUKWAN
SUKWAN 1/25/2016 0 0
PNS PNS 3/1/1987 28 9
PNS PNS 3/1/1992 23 9

PNS PNS 1/1/1989 26 11

PNS PNS 3/1/1992 23 9
PNS PNS 3/1/1995 20 9
PNS PNS 3/1/1997 18 9
PNS PNS 3/1/1991 24 9
PNS PNS 12/1/2001 15 0
PNS PNS 12/1/2001 15 0
PNS PNS 1/1/2007 21 11
PNS PNS 1/1/2007 11 11
PNS PNS 1/1/2008 10 11
PNS PNS 1/1/2008 8 11
PNS PNS 1/1/2008 8 11
PNS PNS 1/1/2008 8 11
PNS PNS 4/1/2006 9 8
PNS PNS 3/1/1990 25 9
PNS PNS 3/1/1990 25 9
PTT PUSAT PTT 7/1/2005 10 5
PTT PUSAT PTT 7/1/2006 9 5
PTT PUSAT PTT 12/1/2007 8 0
PTT PUSAT PTT 6/1/2007 8 6
PTT PUSAT PTT 7/1/2011 4 5
PTT PROV PTT 8/1/2009 6 4
PTT PROV PTT 5/1/2011 4 7
PTT PROV PTT 5/1/2011 4 7
PTT PROV PTT 8/1/2009 6 4
KONTRK DINAS 1/1/2006 9 11
SUKWAN 12/20/2004 11 0
SUKWAN 8/1/2006 9 4
SUKWAN 11/28/2006 9 1
SUKWAN 9/20/2013 2 3
SUKWAN 11/2/1998 4 1
SUKWAN 9/1/2001 14 4
SUKWAN 12/2/2004 11 0
SUKWAN 10/3/2011 4 2
SUKWAN 9/6/2011 4 3
SUKWAN 9/30/2011 4 3
SUKWAN 10/10/2011 4 2
SUKWAN 10/17/2010 4 2
SUKWAN 11/1/2011 4 1
SUKWAN 8/25/2012 3 4
SUKWAN 8/1/2013 2 4
SUKWAN 12/27/2013 2 0
SUKWAN 10/2/2014 1 2
SUKWAN 10/22/2014 1 2
SUKWAN 11/2/2014 1 1
SUKWAN 10/20/2014 1 2
SUKWAN 10/20/2014 1 2
SUKWAN 12/8/2014 1 0
SUKWAN 3/2/2015 0 9
SUKWAN 2/2/2015 0 10
SUKWAN 1/5/2015 0 11
SUKWAN 2/2/2015 0 10
SUKWAN 3/1/2015 0 9
SUKWAN 3/2/2015 0 9
SUKWAN 3/3/2015 0 9
SUKWAN 4/3/2015 0 8
SUKWAN 5/4/2015 0 7
SUKWAN 6/8/2015 0 6
SUKWAN 9/21/2015 0 3
SUKWAN 9/21/2015 0 3
SUKWAN 10/5/2015 0 2
SUKWAN 11/17/2015 0 1
SUKWAN 12/2/2015 0 0
SUKWAN 12/2/2015 0 0
SUKWAN 11/30/2015 0 1
SUKWAN 12/18/2015 0 0
SUKWAN 12/12/2015 0 0
SUKWAN 1/4/2016 0 0
SUKWAN 2/2/2016 0 0
SUKWAN 2/2/2016 0 0
SUKWAN 2/2/2016 0 0
SUKWAN 1/2/2016 0 0
SUKWAN 1/2/2016 0 0
SUKWAN 1/2/2016 0 0
DATA NOMINATIF PEGAWAI
UPT PUSKESMAS MUNDU
KEADAAN BULAN MEI 2016

NO NAMA TEMPAT/TANGGAL LAHIR NIK NIP/NR.PTT STR SIP

1 2 3 4
1 dr. H. SYAFAAT MULYANTO. MQIH PEKALONGAN/ 08 OKTOBER 1966 3329120810660007 19661008 199603 1 002
2 dr. GIKA FAJARIANAH ACEH TENGAH/ 22 JULI 1985 3209126207850003 19850722 201412 2 002 33211002-15112253 449/SIP-DU-135/YF/Dinkes/VI/2015
3 drg. DENY IRAWAN CIREBON/ 07 JUNI 1981 3209230706810003
4 dr.ITO MASITOH CIREBON/ 05 FEBRUARI 1983 3209384502830004
5 dr.DINA INDAYANI MEDAN/ 15 SEPTEMBER 1982 3274055509820005
6 UUS SUGEMA KUNINGAN/ 10 JULI 1966 3209111007660004 19660710 198703 1 003 131251112-0109432
7 SUMARNI SUMIARTINI CIREBON/ 05 JULI 1971 3209124507710006 19710705 199203 2 005 130252115-0880023 449/SIKB-1381/YF/DINKES/VI/2012
8 JAN JAN ROKHMATUL JANNAH Cirebon/09/11/1966 3209104911660006 19661109 198603 2 002 Dalam Proses Pembuatan
9 TUNIYAH INDRAMAYU/ 11 NOPEMBER 1967 3209125111670001 19671011 198901 2 004 Dalam Proses Pembuatan
10 LULUK KUSTONIAH MOJOKERTO/01 FEBRUARI 1972 3209124102720002 19720201 199203 2 006 130252115-0880085 449/SIKB-142/YF/DINKES/VI/2012
11 SRI RATNA AYU CIREBON/ 16 OKTOBER 1973 3209365610730003 19731016 199503 2 003
12 NURANTI BANTUL/ 19 APRIL 1975 3209205904750004 19750419 199703 2 001
13 MUHYIDIN CIREBON/ 03 AGUSTUS 1962 3209100308620003 19620803 199103 1 003
14 IMROATUL AZIZAH CIREBON/ 05 NOMPEMBER 1973 320912451173000 19731105 200112 2 001 130252115-0880440 449/SIKB-134/YF/DINKES/VI/2012
15 DEDEK KUSNIATI CIREBON/ 24 JULI 1975 3209126407750006 19750724 200112 2 002 132052115-0965488 449/SIKB-140/YF/DINKES/VI/2012
16 ROHAYATI SUMEDANG/ 24 DESEMBER 1974 3209126412740002 19741224 200701 2 005
17 IDAH LAENI CIREBON/ 19 MEI 1976 3209185905760001 19760519 200701 2 007 130152114-0805300
18 YULY YUNITA CIREBON/ 11 JUNI 1980 3209125209830006 19800611 200801 2 006 130152114-0805310
19 NANANG SUPARMAN CIREBON/ 11 JUNI 1973 3209361106730002 19730611 200801 1 006 Dalam Proses Pembuatan
20 KARTONO CIREBON/ 02 MARET 1980 3209210203800014 19800302 200801 1 006 130151114-0805311
21 SRI YANAH RAHAYU CIREBON/ 16 AGUSTUS 1978 3209125605780014 19780816 200801 2 008
22 YUSUP CIREBON/ 24 JUNI 1983 3209152406830002 19830624 200604 1 005
23 ATIN HERYATI CIREBON/ 10/12/1968 3209105026800001 19681210 199003 2 006 449/SIKB/018/YF/DINKES/II/2011
24 ERVINA SUSILAWATI CIREBON/ 22/04/1977 3212216204770006 19770422 200801 2 005 130252112-0545923 157/SIKB/YANKES/2014
25 EMI NURHIKMAH JAKARTA/ 28 JULI 1980 3209126807800012 10.4.047.1704 130252115-0880001
26 IKA MERDEKAWATI ARJAWINANGUN/ 16 AGUSTUS 1983 3209125608830006 10.4.047.710 130252115-0880084
27 RANI SORAYA CIREBON/ 19 SEPTEMBER 1985 3209125909850004 10.4.048.14328 130252115-0880027 449/SIP.Bd-099/YF/DINKES/VI/2012
28 DEWI DAMAYANTI CIREBON/ 21 DESEMBER 1984 3209196112840008 10.4.047.11767
29 RIZKI RIFATUL NISA
30 YENI RAHMAWATI
31 RETNO SULIESTYA NING AYU
32 RIRIN TRI UTAMI
33 HARNI JUNAENI
34 SUNENGSIH
35 CIPI SUCIAWATI
36 TETY HERAWATI
37 MOH. YASIN
38 YUNITA INTAN WULANDARI
39 MADI
40 HANIPAH
41 BAHRUDIN
42 SULISTYORINI
43 MIRA SUSILAWATI
44 DEVI IRA SARI
45 SHEINA MUTIARA MAYLISA
46 AYU KHAERUNNISA
47 FATIMAH
48 SITI AISAH
49 RIZKYA AMALIA
CIREBON/ 22 SEPTEMBER 1989 3209126209890003 10.4.030.107
CIREBON/ 10 NOPEMBER 1979 3209125011790004 873.32.08.09.0115 130252115-0880086
CIREBON/ 13 APRIL 1988 3209215304880005 873.32.08.11.0609 130252115-0880123
CIREBON/ 02 MARET 1990 3209174203906354 873.32.07.11.0611
CIREBON/ 01 JUNI 1985 3274034106850013 873.32.08.09.0081 130252115-0867347
CIREBON/ 08 MEI 1979 3209124805790001 PKD Dalam Proses Pembuatan
CIREBON/ 24 MEI 1980 3209126405800004 SUKWAN
CIREBON, 03 MARET 1982 3209144303820006 SUKWAN
INDRAMAYU/ 04 JANUARI 1981 3209120401810001 SUKWAN
CIREBON/ 15 JUNI 1989 3209125506890005 SUKWAN
CIREBON/ 11/06/1971 3209120108720009 SUKWAN
CIREBON/ 07/07/1983 3209124702830006 SUKWAN
CIREBON/ 10/06/1979 3209121006790008 SUKWAN
CIREBON/ 24/04/1987 3209136404870002 SUKWAN
CIREBON/ 12/07/1991 3274044207890001 130252112-0391863
CIREBON/ 05/02/1992 3209124302910008 130252115-0965310
CIREBON/ 24/09/1989 3209246409890003 130252115-0965363
CIREBON/ 11/06/1990 320940510690002 130252115-0965314
CIREBON/ 08/10/1988 3209185110880004 130252115-0965500
CIREBON/ 12/03/1991 3209125203910013 130252112-0589514
CILEDUG/ 26/12/1989 3209026612890005 130252115-0879993 449/SIKB-127/YF/DINKES/XII/2014
50 AHMAD RIYANTO CIREBON/ 13/01/1982
51 TIARA MAHARANI INDRAMAYU/ 29/11/1993 3209386911930002 131452115-0904920
52 FRITA MARVIANA CIREBON/ 26/03/1993 3209126603930001 130252115-0929329
53 YULENI CIREBON/ 08/06/1991 1605024806910002 Dalam Proses Pembuatan
54 EKA RUKMAWATI MAJALENGKA/ 21/03/1991 3210076103910001 1302521120507780
55 NITA SULISTYANINGSIH BREBES/ 19/01/1992 3329125901920006 130252114-0731163
56 NURUL ATIKAH CIREBON/ 07/12/1993 3209154712930005 Dalam Proses Pembuatan
57 WULAN PUJIHASTUTI CIREBON/ 18/12/1981 3274035812810014 19811218/STRA-STFB/2014/236640 19811218/SIPA_32.09/2015/2064
58 DEASY ROSDYANA DEWI CIREBON/ 08/12/1993 3274034812930006 130252115-0929325
59 ARI SUBANDI BREBES/ 03/11/1991 3329090311910002 Dalam Proses Pembuatan
60 ROSILAWATI CIREBON/ 14/12/1993 3209345412930001
61 EKA FAJARWATI CIREBON/ 16/06/1992 3209305606920003 130252113-0697808
62 KIKI SRI REJEKI CIREBON/ 22/09/1993 3209126209930008
63 IKE NURJANAH CIREBON/ 21/04/1991 3209126104910017
64 INTAN NUR ROKHMAWATI CIREBON/ 02/04/1993 3209124204930003
65 WIWIN WIDIANINGSIH INDRAMAYU/ 06/05/1992 3212234605920004 130252115-1044055
66 TITIN BREBES/ 23/07/1991 3329166307910006 140252115-0912887
67 ANITA ANGGRAENI CIREBOB/ 04/06/1990 3209124406903990 130252115-0867485
68 MELISA CIREBON/ 09/06/1992 3209124906910010 130252113-0697863
69 LISNA LISKA RAMADANI CIREBON/ 13/05/1989 3274055305890007 322011010805.Bdn
70 AGUS SUPRIYADI CIREBON/ 08/03/1979 6201010803790001
71 RETNO LESTARI CIREBON/ 23/03/1994 3209126303940006
72 NITA HARDIANTI CIREBON/ 12/10/1993 3209125210930010
73 ELVIAN HERAWAN CIREBON/ 22/02/1994 3274033202940010
75 HESTI UMIYATIN CIREBON, 15/09/1997 3209165506970017
76 ENDAH LIR WULAN INDRAMAYU, 29/11/1993 3212206911930001
77 DESSY ARIFIYANTI CIREBON, 19/12/1991 3209195912910003
78 FITRI ANDAYANI CIREBON, 22/03/1994 3209046203940007
79 FITRI WAHYUNI CIREBON, 03/06/1994 3209404306930001
80 AGUS HAMID CIREBON, 03/06/1995 3209121809770004
81 AHMAD SOLEH CIREBON, 25/12/1979 3274042512790001
82 MUSTAMID CIREBON, 03/06/1997 3209100512910007
83 MOHAMMAD TOHA CIREBON, 13/06/1985
84 DAHYATI CIREBON, 10/04/1992 3209125004910010 Dalam Proses Pembuatan
85 WIDIA AYU LESTARI CIREBON, 25/12/1993 3209036512930000
86 SUSI SETIAWATI CIREBON, 27/01/1993 3209056701930008 130252115-1042867
87 EUIS RAHMAWATI CIREBON, 01/02/1992 3209104102920022 130252114-0731394
88 SITI AISAH CIREBON, 27/07/1988 3209386707880005
89 WIWIN WIDIASTUTI CIREBON, 16/10/1993 3209125610930008
90 TORIDIN CIREBON, 07/03/1989 3209250307890001
91 LELYTA RAHMAWATI MAGETAN, 19/06/1993 3209125906930002 130252115-1042898
92 NUR SETIANA CIREBON, 06/11/1996 3209120611960006
93 AAN NIRA CIREBON, 25/07/1993 3209216507930003
94
95

Mengetahui
Kepala UPT Puskesmas Mundu

dr.H.Syafaat Mulyanto,MQIH
NIP : 19661008 199603 1 003
 PANGKAT KEPEGAWAIAN
NOMOR TMT TAHUN
NPWP NO HP JABATAN PENDIDIKAN TERAKHIR
KARPEG PANGKAT GOL TMT.GOL JABATAN LULUS STATUS KEPEG JENIS
KEPEG

5 6 7 8 9 10 11 14 15
67.719.238.7-426.000 081223339968 PEMBINA IV.A 10/1/2003 KEPALA PUSKESMAS S-2 1999 PNS PNS
36.545.850.4-426.001 081321199221 PENATA MUDA TK I III.B 12/1/2014 DOKTER UMUM 12/1/2014 DOKTER UMUM (PROFESI) 2010 CPNS CPNS
DOKTER GIGI 7/1/2015 DOKTER GIGI SUKWAN
SUKWAN DOKTER UMUM DIKTER UMUM 9PROFESI) 2007 SUKWAN
SUKWAN DOKTER UMUM 1/25/2016 DOKTER UMUM (PROFESI) 2013 SUKWAN
58.648.569.0-426.000 08122213738 E.552714 PENATA TK I III. D 4/1/2013 SANITARIAN PENYELIA 4/1/2013 S.1 KESEHATAN MASYARAKAT 2012 PNS PNS
58.648.580.7-426.000 08122354116 G.020041 PENATA TK I III.D 10/1/2014 BIDAN PENYELIA 10/1/2014 D-4 KEBIDANAN 2012 PNS PNS
14.322.611.6-426.001 D.330251 PENATA TK I III.D PERAWAT PENYELIA 4/1/2016
24.449.719.3-426.000 081320632142 F.007828 PENATA III.C 4/1/2008 PERAWAT PENYELIA 4/1/2008 SPK 1987 PNS PNS
58.648.571.6-426.000 081324678672 F.050832 PENATA III.C 10/1/2012 BIDAN PENYELIA 10/1/2012 D-3 KEBIDANAN 2009 PNS PNS
58.648.572.4-426.000 081223840070 G.243502 PENATA MUDA TK I III.B 4/1/2013 SANITARIAM PELAKSANA LANJUTAN 4/1/2013 D-I SPPH 1994 PNS PNS
58.648.573.2-426.000 087829900549 G.358503 PENATA MUDA III.A 4/1/2013 PELAKSANA GIZI 4/1/2013 D-I SPAG 1995 PNS PNS
24.166.220.4-426.000 082117558603 E.781194 PENATA MUDA III.A 10/1/2013 PELAKSANA 10/1/2013 SMA 1983 PNS PNS
58.648.575.7-426.000 08122186145 L.019840 PENATA MUDA III.A 10/1/2014 BIDAN PELAKSANA LANJUTAN 10/1/2014 D-3 KEBIDANAN 2010 PNS PNS
58.648.574.0-426.000 081395616326 L.019841 PENATA MUDA III.A 10/1/2014 BIDAN PELAKSANA LANJUTAN 10/1/2014 D-3 KEBIDANAN 2010 PNS PNS
58.648.579.9-426.000 082127742993 N.315108 PENGATUR II.C 4/1/2011 PERAWAT PELAKSANA 10/1/2014 D-1 KEBIDANAN 1994 PNS PNS
58.647.404.1-426.000 082129010021 N.315013 PENATA MUDA III.A 4/1/2014 PERAWAT PELAKSANA LANJUTAN 4/2/2014 D-3 KEBIDANAN 2000 PNS PNS
58.648.581.5-426.000 081220770568 N.621558 PENATA MUDA III.A 10/1/2014 PERAWAT PELAKSANA 10/1/2014 S-1 KEPERAWATAN 2013 PNS PNS
58.648.312.5-426.000 081909891177 N.622695 PENATA MUDA III.A 10/1/2015 PERAWAT PELAKSANA LANJUTAN 10/1/2015 D-3 KEPERAWATAN 1996 PNS PNS
58.648.582.3-426.000 082119289852 N.622689 PENGATUR MUDA TKII.D 4/1/2012 PERAWAT PELAKSANA 4/1/2012 D-3 KEPERAWATAN 2001 PNS PNS
58.648.577.3-426.000 085295874424 N.621587 PENATA MUDA III.A 4/1/2015 PERAWAT PELAKSANA LANJUTAN 4/1/2015 D-3 KEPERAWATAN 1999 PNS PNS
54.618.688.3-426.000 087728895543 N.155393 PENGATUR II.C 4/1/2015 FUNGSIONAL UMUM 4/1/2015 SMF 2002 PNS PNS
PENATA MUDA TK I III.B BIDAN 7/1/2005 D-3 KEBIDANAN 2010 PNS PNS
N.622306 PENATA MUDA III.A 10/1/2014 BIDAN 1/1/2008 D-4 KEBIDANAN 2013 PNS PNS
66.441.143.6-426.000 081313224203 PTT BIDAN DESA SINARANCANG 7/1/2005 D-3 KEBIDANAN 2005 PTT PUSAT PTT
44.320.005.0-426.000 08971555277 PTT BIDAN DESA CITEMU 7/1/2006 D-3 KEBIDANAN 2006 PTT PUSAT PTT
49.554.678.0-426.001 082127357911 PTT BIDAN DESA MUNDUMESIGIT 6/1/2009 D-3 KEBIDANAN 2007 PTT PUSAT PTT
35.847.110.0-426.000 082221018900 PTT BIDAN DESA PAMENGKANG 6/1/2007 D-3 KEBIDANAN 2006 PTT PUSAT PTT
66.464.591.8-426.000 085315606332 PTT BIDAN DESA PENPEN 7/1/2011 D-3 KEBIDANAN 2010 PTT PUSAT PTT
45.247.273.3-426.000 081395655577 PTT BIDAN PONED 8/1/2009 D-3 KEBIDANAN 2007 PTT PROV PTT
36.564.079.6-426.000 085316137063 PTT BIDAN PONED 5/1/2011 D-3 KEBIDANAN 2009 PTT PROV PTT
PTT BIDAN PONED 5/1/2011 D-3 KEBIDANAN 2010 PTT PROV PTT
PTT BIDAN PONED 8/1/2009 D-3 KEBIDANAN 2007 PTT PROV PTT
PTT PERAWAT 1/1/2006 D-3 KEPERAWATAN 2002 KONTRK DINAS
SUKWAN PERAWAT 12/20/2004 D-3 KEPERAWATAN 2002 SUKWAN
SUKWAN PERAWAT 8/1/2006 D-3 KEPERAWATAN 2005 SUKWAN
05.804.397.7-426.000 085295952060 SUKWAN PERAWAT 11/28/2006 S-1 KEPERAWATAN 2005 SUKWAN
70.623.385.5-426.000 SUKWAN PERAWAT 9/20/2013 D-3 KEPERAWATAN 2013 SUKWAN
70.630.202.3-426.000 087728756640 SUKWAN CLEANING SERVICE 11/2/1998 SD 1987 SUKWAN
70.623.205.5-426.000 082324025399 SUKWAN PENDAFTARAN 9/1/2001 SMK 2001 SUKWAN
70.623.154.5-426.000 085224599378 SUKWAN PENDAFTARAN 12/2/2004 SMA 1997 SUKWAN
SUKWAN PENGELOLA OBAT 10/3/2011 S-1 FARMASI 2008 SUKWAN
SUKWAN BIDAN PONED 9/6/2011 D-3 KEBIDANAN 2010 SUKWAN
SUKWAN BIDAN PONED 9/30/2011 D-3 KEBIDANAN 2011 SUKWAN
70.636.725.7-426.000 082221521509 SUKWAN BIDAN PONED 10/10/2011 D-3 KEBIDANAN 2010 SUKWAN
SUKWAN BIDAN PONED 10/17/2010 D-3 KEBIDANAN 2011 SUKWAN
SUKWAN BIDAN PONED 11/1/2011 D-3 KEBIDANAN 2011 SUKWAN
SUKWAN BIDAN PONED 8/25/2012 D-3 KEBIDANAN 2012 SUKWAN
SUKWAN BIDAN DESA WARUDUWUR 8/1/2013 D-3 KEBIDANAN 2011 SUKWAN
 SUKWAN DRIVER 12/27/2013 SMA SUKWAN
SUKWAN ANALIS 10/2/2014 D-3 ANALIS KESEHATAN 2014 SUKWAN
SUKWAN BIDAN PONED 10/22/2014 D-3 KEBIDANAN 2014 SUKWAN
SUKWAN PERAWAT 11/2/2014 S-1 KEPERAWATAN 2014 SUKWAN
72.986.990.9-438.000 081320738732 SUKWAN BIDAN 10/20/2014 D-3 KEBIDANAN 2012 SUKWAN
71.630.539.6-501.000 087730372727 SUKWAN BIDAN 10/20/2014 D-3 KEBIDANAN 2013 SUKWAN
SUKWAN BIDAN 12/8/2014 D-3 KEBIDANAN 2014 SUKWAN
SUKWAN PENGELOLA OBAT 3/2/2015 APOTEKER/S-1 FARMASI 2014 SUKWAN
73.879.253.0-426.000 81222344600 SUKWAN BIDAN 2/2/2015 D-3 KEBIDANAN 2014 SUKWAN
SUKWAN PERAWAT GIGI 1/5/2015 D-3 KEPERAWATAN GIGI 2014 SUKWAN
SUKWAN BIDAN PONED 2/2/2015 D-3 KEBIDANAN 2014 SUKWAN
083894934356 SUKWAN BIDAN 3/1/2015 D-3 KEBIDANAN 2013 SUKWAN
SUKWAN PERAWAT 3/2/2015 D-3 KEPERAWATAN 2014 SUKWAN
72.822.206.8-426.000 082225946279 SUKWAN BIDAN 3/3/2015 D-3 KEBIDANAN 2014 SUKWAN
72.799.268.7-426.000 SUKWAN BIDAN 4/3/2015 D-3 KEBIDANAN 2014 SUKWAN
SUKWAN BIDAN 5/4/2015 D-3 KEBIDANAN 2014 SUKWAN
74.907.867.1-501.000 087730768628 SUKWAN BIDAN 6/8/2015 D-3 KEBIDANAN 2014 SUKWAN
087883338752 SUKWAN BIDAN 9/21/2015 D-3 KEBIDANAN 2012 SUKWAN
SUKWAN BIDAN 9/21/2015 D-3 KEBIDANAN 213 SUKWAN
74.326.543.1-426.000 082117510575 SUKWAN BIDAN 10/5/2015 D-3 KEBIDANAN 2011 SUKWAN
SUKWAN PEMBANTU TU 11/17/2015 SMA 1997 SUKWAN
76.105.862.7-426.000 089618310414 SUKWAN BIDAN 12/2/2015 D-3 KEBIDANAN 2015 SUKWAN
SUKWAN PERAWAT 12/2/2015 D-3 KEPERAWATAN 2015 SUKWAN
75.748.981.0-426.000 085647713316 SUKWAN AHLI GIZI 11/30/2015 S-1 ILMU GIZI 2015 SUKWAN
SUKWAN ASISTEN APOTEKER 12/15/2015 SMK 2015 SUKWAN
SUKWAN BIDAN 1/4/2016 D-3 KEBIDANAN 2014 SUKWAN
SUKWAN BIDAN 2/2/2016 D-3 KEBIDANAN 2015 SUKWAN
SUKWAN PERAWAT GIGI 2/2/2016 D-3 KEPERAWATAN GIGI 2015 SUKWAN
SUKWAN PERAWAT GIGI 2/2/2016 D-3 KEPERAWATAN GIGI 2015 SUKWAN
49.330.710.2-426.000 SUKWAN SECURITY 1/2/2016 SLTA SUKWAN
SUKWAN SECURITY 1/2/2016 SLTA 1997 SUKWAN
72.771.890.0-426.000 081324256796 SUKWAN SECURITY 1/2/2016 SLTA 2010 SUKWAN
081324599490 SUKWAN SECURITY 1/23/2016 SLTA 2005 SUKWAN
SUKWAN PERAWAT 3/1/2016 D-3 KEPERAWATAN 2014 SUKWAN
087728998849 SUKWAN PERAWAT 3/1/2016 S-1 KEPERAWATAN 2015 SUKWAN
75.748.778.0-426.000 085871337266 SUKWAN BIDAN 3/1/2016 D-3 KEBIDANAN 2014 SUKWAN
087728907092 SUKWAN BIDAN 3/14/2016 D-3 KEBIDANAN 2013 SUKWAN
 SUKWAN PERAWAT 3/14/2016 S-1 KEPERAWATAN/NERS 2014 SUKWAN
SUKWAN BIDAN 3/14/2016 D-3 KEBIDANAN 2015 SUKWAN
082312720442 SUKWAN PERAWAT 4/1/2016 D-3 KEPERAWATAN 2011 SUKWAN
082119661153 SUKWAN BIDAN 4/26/2016 D-3 KEBIDANAN 2014 SUKWAN
085315319999 SUKWAN PENGELOLA OBAT 5/1/2016 SMF 2015 SUKWAN
SUKWAN PENGELOLA OBAT 5/1/2016 D-3 FARMASI 2015 SUKWAN

Pembuat Daftar

Muhyidin
NIP: 19620803 199103 1 003
 MASA KERJA
TMT
MENJADI
PEGAWAI TAHUN BULAN

16 17 18
3/1/1996 19 9
12/1/2014 1 0

1/25/2016 0 4
3/1/1987 28 9
3/1/1992 23 9

1/1/1989 26 11
3/1/1992 23 9
3/1/1995 20 9
3/1/1997 18 9
3/1/1991 24 9
12/1/2001 15 0
12/1/2001 15 0
1/1/2007 21 11
1/1/2007 11 11
1/1/2008 10 11
1/1/2008 8 11
1/1/2008 8 11
1/1/2008 8 11
4/1/2006 9 8
3/1/1990 25 9
3/1/1990 25 9
7/1/2005 10 5
7/1/2006 9 5
12/1/2007 8 0
6/1/2007 8 6
 7/1/2011 4 5
8/1/2009 6 4
5/1/2011 4 7
5/1/2011 4 7
8/1/2009 6 4
1/1/2006 9 11
12/20/2004 11 0
8/1/2006 9 4
11/28/2006 9 1
9/20/2013 2 3
11/2/1998 4 1
9/1/2001 14 4
12/2/2004 11 0
10/3/2011 4 2
9/6/2011 4 3
9/30/2011 4 3
10/10/2011 4 2
10/17/2010 4 2
11/1/2011 4 1
8/25/2012 3 4
8/1/2013 2 4
12/27/2013 2 0
10/2/2014 1 2
10/22/2014 1 2
11/2/2014 1 1
10/20/2014 1 2
10/20/2014 1 2
12/8/2014 1 0
3/2/2015 0 9
2/2/2015 0 10
1/5/2015 0 11
2/2/2015 0 10
3/1/2015 0 9
3/2/2015 0 9
3/3/2015 0 9
4/3/2015 0 8
5/4/2015 0 7
6/8/2015 0 6
9/21/2015 0 3
9/21/2015 0 3
10/5/2015 0 2
11/17/2015 0 1
12/2/2015 0 0
12/2/2015 0 0
11/30/2015 0 1
12/12/2015 0 0
1/4/2016 0 0
2/2/2016 0 0
2/2/2016 0 0
2/2/2016 0 0
1/2/2016 0 0
1/2/2016 0 4
1/2/2016 0 0
1/23/2016 0 0
3/1/2016 0 0
3/1/2016 0 0
3/1/2016 0 0
3/14/2016 0 0
3/14/2016 0 0
3/14/2016 0 0
4/1/2016 0 0
4/26/2016
5/1/2016 0 0
5/1/2016 0 0