DPT Petugas Terbaru 2016

DAFTAR PENERIMAAN TRANSPORT DALAM RANGKA KONSULTASI BOK KE DIKES KAB.
LOTIM
PADA PUSKESMAS RENSING KECAMATAN SAKRA BARAT
KABUPATEN LOMBOK TIMUR
Tanggal: 27 dan 28 September 2016

UANG
JML JML UANG JML UANG
NO NAMA PESERTA JABATAN TRANPORT/H TANDA TANGAN
HARI TRANSPORT DITERIMA
ARI ( RP )
1 Suhardi Teknisi BOK 2 35,000 35,000 70,000 1
2 Nurhayati, ST Bendahara BOK 2 35,000 35,000 70,000 2
JUMLAH 140,000
Terbilang: Seratus Empat Puluh Ribu Rupiah
Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas
H. AHMAT A, S.Kep, MM NURHAYATI, ST

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DAFTAR PENERIMAAN TRANSPORT PETUGAS DALAM RANGKA KONSULTASI BOK KE DIKES KAB. LOTIM
Tanggal: 27 dan 28 Oktober 2016

UANG
ARI ( RP )
JUMLAH 140,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 28 dan 29 November 2016

UANG
ARI ( RP )
JUMLAH 140,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 27 dan 28 Desember 2016

UANG
ARI ( RP )
JUMLAH 140,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DAFTAR PENERIMAAN HONOR PENGELOLA KEUANGAN BANTUAN OPERASIONAL KESEHATAN (BOK)
Tanggal: 25 Juli 2016

UANG
ARI ( RP )
1 H. Ahmat, S.Kep, MM Ka. Pusk. Rensing 1 200,000 200,000 200,000 1
JUMLAH 400,000
Terbilang: Empat Ratus Lima Puluh Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal : 30 Agustus 2016

UANG
ARI ( RP )
JUMLAH 400,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal : 28 September 2016

UANG
ARI ( RP )
JUMLAH 400,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal : 25 Oktober 2016

UANG
ARI ( RP )
JUMLAH 400,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DAFTAR PENERIMAAN TRANSPORT PESERTA
DALAM RANGKA KEGIATAN PERTEMUAN VERIFIKASI ODF
TINGKAT PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR
Tanggal : 18 Mei 2016

UANG
ARI ( RP )
1 1 30,000 30,000 30,000 1
2 1 30,000 30,000 30,000 2
3 1 30,000 30,000 30,000 3
4 1 30,000 30,000 30,000 4
5 1 30,000 30,000 30,000 5
6 1 30,000 30,000 30,000 6
7 1 30,000 30,000 30,000 7
8 1 30,000 30,000 30,000 8
9 1 30,000 30,000 30,000 9
10 1 30,000 30,000 30,000 10
11 1 30,000 30,000 30,000 11
12 1 30,000 30,000 30,000 12
13 1 30,000 30,000 30,000 13
14 1 30,000 30,000 30,000 14
15 1 30,000 30,000 30,000 15
JUMLAH 450,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DAFTAR PENERIMAAN TRANSPORT TIM PUSKESMAS
DALAM RANGKA KEGIATAN PERTEMUAN VERIFIKASI ODF

UANG
ARI ( RP )
2 Nurhayati, ST Sanitarian 1 30,000 30,000 30,000 2
3 Siti Emiyati, A.MKL Sanitarian 1 30,000 30,000 30,000 3
JUMLAH 90,000
Terbilang: Sembilan Puluh Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN ORIENTASI KEMITRAAN DENGAN DA'I KESEHATAN
Tanggal : 18 Juni 2016

UANG
ARI ( RP )
1 1 30,000 30,000 30,000 1
2 1 30,000 30,000 30,000 2
3 1 30,000 30,000 30,000 3
4 1 30,000 30,000 30,000 4
5 1 30,000 30,000 30,000 5
6 1 30,000 30,000 30,000 6
7 1 30,000 30,000 30,000 7
8 1 30,000 30,000 30,000 8
9 1 30,000 30,000 30,000 9
10 1 30,000 30,000 30,000 10
11 1 30,000 30,000 30,000 11
12 1 30,000 30,000 30,000 12
13 1 30,000 30,000 30,000 13
14 1 30,000 30,000 30,000 14
15 1 30,000 30,000 30,000 15
JUMLAH 450,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DAFTAR PENERIMAAN TRANSPORT NARASUMBER PUSKESMAS
DALAM RANGKA KEGIATAN ORIENTASI KEMITRAAN DENGAN DA'I KESEHATAN

UANG
ARI ( RP )
1 H. Ahmat A, S.Kep, MM Ka. Pusk. Rensing 1 30,000 30,000 30,000 1
2 Nurhayati, ST Sanitarian 1 30,000 30,000 30,000 2
3 Siti Emiyati, A.MKL Sanitarian 1 30,000 30,000 30,000 3
JUMLAH 90,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PELAKSANAAN SURVEY PHBS
Tanggal : 2 dan 3 Juni 2016

UANG
ARI ( RP )
1 Yanti Nurmayana Kader 2 15,000 15,000 30,000 1
2 Nurul Hasriana Kader 2 15,000 15,000 30,000 2
3 Ramikawati Kader 2 15,000 15,000 30,000 3
4 Yuliana S Kader 2 15,000 15,000 30,000 4
5 Sopa Marwati Kader 2 15,000 15,000 30,000 5
6 Solatiah Kader 2 15,000 15,000 30,000 6
7 Nurhasni Kader 2 15,000 15,000 30,000 7
8 Siiti Saodah Kader 2 15,000 15,000 30,000 8
9 Zakiah Kader 2 15,000 15,000 30,000 9
10 Nikmah Kader 2 15,000 15,000 30,000 10
11 Shopiatul Kader 2 15,000 15,000 30,000 11
12 Marhaini Kader 2 15,000 15,000 30,000 12
13 Uswatun Kader 2 15,000 15,000 30,000 13
14 Nurhalimah Kader 2 15,000 15,000 30,000 14
15 Hj. Umayah Kader 2 15,000 15,000 30,000 15
JUMLAH 450,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN SOSIALISASI TENTANG TEKHNIK SURVEY PHBS

UANG
ARI ( RP )
1 Kader 1 30,000 30,000 30,000 1
2 Kader 1 30,000 30,000 30,000 2
3 Kader 1 30,000 30,000 30,000 3
4 Kader 1 30,000 30,000 30,000 4
5 Kader 1 30,000 30,000 30,000 5
6 Kader 1 30,000 30,000 30,000 6
7 Kader 1 30,000 30,000 30,000 7
8 Kader 1 30,000 30,000 30,000 8
9 Kader 1 30,000 30,000 30,000 9
10 Kader 1 30,000 30,000 30,000 10
11 Kader 1 30,000 30,000 30,000 11
12 Kader 1 30,000 30,000 30,000 12
13 Kader 1 30,000 30,000 30,000 13
14 Kader 1 30,000 30,000 30,000 14
15 Kader 1 30,000 30,000 30,000 15
JUMLAH 450,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PEMBINAAN SEKALIGUS PENGUKUHAN SAKA BAKTI HUSADA

UANG
ARI ( RP )
1 1 25,000 25,000 25,000 1
2 1 25,000 25,000 25,000 2
3 1 25,000 25,000 25,000 3
4 1 25,000 25,000 25,000 4
5 1 25,000 25,000 25,000 5
6 1 25,000 25,000 25,000 6
7 1 25,000 25,000 25,000 7
8 1 25,000 25,000 25,000 8
9 1 25,000 25,000 25,000 9
10 1 25,000 25,000 25,000 10
11 1 25,000 25,000 25,000 11
12 1 25,000 25,000 25,000 12
13 1 25,000 25,000 25,000 13
14 1 25,000 25,000 25,000 14
15 1 25,000 25,000 25,000 15
JUMLAH 375,000
Terbilang: Tiga Ratus Tujuh Puluh Lima Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PERTEMUAN SOSIALISASI STBM
Tanggal : 18 April 2016

UANG
ARI ( RP )
1 1 30,000 30,000 30,000 1
2 1 30,000 30,000 30,000 2
3 1 30,000 30,000 30,000 3
4 1 30,000 30,000 30,000 4
5 1 30,000 30,000 30,000 5
6 1 30,000 30,000 30,000 6
7 1 30,000 30,000 30,000 7
8 1 30,000 30,000 30,000 8
9 1 30,000 30,000 30,000 9
10 1 30,000 30,000 30,000 10
11 1 30,000 30,000 30,000 11
12 1 30,000 30,000 30,000 12
13 1 30,000 30,000 30,000 13
14 1 30,000 30,000 30,000 14
15 1 30,000 30,000 30,000 15
JUMLAH 450,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DAFTAR PENERIMAAN TRANSPORT PERJALANAN NARASUMBER
DALAM RANGKA KEGIATAN SOSIALISASI STBM
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR
Tanggal: 18 April 2016
UANG JUMLAH
JML. JML. UANG
NO NAMA JABATAN TRANSPORT/ UANG DI TANDA TANGAN
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Lalu Saruji Ahmad, SKM Kasi P2PL 1 50,000 50,000 50,000 1. __________
2 Ahmad Daenuri, SKM Staf P2PL 1 50,000 50,000 50,000 2 ___________
JUMLAH 100,000
Terbilang: Seratus Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN SOSIALISASI STBM

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 H. Ahmat A, S.Kep, MM Ka. Pusk. Rensing 1 30,000 30,000 30,000 1. __________
2 Nurhayati, ST Sanitarian 1 30,000 30,000 30,000 2 ___________
3 Siti Emiyati, A.Md. KL Sanitarian 1 30,000 30,000 30,000
JUMLAH 90,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS
DALAM RANGKA KEGIATAN PEMICUAN STBM
Tanggal: 7 dan 8 Maret 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Nurhayati Sanitarian 2 30,000 60,000 60,000 1. __________
2 Nurul Asmayati Sanitarian 2 30,000 60,000 60,000 2 ___________
3 Siti Emiyati Sanitarian 2 30,000 60,000 60,000 3. __________
JUMLAH 180,000
Terbilang: Seratus Delapan Puluh Ribu Rupiah
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 8 dan 9 April 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 180,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 1, 3, 4, 5, dan 6 Juni 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8

JUMLAH 375,000
Selong,
HJ. BARI'AH, S.Kep NURHAYATI, ST
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 20, 21, 22, 23, dan 24 Oktober 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 25, 26, 27, 28, dan 30 Nopember 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 2, 3, 4, 5, dan 7 Desember 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8

JUMLAH 375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 21 dan 22 Januari 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 24 dan 25 Februari 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 180,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 9 dan 10 Mei 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8

JUMLAH 180,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 25 Januari 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 H. Ahmat A, S.Kep, MM Ka. Pusk. 1 200,000 200,000 200,000 1. __________
2 Nurhayati, ST Bendahara BOK 1 200,000 200,000 200,000 2 ___________
JUMLAH 400,000
Terbilang: Empat Ratus Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 25 Februari 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 26 Maret 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 25 Mei 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 30 Agustus 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DAFTAR PENERIMAAN TRANSPORT PETUGAS
DALAM RANGKA KEGIATAN UPAYA PENANGGULANGAN PENYAKIT POTENSIL (KLB)
Tanggal: 13, 14, dan 15 Januari 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Nurhayati, ST Sanitarian 3 30,000 30,000 90,000 1. __________
2 Siti Emiyati Sanitarian 3 30,000 30,000 90,000 2 ___________
2 Harlin Normalia Pet. Promkes 3 30,000 30,000 90,000 3. __________
JUMLAH 270,000
Terbilang: Dua Ratus Tujuh Puluh Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KELAS IBU HAMIL DI DESA RENSING
Tanggal: 6, 7, dan 8 April 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Miskiah, A.Md. Keb Bidan Pusk. 3 25,000 75,000 75,000 1. __________
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Terbilang: Seratus Lima Puluh Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KELAS IBU HAMIL DI DESA GN. RAJAK
Tanggal: 25, 26, dan 27 Mei 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Husnaini, A.Md. Keb Bidan Pusk. 3 25,000 75,000 75,000 1. __________
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN KELAS IBU HAMIL DI DESA BUNGTIANG

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Bq. Sri Utari RN, A.Md. Keb Bidan Pusk. 3 25,000 75,000 75,000 1. __________
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENYELIDIKAN EPIDEMIOLOGI
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Seman Pet. Promkes 3 30,000 30,000 90,000 2 ___________
JUMLAH 270,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 22, 24, dan 27 Februari 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Seman Pet. Promkes 3 30,000 30,000 90,000 2 ___________
JUMLAH 270,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 10, 11, dan 12 Maret 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Lalu Muh. Satrianadi Perawat 3 30,000 30,000 90,000 2 ___________
2 Harlin Normalia Promkes 3 30,000 30,000 90,000 3. __________

JUMLAH 270,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Lalu Muh. Satrianadi Perawat 3 30,000 30,000 90,000 2 ___________
2 Siti Emiyati Promkes 3 30,000 30,000 90,000 3. __________

JUMLAH 270,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Siti Emiyati, A.MKL Perawat 3 30,000 30,000 90,000 2 ___________
2 Harlin Normalia, SKM Promkes 3 30,000 30,000 90,000 3. __________
JUMLAH 270,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENDATAAN DAN PENGAWASAN TTU, TUI, TPM
Tanggal: 2 dan 5 Januari 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Nurul Asmayati H. Sanitarian 2 30,000 30,000 60,000 1. __________
JUMLAH 120,000
Terbilang: Seratus Dua Puluh Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 120,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Harlin Normalia Promkes 2 30,000 30,000 60,000 2 ___________
JUMLAH 120,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 120,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENYULUHAN HIV-AIDS DI SEKOLAH SMA/MA/SMK
Tanggal: 1, 11, 15, 16, 17, 18, 19, 21, 22, 23, 26, 28, 29, dan 30 Desember 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Lalu Muh. Satrianadi, S.Kep Perawat 14 25,000 25,000 350,000 1. __________
2 Nurhayati, ST Sanitarian 14 25,000 25,000 350,000 2 ___________
3 dr. Lusy Dwitama Lery dokter 14 25,000 25,000 350,000 3. ___________
JUMLAH 1,050,000
Terbilang: Satu Juta Lima Puluh Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DAFTAR PENERIMAAN TRANSPORT NARASUMBER KABUPATEN
DALAM RANGKA KEGIATAN MINILOKAKARYA TRIWULAN TK. PUSKESMAS RENSING
Tanggal: 23 Desember 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Lalu Bagus Wikrama Kasi UKS 1 150,000 150,000 150,000 1. __________
2 Nurhayati - 1 150,000 150,000 150,000 2 ___________
JUMLAH 300,000
Terbilang: Tiga Ratus Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN DISTRIBUSI DANA KADER POSYANDU
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Hazrin, SKM Kasi Promkes 1 150,000 150,000 150,000 1. __________
2 Fitriani, A.Md. Keb Staf 1 150,000 150,000 150,000 2 ___________
JUMLAH 300,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PELACAKAN JAMAAH HAJI YANG BARU PULANG DARI MAKKAH
Tanggal: 10, 12, 13, 15, 16, 17, 19, 20, 21, 22, 23, 24, 26, 27, 28, 29, 30, dan 31 Oktober 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 H. Ridwan, S.Kep Perawat 18 25,000 450,000 450,000 1. __________
2 Muhyiddin Staf 18 25,000 450,000 450,000 2 ___________
JUMLAH 900,000
Terbilang: Sembilan Ratus Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan, A.MG TPG 3 25,000 75,000 75,000 2 ___________
JUMLAH 150,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muliatun, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KELAS IBU HAMIL DI DESA RENSING BAT

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Bq. Sri Utari, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 1. __________
2 Sumiati, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KELAS IBU HAMIL DI DESA PEMATUNG

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muliatun, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KELAS IBU HAMIL DI DESA MT. BETER

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Inna Fakhria, SST Bidan Pusk. 3 30,000 90,000 90,000 1. __________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Muliatun, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 1. __________
2 Miskiah, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN KELAS IBU HAMIL DI DESA PENGKELAK MAS

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Sumiati, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 1. __________
2 Eli Marliyana, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Bq. Sri Utari, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 1. __________
JUMLAH 180,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN KELAS IBU HAMIL DI DESA KEMBANG ARE SAMPAI

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Eli Marliyana, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN KELAS IBU HAMIL DI DESA KEMBANG ARE SAMPAI

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Bq. Sri Utari RN, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DAFTAR PENERIMAAN TRANSPORT NARASUMBER
DALAM RANGKA KEGIATAN PERTEMUAN SOSIALISASI DOKTER KECIL TK. PUSKESMAS RENSING
DI PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

UANG
NO NAMA PESERTA JABATAN TRANPORT/HA TANDA TANGAN
RI ( RP )
Staf dikes (Prog. kes.

1 Muh. Farid Wajdi 1 150,000 150,000 150,000 1. ________________
Institusi)
2 Ikhwal Yanti Staf dikes 1 150,000 150,000 150,000 2 ______________
JUMLAH 300,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PERTEMUAN SOSIALISASI DOKTER KECIL TK. PUSKESMAS RENSING

UANG
NO NAMA JABATAN TRANPORT/HARI TANDA TANGAN
( RP )
1 1 Hr 150,000 150,000 150,000 1
2 1 Hr 150,000 150,000 150,000 2
JUMLAH 300,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
61 Marwiyah,Spd Kader Sangke langit 1 Hr 25.000 25.000 25.000 61
62 Ikarianti Kader Sangke langit 1 Hr 25.000 25.000 25.000 62
63 Yuliana.S Kader lendang elah 1 Hr 25.000 25.000 25.000 63
64 Haulani Kader lendang elah 1 Hr 25.000 25.000 25.000 64
65 Mardiyah Kader Gawah jarak 1 Hr 25.000 25.000 25.000 65
66 Resnawati Kader Gawah jarak 1 Hr 25.000 25.000 25.000 66
67 Husnul hotmi Kader rejeng Nyungkar 1 Hr 25.000 25.000 25.000 67
68 Sabariah Kader rejeng Nyungkar 1 Hr 25.000 25.000 25.000 68
69 Sri Puji kader mengkuru 1 Hr 25.000 25.000 25.000 69
70 sukmawartini kader mengkuru 1 Hr 25.000 25.000 25.000 70
71 Sri Wulandari kader sangupati 1 Hr 25.000 25.000 25.000 71
72 Bq.emi Lestari kader sangupati 1 Hr 25.000 25.000 25.000 72
73 Hafizah Kader pesanggrahan 1 Hr 25.000 25.000 25.000 73
74 hanifah Kader pesanggrahan 1 Hr 25.000 25.000 25.000 74
75 B.fathul jannah Kader sanggo 1 Hr 25.000 25.000 25.000 75
76 B.Fatmawati Kader sanggo 1 Hr 25.000 25.000 25.000 76
77 Jamilah kader tanak kaken 1 Hr 25.000 25.000 25.000 77
78 B.Mulianah kader tanak kaken 1 Hr 25.000 25.000 25.000 78
79 Halimatussakdiah kader Tongke 1 Hr 25.000 25.000 25.000 79
80 Nurlaela azmi kader Tongke 1 Hr 25.000 25.000 25.000 80
81 Yuliana safitri kader Jerua 1 Hr 25.000 25.000 25.000 81
82 zaenabung kader Jerua 1 Hr 25.000 25.000 25.000 82
83 Sri Kader malah 1 Hr 25.000 25.000 25.000 83
84 Hj.Nursehan Kader malah 1 Hr 25.000 25.000 25.000 84
85 Srianom kade dasan tengak 1 Hr 25.000 25.000 25.000 85
86 Umi Kalsum kade dasan tengak 1 Hr 25.000 25.000 25.000 86
87 Bq.Linda Yuliana kader Poyak oyak 1 Hr 25.000 25.000 25.000 87
88 Bq.Mustika.R kader Poyak oyak 1 Hr 25.000 25.000 25.000 88
89 Nurhasanah Kader bageq Nyale 1 Hr 25.000 25.000 25.000 89
90 raihul inayah Kader bageq Nyale 1 Hr 25.000 25.000 25.000 90
91 Bq.Zohriah kader dasan baru 1 Hr 25.000 25.000 25.000 91
92 Rohana kader dasan baru 1 Hr 25.000 25.000 25.000 92
93 Suarniwati kader Monjet bat 1 Hr 25.000 25.000 25.000 93
94 Bq.Rohiyatul.H kader Monjet bat 1 Hr 25.000 25.000 25.000 94
95 Masni kader penandak 1 Hr 25.000 25.000 25.000 95
96 Misniana kader penandak 1 Hr 25.000 25.000 25.000 96
97 Zuhriatun kader tanjah anjah 1 Hr 25.000 25.000 25.000 97
98 Hartini kader tanjah anjah 1 Hr 25.000 25.000 25.000 98
99 Ida mayanti kader karang baru 1 Hr 25.000 25.000 25.000 99
100 Hindun kader karang baru 1 Hr 25.000 25.000 25.000 100
101 Ikawati kader pengk,mas 1 Hr 25.000 25.000 25.000 101
102 Iq.rodi kader pengk,mas 1 Hr 25.000 25.000 25.000 102
103 Jami'ah Kader semanggleng 1 Hr 25.000 25.000 25.000 103
104 jauhariah Kader semanggleng 1 Hr 25.000 25.000 25.000 104
105 Saidah kader Pongkor 1 Hr 25.000 25.000 25.000 105
106 Bq.Icah kader Pongkor 1 Hr 25.000 25.000 25.000 106
107 Siti Fatimah Kader gerisak 1 Hr 25.000 25.000 25.000 107
108 Zuhaeratul Kader gerisak 1 Hr 25.000 25.000 25.000 108
109 Herlin kader penutus 1 Hr 25.000 25.000 25.000 109
110 Mahuni kader penutus 1 Hr 25.000 25.000 25.000 110
111 Indrawati kader Repok tengak 1 Hr 25.000 25.000 25.000 111
112 Sri ayu kader Repok tengak 1 Hr 25.000 25.000 25.000 112
113 Zuhriatun kader gwh gadung 1 Hr 25.000 25.000 25.000 113
114 farida Asiani kader gwh gadung 1 Hr 25.000 25.000 25.000 114
115 Fatimah kader gwh gadung Tgh 1 Hr 25.000 25.000 25.000 115
116 Nurhalimah kader gwh gadung Tgh 1 Hr 25.000 25.000 25.000 116
117 Sumarni Kader gwh gadung Tmr 1 Hr 25.000 25.000 25.000 117
118 Siti Rahmah Kader gwh gadung Tmr 1 Hr 25.000 25.000 25.000 118
119 Sahni Kader Batu tandak 1 Hr 25.000 25.000 25.000 119
120 Martini Kader Batu tandak 1 Hr 25.000 25.000 25.000 120
121 Nuraini kader gerepek santek 1 Hr 25.000 25.000 25.000 121
122 Maisah kader gerepek santek 1 Hr 25.000 25.000 25.000 122
123 Anita jajang Kader Repok are 1 Hr 25.000 25.000 25.000 123
124 rauhun Kader Repok are 1 Hr 25.000 25.000 25.000 124
125 Rehanah kader bungtiang Brt 1 Hr 25.000 25.000 25.000 125
126 Hartini kader bungtiang Brt 1 Hr 25.000 25.000 25.000 126
127 fitriani kader Bungtiang tmr 1 Hr 25.000 25.000 25.000 127
128 Rohani kader Bungtiang tmr 1 Hr 25.000 25.000 25.000 128
129 Siti Aisyah Kader gerisak 1 Hr 25.000 25.000 25.000 129
130 Salmiah Kader gerisak 1 Hr 25.000 25.000 25.000 130
131 Nursamsi Kader bungambar 1 Hr 25.000 25.000 25.000 131

132 Munawati Kader bungambar 1 Hr 25.000 25.000 25.000 132
133 Bq.kalsum kader mt.Mesir 1 Hr 25.000 25.000 25.000 133
134 Bq.Zubaedah kader mt.Mesir 1 Hr 25.000 25.000 25.000 134
135 Masitah kader Montong 1 Hr 25.000 25.000 25.000 135
136 Endra kader Montong 1 Hr 25.000 25.000 25.000 136
137 Mariani ratna.k kader Bungtiang sltn 1 Hr 25.000 25.000 25.000 137
138 Ziadatul hilmi kader Bungtiang sltn 1 Hr 25.000 25.000 25.000 138
139 Raehanun kader bungtiang T 1 Hr 25.000 25.000 25.000 139
140 Solatiah kader bungtiang T 1 Hr 25.000 25.000 25.000 140
141 Masturi Kader bungtiang Tgh 1 Hr 25.000 25.000 25.000 141
142 Suriani Kader bungtiang Tgh 1 Hr 25.000 25.000 25.000 142
143 Sarifah kader bungtiang brt 1 Hr 25.000 25.000 25.000 143
144 Halimah kader bungtiang brt 1 Hr 25.000 25.000 25.000 144
145 Mulianah kader borok dalem 1 Hr 25.000 25.000 25.000 145
146 Satriah kader borok dalem 1 Hr 25.000 25.000 25.000 146
147 Sinarep Kader Borok luah 1 Hr 25.000 25.000 25.000 147
148 Eli ermawati Kader Borok luah 1 Hr 25.000 25.000 25.000 148
149 Sinarep kader mt.pendem 1 Hr 25.000 25.000 25.000 149
150 Eli ermawati kader mt.pendem 1 Hr 25.000 25.000 25.000 150
151 Hj.darmataksiah Kader lk.kolo 1 Hr 25.000 25.000 25.000 151
152 Ana Rodianti Kader lk.kolo 1 Hr 25.000 25.000 25.000 152
153 Bq.hayatul kader toyang 1 Hr 25.000 25.000 25.000 153
154 Hurniawati kader toyang 1 Hr 25.000 25.000 25.000 154
155 Nurjannah Kader dewe lanji 1 Hr 25.000 25.000 25.000 155
156 Riza ariani Kader dewe lanji 1 Hr 25.000 25.000 25.000 156
157 Mariani Kader presak 1 Hr 25.000 25.000 25.000 157
158 Ernawati Kader presak 1 Hr 25.000 25.000 25.000 158
159 sahriwati kader kondok 1 Hr 25.000 25.000 25.000 159
160 Isnawati kader kondok 1 Hr 25.000 25.000 25.000 160
161 Supawati Kader Sukawangi 1 Hr 25.000 25.000 25.000 161
162 Sumiati Kader Sukawangi 1 Hr 25.000 25.000 25.000 162
163 Slimin kader jeropoto 1 Hr 25.000 25.000 25.000 163
164 sakmah kader jeropoto 1 Hr 25.000 25.000 25.000 164
165 Mutiara kader tangar 1 Hr 25.000 25.000 25.000 165
166 Sumarni kader tangar 1 Hr 25.000 25.000 25.000 166
167 Parmi kader Asem/Jekeh 1 Hr 25.000 25.000 25.000 167
168 zuhriah kader Asem/Jekeh 1 Hr 25.000 25.000 25.000 168
169 Eny susilawati Kader dasan repok 1 Hr 25.000 25.000 25.000 169
170 iq.Asri Kader dasan repok 1 Hr 25.000 25.000 25.000 170
171 Siti hadijah kader sukarara Utr 1 Hr 25.000 25.000 25.000 171
172 Rohnam kader sukarara Utr 1 Hr 25.000 25.000 25.000 172
173 Sahimin Kader sukarara sltn 1 Hr 25.000 25.000 25.000 173
174 Husniwati Kader sukarara sltn 1 Hr 25.000 25.000 25.000 174
175 Asiah Kader pejaring 1 Hr 25.000 25.000 25.000 175
176 Istiareni Kader pejaring 1 Hr 25.000 25.000 25.000 176
177 Nurminah kader Selayar 1 Hr 25.000 25.000 25.000 177
178 Iwang kader Selayar 1 Hr 25.000 25.000 25.000 178
179 Husniatun Kader dengkur 1 Hr 25.000 25.000 25.000 179
180 Astuti handayani Kader dengkur 1 Hr 25.000 25.000 25.000 180
181 Sekarniwati kader Pejaring T 1 Hr 25.000 25.000 25.000 181
182 Marniati kader Pejaring T 1 Hr 25.000 25.000 25.000 182
183 Halimah Kader Pejaring Brt 1 Hr 25.000 25.000 25.000 183
184 Nuraini Kader Pejaring Brt 1 Hr 25.000 25.000 25.000 184
185 Bq. Nurhidayati Kader Jerue bawak 1 Hr 25.000 25.000 25.000 185
186 Yulia Mustikawati Kader Jerue bawak 1 Hr 25.000 25.000 25.000 186
187 Nurul Hidayana Mt. Prapen 1 Hr 25.000 25.000 25.000 187
188 Rosdiana Mt. Prapen 1 Hr 25.000 25.000 25.000 188
189 Sutatik Kader bt. Ngrengseng 1 Hr 25.000 25.000 25.000 189
190 Hartini Kader bt. Ngrengseng 1 Hr 25.000 25.000 25.000 190
TOTAL -
Setuju Dibayar Selong,

Kepala Puskesmas Rensing LUNAS DIBAYAR
Bendahara BOK Puskesmas
( HJ.BARI'AH,S.Kep ) ( NURHAYATI, ST )
NIP.19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KELAS IBU BALITA DI DESA JEROGUNUNG
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Inna Fakhria, SST Bidan 3 30,000 90,000 90,000 1. __________
2 Husnaini, A.Md. Keb Bidan 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KELAS IBU BALITA DI DESA MENGKURU

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Lathifah, SKM Bidan Pusk. 3 30,000 90,000 90,000 1. __________
2 Ely Marliyana, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KELAS IBU BALITA DI DESA TANAK KAKEN

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KELAS IBU BALITA DI DESA GERISAK SEMANGGELENG

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Bq. Sri Utari RN Bidan Pusk. 3 30,000 90,000 90,000 1. __________
2 Inna Fakhria, SST Bidan Pusk. 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KELAS IBU BALITA DI DESA GADUNG MAS

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Lathifah, SKM Bidan Pusk. 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN KELAS IBU BALITA DI DESA BOROK TOYANG

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Miskiah, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN KELAS IBU BALITA DI DESA BOYEMARE

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Lathiifah, SKM Bidan Pusk. 3 30,000 90,000 90,000 1. __________
2 Husnaini, A.Md. Keb Bidan Pusk. 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DAFTAR PENERIMAAN TRANSPORT FASILITATOR

DALAM RANGKA KEGIATAN KELAS IBU BALITA DI DESA PEJARING

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENYULUHAN/PEMBINAAN TENTANG PHBS DAN SOSIALISASI KEG. SAKURA PROG.
Tanggal: 11, 13, 15, 16, 17, 18, dan 22 Juni 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Siti Aisyatul Syahri Perawat 7 25,000 175,000 175,000 1. __________
2 Sri Lathifah Staf 7 25,000 175,000 175,000 2 ___________
JUMLAH 350,000
Terbilang: Tiga Ratus Lima Puluh Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENJARINGAN KESEHATAN SISWA SD/MI
Tanggal: 6, 7, 8, 9, 10, 11, 27, 28, 29, 30, dan 31 Juli 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Siti Rauhil Azizah Perawat Gigi 11 25,000 275,000 275,000 1. __________
2 Nana Agriani S. Perawat 11 25,000 275,000 275,000 2 ___________
3 Septiawan Raedani Ass. Apoteker 11 25,000 275,000 275,000 3. __________
JUMLAH 825,000
Terbilang: Delapan Ratus Dua Puluh Lima Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 3, 4, 5, 6, 7, 8, 10, 11, 12, 13, 14, 15, 18, 19, 20, 21, dan 22 Agustus 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Roslina Yuniharti Perawat 17 25,000 425,000 425,000 2 ___________
3 Nana Agriani Solehah Perawat 17 25,000 425,000 425,000 3. __________
JUMLAH 1,275,000
Terbilang: Satu Juta Dua Ratus Tujuh Puluh Lima Ribu Rupiah
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14, 15, 16, 17, 18, dan 19 September 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 1,275,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN PEMBINAAN PHBS DAN SOSIALISASI SAKURA PROGRAM
Tanggal: 15, 16, 17, 19, 20, 21, 22, dan 23 Oktober 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Lalu Indra Jaya Kusuma Perawat gigi 8 25,000 200,000 200,000 1. __________
JUMLAH 400,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN PEMBINAAN PHBS DAN SOSIALISASI SAKURA PROGRAM
Tanggal: 19, 20, 21, 23, 24, 25, 26, dan 27 Nopember 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Lalu Indra Jaya Kusuma Perawat gigi 8 25,000 200,000 200,000 1. __________
2 Suhardi Staf 8 25,000 200,000 200,000 2 ___________
JUMLAH 400,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 11, 13, 15, 16, 17, 18, dan 22 Juni 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 350,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 6, 7, 8, 9, 10, 11, 27, 28, 29, 30, dan 31 Juli 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Nana Agriani S. Perawat 11 25,000 275,000 275,000 2 ___________
3 Septiawan Raedani Ass. Apoteker 11 25,000 275,000 275,000 3. __________
JUMLAH 825,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 3, 4, 5, 6, 7, 8, 10, 11, 12, 13, 14, 15, 18, 19, 20, 21, dan 22 Agustus 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 1,275,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14, 15, 16, 17, 18, dan 19 September 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 1,275,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 3, 5, 6, 7, 8, 10, 12, 13, 15, 17, 19, 20, 21, dan 22 Oktober 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Siti Rauhil Azizah Staf 15 25,000 375,000 375,000 1. __________
2 Nana Agriani Solehah Perawat 15 25,000 375,000 375,000 2 ___________
3 Sri Latifah Perawat 15 25,000 375,000 375,000 3. __________
JUMLAH 1,125,000
Terbilang: Satu Juta Seratus Dua Puluh Lima Ribu Rupiah
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN PENJARINGAN KESEHATAN SISWA SMP SEDERAJAT, SMA SEDERAJAT,
PENDATAAN SEKOLAH NEGERI SWASTA, PEMANTAUAN STRATA UKS, DAN SURVEY PHBS
PUSKESMAS RENSING KAB. LOMBOK TIMUR
Tanggal: 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 13, 14, 16, 17, dan 18 Nopember 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Roslina Yuni Harti Perawat 15 25,000 375,000 375,000 2 ___________
3 Sri Latifah Staf 15 25,000 375,000 375,000 3. __________
JUMLAH 1,125,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 11, 13, 15, 16, 17, 18, dan 22 Juni 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 350,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENYULUHAN & PEMERIKSAAN KESEHATAN GIGI DAN MULUT SISWA SD/MI
Tanggal: 8, 9, 10, 11, 27, 28, dan 29 Juli 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Siti Aisyatul Syahri Promkes 7 25,000 175,000 175,000 1. __________
2 Harlin Normalia Perawat 7 25,000 175,000 175,000 2 ___________
JUMLAH 350,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 3, 4, 5, 6, 7, 8, dan 10 Agustus 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Lalu Indra Jaya Kusuma Perawat Gigi 7 25,000 175,000 175,000 1. __________
2 Siti Aisyatul Syahri Perawat 7 25,000 175,000 175,000 2 ___________
JUMLAH 350,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 7, 8, 9, 10, 11, 12, 14, dan 15 September 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 11, 13, 15, 16, 17, 18, dan 22 Juni 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 350,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 8, 9, 10, 11, 27, 28, dan 29 Juli 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Siti Aisyatul Syahri Promkes 7 25,000 175,000 175,000 1. __________
2 Harlin Normalia Perawat 7 25,000 175,000 175,000 2 ___________
JUMLAH 350,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN DISTRIBUSI OBAT CACING DI SEKOLAH (SD/MI)
Tanggal: 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14, 15, 16, dan 17 September 2015
UANG JUMLAH
JML. UANG
NO NAMA JABATAN JML. HARI TRANSPORT/ UANG DI TANDA TANGAN
TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Siti Rohmatullah Petugas Lab. 15 x 2 25,000 750,000 750,000 1. __________
2 Sri Latifah Staf 15 x 2 25,000 750,000 750,000 2 ___________
3 Septiawan Raedani Staf 15 x 2 25,000 750,000 750,000 3. ___________
JUMLAH 2,250,000
Terbilang: Dua Juta Dua Ratus Ratus Lima Puluh Ribu Rupiah
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 11, 13, 15, 16, 17, 18, dan 22 Juni 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 350,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 8, 9, 11, 27, 28, 29, dan 30 Juli 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 350,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 350,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 350,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Suhardi Staf 8 25,000 200,000 200,000 2 ___________
JUMLAH 400,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PERTEMUAN TEKNIK SURVEY PHBS TK. PUSKESMAS RENSING
Tanggal: 16 Juni 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Maruny Widyastuti, SKM Kasi Promkes 1 150,000 150,000 150,000 1. __________
2 Hazrin, SKM Kabid Promkes 1 150,000 150,000 150,000 2 ___________
JUMLAH 300,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PEMANTAUAN PERTUMBUHAN BALITA
Tanggal: 1, 2, 6, 7, 8, 9, 11, 13, 14, 15, 16, 17, 18, dan 20 April 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Muslihan, A.MG TPG 10 25,000 250,000 250,000 1. __________
2 Bq. Zohriah Perawat 10 25,000 250,000 250,000 2 ___________
JUMLAH 500,000
Terbilang: Lima Ratus Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 4, 5, 6, 7, 8, 9, 11, 12, 13, 18, 19, dan 20 Mei 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Muslihan, A.MG TPG 10 25,000 250,000 250,000 1. __________
JUMLAH 500,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 1, 3, 4, 5, 6, 8, 9, 10, 11, 12, 16, 17, 18, 20, 22, 23, 24, 25, dan 27 Juni 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Suhardi Staf 10 25,000 250,000 250,000 1. __________
JUMLAH 500,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 6, 7, 8, 9, 10, 11, 13, 14, 15, dan 22 Juli 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Muslihan TPG 10 25,000 250,000 250,000 1. __________
JUMLAH 500,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PEMANTAUAN GARAM BERYODIUM
Tanggal: 3, 4, 5, 6, 8, 10, 11, 12, 13, 15, 18, 19, 20, 22, 24, 25, 26, dan 27 Agustus 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Hariani Rosanti F. TPG 18 25,000 450,000 450,000 1. __________
2 Muslihan TPG 18 25,000 450,000 450,000 2 ___________
JUMLAH 900,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
8000
36
288000
DALAM RANGKA KEGIATAN VERIFIKASI DAN SWEEPING PENIMBANGAN BALITA
Tanggal: 1, 2, 3, 5, 7, 8, 10, 11, 12, 14, 15, 16, 17, 18, 19, 21, 22, dan 23 Desember 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Hariani Rosanti F TPG 18 25,000 450,000 450,000 1. __________
2 Muslihan TPG 18 25,000 450,000 450,000 2 ___________
JUMLAH 900,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 4, 5, 6, 7, 8, 9, 11, 12, 13, 18, 19, dan 20 Mei 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Muslihan, A.MG TPG 10 25,000 250,000 250,000 1. __________
JUMLAH 500,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 1, 3, 4, 5, 6, 8, 9, 10, 11, 12, 16, 17, 18, 20, 22, 23, 24, 25, dan 27 Juni 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Suhardi Staf 10 25,000 250,000 250,000 1. __________
JUMLAH 500,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 6, 7, 8, 9, 10, 11, 13, 14, 15, dan 22 Juli 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Muslihan TPG 10 25,000 250,000 250,000 1. __________
JUMLAH 500,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 3, 4, 5, 6, 8, 10, 11, 12, 13, 15, 20, dan 22 Agustus 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Bq. Zohriah Perawat 10 25,000 250,000 250,000 1. __________
2 Sri Latifah Staf 10 25,000 250,000 250,000 2 ___________
JUMLAH 500,000
Selong,
HJ. BARI'AH, S.Kep NURHAYATI, S.TL
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Hariani Rosanti TPG 10 25,000 250,000 250,000 1. __________
2 Muslihan TPG 10 25,000 250,000 250,000 2 ___________
JUMLAH 500,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 2, 3, 5, 7, 8, 9, 10, 11, 12, 14, 15, 16, 17, dan 19 September 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan TPG 10 25,000 250,000 250,000 2 ___________
JUMLAH 500,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 5, 6, 7, 8, 10, 12, 13, 15, 16, 17, 19, 20, dan 26 Oktober 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan TPG 10 25,000 250,000 250,000 2 ___________
JUMLAH 500,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan TPG 10 25,000 250,000 250,000 2 ___________
JUMLAH 500,000

Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 2, 3, 5, 7, 8, 10, 12, 14, 15, 16, 17, 19, 21, 22, 23, 26, dan 28 Desember 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Septiawan Raedani Staf 15 25,000 375,000 375,000 2 ___________

3 Sri Latifah Staf 15 25,000 375,000 375,000
JUMLAH 1,125,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
8000
36
288000
Tanggal: 2, 3, 4, 6, 9, 10, 11, 13, 15, 16, 17, 18, 20, dan 22 Februari 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Muslihan, A.MG TPG 10 30,000 300,000 300,000 1. __________
2 Wahidatul Laeni, A.MG TPG 10 30,000 300,000 300,000 2 ___________
JUMLAH 600,000
Terbilang: Enam Ratus Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 7, 8, 10, 12, 14, 15, 16, 17, 19, 21, 22, 23, 24, dan 26 Maret 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Muslihan, A.MG TPG 10 30,000 300,000 300,000 1. __________
JUMLAH 600,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Muslihan, A.MG TPG 10 30,000 300,000 300,000 1. __________
JUMLAH 600,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Muslihan, A.MG TPG 10 30,000 300,000 300,000 1. __________
JUMLAH 600,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 9, 10, 11, 12, 18, 19, 21, 23, 24, 25, 26, dan 28 Mei 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Muslihan, A.MG TPG 10 30,000 300,000 300,000 1. __________
JUMLAH 600,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Sri Latifah Staf 10 25,000 250,000 250,000 2 ___________
JUMLAH 500,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan TPG 10 25,000 250,000 250,000 2 ___________
JUMLAH 500,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 2, 3, 5, 7, 8, 9, 10, 11, 12, 14, 15, 16, 17, dan 19 September 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan TPG 10 25,000 250,000 250,000 2 ___________
JUMLAH 500,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan TPG 10 25,000 250,000 250,000 2 ___________
JUMLAH 500,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Muslihan TPG 10 25,000 250,000 250,000 2 ___________
JUMLAH 500,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 2, 3, 5, 7, 8, 10, 12, 14, 15, 16, 17, 19, 21, 22, 23, 26, dan 28 Desember 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Septiawan Raedani Staf 15 25,000 375,000 375,000 2 ___________

3 Sri Latifah Staf 15 25,000 375,000 375,000
JUMLAH 1,125,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
8000
36
288000
DALAM RANGKA KEGIATAN SWEEPING PIN POLIO
Tanggal: 10, 11, 12, 13, 14, dan 15 Maret 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 H. Seman Vaksinator 3 30,000 90,000 90,000 1. __________
2 Lalu Muh. Ilyas Perawat 4 30,000 120,000 120,000 2 ___________
3 Lalu Wathoni Usman Perawat 3 30,000 90,000 90,000 3. __________
JUMLAH 300,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN SWEEPING IMUNISASI RUTIN
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Rohyatul Aini Perawat 2 25,000 50,000 50,000 2 ___________
3 Lalu Muh. Hairussopian Perawat 2 25,000 50,000 50,000 3. __________
4 Rena Noviarni Perawat 2 25,000 50,000 50,000 4 ___________

JUMLAH 200,000
Terbilang: Dua Ratus Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KAMPANYE ANTI ANEMIA DAN PEMBERIAN TABLET Fe PADA ANAK SEKOLAH
Tanggal: 4, 5, 6, 7, 8, 9, 11, 12, 13, 14, 15, 16, 21, 22, 23, 25, 26, dan 27 April 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Roslina Yuniarti, S.Kep Perawat 18 30,000 540,000 540,000 1. __________
2 Sriningsih, A.Md. Kep Perawat 18 30,000 540,000 540,000 2 ___________
JUMLAH 1,080,000
Terbilang: Satu Juta Delapan Puluh Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KAMPANYE ANTI ANEMIA, PEMBERIAN TABLET Fe, DAN PEMERIKSAAN Hb ANAK SEKOLAH
Tanggal: 2, 3, 5, 6, 7, 8, 9, 10, 12, 13, 26, 27, 28, 29, 30, dan 31 Oktober 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Sriningsih Perawat 16 25,000 400,000 400,000 1. __________
2 Miskiah Bidan puskesmas 16 25,000 400,000 400,000 2 ___________
3 Muliatun Bidan puskesmas 16 25,000 400,000 400,000 3. __________
4 Muh. Ali Musirri Analis 16 25,000 400,000 400,000 4 ___________
JUMLAH 1,600,000
Terbilang: Satu Juta Enam Ratus Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KAMPANYE ANTI ANEMIA, PEMBERIAN TABLET Fe, DAN PEMERIKSAAN Hb ANAK SEKOLAH
Tanggal: 1, 2, 3, 4, 5, 7, 8, 10, 11, 12, 14, dan 15 Desember 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Bq. Sri Utari RN Bidan puskesmas 12 25,000 300,000 300,000 2 ___________
3 Bq. Nurdiana Bidan Desa 12 25,000 300,000 300,000 3. __________
4 Siti Rohmatullah Pet. Lab. 12 25,000 300,000 300,000 4 ___________
JUMLAH 1,200,000
Terbilang: Satu Juta Dua Ratus Ribu Rupiah
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENDATAAN SASARAN BIAS ANAK SEKOLAH SD/MI
Tanggal: 25, 26, 27, 28, dan 29 Agustus 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Lalu Wathoni Usman Perawat 3 25,000 75,000 75,000 2 ___________
3 Lalu Muh. Ilyas Perawat 2 25,000 50,000 50,000 3. __________
10 JUMLAH 250,000
Terbilang: Dua Ratus Lima Puluh Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PELAYANAN IMUNISASI RUTIN DI POSYANDU
Tanggal: 1, 2, 4, 6, 7, 8, 9, 11, 13, 14, 15, 16, 18, 20, 21, 22, 23, 24, 25, 27, 29, dan 30 April 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 25,000 225,000 225,000 2 ___________
3 Nurhasanah Perawat 12 25,000 300,000 300,000 3. __________
4 Asrul Hamidi Perawat 12 25,000 300,000 300,000 4 ___________
5 Rohyatul Aini Perawat 15 25,000 375,000 375,000 5. __________
6 Mas'ud Jayapura Perawat 8 25,000 200,000 200,000 6 ___________
7 Lalu Wathoni Usman Perawat 15 25,000 375,000 375,000 7. ___________
8 Lalu Muh. Hairussopian Perawat 9 25,000 225,000 225,000 8. ___________
95 JUMLAH 2,375,000
Terbilang: Dua Juta Tiga Ratus Tujuh Puluh Lima Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 2, 4, 5, 6, 7, 9, 11, 12, 13, 18, 19, 20, 21, 23, 25, 26, 27, 28, dan 30 Mei 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 25,000 225,000 225,000 2 ___________
JUMLAH 2,375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 3, 4, 5, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 20, 22, 23, 24, 25, dan 27 Juni 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 25,000 225,000 225,000 2 ___________
JUMLAH 2,375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 2, 3, 4, 6, 7, 8, 9, 11, 13, 14, 15, 22, 23, 24, 25, 27, 28, 29, 30, dan 31 Juli 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 25,000 225,000 225,000 2 ___________
6 Mas'ut Jayapura Perawat 8 25,000 200,000 200,000 6 ___________
JUMLAH 2,375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 3, 4, 5, 6, 8, 10, 11, 12, 13, 15, 18, 19, 20, 22, 24, 25, 26, dan 27 Agustus 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 25,000 225,000 225,000 2 ___________
JUMLAH 2,375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 2, 3, 5, 7, 8, 9, 10, 12, 14, 15, 16, 17, 19, 20, 21, 22, 23, 25, 26, dan 28 September 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 18 25,000 450,000 450,000 2 ___________
JUMLAH 2,375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN PELAYANAN BULAN IMUNISASI ANAK SEKOLAH (BIAS) SD / MI
Tanggal: 3, 5, 6, 7, 8, 9, 10, 12, 13, 15, 16, 17, 19, 20, 21, 22, 26, 27, 28, 29, 30, dan 31 Oktober 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Ridwan Perawat 7 25,000 175,000 175,000 2 ___________
5 Abd. Syakur Perawat 6 25,000 150,000 150,000 5. __________
6 Trisna Ariani Perawat 6 25,000 150,000 150,000 6 ___________
7 H. Hernan Perawat 5 25,000 125,000 125,000 7. ___________
8 Ridwan, SH Perawat 5 25,000 125,000 125,000 8
9 Lalu Muh. Ilyas Perawat 6 25,000 150,000 150,000 9
10 Asrul Hamidi Perawat 6 25,000 150,000 150,000 10
11 Siti Aisyatul Syahri Perawat 7 25,000 175,000 175,000 11
12 Nurul Huda Perawat 7 25,000 175,000 175,000 12
13 Mas'ud Jayapura Perawat 3 25,000 75,000 75,000 13
14 Nana Agriani S Perawat 3 25,000 75,000 75,000 14
15 Lalu Muh. Hairussopian Perawat 7 25,000 175,000 175,000 15
16 Rohyatul Aini Perawat 7 25,000 175,000 175,000 16
JUMLAH 2,250,000
Terbilang: Dua Juta Dua Ratus Lima Puluh Ribu Rupiah
Selong,
H. SEJARAH, S.Sos NURHAYATI, ST

NIP. 19661231 198603 1 093 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN PELAYANAN BULAN IMUNISASI ANAK SEKOLAH (BIAS) SD / MI
Tanggal: 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 13, 14, 16, 17, 18, 19, 21, 23, 24, 25, 26, 27, 28, dan 30 Nopember 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Ridwan Perawat 7 25,000 175,000 175,000 2 ___________
5 Abd. Syakur Perawat 6 25,000 150,000 150,000 5. __________
6 Trisna Ariani Perawat 6 25,000 150,000 150,000 6 ___________
7 H. Hernan Perawat 5 25,000 125,000 125,000 7. ___________
8 Ridwan, SH Perawat 5 25,000 125,000 125,000 8
9 Lalu Muh. Ilyas Perawat 6 25,000 150,000 150,000 9
10 Asrul Hamidi Perawat 6 25,000 150,000 150,000 10
11 Siti Aisyatul Syahri Perawat 7 25,000 175,000 175,000 11
12 Nurul Huda Perawat 7 25,000 175,000 175,000 12
13 Mas'ud Jayapura Perawat 3 25,000 75,000 75,000 13
14 Nana Agriani S Perawat 3 25,000 75,000 75,000 14
15 Lalu Muh. Hairussopian Perawat 7 25,000 175,000 175,000 15
16 Rohyatul Aini Perawat 7 25,000 175,000 175,000 16
JUMLAH 2,250,000
Terbilang: Dua Juta Dua Ratus Lima Puluh Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 1, 2, 4, 6, 7, 8, 9, 11, 13, 14, 15, 16, 18, 20, 21, 22, 23, 24, 25, 27, 29, dan 30 April 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 25,000 225,000 225,000 2 ___________
95 JUMLAH 2,375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 2, 3, 4, 6, 9, 10, 11, 12, 13, 15, 16, 17, 18, 20, 22, 23, 24, 25, 27, dan 29 Februari 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 30,000 270,000 270,000 2 ___________
JUMLAH 2,850,000
Terbilang: Dua Juta Delapan Ratus Lima Puluh Ribu Rupiah
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 2, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14, 16, 18, 19, 20, 21, dan 23 April 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 30,000 270,000 270,000 2 ___________
7 Ahmad Suryadi Perawat 15 30,000 450,000 450,000 7. ___________
95 JUMLAH 2,850,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 9, 10, 11, 12, 14, 16, 17, 18, 19, 21, 23, 24, 25, 26, dan 28 Mei 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 30,000 270,000 270,000 2 ___________
7 Ahmad Suryadi Perawat 15 30,000 450,000 450,000 7. ___________
JUMLAH 2,850,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 1, 3, 4, 5, 6, 8, 10, 11, 12, 13, 15, 18, 19, 20, 22, 24, 25, 26, dan 27 Agustus 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 25,000 225,000 225,000 2 ___________
JUMLAH 2,375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 2, 3, 5, 7, 8, 9, 10, 12, 14, 15, 16, 17, 19, 20, 21, 22, 23, 25, 26, dan 28 September 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 25,000 225,000 225,000 2 ___________
JUMLAH 2,375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 3, 5, 6, 7, 8, 10, 12, 13, 15, 16, 17, 19, 20, 21, 22, 23, 24, 26, 27, 28, 29, dan 31 Oktober 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 18 25,000 450,000 450,000 2 ___________
JUMLAH 2,375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 2, 3, 4, 5, 7, 9, 10, 11, 12, 14, 16, 17, 18, 19, 21, 23, 24, 25, 26, 27, dan 28 Nopember 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 25,000 225,000 225,000 2 ___________
JUMLAH 2,375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 2, 3, 5, 7, 8, 10, 11, 12, 14, 15, 16, 17, 18, 19, 21, 22, 23, 26, 28, 29, dan 30 Desember 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 H. Hernan Perawat 9 25,000 225,000 225,000 2 ___________
JUMLAH 2,375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN BIMTEK MANAJEMEN KE PUSTU DAN POLINDES
Tanggal: 18, 20, 21, 22, 23, 24, 25, 27, 28, 29, dan 30 April 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Hj. Bari'ah, S.Kep Ka. Pusk. 11 25,000 275,000 275,000 1. __________
2 Ridwan, SH Ka. Tata Usaha 11 25,000 275,000 275,000 2 ___________
3 Inna Fakhria, SST Bidan PKM 11 25,000 275,000 275,000 3. __________
JUMLAH 825,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 10, 11, 12, 13, 14, 15, 20, 21, 22, 24, dan 25 Agustus 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Hj. Bari'ah, S.Kep Ka. Pusk. 11 25,000 275,000 275,000 1. __________
2 Ridwan, SH Ka. Tata Usaha 11 25,000 275,000 275,000 2 ___________
3 Lathifah, SKM Bidan Koord. 11 25,000 275,000 275,000 3. __________
JUMLAH 825,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 1, 2, 3, 4, 5, 7, 8, 10, 11, 12, dan 14 Desember 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Ridwan, SH Ka. Subbag TU 11 25,000 275,000 275,000 1. __________
2 Lathifah, SKM Bidan Koord. 11 25,000 275,000 275,000 2 ___________
3 H. Ridwan, S.Kep Perawat 11 25,000 275,000 275,000 3. __________
JUMLAH 825,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 21, 22, 23, 25, 26, 27, 28, dan 29 April 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 H. Ahmat, S.Kep, MM Ka. Pusk. 8 30,000 240,000 240,000 1. __________
3 Ridwan, SH Ka. Sub. Bag TU 8 30,000 240,000 240,000 3. __________
JUMLAH 720,000
Terbilang: Tujuh Ratus Dua Puluh Ribu Rupiah
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 5, 6, 10, 17, 19, 20, 22, dan 28 Desember 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 H. Ahmat, S.Kep, MM Ka. Pusk. 8 30,000 240,000 240,000 1. __________
3 Ridwan, SH Ka. Sub. Bag TU 8 30,000 240,000 240,000 3. __________
JUMLAH 720,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN MONITORING PASCA PEMICUAN STBM
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 120,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 120,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 120,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 27, 28, 29, 30, dan 31 Juli 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 25, 26, 27, 28, dan 29 Agustus 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8

JUMLAH 375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000

Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENGAMBILAN SAMPEL AIR
Tanggal: 17, 18, 19, 21,22, 23, 24, 26, 28, 29, 30, dan 31 Maret 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 720,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENGAMBILAN SAMPEL AIR
Tanggal: 11, 12, 13, 14, 15, 16, 25, 26, 27, 28, 29, dan 30 April 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 720,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 11, 12, 13, 14, 15, 16, 25, 26, 27, 28, 29, dan 30 April 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 1,080,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 180,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 1, 3, 4, 5, dan 6 Juni 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8

JUMLAH 375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000

Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN KAPORISASI
Tanggal: 10, 11, 12, 14, 15, 16, 17, 18, 19, 21, 22, 23, 24, 26, 28, 29, 30, dan 31 Maret 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Sri Latifah Staf 18 30,000 540,000 540,000 2 ___________
JUMLAH 1,080,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 1, 3, 4, 5, dan 6 Juni 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 180,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 1, 3, 4, 5, dan 6 Juni 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8

JUMLAH 375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 375,000

Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN POSYANDU PARU SEHAT (PPS) DI POSYANDU
Tanggal: 4, 5, 6, 7, dan 9 Januari 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Lalu Muh. Satrianadi Petugas TB 5 30,000 150,000 150,000 1. __________
2 Nurhayati Saniatarian 5 30,000 150,000 150,000 2 ___________
3 Jumadil Perawat 5 30,000 150,000 150,000 3. __________
JUMLAH 450,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 1, 2, 3, 4, dan 6 Februari 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
3 Jumadil Perawat 5 30,000 150,000 150,000 3. __________
JUMLAH 450,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 1, 2, 3, 4, dan 5 Maret 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
3 Jumadil Perawat 5 30,000 150,000 150,000 3. __________
JUMLAH 450,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 4, 5, 6, 7, dan 8 April 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Nurhayati Sanitarian 5 30,000 150,000 150,000 2 ___________
3 Jumadil Perawat 5 30,000 150,000 150,000 3. __________
JUMLAH 450,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 9, 10, 11, 12, dan 13 Mei 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Nurhayati Sanitarian 5 30,000 150,000 150,000 2 ___________
3 Jumadil Perawat 5 30,000 150,000 150,000 3. __________
JUMLAH 450,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 11, 12, 14, 15, dan 16 September 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Samsurrizal Perawat 5 25,000 125,000 125,000 2 ___________
3 Nurhayati HS 5 25,000 125,000 125,000 3. __________
4 Siti Rohmatullah Analis 5 25,000 125,000 125,000 4 ___________
5 Aisyah Kader 1 25,000 25,000 25,000 5. __________
6 Antin Kader 1 25,000 25,000 25,000 6 ___________
7 Anin Kader 1 25,000 25,000 25,000 7. __________
8 Iq. Anggun Kader 1 25,000 25,000 25,000 8 ___________
9 Neni Sumarni Kader 1 25,000 25,000 25,000 9. __________
JUMLAH 625,000
Terbilang: Enam Ratus Dua Puluh Lima Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Samsurrizal Perawat 5 25,000 125,000 125,000 2 ___________
3 Nurhayati HS 5 25,000 125,000 125,000 3. __________
5 Nurhasanah Kader 1 25,000 25,000 25,000 5. __________
6 Mardiana Kader 1 25,000 25,000 25,000 6 ___________
7 Sopiati Kader 1 25,000 25,000 25,000 7. __________
8 Mukminah Kader 1 25,000 25,000 25,000 8 ___________
9 Nurhasni Kader 1 25,000 25,000 25,000 9. __________
JUMLAH 625,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Samsul Rizal Perawat 5 25,000 125,000 125,000 2 ___________
3 Nurhayati HS 5 25,000 125,000 125,000 3. __________
5 Fitriani Kader 1 25,000 25,000 25,000 5. __________
6 Ika Ifada Kader 1 25,000 25,000 25,000 6 ___________
7 Masitah Kader 1 25,000 25,000 25,000 7. __________
8 Rehanah Kader 1 25,000 25,000 25,000 8 ___________
9 Munawati Kader 1 25,000 25,000 25,000 9. __________
JUMLAH 625,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Samsul Rizal Perawat 5 25,000 125,000 125,000 2 ___________
3 Nurhayati HS 5 25,000 125,000 125,000 3. __________
5 Mariani Kader 1 25,000 25,000 25,000 5. __________
6 Susanti Kader 1 25,000 25,000 25,000 6 ___________
7 Zohrah Kader 1 25,000 25,000 25,000 7. __________
8 Hj. Munawarah Kader 1 25,000 25,000 25,000 8 ___________
9 Maesum Kader 1 25,000 25,000 25,000 9. __________
JUMLAH 625,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PEMERIKSAAN & PENYULUHAN KESEHATAN MATA TELINGA
Tanggal: 11,12, dan 13 Januari 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Siti Rauhil Azizah Perawat Gigi 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 9, 10, 11, dan 12 Februari 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 180,000
Terbilang: Dua Ratus Empat Puluh Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Bq. Muspita Rini Perawat 3 30,000 90,000 90,000 2 ___________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Bq. Muspita Rini Perawat 3 30,000 90,000 90,000 1. __________
JUMLAH 180,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PEMERIKSAAN & PENYULUHAN KESEHATAN INDRA (MATA & TELINGA)
Tanggal: agustus 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Roslina Yuniharti Perawat 5 25,000 125,000 125,000 1. __________
2 Lalu Muh. Hairus Sopian Perawat 5 25,000 125,000 125,000 2 ___________
JUMLAH 250,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 2, 3, 4, dan 5 September 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 250,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Rena Noviarni Perawat 5 25,000 125,000 125,000 1. __________
2 Sriningsih Perawat 5 25,000 125,000 125,000 2 ___________
JUMLAH 250,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Nana Agriani S Perawat 5 25,000 125,000 125,000 2 ___________
JUMLAH 250,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PELAYANAN KESEHATAN LANSIA DI POSYANDU LANSIA
Tanggal: 4, 5, 6, 7, 9, 11, 12, 14, 16, 18, 20, 23, dan 25 Januari 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Gita Asmarani Perawat 13 30,000 390,000 390,000 2 ___________
JUMLAH 780,000
Terbilang: Tujuh Ratus Delapan Puluh Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 2, 3, 4, 6, 9, 10, 11, 16, 17, 18, 23, 24, dan 25 Februari 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Bq. Rohmatun Azizah Perawat 13 30,000 390,000 390,000 2 ___________
JUMLAH 780,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 4, 5, 6, 9, 11, 12, 13, 16, 18, 19, 20, 23, dan 25 April 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Bq. Rohmatun Azizah Perawat 13 30,000 390,000 390,000 2 ___________
JUMLAH 780,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 3, 4, 7, 9, 10, 14, 16, 17, 18, 23, 24, 25, dan 26 Mei 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Sriningsih, S.Kep Perawat 13 30,000 390,000 390,000 1. __________
2 Bq. Rohmatun Azizah, A.Md. Kep Perawat 13 30,000 390,000 390,000 2 ___________
JUMLAH 780,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 1, 2, 3, 4, 6, 7, 8, 9, 10, 11, 13, 14, dan 15 Juli 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 650,000
Terbilang: Enam Ratus Lima Puluh Ribu Rupiah
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 3, 4, 5, 6, 8, 10, 11, 12, 13, 15, 18, 19, dan 20 Agustus 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 650,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 2, 3, 5, 7, 8, 9, 12, 14, 15, 16, 19, 21, dan 22 September 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 650,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 650,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 2, 3, 4, 7, 9, 10, 11, 14, 16, 17, 18, 21, dan 23 Nopember 2015
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 650,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN DETEKSI DINI PTM
Tanggal: 2, 3, 6, 11, 16, 17, 23, dan 25 Februari 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Trisna Ariani, A.Md. Kep Perawat 8 30,000 240,000 240,000 1. __________
2 Gita Asmarani, A.Md. Kep Perawat 8 30,000 240,000 240,000 2 ___________
JUMLAH 480,000
Terbilang: Empat Ratus Delapan Puluh Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 4, 5, 9, 13, 16, 18, 20, dan 25 April 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Trisna Ariani, A.Md. Kep Perawat 8 30,000 240,000 240,000 1. __________
JUMLAH 480,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 2, 3, 7, 9, 16, 18, 24, dan 25 Mei 2016

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Roslina Januharti, S. Kep Perawat 8 30,000 240,000 240,000 1. __________
JUMLAH 480,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 1, 3, 6, 7, 8, 10, 14, dan 15 Juli 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
1 Trisna Ariani Perawat 8 25,000 200,000 200,000 1. __________
2 Abd. Syakur Perawat 8 25,000 200,000 200,000 2 ___________
JUMLAH 400,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 3, 5, 8, 10, 11, 13, 19, dan 20 Agustus 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 2, 3, 5, 8, 10, 14, 17, dan 21 Desember 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 400,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENGAMBILAN VAKSIN KE DIKES KAB. LOTIM
Tanggal: 01 Februari 2016
UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
2 Lalu Muh. Irsan Sopir 1 50,000 50,000 50,000 2 ___________
JUMLAH 100,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENGAMBILAN VAKSIN RUTIN KE DIKES KAB. LOTIM

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 100,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENGAMBILAN VAKSIN UNTUK KEPERLUAN PIN POLIO KE DIKES KAB. LOTIM

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 96,000
Terbilang: Sembilan Puluh Enam Ribu Rupiah
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 100,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 100,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 01 Agustus 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 300,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 01 September 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 300,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 01 Oktober 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 300,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 02 Nopember 2015

UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 300,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
HARI TRANSPORT
HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 300,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PERTEMUAN SOSIALISASI & PEMBENTUKAN KP ASI
DI DESA MONTONG BETER, WILAYAH KERHA PUSKESMAS RENSING

UANG
NO NAMA KADER JABATAN TRANPORT/H
ARI ( RP )
1 1 Hr 30,000 30,000 30,000
2 1 Hr 30,000 30,000 30,000
3 1 Hr 30,000 30,000 30,000
4 1 Hr 30,000 30,000 30,000
5 1 Hr 30,000 30,000 30,000
6 1 Hr 30,000 30,000 30,000
7 1 Hr 30,000 30,000 30,000
8 1 Hr 30,000 30,000 30,000
9 1 Hr 30,000 30,000 30,000
10 1 Hr 30,000 30,000 30,000
11 1 Hr 30,000 30,000 30,000
12 1 Hr 30,000 30,000 30,000
13 1 Hr 30,000 30,000 30,000
14 1 Hr 30,000 30,000 30,000
15 1 Hr 30,000 30,000 30,000
16 1 Hr 30,000 30,000 30,000
17 1 Hr 30,000 30,000 30,000
18 1 Hr 30,000 30,000 30,000
19 1 Hr 30,000 30,000 30,000
20 1 Hr 30,000 30,000 30,000

JUMLAH 600,000
Selong,
Setuju Dibayar
Kepala Puskesmas Rensing Bendahara BOK
H. AHMAT A, S.Kep, MM
NIP. 19661231 198803 1 306 NIP. 19751212 1
61 Marwiyah,Spd Kader Sangke langit 1 Hr 25.000 25.000 25.000
62 Ikarianti Kader Sangke langit 1 Hr 25.000 25.000 25.000
63 Yuliana.S Kader lendang elah 1 Hr 25.000 25.000 25.000
64 Haulani Kader lendang elah 1 Hr 25.000 25.000 25.000
65 Mardiyah Kader Gawah jarak 1 Hr 25.000 25.000 25.000
66 Resnawati Kader Gawah jarak 1 Hr 25.000 25.000 25.000
67 Husnul hotmi Kader rejeng Nyung 1 Hr 25.000 25.000 25.000
68 Sabariah Kader rejeng Nyung 1 Hr 25.000 25.000 25.000
69 Sri Puji kader mengkuru 1 Hr 25.000 25.000 25.000
70 sukmawartini kader mengkuru 1 Hr 25.000 25.000 25.000
71 Sri Wulandari kader sangupati 1 Hr 25.000 25.000 25.000
72 Bq.emi Lestari kader sangupati 1 Hr 25.000 25.000 25.000
73 Hafizah Kader pesanggrahan 1 Hr 25.000 25.000 25.000
74 hanifah Kader pesanggrahan 1 Hr 25.000 25.000 25.000
75 B.fathul jannah Kader sanggo 1 Hr 25.000 25.000 25.000
76 B.Fatmawati Kader sanggo 1 Hr 25.000 25.000 25.000
77 Jamilah kader tanak kaken 1 Hr 25.000 25.000 25.000
78 B.Mulianah kader tanak kaken 1 Hr 25.000 25.000 25.000
79 Halimatussakdiah kader Tongke 1 Hr 25.000 25.000 25.000
80 Nurlaela azmi kader Tongke 1 Hr 25.000 25.000 25.000
81 Yuliana safitri kader Jerua 1 Hr 25.000 25.000 25.000
82 zaenabung kader Jerua 1 Hr 25.000 25.000 25.000
83 Sri Kader malah 1 Hr 25.000 25.000 25.000
84 Hj.Nursehan Kader malah 1 Hr 25.000 25.000 25.000
85 Srianom kade dasan tengak 1 Hr 25.000 25.000 25.000
86 Umi Kalsum kade dasan tengak 1 Hr 25.000 25.000 25.000
87 Bq.Linda Yuliana kader Poyak oyak 1 Hr 25.000 25.000 25.000
88 Bq.Mustika.R kader Poyak oyak 1 Hr 25.000 25.000 25.000
89 Nurhasanah Kader bageq Nyale 1 Hr 25.000 25.000 25.000
90 raihul inayah Kader bageq Nyale 1 Hr 25.000 25.000 25.000
91 Bq.Zohriah kader dasan baru 1 Hr 25.000 25.000 25.000
92 Rohana kader dasan baru 1 Hr 25.000 25.000 25.000
93 Suarniwati kader Monjet bat 1 Hr 25.000 25.000 25.000
94 Bq.Rohiyatul.H kader Monjet bat 1 Hr 25.000 25.000 25.000
95 Masni kader penandak 1 Hr 25.000 25.000 25.000
96 Misniana kader penandak 1 Hr 25.000 25.000 25.000
97 Zuhriatun kader tanjah anjah 1 Hr 25.000 25.000 25.000
98 Hartini kader tanjah anjah 1 Hr 25.000 25.000 25.000
99 Ida mayanti kader karang baru 1 Hr 25.000 25.000 25.000
100 Hindun kader karang baru 1 Hr 25.000 25.000 25.000
101 Ikawati kader pengk,mas 1 Hr 25.000 25.000 25.000
102 Iq.rodi kader pengk,mas 1 Hr 25.000 25.000 25.000
103 Jami'ah Kader semanggleng 1 Hr 25.000 25.000 25.000
104 jauhariah Kader semanggleng 1 Hr 25.000 25.000 25.000
105 Saidah kader Pongkor 1 Hr 25.000 25.000 25.000
106 Bq.Icah kader Pongkor 1 Hr 25.000 25.000 25.000
107 Siti Fatimah Kader gerisak 1 Hr 25.000 25.000 25.000
108 Zuhaeratul Kader gerisak 1 Hr 25.000 25.000 25.000
109 Herlin kader penutus 1 Hr 25.000 25.000 25.000
110 Mahuni kader penutus 1 Hr 25.000 25.000 25.000
111 Indrawati kader Repok tengak 1 Hr 25.000 25.000 25.000
112 Sri ayu kader Repok tengak 1 Hr 25.000 25.000 25.000
113 Zuhriatun kader gwh gadung 1 Hr 25.000 25.000 25.000
114 farida Asiani kader gwh gadung 1 Hr 25.000 25.000 25.000
115 Fatimah kader gwh gadung 1 Hr 25.000 25.000 25.000
116 Nurhalimah kader gwh gadung 1 Hr 25.000 25.000 25.000
117 Sumarni Kader gwh gadung 1 Hr 25.000 25.000 25.000
118 Siti Rahmah Kader gwh gadung 1 Hr 25.000 25.000 25.000
119 Sahni Kader Batu tandak 1 Hr 25.000 25.000 25.000
120 Martini Kader Batu tandak 1 Hr 25.000 25.000 25.000
121 Nuraini kader gerepek sante 1 Hr 25.000 25.000 25.000
122 Maisah kader gerepek sante 1 Hr 25.000 25.000 25.000
123 Anita jajang Kader Repok are 1 Hr 25.000 25.000 25.000
124 rauhun Kader Repok are 1 Hr 25.000 25.000 25.000
125 Rehanah kader bungtiang Brt 1 Hr 25.000 25.000 25.000
126 Hartini kader bungtiang Brt 1 Hr 25.000 25.000 25.000
127 fitriani kader Bungtiang tm 1 Hr 25.000 25.000 25.000
128 Rohani kader Bungtiang tm 1 Hr 25.000 25.000 25.000
129 Siti Aisyah Kader gerisak 1 Hr 25.000 25.000 25.000
130 Salmiah Kader gerisak 1 Hr 25.000 25.000 25.000
131 Nursamsi Kader bungambar 1 Hr 25.000 25.000 25.000

132 Munawati Kader bungambar 1 Hr 25.000 25.000 25.000
133 Bq.kalsum kader mt.Mesir 1 Hr 25.000 25.000 25.000
134 Bq.Zubaedah kader mt.Mesir 1 Hr 25.000 25.000 25.000
135 Masitah kader Montong 1 Hr 25.000 25.000 25.000
136 Endra kader Montong 1 Hr 25.000 25.000 25.000
137 Mariani ratna.k kader Bungtiang slt 1 Hr 25.000 25.000 25.000
138 Ziadatul hilmi kader Bungtiang slt 1 Hr 25.000 25.000 25.000
139 Raehanun kader bungtiang T 1 Hr 25.000 25.000 25.000
140 Solatiah kader bungtiang T 1 Hr 25.000 25.000 25.000
141 Masturi Kader bungtiang Tg 1 Hr 25.000 25.000 25.000
142 Suriani Kader bungtiang Tg 1 Hr 25.000 25.000 25.000
143 Sarifah kader bungtiang brt 1 Hr 25.000 25.000 25.000
144 Halimah kader bungtiang brt 1 Hr 25.000 25.000 25.000
145 Mulianah kader borok dalem 1 Hr 25.000 25.000 25.000
146 Satriah kader borok dalem 1 Hr 25.000 25.000 25.000
147 Sinarep Kader Borok luah 1 Hr 25.000 25.000 25.000
148 Eli ermawati Kader Borok luah 1 Hr 25.000 25.000 25.000
149 Sinarep kader mt.pendem 1 Hr 25.000 25.000 25.000
150 Eli ermawati kader mt.pendem 1 Hr 25.000 25.000 25.000
151 Hj.darmataksiah Kader lk.kolo 1 Hr 25.000 25.000 25.000
152 Ana Rodianti Kader lk.kolo 1 Hr 25.000 25.000 25.000
153 Bq.hayatul kader toyang 1 Hr 25.000 25.000 25.000
154 Hurniawati kader toyang 1 Hr 25.000 25.000 25.000
155 Nurjannah Kader dewe lanji 1 Hr 25.000 25.000 25.000
156 Riza ariani Kader dewe lanji 1 Hr 25.000 25.000 25.000
157 Mariani Kader presak 1 Hr 25.000 25.000 25.000
158 Ernawati Kader presak 1 Hr 25.000 25.000 25.000
159 sahriwati kader kondok 1 Hr 25.000 25.000 25.000
160 Isnawati kader kondok 1 Hr 25.000 25.000 25.000
161 Supawati Kader Sukawangi 1 Hr 25.000 25.000 25.000
162 Sumiati Kader Sukawangi 1 Hr 25.000 25.000 25.000
163 Slimin kader jeropoto 1 Hr 25.000 25.000 25.000
164 sakmah kader jeropoto 1 Hr 25.000 25.000 25.000
165 Mutiara kader tangar 1 Hr 25.000 25.000 25.000
166 Sumarni kader tangar 1 Hr 25.000 25.000 25.000
167 Parmi kader Asem/Jekeh 1 Hr 25.000 25.000 25.000
168 zuhriah kader Asem/Jekeh 1 Hr 25.000 25.000 25.000
169 Eny susilawati Kader dasan repok 1 Hr 25.000 25.000 25.000
170 iq.Asri Kader dasan repok 1 Hr 25.000 25.000 25.000
171 Siti hadijah kader sukarara Utr 1 Hr 25.000 25.000 25.000
172 Rohnam kader sukarara Utr 1 Hr 25.000 25.000 25.000
173 Sahimin Kader sukarara sltn 1 Hr 25.000 25.000 25.000
174 Husniwati Kader sukarara sltn 1 Hr 25.000 25.000 25.000
175 Asiah Kader pejaring 1 Hr 25.000 25.000 25.000
176 Istiareni Kader pejaring 1 Hr 25.000 25.000 25.000
177 Nurminah kader Selayar 1 Hr 25.000 25.000 25.000
178 Iwang kader Selayar 1 Hr 25.000 25.000 25.000
179 Husniatun Kader dengkur 1 Hr 25.000 25.000 25.000
180 Astuti handayani Kader dengkur 1 Hr 25.000 25.000 25.000
181 Sekarniwati kader Pejaring T 1 Hr 25.000 25.000 25.000
182 Marniati kader Pejaring T 1 Hr 25.000 25.000 25.000
183 Halimah Kader Pejaring Brt 1 Hr 25.000 25.000 25.000
184 Nuraini Kader Pejaring Brt 1 Hr 25.000 25.000 25.000
185 Bq. Nurhidayati Kader Jerue bawak 1 Hr 25.000 25.000 25.000
186 Yulia Mustikawati Kader Jerue bawak 1 Hr 25.000 25.000 25.000
187 Nurul Hidayana Mt. Prapen 1 Hr 25.000 25.000 25.000
188 Rosdiana Mt. Prapen 1 Hr 25.000 25.000 25.000
189 Sutatik Kader bt. Ngrengse 1 Hr 25.000 25.000 25.000
190 Hartini Kader bt. Ngrengse 1 Hr 25.000 25.000 25.000
TOTAL -

Bendahara BOK Puskesm
NIP.19641231 198511 2 040 NIP. 19751212 199603 2 0
ERIMAAN TRANSPORT PESERTA
RTEMUAN SOSIALISASI & PEMBENTUKAN KP ASI
R, WILAYAH KERHA PUSKESMAS RENSING
TANDA TANGAN
10
11
12
13
14
15
16
17
18
19
20
LUNAS DIBAYAR
NURHAYATI, ST
NIP. 19751212 199603 2 002
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PERTEMUAN SOSIALISASI PENGOBATAN TRADISIONAL (BA

UANG
ARI ( RP )
1 Herlin S Sekdes 1 Hr 25,000 25,000 25,000
2 Arpan Efendi Sekdes 1 Hr 25,000 25,000 25,000
3 Sumahir Sekdes 1 Hr 25,000 25,000 25,000
4 H. Ismail Sekdes 1 Hr 25,000 25,000 25,000
5 L. Muh. Yusuf Kaurkesra 1 Hr 25,000 25,000 25,000
6 Sumarni Kaur Keuangan 1 Hr 25,000 25,000 25,000
7 Martini Kaur kesra 1 Hr 25,000 25,000 25,000
8 H. Lalu Rahmat Kaur 1 Hr 25,000 25,000 25,000
9 M. Ali Jafar Kaur 1 Hr 25,000 25,000 25,000
10 Syahram Kaur 1 Hr 25,000 25,000 25,000
11 L. Muh. Satrianadi Staf 1 Hr 25,000 25,000 25,000
12 H. Abdullah Kades 1 Hr 25,000 25,000 25,000
13 H. Muh. Sahdan Kades 1 Hr 25,000 25,000 25,000
14 M. Syaiful Staf 1 Hr 25,000 25,000 25,000
15 Muhyiddin Kader 1 Hr 25,000 25,000 25,000
16 Ridwan Staf 1 Hr 25,000 25,000 25,000
17 Suhardi Staf 1 Hr 25,000 25,000 25,000
18 Harlin Normalia Staf 1 Hr 25,000 25,000 25,000
19 Bq. Zohrah Staf 1 Hr 25,000 25,000 25,000
20 Iwang Kader 1 Hr 25,000 25,000 25,000
21 Harniwati Kader 1 Hr 25,000 25,000 25,000
22 Mutmainnah Kader 1 Hr 25,000 25,000 25,000
23 Lasih Kader 1 Hr 25,000 25,000 25,000
24 Fitriani Kader 1 Hr 25,000 25,000 25,000
25 Sakmah Kader 1 Hr 25,000 25,000 25,000
JUMLAH 625,000
Selong,
Setuju Dibayar
HJ. BARI'AH, S.Kep

NIP. 19641231 198511 2 040 NIP. 19751212 1

TOTAL -

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 0
UAN SOSIALISASI PENGOBATAN TRADISIONAL (BATRA)
NSING KABUPATEN LOMBOK TIMUR
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
LUNAS DIBAYAR
NURHAYATI, ST
NIP. 19751212 199603 2 002
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PERTEMUAN TEKNIK SURVEY PHBS TK. PUSKESMAS RENS

UANG
ARI ( RP )
1 Nurlaili Azmi Kader 1 Hr 25,000 25,000 25,000
2 Sumiati Kader 1 Hr 25,000 25,000 25,000
3 Jaminatul Kader 1 Hr 25,000 25,000 25,000
4 Jami'ah Kader 1 Hr 25,000 25,000 25,000
5 Sri Wulandari Kader 1 Hr 25,000 25,000 25,000
6 Hartini Kader 1 Hr 25,000 25,000 25,000
7 Bq. Jeniah Kader 1 Hr 25,000 25,000 25,000
8 Sofa Marwati Kader 1 Hr 25,000 25,000 25,000
9 Mutiara Kader 1 Hr 25,000 25,000 25,000
10 Susanti Kader 1 Hr 25,000 25,000 25,000
11 Fitriani Kader 1 Hr 25,000 25,000 25,000
12 Mahdan Kader 1 Hr 25,000 25,000 25,000
13 Nurminah Kader 1 Hr 25,000 25,000 25,000
14 Uswatun Hasanah Kader 1 Hr 25,000 25,000 25,000
15 Mutmainnah Kader 1 Hr 25,000 25,000 25,000
16 Yanti Nurmayana Kader 1 Hr 25,000 25,000 25,000
17 Erni Anita S Kader 1 Hr 25,000 25,000 25,000
18 Muhidin Kader 1 Hr 25,000 25,000 25,000
19 Iwang Kader 1 Hr 25,000 25,000 25,000
20 Harun Kader 1 Hr 25,000 25,000 25,000
21 Harniwati Kader 1 Hr 25,000 25,000 25,000
22 Sakmah Kader 1 Hr 25,000 25,000 25,000
23 Hj. Muslihati Kader 1 Hr 25,000 25,000 25,000
24 Lasih Kader 1 Hr 25,000 25,000 25,000
25 Suriani Kader 1 Hr 25,000 25,000 25,000
26 Rakmah Kader 1 Hr 25,000 25,000 25,000
27 Yeni Mustika Kader 1 Hr 25,000 25,000 25,000
28 Solatiah Kader 1 Hr 25,000 25,000 25,000
29 Marhaeni Kader 1 Hr 25,000 25,000 25,000
30 Puspariani Kader 1 Hr 25,000 25,000 25,000
JUMLAH 750,000
Terbilang: Tujuh Ratus Lima Puluh Ribu Rupiah
Selong,
Setuju Dibayar
HJ. BARI'AH, S.Kep

NIP. 19641231 198511 2 040 NIP. 19751212 1

TOTAL -

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 0
MUAN TEKNIK SURVEY PHBS TK. PUSKESMAS RENSING
NSING KABUPATEN LOMBOK TIMUR
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Terbilang: Tujuh Ratus Lima Puluh Ribu Rupiah
LUNAS DIBAYAR
NURHAYATI, ST
NIP. 19751212 199603 2 002
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN SOSIALISASI DAN PEMBENTUKAN DESA SIAGA (DESI)
DI DESA TANAK KAKEN, WIL. KERJA PUSKESMAS RENSING KABUPATEN LOMBOK TIM

UANG
NO NAMA PESERTA JABATAN TRANPORT/H
ARI ( RP )
1 Jamilah Kader 1 25,000 25,000 25,000
2 Rabiatul Khair Kader 1 25,000 25,000 25,000
3 Nurlaili Azmi Kader 1 25,000 25,000 25,000
4 Mukdis toma 1 25,000 25,000 25,000
5 Ihsan toma 1 25,000 25,000 25,000
6 Maksum kadus 1 25,000 25,000 25,000
7 L. Hadi Langga kadus 1 25,000 25,000 25,000
8 Mojahar BPD 1 25,000 25,000 25,000
9 Masrzuki kadus 1 25,000 25,000 25,000
10 H. Hernan pet. Pustu tn. Kaken 1 25,000 25,000 25,000
11 Ihsan kades 1 25,000 25,000 25,000
12 L. Muh. Yusuf kaur kesra 1 25,000 25,000 25,000
13 Herman kaur keungan 1 25,000 25,000 25,000
14 Muh. Rifai Kadus 1 25,000 25,000 25,000
15 Bq. Hera Ristina Staf 1 25,000 25,000 25,000
16 Bq. Irma Suryani Staf 1 25,000 25,000 25,000
17 H. Sahrudin LKMD 1 25,000 25,000 25,000
18 Bq. Fathul Jannah Kader 1 25,000 25,000 25,000
19 Hamidi Staf 1 25,000 25,000 25,000
JUMLAH 475,000
Terbilang: Empat Ratus Tujuh Puluh Lima Ribu Rupiah
Selong,
Setuju Dibayar
HJ. BARI'AH, S.Kep

NIP. 19641231 198511 2 040 NIP. 19751212 1

TOTAL -

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 0
IALISASI DAN PEMBENTUKAN DESA SIAGA (DESI)
A PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
Terbilang: Empat Ratus Tujuh Puluh Lima Ribu Rupiah
LUNAS DIBAYAR
NURHAYATI, ST
NIP. 19751212 199603 2 002
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PERTEMUAN MUSYAWARAH MASYARAKAT DESA (MMD
DI DESA RENSING RAYA, WIL. KERJA PUSKESMAS RENSING KABUPATEN LOMBOK TIM

UANG
ARI ( RP )
1 1 30,000 30,000 30,000
2 1 30,000 30,000 30,000
3 1 30,000 30,000 30,000
4 1 30,000 30,000 30,000
5 1 30,000 30,000 30,000
6 1 30,000 30,000 30,000
7 1 30,000 30,000 30,000
8 1 30,000 30,000 30,000
9 1 30,000 30,000 30,000
10 1 30,000 30,000 30,000
11 1 30,000 30,000 30,000
12 1 30,000 30,000 30,000
13 1 30,000 30,000 30,000
14 1 30,000 30,000 30,000
15 1 30,000 30,000 30,000

JUMLAH 450,000
Selong,
Setuju Dibayar
NIP. 19661231 198803 1 306 NIP. 19751212 1
DALAM RANGKA KEGIATAN PERTEMUAN MUSYAWARAH MASYARAKAT DESA (MMD
DI DESA JEROGUNUNG, WIL. KERJA PUSKESMAS RENSING KABUPATEN LOMBOK TIMU

UANG
ARI ( RP )
1 1 30,000 30,000 30,000
2 1 30,000 30,000 30,000
3 1 30,000 30,000 30,000
4 1 30,000 30,000 30,000
5 1 30,000 30,000 30,000
6 1 30,000 30,000 30,000
7 1 30,000 30,000 30,000
8 1 30,000 30,000 30,000
9 1 30,000 30,000 30,000
10 1 30,000 30,000 30,000
11 1 30,000 30,000 30,000
12 1 30,000 30,000 30,000
13 1 30,000 30,000 30,000
14 1 30,000 30,000 30,000
15 1 30,000 30,000 30,000

JUMLAH 450,000
Selong,
Setuju Dibayar
NIP. 19661231 198803 1 306 NIP. 19751212 1

TOTAL -

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 0
TEMUAN MUSYAWARAH MASYARAKAT DESA (MMD)
TANDA TANGAN
10
11
12
13
14
15
LUNAS DIBAYAR
NURHAYATI, ST
NIP. 19751212 199603 2 002
TEMUAN MUSYAWARAH MASYARAKAT DESA (MMD)
TANDA TANGAN
10
11
12
13
14
15
LUNAS DIBAYAR
NURHAYATI, ST
NIP. 19751212 199603 2 002
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN MMD & SMD TINGKAT PUSKESMAS RENSING
Tanggal : 30 Juli 2015

UANG
ARI ( RP )
1 Hj. Umaiyah Kader 1 25,000 25,000 25,000
2 Shopiatul Bariah Kader 1 25,000 25,000 25,000
3 Nuri Hasriana Kader 1 25,000 25,000 25,000
4 Marhaini Kader 1 25,000 25,000 25,000
5 M. Yasin Kadus 1 25,000 25,000 25,000
6 Syamsul Rijal LKMD 1 25,000 25,000 25,000
7 Desi Hasri Rahman Staf 1 25,000 25,000 25,000
8 Munggah RT 1 25,000 25,000 25,000
9 H. Ismail Sekdes 1 25,000 25,000 25,000
10 H. Darmawan Toga 1 25,000 25,000 25,000
11 M. Kazwaen S Staf 1 25,000 25,000 25,000
12 Badarudin Kadus 1 25,000 25,000 25,000
13 Ahyanudin Kaur 1 25,000 25,000 25,000
14 M. Ali Mashri Kadus 1 25,000 25,000 25,000
15 H.Saparudin BPD 1 25,000 25,000 25,000
16 M. Tuhirudin BPD 1 25,000 25,000 25,000
17 Nuruddin Ketua BPD 1 25,000 25,000 25,000
18 Bq. Husnul Khotimah Bidan Desa 1 25,000 25,000 25,000
19 Nurhalimah Kader 1 25,000 25,000 25,000
20 Nurhasni Kader 1 25,000 25,000 25,000
21 Solatiyah Kader 1 25,000 25,000 25,000
22 Uswatun Hasanah Kader 1 25,000 25,000 25,000
23 Sopa Marwati Kader 1 25,000 25,000 25,000
24 Yuliana susanti Kader 1 25,000 25,000 25,000
25 H. Zaenal M. LKMD 1 25,000 25,000 25,000
26 M. Khairi LKMD 1 25,000 25,000 25,000
27 Yanti Nurmayana Kader 1 25,000 25,000 25,000
28 Abu Bakar BPD 1 25,000 25,000 25,000
29 H. Dahman LKMD 1 25,000 25,000 25,000
30 H. Shofiyan Toga 1 25,000 25,000 25,000
31 Muh. Hilmi KADES 1 25,000 25,000 25,000
32 Fitriah Kader 1 25,000 25,000 25,000
33 Harlin normalia Staf 1 25,000 25,000 25,000
34 H. Seman Staf 1 25,000 25,000 25,000
JUMLAH 850,000
Terbilang: Delapan Ratus Lima Puluh Ribu Rupiah
Selong,
Setuju Dibayar
HJ. BARI'AH, S.Kep

NIP. 19641231 198511 2 040 NIP. 19751212 1

TOTAL -

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 0
N MMD & SMD TINGKAT PUSKESMAS RENSING
SING KABUPATEN LOMBOK TIMUR
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
Terbilang: Delapan Ratus Lima Puluh Ribu Rupiah
LUNAS DIBAYAR
NURHAYATI, ST
NIP. 19751212 199603 2 002
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DAFTAR PENERIMAAN TRANSPORT KADER
DALAM RANGKA KEGIATAN SURVEY PHBS TATANAN RUMAH TANGGA (RT)
Tanggal : 22 dan 23 Juni 2015

UANG
ARI ( RP )
1 Nurlaili Azmi Kader 2 25,000 50,000 50,000
2 Sumiati Kader 2 25,000 50,000 50,000
3 Jaminatul Kader 2 25,000 50,000 50,000
4 Jami'ah Kader 2 25,000 50,000 50,000
5 Sri Wulandari Kader 2 25,000 50,000 50,000
6 Hartini Kader 2 25,000 50,000 50,000
7 Bq. Jeniah Kader 2 25,000 50,000 50,000
8 Sofa Marwati Kader 2 25,000 50,000 50,000
9 Mutiara Kader 2 25,000 50,000 50,000
10 Susanti Kader 2 25,000 50,000 50,000
11 Fitriani Kader 2 25,000 50,000 50,000
12 Mahdan Kader 2 25,000 50,000 50,000
13 Nurminah Kader 2 25,000 50,000 50,000
14 Uswatun Hasanah Kader 2 25,000 50,000 50,000
15 Mutmainnah Kader 2 25,000 50,000 50,000
16 Yanti Nurmayana Kader 2 25,000 50,000 50,000
17 Erni Anita S Kader 2 25,000 50,000 50,000
18 Muhidin Kader 2 25,000 50,000 50,000
19 Iwang Kader 2 25,000 50,000 50,000
20 Harun Kader 2 25,000 50,000 50,000
21 Harniwati Kader 2 25,000 50,000 50,000
22 Sakmah Kader 2 25,000 50,000 50,000
23 Hj. Muslihati Kader 2 25,000 50,000 50,000
24 Lasih Kader 2 25,000 50,000 50,000
25 Suriani Kader 2 25,000 50,000 50,000
26 Rakmah Kader 2 25,000 50,000 50,000
27 Yeni Mustika Kader 2 25,000 50,000 50,000
28 Solatiah Kader 2 25,000 50,000 50,000
29 Marhaeni Kader 2 25,000 50,000 50,000
30 Puspariani Kader 2 25,000 50,000 50,000
JUMLAH 1,500,000
Terbilang: Satu Juta Lima Ratus Ribu Rupiah
Selong,
Setuju Dibayar
HJ. BARI'AH, S.Kep

NIP. 19641231 198511 2 040 NIP. 19751212 1

TOTAL -

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 0
ERIMAAN TRANSPORT KADER
SURVEY PHBS TATANAN RUMAH TANGGA (RT)
SING KABUPATEN LOMBOK TIMUR
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Terbilang: Satu Juta Lima Ratus Ribu Rupiah
LUNAS DIBAYAR
NURHAYATI, ST
NIP. 19751212 199603 2 002
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
PEMERINTAH KABUPATEN LOMBOK TIMUR
PUSKESMAS RENSING KECAMATAN SAKRA BARAT
SURAT TUGAS
Nomor : 440 / / VI / Pusk / 2015
NO NAMA KADER JABATAN KEGIATAN
1 Nurlaili Azmi Kader Survey PHBS tatanan RT

2 Sumiati Kader Survey PHBS tatanan RT
3 Jaminatul Kader Survey PHBS tatanan RT
4 Jami'ah Kader Survey PHBS tatanan RT
5 Sri Wulandari Kader Survey PHBS tatanan RT
6 Hartini Kader Survey PHBS tatanan RT
7 Bq. Jeniah Kader Survey PHBS tatanan RT
8 Sofa Marwati Kader Survey PHBS tatanan RT
9 Mutiara Kader Survey PHBS tatanan RT
10 Susanti Kader Survey PHBS tatanan RT
11 Fitriani Kader Survey PHBS tatanan RT
12 Mahdan Kader Survey PHBS tatanan RT
13 Nurminah Kader Survey PHBS tatanan RT
14 Uswatun Hasanah Kader Survey PHBS tatanan RT
15 Mutmainnah Kader Survey PHBS tatanan RT
16 Yanti Nurmayana Kader Survey PHBS tatanan RT
17 Erni Anita S Kader Survey PHBS tatanan RT
18 Muhidin Kader Survey PHBS tatanan RT
19 Iwang Kader Survey PHBS tatanan RT
20 Harun Kader Survey PHBS tatanan RT
21 Harniwati Kader Survey PHBS tatanan RT
22 Sakmah Kader Survey PHBS tatanan RT
23 Hj. Muslihati Kader Survey PHBS tatanan RT
24 Lasih Kader Survey PHBS tatanan RT
25 Suriani Kader Survey PHBS tatanan RT
26 Rakmah Kader Survey PHBS tatanan RT
27 Yeni Mustika Kader Survey PHBS tatanan RT
28 Solatiah Kader Survey PHBS tatanan RT
29 Marhaeni Kader Survey PHBS tatanan RT
30 Puspariani Kader Survey PHBS tatanan RT
Pembiayaan perjalanan dibebankan pada : Dana Bantuan Operasional Kesehatan TA. 2015
Demikian surat tugas ini dibuat untuk dapat dilaksanakan sebaik-baiknya

Kepala Puskes
NIP. 19641231
Setuju Dibayar
Kepala Puskesmas Rensing
( HJ.BARI'AH,S.Kep )
NIP.19641231 198511 2 040
NTAH KABUPATEN LOMBOK TIMUR
S RENSING KECAMATAN SAKRA BARAT
SURAT TUGAS
TANGGAL
PELAKSANAAN
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
22 dan 23 Juni 2015
: Dana Bantuan Operasional Kesehatan TA. 2015

Kabupaten Lombok Timur
TA.2015
HJ. BARIAH, S.Kep

NIP. 19641231 198511 2 040
Selong,
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
SURAT TUGAS
Nomor : 440 / / V / Pusk / 2015
1 Susanti Kader Peteluan Brt Pekan Penimbangan

2 Syafriatun Kader Peteluan Brt Pekan Penimbangan
3 fitriani Kader Peteluan T Pekan Penimbangan
4 Titik hartatik Kader Peteluan T Pekan Penimbangan
5 Erni Susilawati kader Mt.Galeng Pekan Penimbangan
6 Suwarni kader Mt.Galeng Pekan Penimbangan
7 Zohriah Kader mt.Tebolak Pekan Penimbangan
8 Maemanah Kader mt.Tebolak Pekan Penimbangan
9 Hj.Halimah Kader Batu Nguek Pekan Penimbangan
10 Eli sumarni Kader Batu Nguek Pekan Penimbangan
11 Rehanun Kader Bgk Lonjer Pekan Penimbangan
12 Maemunah Kader Bgk Lonjer Pekan Penimbangan
13 Masiah kader Lingk laki Pekan Penimbangan
14 Bq.Sri Wahyuni kader Lingk laki Pekan Penimbangan
15 Hj.Marhamah Kader tampih Pekan Penimbangan
16 Nuriwati Kader tampih Pekan Penimbangan
17 Hartini Kader menuntut Pekan Penimbangan
18 Zohriati Kader menuntut Pekan Penimbangan
19 Sofa Marwati kader rensing bat Pekan Penimbangan
20 Reni Ismayani kader rensing bat Pekan Penimbangan
21 Siti saodah kader lepok Pekan Penimbangan
22 Solatiah kader lepok Pekan Penimbangan
23 Sopi Kader Tmk rurung Pekan Penimbangan
24 Nikmah Kader Tmk rurung Pekan Penimbangan
25 B.wahida s Kader Bimbi Pekan Penimbangan
26 Maryam Kader Bimbi Pekan Penimbangan
27 Kamariah Kader Rensing tmk Pekan Penimbangan
28 Jaminatun Kader Rensing tmk Pekan Penimbangan
29 Dwinita kader Gb.Masjid Pekan Penimbangan
30 Rusmiati kader Gb.Masjid Pekan Penimbangan
31 Neni Mustika Kader gb.dangah Pekan Penimbangan
32 Muni'ah Kader gb.dangah Pekan Penimbangan
33 Hj.Muslihati Kader repok dese Pekan Penimbangan
34 Maenah Kader repok dese Pekan Penimbangan
35 Siti Zaenab Kader Lk.Mudung Pekan Penimbangan
36 masitah Kader Lk.Mudung Pekan Penimbangan
37 Nining tiasih Kader emb.sayut Pekan Penimbangan
38 Nurjanah Kader emb.sayut Pekan Penimbangan
39 siti hadijah Kader menurik Pekan Penimbangan
40 Nursiah Kader menurik Pekan Penimbangan
41 Rohani kader pematung.T Pekan Penimbangan
42 Nuraini kader pematung.T Pekan Penimbangan
43 Pahrul aini Kader mt.cope Pekan Penimbangan
44 Muni'ah Kader mt.cope Pekan Penimbangan
45 Sumiati Kader mt.Siluman Pekan Penimbangan
46 Bq.jamilah Kader mt.Siluman Pekan Penimbangan
47 Nurminah Kader Panggongan Pekan Penimbangan
48 Mahani Kader Panggongan Pekan Penimbangan
49 B.tuti suryani Kader gunung rajak Pekan Penimbangan
50 B.Husnul.H Kader gunung rajak Pekan Penimbangan
51 Sri Puji A.N Kader pengenjuk Pekan Penimbangan
52 Nurlaela H Kader pengenjuk Pekan Penimbangan
53 Ani rohimah Kader bungtandang Pekan Penimbangan
54 Suriati Kader bungtandang Pekan Penimbangan
55 Sarikul Jannah Kader baren mayung Pekan Penimbangan
56 B.Rosiana Kader baren mayung Pekan Penimbangan
57 Maisum Kader monjet Timuk Pekan Penimbangan
58 Nurazizah Kader monjet Timuk Pekan Penimbangan
59 Reni Erna kader gerumus Pekan Penimbangan
60 Bq.roza kader gerumus Pekan Penimbangan
61 Marwiyah,Spd Kader Sangke langit Pekan Penimbangan

62 Ikarianti Kader Sangke langit Pekan Penimbangan
63 Yuliana.S Kader lendang elah Pekan Penimbangan
64 Haulani Kader lendang elah Pekan Penimbangan
65 Mardiyah Kader Gawah jarak Pekan Penimbangan
66 Resnawati Kader Gawah jarak Pekan Penimbangan
67 Husnul hotmi Kader rejeng Nyungkar Pekan Penimbangan
68 Sabariah Kader rejeng Nyungkar Pekan Penimbangan
69 Sri Puji kader mengkuru Pekan Penimbangan
70 sukmawartini kader mengkuru Pekan Penimbangan
71 Sri Wulandari kader sangupati Pekan Penimbangan
72 Bq.emi Lestari kader sangupati Pekan Penimbangan
73 Hafizah Kader pesanggrahan Pekan Penimbangan
74 hanifah Kader pesanggrahan Pekan Penimbangan
75 B.fathul jannah Kader sanggo Pekan Penimbangan
76 B.Fatmawati Kader sanggo Pekan Penimbangan
77 Jamilah kader tanak kaken Pekan Penimbangan
78 B.Mulianah kader tanak kaken Pekan Penimbangan
79 Halimatussakdiah kader Tongke Pekan Penimbangan
80 Nurlaela azmi kader Tongke Pekan Penimbangan
81 Yuliana safitri kader Jerua Pekan Penimbangan
82 zaenabung kader Jerua Pekan Penimbangan
83 Sri Kader malah Pekan Penimbangan
84 Hj.Nursehan Kader malah Pekan Penimbangan
85 Srianom kade dasan tengak Pekan Penimbangan
86 Umi Kalsum kade dasan tengak Pekan Penimbangan
87 Bq.Linda Yuliana kader Poyak oyak Pekan Penimbangan
88 Bq.Mustika.R kader Poyak oyak Pekan Penimbangan
89 Nurhasanah Kader bageq Nyale Pekan Penimbangan
90 raihul inayah Kader bageq Nyale Pekan Penimbangan
91 Bq.Zohriah kader dasan baru Pekan Penimbangan
92 Rohana kader dasan baru Pekan Penimbangan
93 Suarniwati kader Monjet bat Pekan Penimbangan
94 Bq.Rohiyatul.H kader Monjet bat Pekan Penimbangan
95 Masni kader penandak Pekan Penimbangan
96 Misniana kader penandak Pekan Penimbangan
97 Zuhriatun kader tanjah anjah Pekan Penimbangan
98 Hartini kader tanjah anjah Pekan Penimbangan
99 Ida mayanti kader karang baru Pekan Penimbangan
100 Hindun kader karang baru Pekan Penimbangan
101 Ikawati kader pengk,mas Pekan Penimbangan
102 Iq.rodi kader pengk,mas Pekan Penimbangan
103 Jami'ah Kader semanggleng Pekan Penimbangan
104 jauhariah Kader semanggleng Pekan Penimbangan
105 Saidah kader Pongkor Pekan Penimbangan
106 Bq.Icah kader Pongkor Pekan Penimbangan
107 Siti Fatimah Kader gerisak Pekan Penimbangan
108 Zuhaeratul Kader gerisak Pekan Penimbangan
109 Herlin kader penutus Pekan Penimbangan
110 Mahuni kader penutus Pekan Penimbangan
111 Indrawati kader Repok tengak Pekan Penimbangan
112 Sri ayu kader Repok tengak Pekan Penimbangan
113 Zuhriatun kader gwh gadung Pekan Penimbangan
114 farida Asiani kader gwh gadung Pekan Penimbangan
115 Fatimah kader gwh gadung Tgh Pekan Penimbangan
116 Nurhalimah kader gwh gadung Tgh Pekan Penimbangan
117 Sumarni Kader gwh gadung Tmr Pekan Penimbangan
118 Siti Rahmah Kader gwh gadung Tmr Pekan Penimbangan
119 Sahni Kader Batu tandak Pekan Penimbangan
120 Martini Kader Batu tandak Pekan Penimbangan
121 Nuraini kader gerepek santek Pekan Penimbangan
122 Maisah kader gerepek santek Pekan Penimbangan
123 Anita jajang Kader Repok are Pekan Penimbangan
124 rauhun Kader Repok are Pekan Penimbangan
125 Rehanah kader bungtiang Brt Pekan Penimbangan
126 Hartini kader bungtiang Brt Pekan Penimbangan
127 fitriani kader Bungtiang tmr Pekan Penimbangan
128 Rohani kader Bungtiang tmr Pekan Penimbangan
129 Siti Aisyah Kader gerisak Pekan Penimbangan
130 Salmiah Kader gerisak Pekan Penimbangan
131 Nursamsi Kader bungambar Pekan Penimbangan

132 Munawati Kader bungambar Pekan Penimbangan
133 Bq.kalsum kader mt.Mesir Pekan Penimbangan
134 Bq.Zubaedah kader mt.Mesir Pekan Penimbangan
135 Masitah kader Montong Pekan Penimbangan
136 Endra kader Montong Pekan Penimbangan
137 Mariani ratna.k kader Bungtiang sltn Pekan Penimbangan
138 Ziadatul hilmi kader Bungtiang sltn Pekan Penimbangan
139 Raehanun kader bungtiang T Pekan Penimbangan
140 Solatiah kader bungtiang T Pekan Penimbangan
141 Masturi Kader bungtiang Tgh Pekan Penimbangan
142 Suriani Kader bungtiang Tgh Pekan Penimbangan
143 Sarifah kader bungtiang brt Pekan Penimbangan
144 Halimah kader bungtiang brt Pekan Penimbangan
145 Mulianah kader borok dalem Pekan Penimbangan
146 Satriah kader borok dalem Pekan Penimbangan
147 Sinarep Kader Borok luah Pekan Penimbangan
148 Eli ermawati Kader Borok luah Pekan Penimbangan
149 Sinarep kader mt.pendem Pekan Penimbangan
150 Eli ermawati kader mt.pendem Pekan Penimbangan
151 Hj.darmataksiah Kader lk.kolo Pekan Penimbangan
152 Ana Rodianti Kader lk.kolo Pekan Penimbangan
153 Bq.hayatul kader toyang Pekan Penimbangan
154 Hurniawati kader toyang Pekan Penimbangan
155 Nurjannah Kader dewe lanji Pekan Penimbangan
156 Riza ariani Kader dewe lanji Pekan Penimbangan
157 Mariani Kader presak Pekan Penimbangan
158 Ernawati Kader presak Pekan Penimbangan
159 sahriwati kader kondok Pekan Penimbangan
160 Isnawati kader kondok Pekan Penimbangan
161 Supawati Kader Sukawangi Pekan Penimbangan
162 Sumiati Kader Sukawangi Pekan Penimbangan
163 Slimin kader jeropoto Pekan Penimbangan
164 sakmah kader jeropoto Pekan Penimbangan
165 Mutiara kader tangar Pekan Penimbangan
166 Sumarni kader tangar Pekan Penimbangan
167 Parmi kader Asem/Jekeh Pekan Penimbangan
168 zuhriah kader Asem/Jekeh Pekan Penimbangan
169 Eny susilawati Kader dasan repok Pekan Penimbangan
170 iq.Asri Kader dasan repok Pekan Penimbangan
171 Siti hadijah kader sukarara Utr Pekan Penimbangan
172 Rohnam kader sukarara Utr Pekan Penimbangan
173 Sahimin Kader sukarara sltn Pekan Penimbangan
174 Husniwati Kader sukarara sltn Pekan Penimbangan
175 Asiah Kader pejaring Pekan Penimbangan
176 Istiareni Kader pejaring Pekan Penimbangan
177 Nurminah kader Selayar Pekan Penimbangan
178 Iwang kader Selayar Pekan Penimbangan
179 Husniatun Kader dengkur Pekan Penimbangan
180 Astuti handayani Kader dengkur Pekan Penimbangan
181 Sekarniwati kader Pejaring T Pekan Penimbangan
182 Marniati kader Pejaring T Pekan Penimbangan
183 Halimah Kader Pejaring Brt Pekan Penimbangan
184 Nuraini Kader Pejaring Brt Pekan Penimbangan
185 Bq. Nurhidayati Kader Jerue bawak Pekan Penimbangan
186 Yulia Mustikawati Kader Jerue bawak Pekan Penimbangan
187 Nurul Hidayana Mt. Prapen Pekan Penimbangan
188 Rosdiana Mt. Prapen Pekan Penimbangan
189 Sutatik Kader bt. Ngrengseng Pekan Penimbangan
190 Hartini Kader bt. Ngrengseng Pekan Penimbangan

Kepala Puskes
NIP. 19641231
Setuju Dibayar
NIP.19641231 198511 2 040
SURAT TUGAS
TANGGAL
PELAKSANAAN
4 Mei 2015
4 Mei 2015
4 Mei 2015
4 Mei 2015
4 Mei 2015
4 Mei 2015
4 Mei 2015
4 Mei 2015
4 Mei 2015
4 Mei 2015
5 Mei 2015
5 Mei 2015
5 Mei 2015
5 Mei 2015
5 Mei 2015
5 Mei 2015
5 Mei 2015
5 Mei 2015
5 Mei 2015
5 Mei 2015
6 Mei 2015
6 Mei 2015
6 Mei 2015
6 Mei 2015
6 Mei 2015
6 Mei 2015
6 Mei 2015
6 Mei 2015
6 Mei 2015
6 Mei 2015
7 Mei 2015
7 Mei 2015
7 Mei 2015
7 Mei 2015
7 Mei 2015
7 Mei 2015
8 Mei 2015
8 Mei 2015
8 Mei 2015
8 Mei 2015
8 Mei 2015
8 Mei 2015
9 Mei 2015
9 Mei 2015
9 Mei 2015
9 Mei 2015
9 Mei 2015
9 Mei 2015
11 Mei 2015
11 Mei 2015
11 Mei 2015
11 Mei 2015
11 Mei 2015
11 Mei 2015
12 Mei 2015
12 Mei 2015
12 Mei 2015
12 Mei 2015
12 Mei 2015
12 Mei 2015
13 Mei 2015
13 Mei 2015
13 Mei 2015
13 Mei 2015
18 Mei 2015
18 Mei 2015
18 Mei 2015
18 Mei 2015
19 Mei 2015
19 Mei 2015
19 Mei 2015
19 Mei 2015
20 Mei 2015
20 Mei 2015
20 Mei 2015
20 Mei 2015
21 Mei 2015
21 Mei 2015
21 Mei 2015
21 Mei 2015
21 Mei 2015
21 Mei 2015
21 Mei 2015
21 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
22 Mei 2015
23 Mei 2015
23 Mei 2015
23 Mei 2015
23 Mei 2015
23 Mei 2015
23 Mei 2015
23 Mei 2015
23 Mei 2015
23 Mei 2015
23 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
25 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
26 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015
27 Mei 2015

TA.2015
HJ. BARIAH, S.Kep

NIP. 19641231 198511 2 040
Selong,
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
SURAT TUGAS
Nomor : 440 / / XI / Pusk / 2015
Tanggal : 02 Nopember 2015




Kepala Puskes
NIP. 19641231
Setuju Dibayar
NIP.19641231 198511 2 040
SURAT TUGAS
TANGGAL
PELAKSANAAN
2 Nopember 2015
2 Nopember 2015
2 Nopember 2015
2 Nopember 2015
2 Nopember 2015
2 Nopember 2015
2 Nopember 2015
2 Nopember 2015
2 Nopember 2015
2 Nopember 2015
3 Nopember 2015
3 Nopember 2015
3 Nopember 2015
3 Nopember 2015
3 Nopember 2015
3 Nopember 2015
3 Nopember 2015
3 Nopember 2015
3 Nopember 2015
3 Nopember 2015
4 Nopember 2015
4 Nopember 2015
4 Nopember 2015
4 Nopember 2015
4 Nopember 2015
4 Nopember 2015
4 Nopember 2015
4 Nopember 2015
4 Nopember 2015
4 Nopember 2015
5 Nopember 2015
5 Nopember 2015
5 Nopember 2015
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TA.2015
HJ. BARIAH, S.Kep

NIP. 19641231 198511 2 040
Selong,
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
SURAT TUGAS
Nomor : 440 / / II / Pusk / 2016
Tanggal : 02 Februari 2016
TANGGAL
PELAKSANAAN
1 Susanti Kader Peteluan Brt Distribusi Kapsul Vitamin A 2 Februari 2016
2 fitriani Kader Peteluan T Distribusi Kapsul Vitamin A 2 Februari 2016
3 Erni Susilawati kader Mt.Galeng Distribusi Kapsul Vitamin A 2 Februari 2016
4 Zohriah Kader mt.Tebolak Distribusi Kapsul Vitamin A 2 Februari 2016
5 Hj.Halimah Kader Batu Nguek Distribusi Kapsul Vitamin A 2 Februari 2016
6 Rehanun Kader Bgk Lonjer Distribusi Kapsul Vitamin A 2 Februari 2016
7 Masiah kader Lingk laki Distribusi Kapsul Vitamin A 3 Februari 2016
8 Hj.Marhamah Kader tampih Distribusi Kapsul Vitamin A 3 Februari 2016
9 Hartini Kader menuntut Distribusi Kapsul Vitamin A 3 Februari 2016
10 Sofa Marwati kader rensing bat Distribusi Kapsul Vitamin A 3 Februari 2016
11 Siti saodah kader lepok Distribusi Kapsul Vitamin A 3 Februari 2016
12 Sopi Kader Tmk rurung Distribusi Kapsul Vitamin A 3 Februari 2016
13 B.wahida s Kader Bimbi Distribusi Kapsul Vitamin A 3 Februari 2016
14 Kamariah Kader Rensing tmk Distribusi Kapsul Vitamin A 3 Februari 2016
15 Dwinita kader Gb.Masjid Distribusi Kapsul Vitamin A 4 Februari 2016
16 Neni Mustika Kader gb.dangah Distribusi Kapsul Vitamin A 4 Februari 2016
17 Hj.Muslihati Kader repok dese Distribusi Kapsul Vitamin A 4 Februari 2016
18 Siti Zaenab Kader Lk.Mudung Distribusi Kapsul Vitamin A 4 Februari 2016
19 Nining tiasih Kader emb.sayut Distribusi Kapsul Vitamin A 4 Februari 2016
20 Siti hadijah Kader menurik Distribusi Kapsul Vitamin A 4 Februari 2016
21 Rohani kader pematung.T Distribusi Kapsul Vitamin A 6 Februari 2016
22 Pahrul aini Kader mt.cope Distribusi Kapsul Vitamin A 6 Februari 2016
23 Sumiati Kader mt.Siluman Distribusi Kapsul Vitamin A 6 Februari 2016
24 Nurminah Kader Panggongan Distribusi Kapsul Vitamin A 6 Februari 2016
25 B.tuti suryani Kader gunung rajak Distribusi Kapsul Vitamin A 6 Februari 2016
26 Sri Puji A.N Kader pengenjuk Distribusi Kapsul Vitamin A 6 Februari 2016
27 Suriati Kader bungtandang Distribusi Kapsul Vitamin A 6 Februari 2016
28 Sarikul Jannah Kader baren mayung Distribusi Kapsul Vitamin A 6 Februari 2016
29 Maisum Kader monjet Timuk Distribusi Kapsul Vitamin A 9 Februari 2016
30 Reni Erna kader gerumus Distribusi Kapsul Vitamin A 9 Februari 2016
31 Marwiyah,Spd Kader Sangke langit Distribusi Kapsul Vitamin A 9 Februari 2016
32 Yuliana.S Kader lendang elah Distribusi Kapsul Vitamin A 9 Februari 2016
33 Mardiyah Kader Gawah jarak Distribusi Kapsul Vitamin A 9 Februari 2016
34 Husnul hotmi Kader rejeng Nyungkar Distribusi Kapsul Vitamin A 9 Februari 2016
35 Sri Puji kader mengkuru Distribusi Kapsul Vitamin A 10 Februari 2016
36 Sri Wulandari kader sangupati Distribusi Kapsul Vitamin A 10 Februari 2016
37 Hafizah Kader pesanggrahan Distribusi Kapsul Vitamin A 10 Februari 2016
38 B.fathul jannah Kader sanggo Distribusi Kapsul Vitamin A 10 Februari 2016
39 Jamilah kader tanak kaken Distribusi Kapsul Vitamin A 10 Februari 2016
40 Halimatussakdiah kader Tongke Distribusi Kapsul Vitamin A 11 Februari 2016
41 Yuliana safitri kader Jerua atas Distribusi Kapsul Vitamin A 11 Februari 2016
42 Sri Kader malah Distribusi Kapsul Vitamin A 11 Februari 2016
43 Srianom kade dasan tengak Distribusi Kapsul Vitamin A 11 Februari 2016
44 Bq.Linda Yuliana kader Poyak oyak Distribusi Kapsul Vitamin A 11 Februari 2016
45 Nurhasanah Kader bageq Nyale Distribusi Kapsul Vitamin A 11 Februari 2016
46 Bq.Zohriah kader dasan baru Distribusi Kapsul Vitamin A 11 Februari 2016
47 Suarniwati kader Monjet bat Distribusi Kapsul Vitamin A 11 Februari 2016
48 Masni kader penandak Distribusi Kapsul Vitamin A 11 Februari 2016
49 Zuhriatun kader tanjah anjah Distribusi Kapsul Vitamin A 13 Februari 2016
50 Ida mayanti kader karang baru Distribusi Kapsul Vitamin A 13 Februari 2016
51 Ikawati kader pengk,mas Distribusi Kapsul Vitamin A 13 Februari 2016

52 Jami'ah Kader semanggleng Distribusi Kapsul Vitamin A 13 Februari 2016
53 Saidah kader Pongkor Distribusi Kapsul Vitamin A 13 Februari 2016
54 Siti Fatimah Kader gerisak Distribusi Kapsul Vitamin A 13 Februari 2016
55 Herlin kader penutus Distribusi Kapsul Vitamin A 13 Februari 2016
56 Indrawati kader Repok tengak Distribusi Kapsul Vitamin A 13 Februari 2016
57 Zuhriatun kader gwh gadung Distribusi Kapsul Vitamin A 13 Februari 2016
58 Fatimah kader gwh gadung Tgh Distribusi Kapsul Vitamin A 15 Februari 2016
59 Sumarni Kader gwh gadung Tmr Distribusi Kapsul Vitamin A 15 Februari 2016
60 Sahni Kader Batu tandak Distribusi Kapsul Vitamin A 15 Februari 2016
61 Nuraini kader gerepek santek Distribusi Kapsul Vitamin A 15 Februari 2016
62 Anita jajang Kader Repok are Distribusi Kapsul Vitamin A 15 Februari 2016
63 Rehanah kader bungtiang Brt Distribusi Kapsul Vitamin A 15 Februari 2016
64 fitriani kader Bungtiang tmr Distribusi Kapsul Vitamin A 15 Februari 2016
65 Siti Aisyah Kader gerisak Distribusi Kapsul Vitamin A 15 Februari 2016
66 Nursamsi Kader bungambar Distribusi Kapsul Vitamin A 15 Februari 2016
67 Bq.kalsum kader mt.Mesir Distribusi Kapsul Vitamin A 16 Februari 2016
68 Masitah kader Montong Distribusi Kapsul Vitamin A 16 Februari 2016
69 Mariani ratna.k kader Bungtiang sltn Distribusi Kapsul Vitamin A 16 Februari 2016
70 Raehanun kader bungtiang utara Distribusi Kapsul Vitamin A 16 Februari 2016
71 Masturi Kader bungtiang Tmr Distribusi Kapsul Vitamin A 17 Februari 2016
72 Sarifah kader bungtiang brt Distribusi Kapsul Vitamin A 17 Februari 2016
73 Mulianah kader borok dalem Distribusi Kapsul Vitamin A 17 Februari 2016
74 Sinarep Kader Borok luah Distribusi Kapsul Vitamin A 17 Februari 2016
75 Sinarep kader mt.pendem Distribusi Kapsul Vitamin A 18 Februari 2016
76 Hj.darmataksiah Kader lk.kolo Distribusi Kapsul Vitamin A 18 Februari 2016
77 Bq.hayatul kader toyang Distribusi Kapsul Vitamin A 18 Februari 2016
78 Nurjannah Kader dewe lanji Distribusi Kapsul Vitamin A 18 Februari 2016
79 Mariani Kader presak Distribusi Kapsul Vitamin A 20 Februari 2016
80 sahriwati kader kondok Distribusi Kapsul Vitamin A 20 Februari 2016
81 Supawati Kader Sukawangi Distribusi Kapsul Vitamin A 20 Februari 2016
82 Slimin kader jeropoto Distribusi Kapsul Vitamin A 22 Februari 2016
83 Mutiara kader tangar Distribusi Kapsul Vitamin A 22 Februari 2016
84 Parmi kader Asem/Jekeh Distribusi Kapsul Vitamin A 22 Februari 2016
85 Eny susilawati Kader dasan repok Distribusi Kapsul Vitamin A 22 Februari 2016
86 Siti hadijah kader sukarara Utr Distribusi Kapsul Vitamin A 22 Februari 2016
87 Sahimin Kader sukarara sltn Distribusi Kapsul Vitamin A 23 Februari 2016
88 Asiah Kader pejaring Distribusi Kapsul Vitamin A 23 Februari 2016
89 Nurminah kader Selayar Distribusi Kapsul Vitamin A 23 Februari 2016
90 Husniatun Kader dengkur Distribusi Kapsul Vitamin A 25 Februari 2016
91 Sekarniwati kader Pejaring T Distribusi Kapsul Vitamin A 25 Februari 2016
92 Halimah Kader Pejaring Brt Distribusi Kapsul Vitamin A 27 Februari 2016
93 Bq. Nurhidayati Kader Jerue bawak Distribusi Kapsul Vitamin A 29 Februari 2016
94 Nurul Hidayana Mt. Prapen Distribusi Kapsul Vitamin A 29 Februari 2016
95 Sutatik Kader bt. Ngrengseng Distribusi Kapsul Vitamin A 29 Februari 2016
TA.2016
H. AHMAT, S.Kep, MM
NIP. 19661231 198803 1 306

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 002
atan TA. 2016
NIP. 19661231 198803 1 306
NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN DISTRIBUSI VITAMIN A DI POSYANDU
WILAYAH KERJA PUSKESMAS RENSING KECAMATAN SAKRA BARAT
Tanggal: 8, 9, 10, 11, 13, 15, 16, 18, 20, 22, 23, 24, 25, 27, dan 29 Agustus 2016
UANG
NO NAMA ALAMAT TRANPORT/H
ARI ( RP )
1 Susanti Kader Peteluan Brt 1 Hr 15,000 15,000 15,000
2 fitriani Kader Peteluan T 1 Hr 15,000 15,000 15,000
3 Erni Susilawati kader Mt.Galeng 1 Hr 15,000 15,000 15,000
4 Zohriah Kader mt.Tebolak 1 Hr 15,000 15,000 15,000
5 Hj.Halimah Kader Batu Nguek 1 Hr 15,000 15,000 15,000
6 Rehanun Kader Bgk Lonjer 1 Hr 15,000 15,000 15,000
7 Masiah kader Lingk laki 1 Hr 15,000 15,000 15,000
8 Hj.Marhamah Kader tampih 1 Hr 15,000 15,000 15,000
9 Hartini Kader menuntut 1 Hr 15,000 15,000 15,000
10 Sofa Marwati kader rensing bat 1 Hr 15,000 15,000 15,000
11 Siti saodah kader lepok 1 Hr 15,000 15,000 15,000
12 Sopi Kader Tmk rurung 1 Hr 15,000 15,000 15,000
13 B.wahida s Kader Bimbi 1 Hr 15,000 15,000 15,000
14 Kamariah Kader Rensing tmk 1 Hr 15,000 15,000 15,000
15 Dwinita kader Gb.Masjid 1 Hr 15,000 15,000 15,000
16 Neni Mustika Kader gb.dangah 1 Hr 15,000 15,000 15,000
17 Hj.Muslihati Kader repok dese 1 Hr 15,000 15,000 15,000
18 Siti Zaenab Kader Lk.Mudung 1 Hr 15,000 15,000 15,000
19 Nining tiasih Kader emb.sayut 1 Hr 15,000 15,000 15,000
20 Siti hadijah Kader menurik 1 Hr 15,000 15,000 15,000
21 Rohani kader pematung.T 1 Hr 15,000 15,000 15,000
22 Pahrul aini Kader mt.cope 1 Hr 15,000 15,000 15,000
23 Sumiati Kader mt.Siluman 1 Hr 15,000 15,000 15,000
24 Nurminah Kader Panggongan 1 Hr 15,000 15,000 15,000
25 B.tuti suryani Kader gunung rajak 1 Hr 15,000 15,000 15,000
26 Sri Puji A.N Kader pengenjuk 1 Hr 15,000 15,000 15,000
27 Ani rohimah Kader bungtandang 1 Hr 15,000 15,000 15,000
28 Sarikul Jannah Kader baren mayung 1 Hr 15,000 15,000 15,000
29 Maisum Kader monjet Timuk 1 Hr 15,000 15,000 15,000
30 Reni Erna kader gerumus 1 Hr 15,000 15,000 15,000
31 Marwiyah,Spd Kader Sangke langit 1 Hr 15,000 15,000 15,000
32 Yuliana.S Kader lendang elah 1 Hr 15,000 15,000 15,000
33 Mardiyah Kader Gawah jarak 1 Hr 15,000 15,000 15,000
34 Husnul hotmi Kader rejeng Nyungkar 1 Hr 15,000 15,000 15,000
35 Sri Puji kader mengkuru 1 Hr 15,000 15,000 15,000
36 Sri Wulandari kader sangupati 1 Hr 15,000 15,000 15,000
37 Hafizah Kader pesanggrahan 1 Hr 15,000 15,000 15,000
38 B.fathul jannah Kader sanggo 1 Hr 15,000 15,000 15,000
39 Jamilah kader tanak kaken 1 Hr 15,000 15,000 15,000
40 Halimatussakdiah kader Tongke 1 Hr 15,000 15,000 15,000
41 Yuliana safitri kader Jerua atas 1 Hr 15,000 15,000 15,000
42 Sri Kader malah 1 Hr 15,000 15,000 15,000
43 Srianom kade dasan tengak 1 Hr 15,000 15,000 15,000
44 Bq.Linda Yuliana kader Poyak oyak 1 Hr 15,000 15,000 15,000
45 Nurhasanah Kader bageq Nyale 1 Hr 15,000 15,000 15,000
46 Bq.Zohriah kader dasan baru 1 Hr 15,000 15,000 15,000
47 Suarniwati kader Monjet bat 1 Hr 15,000 15,000 15,000
48 Masni kader penandak 1 Hr 15,000 15,000 15,000
49 Zuhriatun kader tanjah anjah 1 Hr 15,000 15,000 15,000
50 Ida mayanti kader karang baru 1 Hr 15,000 15,000 15,000
51 Ikawati kader pengk,mas 1 Hr 15,000 15,000 15,000
52 Jami'ah Kader semanggleng 1 Hr 15,000 15,000 15,000
UANG
ARI ( RP )
53 Saidah kader Pongkor 1 Hr 15,000 15,000 15,000
54 Siti Fatimah Kader gerisak 1 Hr 15,000 15,000 15,000
55 Herlin kader penutus 1 Hr 15,000 15,000 15,000
56 Indrawati kader Repok tengak 1 Hr 15,000 15,000 15,000
57 Zuhriatun kader gwh gadung 1 Hr 15,000 15,000 15,000
58 Fatimah kader gwh gadung Tgh 1 Hr 15,000 15,000 15,000
59 Sumarni Kader gwh gadung Tmr 1 Hr 15,000 15,000 15,000
60 Sahni Kader Batu tandak 1 Hr 15,000 15,000 15,000
900,000
UANG
ARI ( RP )
61 Nuraini kader gerepek santek 1 Hr 15,000 15,000 15,000
62 Anita jajang Kader Repok are 1 Hr 15,000 15,000 15,000
63 Rehanah kader bungtiang Brt 1 Hr 15,000 15,000 15,000
64 fitriani kader Bungtiang tmr 1 Hr 15,000 15,000 15,000
65 Siti Aisyah Kader gerisak 1 Hr 15,000 15,000 15,000
66 Nursamsi Kader bungambar 1 Hr 15,000 15,000 15,000
67 Bq.kalsum kader mt.Mesir 1 Hr 15,000 15,000 15,000
68 Masitah kader Montong 1 Hr 15,000 15,000 15,000
69 Mariani ratna.k kader Bungtiang sltn 1 Hr 15,000 15,000 15,000
70 Raehanun kader bungtiang utara 1 Hr 15,000 15,000 15,000
71 Masturi Kader bungtiang Tmr 1 Hr 15,000 15,000 15,000
72 Sarifah kader bungtiang brt 1 Hr 15,000 15,000 15,000
73 Mulianah kader borok dalem 1 Hr 15,000 15,000 15,000
74 Sinarep Kader Borok luah 1 Hr 15,000 15,000 15,000
75 Sinarep kader mt.pendem 1 Hr 15,000 15,000 15,000
76 Hj.darmataksiah Kader lk.kolo 1 Hr 15,000 15,000 15,000
77 Bq.hayatul kader toyang 1 Hr 15,000 15,000 15,000
78 Nurjannah Kader dewe lanji 1 Hr 15,000 15,000 15,000
79 Mariani Kader presak 1 Hr 15,000 15,000 15,000
80 sahriwati kader kondok 1 Hr 15,000 15,000 15,000
81 Supawati Kader Sukawangi 1 Hr 15,000 15,000 15,000
82 Slimin kader jeropoto 1 Hr 15,000 15,000 15,000
83 Mutiara kader tangar 1 Hr 15,000 15,000 15,000
84 Parmi kader Asem/Jekeh 1 Hr 15,000 15,000 15,000
85 Eny susilawati Kader dasan repok 1 Hr 15,000 15,000 15,000
86 Siti hadijah kader sukarara Utr 1 Hr 15,000 15,000 15,000
87 Sahimin Kader sukarara sltn 1 Hr 15,000 15,000 15,000
88 Asiah Kader pejaring 1 Hr 15,000 15,000 15,000
89 Nurminah kader Selayar 1 Hr 15,000 15,000 15,000
90 Husniatun Kader dengkur 1 Hr 15,000 15,000 15,000
91 Sekarniwati kader Pejaring T 1 Hr 15,000 15,000 15,000
92 Halimah Kader Pejaring Brt 1 Hr 15,000 15,000 15,000
93 Bq. Nurhidayati Kader Jerue bawak 1 Hr 15,000 15,000 15,000
94 Nurul Hidayana Mt. Prapen 1 Hr 15,000 15,000 15,000
95 Sutatik Kader bt. Ngrengseng 1 Hr 15,000 15,000 15,000
JUMLAH 1,425,000
Terbilang: Satu Juta Empat Ratus Dua Puluh Lima Ribu

( H. AHMAT A, S.Kep, MM ) ( NURHAYATI, ST )

NIP.19661231 198803 1 306 NIP. 19751212 199603 2 0
TRANSPORT KADER
RIBUSI VITAMIN A DI POSYANDU
SING KECAMATAN SAKRA BARAT
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
TANDA TANGAN
53
54
55
56
57
58
59
60
TANDA TANGAN
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
525,000
ng: Satu Juta Empat Ratus Dua Puluh Lima Ribu Rupiah
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
SURAT TUGAS
Nomor : 440 / / VIII / Pusk / 2016
TANGGAL
PELAKSANAAN
1 Susanti Kader Peteluan Brt Distribusi Kapsul Vitamin A 8 Agustus 2016
2 fitriani Kader Peteluan T Distribusi Kapsul Vitamin A 8 Agustus 2016
3 Erni Susilawati kader Mt.Galeng Distribusi Kapsul Vitamin A 8 Agustus 2016
4 Zohriah Kader mt.Tebolak Distribusi Kapsul Vitamin A 8 Agustus 2016
5 Hj.Halimah Kader Batu Nguek Distribusi Kapsul Vitamin A 8 Agustus 2016
6 Rehanun Kader Bgk Lonjer Distribusi Kapsul Vitamin A 8 Agustus 2016
7 Masiah kader Lingk laki Distribusi Kapsul Vitamin A 8 Agustus 2016
8 Hj.Marhamah Kader tampih Distribusi Kapsul Vitamin A 8 Agustus 2016
9 Hartini Kader menuntut Distribusi Kapsul Vitamin A 9 Agustus 2016
10 Sofa Marwati kader rensing bat Distribusi Kapsul Vitamin A 9 Agustus 2016
11 Siti saodah kader lepok Distribusi Kapsul Vitamin A 9 Agustus 2016
12 Sopi Kader Tmk rurung Distribusi Kapsul Vitamin A 9 Agustus 2016
13 B.wahida s Kader Bimbi Distribusi Kapsul Vitamin A 9 Agustus 2016
14 Kamariah Kader Rensing tmk Distribusi Kapsul Vitamin A 9 Agustus 2016
15 Dwinita kader Gb.Masjid Distribusi Kapsul Vitamin A 10 Agustus 2016
16 Neni Mustika Kader gb.dangah Distribusi Kapsul Vitamin A 10 Agustus 2016
17 Hj.Muslihati Kader repok dese Distribusi Kapsul Vitamin A 10 Agustus 2016
18 Siti Zaenab Kader Lk.Mudung Distribusi Kapsul Vitamin A 10 Agustus 2016
19 Nining tiasih Kader emb.sayut Distribusi Kapsul Vitamin A 10 Agustus 2016
20 Siti hadijah Kader menurik Distribusi Kapsul Vitamin A 10 Agustus 2016
21 Rohani kader pematung.T Distribusi Kapsul Vitamin A 11 Agustus 2016
22 Pahrul aini Kader mt.cope Distribusi Kapsul Vitamin A 11 Agustus 2016
23 Sumiati Kader mt.Siluman Distribusi Kapsul Vitamin A 11 Agustus 2016
24 Nurminah Kader Panggongan Distribusi Kapsul Vitamin A 11 Agustus 2016
25 B.tuti suryani Kader gunung rajak Distribusi Kapsul Vitamin A 11 Agustus 2016
26 Sri Puji A.N Kader pengenjuk Distribusi Kapsul Vitamin A 11 Agustus 2016
27 Suriati Kader bungtandang Distribusi Kapsul Vitamin A 11 Agustus 2016
28 Sarikul Jannah Kader baren mayung Distribusi Kapsul Vitamin A 11 Agustus 2016
29 Maisum Kader monjet Timuk Distribusi Kapsul Vitamin A 11 Agustus 2016
30 Reni Erna kader gerumus Distribusi Kapsul Vitamin A 13 Agustus 2016
31 Marwiyah,Spd Kader Sangke langit Distribusi Kapsul Vitamin A 13 Agustus 2016
32 Yuliana.S Kader lendang elah Distribusi Kapsul Vitamin A 13 Agustus 2016
33 Mardiyah Kader Gawah jarak Distribusi Kapsul Vitamin A 13 Agustus 2016
34 Husnul hotmi Kader rejeng Nyungkar Distribusi Kapsul Vitamin A 13 Agustus 2016
35 Sri Puji kader mengkuru Distribusi Kapsul Vitamin A 15 Agustus 2016
36 Sri Wulandari kader sangupati Distribusi Kapsul Vitamin A 15 Agustus 2016
37 Hafizah Kader pesanggrahan Distribusi Kapsul Vitamin A 15 Agustus 2016
38 B.fathul jannah Kader sanggo Distribusi Kapsul Vitamin A 15 Agustus 2016
39 Jamilah kader tanak kaken Distribusi Kapsul Vitamin A 15 Agustus 2016
40 Halimatussakdiah kader Tongke Distribusi Kapsul Vitamin A 15 Agustus 2016
41 Yuliana safitri kader Jerua atas Distribusi Kapsul Vitamin A 16 Agustus 2016
42 Sri Kader malah Distribusi Kapsul Vitamin A 16 Agustus 2016
43 Srianom kade dasan tengak Distribusi Kapsul Vitamin A 16 Agustus 2016
44 Bq.Linda Yuliana kader Poyak oyak Distribusi Kapsul Vitamin A 16 Agustus 2016
45 Nurhasanah Kader bageq Nyale Distribusi Kapsul Vitamin A 18 Agustus 2016
46 Bq.Zohriah kader dasan baru Distribusi Kapsul Vitamin A 18 Agustus 2016
47 Suarniwati kader Monjet bat Distribusi Kapsul Vitamin A 18 Agustus 2016
48 Masni kader penandak Distribusi Kapsul Vitamin A 18 Agustus 2016
49 Zuhriatun kader tanjah anjah Distribusi Kapsul Vitamin A 18 Agustus 2016
50 Ida mayanti kader karang baru Distribusi Kapsul Vitamin A 18 Agustus 2016
51 Ikawati kader pengk,mas Distribusi Kapsul Vitamin A 20 Agustus 2016

52 Jami'ah Kader semanggleng Distribusi Kapsul Vitamin A 20 Agustus 2016
53 Saidah kader Pongkor Distribusi Kapsul Vitamin A 20 Agustus 2016
54 Siti Fatimah Kader gerisak Distribusi Kapsul Vitamin A 20 Agustus 2016
55 Herlin kader penutus Distribusi Kapsul Vitamin A 23 Agustus 2016
56 Indrawati kader Repok tengak Distribusi Kapsul Vitamin A 23 Agustus 2016
57 Zuhriatun kader gwh gadung Distribusi Kapsul Vitamin A 23 Agustus 2016
58 Fatimah kader gwh gadung Tgh Distribusi Kapsul Vitamin A 23 Agustus 2016
59 Sumarni Kader gwh gadung Tmr Distribusi Kapsul Vitamin A 23 Agustus 2016
60 Sahni Kader Batu tandak Distribusi Kapsul Vitamin A 23 Agustus 2016
61 Nuraini kader gerepek santek Distribusi Kapsul Vitamin A 23 Agustus 2016
62 Anita jajang Kader Repok are Distribusi Kapsul Vitamin A 23 Agustus 2016
63 Rehanah kader bungtiang Brt Distribusi Kapsul Vitamin A 23 Agustus 2016
64 fitriani kader Bungtiang tmr Distribusi Kapsul Vitamin A 23 Agustus 2016
65 Siti Aisyah Kader gerisak Distribusi Kapsul Vitamin A 23 Agustus 2016
66 Nursamsi Kader bungambar Distribusi Kapsul Vitamin A 23 Agustus 2016
67 Bq.kalsum kader mt.Mesir Distribusi Kapsul Vitamin A 25 Agustus 2016
68 Masitah kader Montong Distribusi Kapsul Vitamin A 25 Agustus 2016
69 Mariani ratna.k kader Bungtiang sltn Distribusi Kapsul Vitamin A 25 Agustus 2016
70 Raehanun kader bungtiang utara Distribusi Kapsul Vitamin A 25 Agustus 2016
71 Masturi Kader bungtiang Tmr Distribusi Kapsul Vitamin A 25 Agustus 2016
72 Sarifah kader bungtiang brt Distribusi Kapsul Vitamin A 25 Agustus 2016
73 Mulianah kader borok dalem Distribusi Kapsul Vitamin A 25 Agustus 2016
74 Sinarep Kader Borok luah Distribusi Kapsul Vitamin A 25 Agustus 2016
75 Sinarep kader mt.pendem Distribusi Kapsul Vitamin A 25 Agustus 2016
76 Hj.darmataksiah Kader lk.kolo Distribusi Kapsul Vitamin A 25 Agustus 2016
77 Bq.hayatul kader toyang Distribusi Kapsul Vitamin A 25 Agustus 2016
78 Nurjannah Kader dewe lanji Distribusi Kapsul Vitamin A 27 Agustus 2016
79 Mariani Kader presak Distribusi Kapsul Vitamin A 27 Agustus 2016
80 sahriwati kader kondok Distribusi Kapsul Vitamin A 27 Agustus 2016
81 Supawati Kader Sukawangi Distribusi Kapsul Vitamin A 27 Agustus 2016
82 Slimin kader jeropoto Distribusi Kapsul Vitamin A 27 Agustus 2016
83 Mutiara kader tangar Distribusi Kapsul Vitamin A 27 Agustus 2016
84 Parmi kader Asem/Jekeh Distribusi Kapsul Vitamin A 27 Agustus 2016
85 Eny susilawati Kader dasan repok Distribusi Kapsul Vitamin A 27 Agustus 2016
86 Siti hadijah kader sukarara Utr Distribusi Kapsul Vitamin A 29 Agustus 2016
87 Sahimin Kader sukarara sltn Distribusi Kapsul Vitamin A 29 Agustus 2016
88 Asiah Kader pejaring Distribusi Kapsul Vitamin A 29 Agustus 2016
89 Nurminah kader Selayar Distribusi Kapsul Vitamin A 29 Agustus 2016
90 Husniatun Kader dengkur Distribusi Kapsul Vitamin A 29 Agustus 2016
91 Sekarniwati kader Pejaring T Distribusi Kapsul Vitamin A 29 Agustus 2016
92 Halimah Kader Pejaring Brt Distribusi Kapsul Vitamin A 29 Agustus 2016
93 Bq. Nurhidayati Kader Jerue bawak Distribusi Kapsul Vitamin A 29 Agustus 2016
94 Nurul Hidayana Mt. Prapen Distribusi Kapsul Vitamin A 29 Agustus 2016
95 Sutatik Kader bt. Ngrengseng Distribusi Kapsul Vitamin A 29 Agustus 2016
TA.2016
H. AHMAT, S.Kep, MM
NIP. 19661231 198803 1 306

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 002
atan TA. 2016
NIP. 19661231 198803 1 306
NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN PEKAN PENIMBANGAN DI POSYANDU WILAYAH KERJA
Tanggal: 1, 3, 5, 6, 7, 8, 10, 12, 13, 15, 16, 17, 19, 20, 21, 22, 23, 24, 26, 27, 28, 29, dan 31 Oktober 2015
UANG
ARI ( RP )
1 Susanti Kader Peteluan Brt 1 Hr 25.000 25.000 25,000
2 Syafriatun Kader Peteluan Brt 1 Hr 25.000 25.000 25,000
3 fitriani Kader Peteluan T 1 Hr 25.000 25.000 25,000
4 Titik hartatik Kader Peteluan T 1 Hr 25.000 25.000 25,000
5 Erni Susilawati kader Mt.Galeng 1 Hr 25.000 25.000 25,000
6 Suwarni kader Mt.Galeng 1 Hr 25.000 25.000 25,000
7 Zohriah Kader mt.Tebolak 1 Hr 25.000 25.000 25,000
8 Maemanah Kader mt.Tebolak 1 Hr 25.000 25.000 25,000
9 Hj.Halimah Kader Batu Nguek 1 Hr 25.000 25.000 25,000
10 Eli sumarni Kader Batu Nguek 1 Hr 25.000 25.000 25,000
11 Rehanun Kader Bgk Lonjer 1 Hr 25.000 25.000 25,000
12 Maemunah Kader Bgk Lonjer 1 Hr 25.000 25.000 25,000
13 Masiah kader Lingk laki 1 Hr 25.000 25.000 25,000
14 Bq.Sri Wahyuni kader Lingk laki 1 Hr 25.000 25.000 25,000
15 Hj.Marhamah Kader tampih 1 Hr 25.000 25.000 25,000
16 Nuriwati Kader tampih 1 Hr 25.000 25.000 25,000
17 Hartini Kader menuntut 1 Hr 25.000 25.000 25,000
18 Zohriati Kader menuntut 1 Hr 25.000 25.000 25,000
19 Sofa Marwati kader rensing bat 1 Hr 25.000 25.000 25,000
20 Reni Ismayani kader rensing bat 1 Hr 25.000 25.000 25,000
21 Siti saodah kader lepok 1 Hr 25.000 25.000 25,000
22 Solatiah kader lepok 1 Hr 25.000 25.000 25,000
23 Sopi Kader Tmk rurung 1 Hr 25.000 25.000 25,000
24 Nikmah Kader Tmk rurung 1 Hr 25.000 25.000 25,000
25 B.wahida s Kader Bimbi 1 Hr 25.000 25.000 25,000
26 Maryam Kader Bimbi 1 Hr 25.000 25.000 25,000
27 Kamariah Kader Rensing tmk 1 Hr 25.000 25.000 25,000
28 Jaminatun Kader Rensing tmk 1 Hr 25.000 25.000 25,000
29 Dwinita kader Gb.Masjid 1 Hr 25.000 25.000 25,000
30 Rusmiati kader Gb.Masjid 1 Hr 25.000 25.000 25,000
31 Neni Mustika Kader gb.dangah 1 Hr 25.000 25.000 25,000
32 Muni'ah Kader gb.dangah 1 Hr 25.000 25.000 25,000
33 Hj.Muslihati Kader repok dese 1 Hr 25.000 25.000 25,000
34 Maenah Kader repok dese 1 Hr 25.000 25.000 25,000
35 Siti Zaenab Kader Lk.Mudung 1 Hr 25.000 25.000 25,000
36 masitah Kader Lk.Mudung 1 Hr 25.000 25.000 25,000
37 Nining tiasih Kader emb.sayut 1 Hr 25.000 25.000 25,000
38 Nurjanah Kader emb.sayut 1 Hr 25.000 25.000 25,000
39 siti hadijah Kader menurik 1 Hr 25.000 25.000 25,000
40 Nursiah Kader menurik 1 Hr 25.000 25.000 25,000
41 Rohani kader pematung.T 1 Hr 25.000 25.000 25,000
42 Nuraini kader pematung.T 1 Hr 25.000 25.000 25,000
43 Pahrul aini Kader mt.cope 1 Hr 25.000 25.000 25,000
44 Muni'ah Kader mt.cope 1 Hr 25.000 25.000 25,000
45 Sumiati Kader mt.Siluman 1 Hr 25.000 25.000 25,000
46 Bq.jamilah Kader mt.Siluman 1 Hr 25.000 25.000 25,000
47 Nurminah Kader Panggongan 1 Hr 25.000 25.000 25,000
48 Mahani Kader Panggongan 1 Hr 25.000 25.000 25,000
49 B.tuti suryani Kader gunung rajak 1 Hr 25.000 25.000 25,000
50 B.Husnul.H Kader gunung rajak 1 Hr 25.000 25.000 25,000
51 Sri Puji A.N Kader pengenjuk 1 Hr 25.000 25.000 25,000
52 Nurlaela H Kader pengenjuk 1 Hr 25.000 25.000 25,000
53 Ani rohimah Kader bungtandang 1 Hr 25.000 25.000 25,000
54 Suriati Kader bungtandang 1 Hr 25.000 25.000 25,000
55 Sarikul Jannah Kader baren mayung 1 Hr 25.000 25.000 25,000
56 B.Rosiana Kader baren mayung 1 Hr 25.000 25.000 25,000
57 Maisum Kader monjet Timuk 1 Hr 25.000 25.000 25,000
58 Nurazizah Kader monjet Timuk 1 Hr 25.000 25.000 25,000
59 Reni Erna kader gerumus 1 Hr 25.000 25.000 25,000
60 Bq.roza kader gerumus 1 Hr 25.000 25.000 25,000
1,500,000
61 Marwiyah,Spd Kader Sangke langit 1 Hr 25.000 25.000 25,000

62 Ikarianti Kader Sangke langit 1 Hr 25.000 25.000 25,000
63 Yuliana.S Kader lendang elah 1 Hr 25.000 25.000 25,000
64 Haulani Kader lendang elah 1 Hr 25.000 25.000 25,000
65 Mardiyah Kader Gawah jarak 1 Hr 25.000 25.000 25,000
66 Resnawati Kader Gawah jarak 1 Hr 25.000 25.000 25,000
67 Husnul hotmi Kader rejeng Nyungkar 1 Hr 25.000 25.000 25,000
68 Sabariah Kader rejeng Nyungkar 1 Hr 25.000 25.000 25,000
69 Sri Puji kader mengkuru 1 Hr 25.000 25.000 25,000
70 sukmawartini kader mengkuru 1 Hr 25.000 25.000 25,000
71 Sri Wulandari kader sangupati 1 Hr 25.000 25.000 25,000
72 Bq.emi Lestari kader sangupati 1 Hr 25.000 25.000 25,000
73 Hafizah Kader pesanggrahan 1 Hr 25.000 25.000 25,000
74 hanifah Kader pesanggrahan 1 Hr 25.000 25.000 25,000
75 B.fathul jannah Kader sanggo 1 Hr 25.000 25.000 25,000
76 B.Fatmawati Kader sanggo 1 Hr 25.000 25.000 25,000
77 Jamilah kader tanak kaken 1 Hr 25.000 25.000 25,000
78 B.Mulianah kader tanak kaken 1 Hr 25.000 25.000 25,000
79 Halimatussakdiah kader Tongke 1 Hr 25.000 25.000 25,000
80 Nurlaela azmi kader Tongke 1 Hr 25.000 25.000 25,000
81 Yuliana safitri kader Jerua 1 Hr 25.000 25.000 25,000
82 zaenabung kader Jerua 1 Hr 25.000 25.000 25,000
83 Sri Kader malah 1 Hr 25.000 25.000 25,000
84 Hj.Nursehan Kader malah 1 Hr 25.000 25.000 25,000
85 Srianom kade dasan tengak 1 Hr 25.000 25.000 25,000
86 Umi Kalsum kade dasan tengak 1 Hr 25.000 25.000 25,000
87 Bq.Linda Yuliana kader Poyak oyak 1 Hr 25.000 25.000 25,000
88 Bq.Mustika.R kader Poyak oyak 1 Hr 25.000 25.000 25,000
89 Nurhasanah Kader bageq Nyale 1 Hr 25.000 25.000 25,000
90 raihul inayah Kader bageq Nyale 1 Hr 25.000 25.000 25,000
91 Bq.Zohriah kader dasan baru 1 Hr 25.000 25.000 25,000
92 Rohana kader dasan baru 1 Hr 25.000 25.000 25,000
93 Suarniwati kader Monjet bat 1 Hr 25.000 25.000 25,000
94 Bq.Rohiyatul.H kader Monjet bat 1 Hr 25.000 25.000 25,000
95 Masni kader penandak 1 Hr 25.000 25.000 25,000
96 Misniana kader penandak 1 Hr 25.000 25.000 25,000
97 Zuhriatun kader tanjah anjah 1 Hr 25.000 25.000 25,000
98 Hartini kader tanjah anjah 1 Hr 25.000 25.000 25,000
99 Ida mayanti kader karang baru 1 Hr 25.000 25.000 25,000
100 Hindun kader karang baru 1 Hr 25.000 25.000 25,000
101 Ikawati kader pengk,mas 1 Hr 25.000 25.000 25,000
102 Iq.rodi kader pengk,mas 1 Hr 25.000 25.000 25,000
103 Jami'ah Kader semanggleng 1 Hr 25.000 25.000 25,000
104 jauhariah Kader semanggleng 1 Hr 25.000 25.000 25,000
105 Saidah kader Pongkor 1 Hr 25.000 25.000 25,000
106 Bq.Icah kader Pongkor 1 Hr 25.000 25.000 25,000
107 Siti Fatimah Kader gerisak 1 Hr 25.000 25.000 25,000
108 Zuhaeratul Kader gerisak 1 Hr 25.000 25.000 25,000
109 Herlin kader penutus 1 Hr 25.000 25.000 25,000
110 Mahuni kader penutus 1 Hr 25.000 25.000 25,000
111 Indrawati kader Repok tengak 1 Hr 25.000 25.000 25,000
112 Sri ayu kader Repok tengak 1 Hr 25.000 25.000 25,000
113 Zuhriatun kader gwh gadung 1 Hr 25.000 25.000 25,000
114 farida Asiani kader gwh gadung 1 Hr 25.000 25.000 25,000
115 Fatimah kader gwh gadung Tgh 1 Hr 25.000 25.000 25,000
116 Nurhalimah kader gwh gadung Tgh 1 Hr 25.000 25.000 25,000
117 Sumarni Kader gwh gadung Tmr 1 Hr 25.000 25.000 25,000
118 Siti Rahmah Kader gwh gadung Tmr 1 Hr 25.000 25.000 25,000
119 Sahni Kader Batu tandak 1 Hr 25.000 25.000 25,000
120 Martini Kader Batu tandak 1 Hr 25.000 25.000 25,000
121 Nuraini kader gerepek santek 1 Hr 25.000 25.000 25,000
122 Maisah kader gerepek santek 1 Hr 25.000 25.000 25,000
123 Anita jajang Kader Repok are 1 Hr 25.000 25.000 25,000
124 rauhun Kader Repok are 1 Hr 25.000 25.000 25,000
125 Rehanah kader bungtiang Brt 1 Hr 25.000 25.000 25,000
126 Hartini kader bungtiang Brt 1 Hr 25.000 25.000 25,000
127 fitriani kader Bungtiang tmr 1 Hr 25.000 25.000 25,000
128 Rohani kader Bungtiang tmr 1 Hr 25.000 25.000 25,000
129 Siti Aisyah Kader gerisak 1 Hr 25.000 25.000 25,000
130 Salmiah Kader gerisak 1 Hr 25.000 25.000 25,000
1,750,000
131 Nursamsi Kader bungambar 1 Hr 25.000 25.000 25,000

132 Munawati Kader bungambar 1 Hr 25.000 25.000 25,000
133 Bq.kalsum kader mt.Mesir 1 Hr 25.000 25.000 25,000
134 Bq.Zubaedah kader mt.Mesir 1 Hr 25.000 25.000 25,000
135 Masitah kader Montong 1 Hr 25.000 25.000 25,000
136 Endra kader Montong 1 Hr 25.000 25.000 25,000
137 Mariani ratna.k kader Bungtiang sltn 1 Hr 25.000 25.000 25,000
138 Ziadatul hilmi kader Bungtiang sltn 1 Hr 25.000 25.000 25,000
139 Raehanun kader bungtiang T 1 Hr 25.000 25.000 25,000
140 Solatiah kader bungtiang T 1 Hr 25.000 25.000 25,000
141 Masturi Kader bungtiang Tgh 1 Hr 25.000 25.000 25,000
142 Suriani Kader bungtiang Tgh 1 Hr 25.000 25.000 25,000
143 Sarifah kader bungtiang brt 1 Hr 25.000 25.000 25,000
144 Halimah kader bungtiang brt 1 Hr 25.000 25.000 25,000
145 Mulianah kader borok dalem 1 Hr 25.000 25.000 25,000
146 Satriah kader borok dalem 1 Hr 25.000 25.000 25,000
147 Sinarep Kader Borok luah 1 Hr 25.000 25.000 25,000
148 Eli ermawati Kader Borok luah 1 Hr 25.000 25.000 25,000
149 Sinarep kader mt.pendem 1 Hr 25.000 25.000 25,000
150 Eli ermawati kader mt.pendem 1 Hr 25.000 25.000 25,000
151 Hj.darmataksiah Kader lk.kolo 1 Hr 25.000 25.000 25,000
152 Ana Rodianti Kader lk.kolo 1 Hr 25.000 25.000 25,000
153 Bq.hayatul kader toyang 1 Hr 25.000 25.000 25,000
154 Hurniawati kader toyang 1 Hr 25.000 25.000 25,000
155 Nurjannah Kader dewe lanji 1 Hr 25.000 25.000 25,000
156 Riza ariani Kader dewe lanji 1 Hr 25.000 25.000 25,000
157 Mariani Kader presak 1 Hr 25.000 25.000 25,000
158 Ernawati Kader presak 1 Hr 25.000 25.000 25,000
159 sahriwati kader kondok 1 Hr 25.000 25.000 25,000
160 Isnawati kader kondok 1 Hr 25.000 25.000 25,000
161 Supawati Kader Sukawangi 1 Hr 25.000 25.000 25,000
162 Sumiati Kader Sukawangi 1 Hr 25.000 25.000 25,000
163 Slimin kader jeropoto 1 Hr 25.000 25.000 25,000
164 sakmah kader jeropoto 1 Hr 25.000 25.000 25,000
165 Mutiara kader tangar 1 Hr 25.000 25.000 25,000
166 Sumarni kader tangar 1 Hr 25.000 25.000 25,000
167 Parmi kader Asem/Jekeh 1 Hr 25.000 25.000 25,000
168 zuhriah kader Asem/Jekeh 1 Hr 25.000 25.000 25,000
169 Eny susilawati Kader dasan repok 1 Hr 25.000 25.000 25,000
170 iq.Asri Kader dasan repok 1 Hr 25.000 25.000 25,000
171 Siti hadijah kader sukarara Utr 1 Hr 25.000 25.000 25,000
172 Rohnam kader sukarara Utr 1 Hr 25.000 25.000 25,000
173 Sahimin Kader sukarara sltn 1 Hr 25.000 25.000 25,000
174 Husniwati Kader sukarara sltn 1 Hr 25.000 25.000 25,000
175 Asiah Kader pejaring 1 Hr 25.000 25.000 25,000
176 Istiareni Kader pejaring 1 Hr 25.000 25.000 25,000
177 Nurminah kader Selayar 1 Hr 25.000 25.000 25,000
178 Iwang kader Selayar 1 Hr 25.000 25.000 25,000
179 Husniatun Kader dengkur 1 Hr 25.000 25.000 25,000
180 Astuti handayani Kader dengkur 1 Hr 25.000 25.000 25,000
181 Sekarniwati kader Pejaring T 1 Hr 25.000 25.000 25,000
182 Marniati kader Pejaring T 1 Hr 25.000 25.000 25,000
183 Halimah Kader Pejaring Brt 1 Hr 25.000 25.000 25,000
184 Nuraini Kader Pejaring Brt 1 Hr 25.000 25.000 25,000
185 Bq. Nurhidayati Kader Jerue bawak 1 Hr 25.000 25.000 25,000
186 Yulia Mustikawati Kader Jerue bawak 1 Hr 25.000 25.000 25,000
187 Nurul Hidayana Mt. Prapen 1 Hr 25.000 25.000 25,000
188 Rosdiana Mt. Prapen 1 Hr 25.000 25.000 25,000
189 Sutatik Kader bt. Ngrengseng 1 Hr 25.000 25.000 25,000
190 Hartini Kader bt. Ngrengseng 1 Hr 25.000 25.000 25,000
JUMLAH 4,750,000
Terbilang: Empat Juta Tujuh Ratus Lima Puluh Ribu R

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 0
N TRANSPORT KADER
MBANGAN DI POSYANDU WILAYAH KERJA
BUPATEN LOMBOK TIMUR
24, 26, 27, 28, 29, dan 31 Oktober 2015
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###
lang: Empat Juta Tujuh Ratus Lima Puluh Ribu Rupiah
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PELAKSANAAN PEKAN IMUNISASI NASIONAL (PIN) POLIO
TK. PUSKESMAS RENSING KECAMATAN SAKRA BARAT

UANG
ARI ( RP )
2 Syafriatun Kader Peteluan Brt 1 Hr 15,000 15,000 15,000
4 Titik hartatik Kader Peteluan T 1 Hr 15,000 15,000 15,000
6 Suwarni kader Mt.Galeng 1 Hr 15,000 15,000 15,000
8 Maemanah Kader mt.Tebolak 1 Hr 15,000 15,000 15,000
10 Eli sumarni Kader Batu Nguek 1 Hr 15,000 15,000 15,000
12 Maemunah Kader Bgk Lonjer 1 Hr 15,000 15,000 15,000
14 Bq.Sri Wahyuni kader Lingk laki 1 Hr 15,000 15,000 15,000
16 Nuriwati Kader tampih 1 Hr 15,000 15,000 15,000
18 Zohriati Kader menuntut 1 Hr 15,000 15,000 15,000
20 Reni Ismayani kader rensing bat 1 Hr 15,000 15,000 15,000
22 Solatiah kader lepok 1 Hr 15,000 15,000 15,000
24 Nikmah Kader Tmk rurung 1 Hr 15,000 15,000 15,000
26 Maryam Kader Bimbi 1 Hr 15,000 15,000 15,000
28 Jaminatun Kader Rensing tmk 1 Hr 15,000 15,000 15,000
30 Rusmiati kader Gb.Masjid 1 Hr 15,000 15,000 15,000
32 Muni'ah Kader gb.dangah 1 Hr 15,000 15,000 15,000
34 Maenah Kader repok dese 1 Hr 15,000 15,000 15,000
36 masitah Kader Lk.Mudung 1 Hr 15,000 15,000 15,000
38 Nurjanah Kader emb.sayut 1 Hr 15,000 15,000 15,000
39 siti hadijah Kader menurik 1 Hr 15,000 15,000 15,000
40 Nursiah Kader menurik 1 Hr 15,000 15,000 15,000
42 Nuraini kader pematung.T 1 Hr 15,000 15,000 15,000
44 Muni'ah Kader mt.cope 1 Hr 15,000 15,000 15,000
46 Bq.jamilah Kader mt.Siluman 1 Hr 15,000 15,000 15,000
48 Mahani Kader Panggongan 1 Hr 15,000 15,000 15,000
50 B.Husnul.H Kader gunung rajak 1 Hr 15,000 15,000 15,000
52 Nurlaela H Kader pengenjuk 1 Hr 15,000 15,000 15,000
54 Suriati Kader bungtandang 1 Hr 15,000 15,000 15,000
56 B.Rosiana Kader baren mayung 1 Hr 15,000 15,000 15,000
58 Nurazizah Kader monjet Timuk 1 Hr 15,000 15,000 15,000
60 Bq.roza kader gerumus 1 Hr 15,000 15,000 15,000
900,000

62 Ikarianti Kader Sangke langit 1 Hr 15,000 15,000 15,000
64 Haulani Kader lendang elah 1 Hr 15,000 15,000 15,000
66 Resnawati Kader Gawah jarak 1 Hr 15,000 15,000 15,000
68 Sabariah Kader rejeng Nyungkar 1 Hr 15,000 15,000 15,000
70 sukmawartini kader mengkuru 1 Hr 15,000 15,000 15,000
72 Bq.emi Lestari kader sangupati 1 Hr 15,000 15,000 15,000
74 hanifah Kader pesanggrahan 1 Hr 15,000 15,000 15,000
76 B.Fatmawati Kader sanggo 1 Hr 15,000 15,000 15,000
78 B.Mulianah kader tanak kaken 1 Hr 15,000 15,000 15,000
80 Nurlaela azmi kader Tongke 1 Hr 15,000 15,000 15,000
81 Yuliana safitri kader Jerua 1 Hr 15,000 15,000 15,000
82 zaenabung kader Jerua 1 Hr 15,000 15,000 15,000
84 Hj.Nursehan Kader malah 1 Hr 15,000 15,000 15,000
86 Umi Kalsum kade dasan tengak 1 Hr 15,000 15,000 15,000
88 Bq.Mustika.R kader Poyak oyak 1 Hr 15,000 15,000 15,000
90 raihul inayah Kader bageq Nyale 1 Hr 15,000 15,000 15,000
92 Rohana kader dasan baru 1 Hr 15,000 15,000 15,000
94 Bq.Rohiyatul.H kader Monjet bat 1 Hr 15,000 15,000 15,000
96 Misniana kader penandak 1 Hr 15,000 15,000 15,000
98 Hartini kader tanjah anjah 1 Hr 15,000 15,000 15,000
100 Hindun kader karang baru 1 Hr 15,000 15,000 15,000
102 Iq.rodi kader pengk,mas 1 Hr 15,000 15,000 15,000
104 jauhariah Kader semanggleng 1 Hr 15,000 15,000 15,000
106 Bq.Icah kader Pongkor 1 Hr 15,000 15,000 15,000
108 Zuhaeratul Kader gerisak 1 Hr 15,000 15,000 15,000
110 Mahuni kader penutus 1 Hr 15,000 15,000 15,000
112 Sri ayu kader Repok tengak 1 Hr 15,000 15,000 15,000
114 farida Asiani kader gwh gadung 1 Hr 15,000 15,000 15,000
116 Nurhalimah kader gwh gadung Tgh 1 Hr 15,000 15,000 15,000
118 Siti Rahmah Kader gwh gadung Tmr 1 Hr 15,000 15,000 15,000
120 Martini Kader Batu tandak 1 Hr 15,000 15,000 15,000
122 Maisah kader gerepek santek 1 Hr 15,000 15,000 15,000
124 rauhun Kader Repok are 1 Hr 15,000 15,000 15,000
126 Hartini kader bungtiang Brt 1 Hr 15,000 15,000 15,000
128 Rohani kader Bungtiang tmr 1 Hr 15,000 15,000 15,000
130 Salmiah Kader gerisak 1 Hr 15,000 15,000 15,000
1,050,000

132 Munawati Kader bungambar 1 Hr 15,000 15,000 15,000
134 Bq.Zubaedah kader mt.Mesir 1 Hr 15,000 15,000 15,000
136 Endra kader Montong 1 Hr 15,000 15,000 15,000
138 Ziadatul hilmi kader Bungtiang sltn 1 Hr 15,000 15,000 15,000
139 Raehanun kader bungtiang T 1 Hr 15,000 15,000 15,000
140 Solatiah kader bungtiang T 1 Hr 15,000 15,000 15,000
141 Masturi Kader bungtiang Tgh 1 Hr 15,000 15,000 15,000
142 Suriani Kader bungtiang Tgh 1 Hr 15,000 15,000 15,000
144 Halimah kader bungtiang brt 1 Hr 15,000 15,000 15,000
146 Satriah kader borok dalem 1 Hr 15,000 15,000 15,000
148 Eli ermawati Kader Borok luah 1 Hr 15,000 15,000 15,000
150 Eli ermawati kader mt.pendem 1 Hr 15,000 15,000 15,000
152 Ana Rodianti Kader lk.kolo 1 Hr 15,000 15,000 15,000
154 Hurniawati kader toyang 1 Hr 15,000 15,000 15,000
156 Riza ariani Kader dewe lanji 1 Hr 15,000 15,000 15,000
158 Ernawati Kader presak 1 Hr 15,000 15,000 15,000
160 Isnawati kader kondok 1 Hr 15,000 15,000 15,000
162 Sumiati Kader Sukawangi 1 Hr 15,000 15,000 15,000
164 sakmah kader jeropoto 1 Hr 15,000 15,000 15,000
166 Sumarni kader tangar 1 Hr 15,000 15,000 15,000
168 zuhriah kader Asem/Jekeh 1 Hr 15,000 15,000 15,000
170 iq.Asri Kader dasan repok 1 Hr 15,000 15,000 15,000
172 Rohnam kader sukarara Utr 1 Hr 15,000 15,000 15,000
174 Husniwati Kader sukarara sltn 1 Hr 15,000 15,000 15,000
176 Istiareni Kader pejaring 1 Hr 15,000 15,000 15,000
178 Iwang kader Selayar 1 Hr 15,000 15,000 15,000
180 Astuti handayani Kader dengkur 1 Hr 15,000 15,000 15,000
182 Marniati kader Pejaring T 1 Hr 15,000 15,000 15,000
184 Nuraini Kader Pejaring Brt 1 Hr 15,000 15,000 15,000
186 Yulia Mustikawati Kader Jerue bawak 1 Hr 15,000 15,000 15,000
188 Rosdiana Mt. Prapen 1 Hr 15,000 15,000 15,000
190 Hartini Kader bt. Ngrengseng 1 Hr 15,000 15,000 15,000
JUMLAH 2,850,000
Terbilang: Dua Juta Delapan Ratus Lima Puluh Ribu R


NIP.19661231 198803 1 306 NIP. 19751212 199603 2 0
N TRANSPORT KADER
N PEKAN IMUNISASI NASIONAL (PIN) POLIO
KECAMATAN SAKRA BARAT
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
###
lang: Dua Juta Delapan Ratus Lima Puluh Ribu Rupiah
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
UANG
ARI ( RP )
1 Susanti Kader Peteluan Brt 1 Hr 25.000 25.000 25,000
2 Syafriatun Kader Peteluan Brt 1 Hr 25.000 25.000 25,000
3 fitriani Kader Peteluan T 1 Hr 25.000 25.000 25,000
4 Titik hartatik Kader Peteluan T 1 Hr 25.000 25.000 25,000
5 Erni Susilawati kader Mt.Galeng 1 Hr 25.000 25.000 25,000
6 Suwarni kader Mt.Galeng 1 Hr 25.000 25.000 25,000
7 Zohriah Kader mt.Tebolak 1 Hr 25.000 25.000 25,000
8 Maemanah Kader mt.Tebolak 1 Hr 25.000 25.000 25,000
9 Hj.Halimah Kader Batu Nguek 1 Hr 25.000 25.000 25,000
10 Eli sumarni Kader Batu Nguek 1 Hr 25.000 25.000 25,000
11 Rehanun Kader Bgk Lonjer 1 Hr 25.000 25.000 25,000
12 Maemunah Kader Bgk Lonjer 1 Hr 25.000 25.000 25,000
13 Masiah kader Lingk laki 1 Hr 25.000 25.000 25,000
14 Bq.Sri Wahyuni kader Lingk laki 1 Hr 25.000 25.000 25,000
15 Hj.Marhamah Kader tampih 1 Hr 25.000 25.000 25,000
16 Nuriwati Kader tampih 1 Hr 25.000 25.000 25,000
17 Hartini Kader menuntut 1 Hr 25.000 25.000 25,000
18 Zohriati Kader menuntut 1 Hr 25.000 25.000 25,000
19 Sofa Marwati kader rensing bat 1 Hr 25.000 25.000 25,000
20 Reni Ismayani kader rensing bat 1 Hr 25.000 25.000 25,000
21 Siti saodah kader lepok 1 Hr 25.000 25.000 25,000
22 Solatiah kader lepok 1 Hr 25.000 25.000 25,000
23 Sopi Kader Tmk rurung 1 Hr 25.000 25.000 25,000
24 Nikmah Kader Tmk rurung 1 Hr 25.000 25.000 25,000
25 B.wahida s Kader Bimbi 1 Hr 25.000 25.000 25,000
26 Maryam Kader Bimbi 1 Hr 25.000 25.000 25,000
27 Kamariah Kader Rensing tmk 1 Hr 25.000 25.000 25,000
28 Jaminatun Kader Rensing tmk 1 Hr 25.000 25.000 25,000
29 Dwinita kader Gb.Masjid 1 Hr 25.000 25.000 25,000
30 Rusmiati kader Gb.Masjid 1 Hr 25.000 25.000 25,000
31 Neni Mustika Kader gb.dangah 1 Hr 25.000 25.000 25,000
32 Muni'ah Kader gb.dangah 1 Hr 25.000 25.000 25,000
33 Hj.Muslihati Kader repok dese 1 Hr 25.000 25.000 25,000
34 Maenah Kader repok dese 1 Hr 25.000 25.000 25,000
35 Siti Zaenab Kader Lk.Mudung 1 Hr 25.000 25.000 25,000
36 masitah Kader Lk.Mudung 1 Hr 25.000 25.000 25,000
37 Nining tiasih Kader emb.sayut 1 Hr 25.000 25.000 25,000
38 Nurjanah Kader emb.sayut 1 Hr 25.000 25.000 25,000
39 siti hadijah Kader menurik 1 Hr 25.000 25.000 25,000
40 Nursiah Kader menurik 1 Hr 25.000 25.000 25,000
41 Rohani kader pematung.T 1 Hr 25.000 25.000 25,000
42 Nuraini kader pematung.T 1 Hr 25.000 25.000 25,000
43 Pahrul aini Kader mt.cope 1 Hr 25.000 25.000 25,000
44 Muni'ah Kader mt.cope 1 Hr 25.000 25.000 25,000
45 Sumiati Kader mt.Siluman 1 Hr 25.000 25.000 25,000
46 Bq.jamilah Kader mt.Siluman 1 Hr 25.000 25.000 25,000
47 Nurminah Kader Panggongan 1 Hr 25.000 25.000 25,000
48 Mahani Kader Panggongan 1 Hr 25.000 25.000 25,000
49 B.tuti suryani Kader gunung rajak 1 Hr 25.000 25.000 25,000
50 B.Husnul.H Kader gunung rajak 1 Hr 25.000 25.000 25,000
51 Sri Puji A.N Kader pengenjuk 1 Hr 25.000 25.000 25,000
52 Nurlaela H Kader pengenjuk 1 Hr 25.000 25.000 25,000
53 Ani rohimah Kader bungtandang 1 Hr 25.000 25.000 25,000
54 Suriati Kader bungtandang 1 Hr 25.000 25.000 25,000
55 Sarikul Jannah Kader baren mayung 1 Hr 25.000 25.000 25,000
56 B.Rosiana Kader baren mayung 1 Hr 25.000 25.000 25,000
57 Maisum Kader monjet Timuk 1 Hr 25.000 25.000 25,000
58 Nurazizah Kader monjet Timuk 1 Hr 25.000 25.000 25,000
59 Reni Erna kader gerumus 1 Hr 25.000 25.000 25,000
60 Bq.roza kader gerumus 1 Hr 25.000 25.000 25,000
1,500,000
61 Marwiyah,Spd Kader Sangke langit 1 Hr 25.000 25.000 25,000

62 Ikarianti Kader Sangke langit 1 Hr 25.000 25.000 25,000
63 Yuliana.S Kader lendang elah 1 Hr 25.000 25.000 25,000
64 Haulani Kader lendang elah 1 Hr 25.000 25.000 25,000
65 Mardiyah Kader Gawah jarak 1 Hr 25.000 25.000 25,000
66 Resnawati Kader Gawah jarak 1 Hr 25.000 25.000 25,000
67 Husnul hotmi Kader rejeng Nyungkar 1 Hr 25.000 25.000 25,000
68 Sabariah Kader rejeng Nyungkar 1 Hr 25.000 25.000 25,000
69 Sri Puji kader mengkuru 1 Hr 25.000 25.000 25,000
70 sukmawartini kader mengkuru 1 Hr 25.000 25.000 25,000
71 Sri Wulandari kader sangupati 1 Hr 25.000 25.000 25,000
72 Bq.emi Lestari kader sangupati 1 Hr 25.000 25.000 25,000
73 Hafizah Kader pesanggrahan 1 Hr 25.000 25.000 25,000
74 hanifah Kader pesanggrahan 1 Hr 25.000 25.000 25,000
75 B.fathul jannah Kader sanggo 1 Hr 25.000 25.000 25,000
76 B.Fatmawati Kader sanggo 1 Hr 25.000 25.000 25,000
77 Jamilah kader tanak kaken 1 Hr 25.000 25.000 25,000
78 B.Mulianah kader tanak kaken 1 Hr 25.000 25.000 25,000
79 Halimatussakdiah kader Tongke 1 Hr 25.000 25.000 25,000
80 Nurlaela azmi kader Tongke 1 Hr 25.000 25.000 25,000
81 Yuliana safitri kader Jerua 1 Hr 25.000 25.000 25,000
82 zaenabung kader Jerua 1 Hr 25.000 25.000 25,000
83 Sri Kader malah 1 Hr 25.000 25.000 25,000
84 Hj.Nursehan Kader malah 1 Hr 25.000 25.000 25,000
85 Srianom kade dasan tengak 1 Hr 25.000 25.000 25,000
86 Umi Kalsum kade dasan tengak 1 Hr 25.000 25.000 25,000
87 Bq.Linda Yuliana kader Poyak oyak 1 Hr 25.000 25.000 25,000
88 Bq.Mustika.R kader Poyak oyak 1 Hr 25.000 25.000 25,000
89 Nurhasanah Kader bageq Nyale 1 Hr 25.000 25.000 25,000
90 raihul inayah Kader bageq Nyale 1 Hr 25.000 25.000 25,000
91 Bq.Zohriah kader dasan baru 1 Hr 25.000 25.000 25,000
92 Rohana kader dasan baru 1 Hr 25.000 25.000 25,000
93 Suarniwati kader Monjet bat 1 Hr 25.000 25.000 25,000
94 Bq.Rohiyatul.H kader Monjet bat 1 Hr 25.000 25.000 25,000
95 Masni kader penandak 1 Hr 25.000 25.000 25,000
96 Misniana kader penandak 1 Hr 25.000 25.000 25,000
97 Zuhriatun kader tanjah anjah 1 Hr 25.000 25.000 25,000
98 Hartini kader tanjah anjah 1 Hr 25.000 25.000 25,000
99 Ida mayanti kader karang baru 1 Hr 25.000 25.000 25,000
100 Hindun kader karang baru 1 Hr 25.000 25.000 25,000
101 Ikawati kader pengk,mas 1 Hr 25.000 25.000 25,000
102 Iq.rodi kader pengk,mas 1 Hr 25.000 25.000 25,000
103 Jami'ah Kader semanggleng 1 Hr 25.000 25.000 25,000
104 jauhariah Kader semanggleng 1 Hr 25.000 25.000 25,000
105 Saidah kader Pongkor 1 Hr 25.000 25.000 25,000
106 Bq.Icah kader Pongkor 1 Hr 25.000 25.000 25,000
107 Siti Fatimah Kader gerisak 1 Hr 25.000 25.000 25,000
108 Zuhaeratul Kader gerisak 1 Hr 25.000 25.000 25,000
109 Herlin kader penutus 1 Hr 25.000 25.000 25,000
110 Mahuni kader penutus 1 Hr 25.000 25.000 25,000
111 Indrawati kader Repok tengak 1 Hr 25.000 25.000 25,000
112 Sri ayu kader Repok tengak 1 Hr 25.000 25.000 25,000
113 Zuhriatun kader gwh gadung 1 Hr 25.000 25.000 25,000
114 farida Asiani kader gwh gadung 1 Hr 25.000 25.000 25,000
115 Fatimah kader gwh gadung Tgh 1 Hr 25.000 25.000 25,000
116 Nurhalimah kader gwh gadung Tgh 1 Hr 25.000 25.000 25,000
117 Sumarni Kader gwh gadung Tmr 1 Hr 25.000 25.000 25,000
118 Siti Rahmah Kader gwh gadung Tmr 1 Hr 25.000 25.000 25,000
119 Sahni Kader Batu tandak 1 Hr 25.000 25.000 25,000
120 Martini Kader Batu tandak 1 Hr 25.000 25.000 25,000
121 Nuraini kader gerepek santek 1 Hr 25.000 25.000 25,000
122 Maisah kader gerepek santek 1 Hr 25.000 25.000 25,000
123 Anita jajang Kader Repok are 1 Hr 25.000 25.000 25,000
124 rauhun Kader Repok are 1 Hr 25.000 25.000 25,000
125 Rehanah kader bungtiang Brt 1 Hr 25.000 25.000 25,000
126 Hartini kader bungtiang Brt 1 Hr 25.000 25.000 25,000
127 fitriani kader Bungtiang tmr 1 Hr 25.000 25.000 25,000
128 Rohani kader Bungtiang tmr 1 Hr 25.000 25.000 25,000
129 Siti Aisyah Kader gerisak 1 Hr 25.000 25.000 25,000
130 Salmiah Kader gerisak 1 Hr 25.000 25.000 25,000
1,750,000
131 Nursamsi Kader bungambar 1 Hr 25.000 25.000 25,000

132 Munawati Kader bungambar 1 Hr 25.000 25.000 25,000
133 Bq.kalsum kader mt.Mesir 1 Hr 25.000 25.000 25,000
134 Bq.Zubaedah kader mt.Mesir 1 Hr 25.000 25.000 25,000
135 Masitah kader Montong 1 Hr 25.000 25.000 25,000
136 Endra kader Montong 1 Hr 25.000 25.000 25,000
137 Mariani ratna.k kader Bungtiang sltn 1 Hr 25.000 25.000 25,000
138 Ziadatul hilmi kader Bungtiang sltn 1 Hr 25.000 25.000 25,000
139 Raehanun kader bungtiang T 1 Hr 25.000 25.000 25,000
140 Solatiah kader bungtiang T 1 Hr 25.000 25.000 25,000
141 Masturi Kader bungtiang Tgh 1 Hr 25.000 25.000 25,000
142 Suriani Kader bungtiang Tgh 1 Hr 25.000 25.000 25,000
143 Sarifah kader bungtiang brt 1 Hr 25.000 25.000 25,000
144 Halimah kader bungtiang brt 1 Hr 25.000 25.000 25,000
145 Mulianah kader borok dalem 1 Hr 25.000 25.000 25,000
146 Satriah kader borok dalem 1 Hr 25.000 25.000 25,000
147 Sinarep Kader Borok luah 1 Hr 25.000 25.000 25,000
148 Eli ermawati Kader Borok luah 1 Hr 25.000 25.000 25,000
149 Sinarep kader mt.pendem 1 Hr 25.000 25.000 25,000
150 Eli ermawati kader mt.pendem 1 Hr 25.000 25.000 25,000
151 Hj.darmataksiah Kader lk.kolo 1 Hr 25.000 25.000 25,000
152 Ana Rodianti Kader lk.kolo 1 Hr 25.000 25.000 25,000
153 Bq.hayatul kader toyang 1 Hr 25.000 25.000 25,000
154 Hurniawati kader toyang 1 Hr 25.000 25.000 25,000
155 Nurjannah Kader dewe lanji 1 Hr 25.000 25.000 25,000
156 Riza ariani Kader dewe lanji 1 Hr 25.000 25.000 25,000
157 Mariani Kader presak 1 Hr 25.000 25.000 25,000
158 Ernawati Kader presak 1 Hr 25.000 25.000 25,000
159 sahriwati kader kondok 1 Hr 25.000 25.000 25,000
160 Isnawati kader kondok 1 Hr 25.000 25.000 25,000
161 Supawati Kader Sukawangi 1 Hr 25.000 25.000 25,000
162 Sumiati Kader Sukawangi 1 Hr 25.000 25.000 25,000
163 Slimin kader jeropoto 1 Hr 25.000 25.000 25,000
164 sakmah kader jeropoto 1 Hr 25.000 25.000 25,000
165 Mutiara kader tangar 1 Hr 25.000 25.000 25,000
166 Sumarni kader tangar 1 Hr 25.000 25.000 25,000
167 Parmi kader Asem/Jekeh 1 Hr 25.000 25.000 25,000
168 zuhriah kader Asem/Jekeh 1 Hr 25.000 25.000 25,000
169 Eny susilawati Kader dasan repok 1 Hr 25.000 25.000 25,000
170 iq.Asri Kader dasan repok 1 Hr 25.000 25.000 25,000
171 Siti hadijah kader sukarara Utr 1 Hr 25.000 25.000 25,000
172 Rohnam kader sukarara Utr 1 Hr 25.000 25.000 25,000
173 Sahimin Kader sukarara sltn 1 Hr 25.000 25.000 25,000
174 Husniwati Kader sukarara sltn 1 Hr 25.000 25.000 25,000
175 Asiah Kader pejaring 1 Hr 25.000 25.000 25,000
176 Istiareni Kader pejaring 1 Hr 25.000 25.000 25,000
177 Nurminah kader Selayar 1 Hr 25.000 25.000 25,000
178 Iwang kader Selayar 1 Hr 25.000 25.000 25,000
179 Husniatun Kader dengkur 1 Hr 25.000 25.000 25,000
180 Astuti handayani Kader dengkur 1 Hr 25.000 25.000 25,000
181 Sekarniwati kader Pejaring T 1 Hr 25.000 25.000 25,000
182 Marniati kader Pejaring T 1 Hr 25.000 25.000 25,000
183 Halimah Kader Pejaring Brt 1 Hr 25.000 25.000 25,000
184 Nuraini Kader Pejaring Brt 1 Hr 25.000 25.000 25,000
185 Bq. Nurhidayati Kader Jerue bawak 1 Hr 25.000 25.000 25,000
186 Yulia Mustikawati Kader Jerue bawak 1 Hr 25.000 25.000 25,000
187 Nurul Hidayana Mt. Prapen 1 Hr 25.000 25.000 25,000
188 Rosdiana Mt. Prapen 1 Hr 25.000 25.000 25,000
189 Sutatik Kader bt. Ngrengseng 1 Hr 25.000 25.000 25,000
190 Hartini Kader bt. Ngrengseng 1 Hr 25.000 25.000 25,000
JUMLAH 4,750,000
Terbilang: Empat Juta Tujuh Ratus Lima Puluh Ribu R

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 0
N TRANSPORT KADER
MBANGAN DI POSYANDU WILAYAH KERJA
BUPATEN LOMBOK TIMUR
25, 26, 27, dan 28 Nopember 2015
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
###
lang: Empat Juta Tujuh Ratus Lima Puluh Ribu Rupiah
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
SURAT TUGAS
Nomor : 440 / / XI / Pusk / 2016
Tanggal : 01 November 2016





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7 November 2016
7 November 2016
7 November 2016
7 November 2016
7 November 2016
7 November 2016
8 November 2016
8 November 2016
8 November 2016
8 November 2016
8 November 2016
8 November 2016
9 November 2016
9 November 2016
9 November 2016
9 November 2016
9 November 2016
9 November 2016
10 November 2016
10 November 2016
10 November 2016
10 November 2016
10 November 2016
10 November 2016
12 November 2016
12 November 2016
12 November 2016
12 November 2016
12 November 2016
12 November 2016
12 November 2016
12 November 2016
14 November 2016
14 November 2016
14 November 2016
14 November 2016
14 November 2016
14 November 2016
14 November 2016
14 November 2016
14 November 2016
14 November 2016
15 November 2016
15 November 2016
15 November 2016
15 November 2016
15 November 2016
15 November 2016
15 November 2016
15 November 2016
16 November 2016
16 November 2016
16 November 2016
16 November 2016
16 November 2016
16 November 2016
16 November 2016
16 November 2016
17 November 2016
17 November 2016
17 November 2016
17 November 2016
17 November 2016
17 November 2016
19 November 2016
19 November 2016
19 November 2016
19 November 2016
21 November 2016
21 November 2016
21 November 2016
21 November 2016
21 November 2016
21 November 2016
21 November 2016
21 November 2016
22 November 2016
22 November 2016
22 November 2016
22 November 2016
22 November 2016
22 November 2016
22 November 2016
22 November 2016
23 November 2016
23 November 2016
23 November 2016
23 November 2016
23 November 2016
23 November 2016
23 November 2016
23 November 2016
23 November 2016
23 November 2016
23 November 2016
23 November 2016
23 November 2016
23 November 2016
24 November 2016
24 November 2016
24 November 2016
24 November 2016
24 November 2016
24 November 2016
24 November 2016
24 November 2016
24 November 2016
24 November 2016
24 November 2016
24 November 2016
24 November 2016
24 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016
26 November 2016

TA.2016
( H. AHMAT A, S.Kep, MM )
NIP.19661231 198803 1 306
Tanggal: 9, 10, 11, 12, 14, 16, 17, 18, 19, 21, 23, 24, 25, 26, dan 28 Mei 2016
UANG
ARI ( RP )
2 Syafriatun Kader Peteluan Brt 1 Hr 15,000 15,000 15,000
4 Titik hartatik Kader Peteluan T 1 Hr 15,000 15,000 15,000
6 Suwarni kader Mt.Galeng 1 Hr 15,000 15,000 15,000
8 Maemanah Kader mt.Tebolak 1 Hr 15,000 15,000 15,000
10 Eli sumarni Kader Batu Nguek 1 Hr 15,000 15,000 15,000
12 Maemunah Kader Bgk Lonjer 1 Hr 15,000 15,000 15,000
14 Bq.Sri Wahyuni kader Lingk laki 1 Hr 15,000 15,000 15,000
16 Nuriwati Kader tampih 1 Hr 15,000 15,000 15,000
18 Zohriati Kader menuntut 1 Hr 15,000 15,000 15,000
20 Reni Ismayani kader rensing bat 1 Hr 15,000 15,000 15,000
22 Solatiah kader lepok 1 Hr 15,000 15,000 15,000
24 Nikmah Kader Tmk rurung 1 Hr 15,000 15,000 15,000
26 Maryam Kader Bimbi 1 Hr 15,000 15,000 15,000
28 Jaminatun Kader Rensing tmk 1 Hr 15,000 15,000 15,000
30 Rusmiati kader Gb.Masjid 1 Hr 15,000 15,000 15,000
32 Muni'ah Kader gb.dangah 1 Hr 15,000 15,000 15,000
34 Maenah Kader repok dese 1 Hr 15,000 15,000 15,000
36 masitah Kader Lk.Mudung 1 Hr 15,000 15,000 15,000
38 Nurjanah Kader emb.sayut 1 Hr 15,000 15,000 15,000
39 siti hadijah Kader menurik 1 Hr 15,000 15,000 15,000
40 Nursiah Kader menurik 1 Hr 15,000 15,000 15,000
42 Nuraini kader pematung.T 1 Hr 15,000 15,000 15,000
44 Muni'ah Kader mt.cope 1 Hr 15,000 15,000 15,000
46 Bq.jamilah Kader mt.Siluman 1 Hr 15,000 15,000 15,000
48 Mahani Kader Panggongan 1 Hr 15,000 15,000 15,000
50 B.Husnul.H Kader gunung rajak 1 Hr 15,000 15,000 15,000
52 Nurlaela H Kader pengenjuk 1 Hr 15,000 15,000 15,000
54 Suriati Kader bungtandang 1 Hr 15,000 15,000 15,000
56 B.Rosiana Kader baren mayung 1 Hr 15,000 15,000 15,000
58 Nurazizah Kader monjet Timuk 1 Hr 15,000 15,000 15,000
60 Bq.roza kader gerumus 1 Hr 15,000 15,000 15,000
900,000

62 Ikarianti Kader Sangke langit 1 Hr 15,000 15,000 15,000
64 Haulani Kader lendang elah 1 Hr 15,000 15,000 15,000
66 Resnawati Kader Gawah jarak 1 Hr 15,000 15,000 15,000
68 Sabariah Kader rejeng Nyungkar 1 Hr 15,000 15,000 15,000
70 sukmawartini kader mengkuru 1 Hr 15,000 15,000 15,000
72 Bq.emi Lestari kader sangupati 1 Hr 15,000 15,000 15,000
74 hanifah Kader pesanggrahan 1 Hr 15,000 15,000 15,000
76 B.Fatmawati Kader sanggo 1 Hr 15,000 15,000 15,000
78 B.Mulianah kader tanak kaken 1 Hr 15,000 15,000 15,000
80 Nurlaela azmi kader Tongke 1 Hr 15,000 15,000 15,000
81 Yuliana safitri kader Jerua 1 Hr 15,000 15,000 15,000
82 zaenabung kader Jerua 1 Hr 15,000 15,000 15,000
84 Hj.Nursehan Kader malah 1 Hr 15,000 15,000 15,000
86 Umi Kalsum kade dasan tengak 1 Hr 15,000 15,000 15,000
88 Bq.Mustika.R kader Poyak oyak 1 Hr 15,000 15,000 15,000
90 raihul inayah Kader bageq Nyale 1 Hr 15,000 15,000 15,000
92 Rohana kader dasan baru 1 Hr 15,000 15,000 15,000
94 Bq.Rohiyatul.H kader Monjet bat 1 Hr 15,000 15,000 15,000
96 Misniana kader penandak 1 Hr 15,000 15,000 15,000
98 Hartini kader tanjah anjah 1 Hr 15,000 15,000 15,000
100 Hindun kader karang baru 1 Hr 15,000 15,000 15,000
102 Iq.rodi kader pengk,mas 1 Hr 15,000 15,000 15,000
104 jauhariah Kader semanggleng 1 Hr 15,000 15,000 15,000
106 Bq.Icah kader Pongkor 1 Hr 15,000 15,000 15,000
108 Zuhaeratul Kader gerisak 1 Hr 15,000 15,000 15,000
110 Mahuni kader penutus 1 Hr 15,000 15,000 15,000
112 Sri ayu kader Repok tengak 1 Hr 15,000 15,000 15,000
114 farida Asiani kader gwh gadung 1 Hr 15,000 15,000 15,000
116 Nurhalimah kader gwh gadung Tgh 1 Hr 15,000 15,000 15,000
118 Siti Rahmah Kader gwh gadung Tmr 1 Hr 15,000 15,000 15,000
120 Martini Kader Batu tandak 1 Hr 15,000 15,000 15,000
122 Maisah kader gerepek santek 1 Hr 15,000 15,000 15,000
124 rauhun Kader Repok are 1 Hr 15,000 15,000 15,000
126 Hartini kader bungtiang Brt 1 Hr 15,000 15,000 15,000
128 Rohani kader Bungtiang tmr 1 Hr 15,000 15,000 15,000
130 Salmiah Kader gerisak 1 Hr 15,000 15,000 15,000
1,050,000

132 Munawati Kader bungambar 1 Hr 15,000 15,000 15,000
134 Bq.Zubaedah kader mt.Mesir 1 Hr 15,000 15,000 15,000
136 Endra kader Montong 1 Hr 15,000 15,000 15,000
138 Ziadatul hilmi kader Bungtiang sltn 1 Hr 15,000 15,000 15,000
139 Raehanun kader bungtiang T 1 Hr 15,000 15,000 15,000
140 Solatiah kader bungtiang T 1 Hr 15,000 15,000 15,000
141 Masturi Kader bungtiang Tgh 1 Hr 15,000 15,000 15,000
142 Suriani Kader bungtiang Tgh 1 Hr 15,000 15,000 15,000
144 Halimah kader bungtiang brt 1 Hr 15,000 15,000 15,000
146 Satriah kader borok dalem 1 Hr 15,000 15,000 15,000
148 Eli ermawati Kader Borok luah 1 Hr 15,000 15,000 15,000
150 Eli ermawati kader mt.pendem 1 Hr 15,000 15,000 15,000
152 Ana Rodianti Kader lk.kolo 1 Hr 15,000 15,000 15,000
154 Hurniawati kader toyang 1 Hr 15,000 15,000 15,000
156 Riza ariani Kader dewe lanji 1 Hr 15,000 15,000 15,000
158 Ernawati Kader presak 1 Hr 15,000 15,000 15,000
160 Isnawati kader kondok 1 Hr 15,000 15,000 15,000
162 Sumiati Kader Sukawangi 1 Hr 15,000 15,000 15,000
164 sakmah kader jeropoto 1 Hr 15,000 15,000 15,000
166 Sumarni kader tangar 1 Hr 15,000 15,000 15,000
168 zuhriah kader Asem/Jekeh 1 Hr 15,000 15,000 15,000
170 iq.Asri Kader dasan repok 1 Hr 15,000 15,000 15,000
172 Rohnam kader sukarara Utr 1 Hr 15,000 15,000 15,000
174 Husniwati Kader sukarara sltn 1 Hr 15,000 15,000 15,000
176 Istiareni Kader pejaring 1 Hr 15,000 15,000 15,000
178 Iwang kader Selayar 1 Hr 15,000 15,000 15,000
180 Astuti handayani Kader dengkur 1 Hr 15,000 15,000 15,000
182 Marniati kader Pejaring T 1 Hr 15,000 15,000 15,000
184 Nuraini Kader Pejaring Brt 1 Hr 15,000 15,000 15,000
186 Yulia Mustikawati Kader Jerue bawak 1 Hr 15,000 15,000 15,000
188 Rosdiana Mt. Prapen 1 Hr 15,000 15,000 15,000
190 Hartini Kader bt. Ngrengseng 1 Hr 15,000 15,000 15,000
JUMLAH 2,850,000


NIP.19661231 198803 1 306 NIP. 19751212 199603 2 0
TRANSPORT KADER
BANGAN DI POSYANDU WILAYAH KERJA
UPATEN LOMBOK TIMUR
8 Mei 2016
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
900,000
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
1,050,000
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
900,000
ang: Dua Juta Delapan Ratus Lima Puluh Ribu Rupiah
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENCEGAHAN DAN PENANGANAN ANEMIA PADA BUMIL

UANG JML UANG
JML JML UANG
NO NAMA JABATAN TRANPORT/HARI ( TRANSPORT TANDA TANGAN
HARI DITERIMA
RP ) (Rp)
1 Hj. Nurul Fajri, SST Staf KIA 1 50,000 50,000 50,000 1
2 Mustika Nurlaeli, SST Staf KIA 1 50,000 50,000 50,000 2
3 Sri Wartini, SST Staf KIA 1 50,000 50,000 50,000 3
JUMLAH 150,000


NIP.19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN ORIETASI ANC TERPADU

UANG JML UANG
JML JML UANG
HARI DITERIMA
RP ) (Rp)
4 Hj. Nurhidayati, SST Staf KIA 1 50,000 50,000 50,000 4
JUMLAH 200,000


NIP.19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN ORIENTASI ANC TERPADU

UANG JUMLAH
JML. JML. UANG
NO NAMA JABATAN TRANSPO UANG DI TANDA TANGAN
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Nila Sari Bidan Desa Mt. Beter 1 30,000 30,000 30,000 1.
2 Daeng Sri Handayani Bidan Desa Gadung mas 1 30,000 30,000 30,000 2
3 Desi Arisanti Bidan Desa Pematung 1 30,000 30,000 30,000 3
4 Fatimatuzzuhrah Bidan Desa Pejaring 1 30,000 30,000 30,000 4
5 Bq. Nurdiana Bides Kmbg. Are Sampai 1 30,000 30,000 30,000 5
6 Irma Januarti Bidan Desa Borok Toyang 1 30,000 30,000 30,000 6
7 Jalilatus sa'ani Bidan Desa Gerisak S. 1 30,000 30,000 30,000 7
8 Luqluil Wardah Bidan Desa Boyemare 1 30,000 30,000 30,000 8
9 Nurul Hidayati Bidan Desa Bungtiang 1 30,000 30,000 30,000 9
10 Ririn Yuliari Bidan Desa Peng. Mas 1 30,000 30,000 30,000 10
11 Yuli Hariani Bidan Desa Jerogunung 1 30,000 30,000 30,000 11
12 Bq. Husnul Khotimah Bidan Desa Rensing bat 1 30,000 30,000 30,000 12
13 Fitria susana dewi Bidan Desa Sukarara 1 30,000 30,000 30,000 13
14 Ayati Bidan Desa Mengkuru 1 30,000 30,000 30,000 14
15 Bq. Laxmi Zahara Bidan Desa Gn. Rajak 1 30,000 30,000 30,000 17
16 Sri Hayuni Bidan Desa Tn. Kaken 1 30,000 30,000 30,000 18
17 Nurul Husna Bidan Desa Rensing raya 1 30,000 30,000 30,000 17
18 Wiwin Ratna Utami Bidan Desa Rensing 1 30,000 30,000 30,000 18
JUMLAH 540,000
Terbilang: Lima Ratus Empat Puluh Ribu Rupiah
Selong,
H. AHMAT A, S.Kep, MM ( NURHAYATI, ST )
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN ORIETASI SUPERVISI FASILITATIF (SUFAS)

UANG JML UANG
JML JML UANG
HARI DITERIMA
RP ) (Rp)
4 Hj. Nurhidayati, SST Staf KIA 1 50,000 50,000 50,000 4
JUMLAH 200,000


NIP.19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN SOSIALISASI PEKAN IMUNISASI NASIONAL (PIN)

UANG
ARI ( RP )
1 1 Hr 30,000 30,000 30,000
2 1 Hr 30,000 30,000 30,000
JUMLAH 60,000


NIP.19661231 198803 1 306 NIP. 19751212 199603 2
ANSPORT NARASUMBER
ASI PEKAN IMUNISASI NASIONAL (PIN)
ECAMATAN SAKRA BARAT
TANDA TANGAN
#REF!
lang: Dua Juta Delapan Ratus Lima Puluh Ribu Rupiah
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN SOSIALISASI PEKAN IMUNISASI NASIONAL (PIN)

UANG
ARI ( RP )
1 1 Hr 30,000 30,000 30,000
2 1 Hr 30,000 30,000 30,000
3 1 Hr 30,000 30,000 30,000
4 1 Hr 30,000 30,000 30,000
5 1 Hr 30,000 30,000 30,000
6 1 Hr 30,000 30,000 30,000
7 1 Hr 30,000 30,000 30,000
8 1 Hr 30,000 30,000 30,000
9 1 Hr 30,000 30,000 30,000
10 1 Hr 30,000 30,000 30,000
11 1 Hr 30,000 30,000 30,000
12 1 Hr 30,000 30,000 30,000
13 1 Hr 30,000 30,000 30,000
14 1 Hr 30,000 30,000 30,000
15 1 Hr 30,000 30,000 30,000
16 1 Hr 30,000 30,000 30,000
17 1 Hr 30,000 30,000 30,000
18 1 Hr 30,000 30,000 30,000
19 1 Hr 30,000 30,000 30,000
20 1 Hr 30,000 30,000 30,000
21 1 Hr 30,000 30,000 30,000
22 1 Hr 30,000 30,000 30,000
23 1 Hr 30,000 30,000 30,000
JUMLAH 690,000
Terbilang: Enam Ratus Sembilan Puluh Ribu Rupiah

Bendahara BOK Puskes

NIP.19661231 198803 1 306 NIP. 19751212 199603 2
AAN TRANSPORT PESERTA
ALISASI PEKAN IMUNISASI NASIONAL (PIN)
NG KECAMATAN SAKRA BARAT
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
#REF!
DALAM RANGKA KEGIATAN DISTRIBUSI VITAMIN A DI POSYANDU
WILAYAH KERJA PUSKESMAS RENSING KECAMATAN SAKRA BARAT
Tanggal: 2, 3, 4, 6, 9, 10, 11, 13, 15, 16, 17, 18, 20, 22, 23, 25, 27, dan 29 Februari 2016
UANG
ARI ( RP )
20 Siti hadijah Kader menurik 1 Hr 15,000 15,000 15,000
41 Yuliana safitri kader Jerua atas 1 Hr 15,000 15,000 15,000
UANG
ARI ( RP )
900,000
UANG
ARI ( RP )
70 Raehanun kader bungtiang utara 1 Hr 15,000 15,000 15,000
71 Masturi Kader bungtiang Tmr 1 Hr 15,000 15,000 15,000
JUMLAH 1,425,000


NIP.19661231 198803 1 306 NIP. 19751212 199603 2 0
TRANSPORT KADER
RIBUSI VITAMIN A DI POSYANDU
SING KECAMATAN SAKRA BARAT
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
TANDA TANGAN
53
54
55
56
57
58
59
60
TANDA TANGAN
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
525,000
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PELAKSANAAN PEKAN IMUNISASI NASIONAL (PIN) P

UANG
NO NAMA JABATAN TRANPORT/H
ARI ( RP )
1 1 Hr 30,000 30,000 30,000
2 1 Hr 30,000 30,000 30,000
3 1 Hr 30,000 30,000 30,000
4 1 Hr 30,000 30,000 30,000
5 1 Hr 30,000 30,000 30,000
6 1 Hr 30,000 30,000 30,000
7 1 Hr 30,000 30,000 30,000
8 1 Hr 30,000 30,000 30,000
9 1 Hr 30,000 30,000 30,000
10 1 Hr 30,000 30,000 30,000
11 1 Hr 30,000 30,000 30,000
12 1 Hr 30,000 30,000 30,000
13 1 Hr 30,000 30,000 30,000
14 1 Hr 30,000 30,000 30,000
15 1 Hr 30,000 30,000 30,000
16 1 Hr 30,000 30,000 30,000
17 1 Hr 30,000 30,000 30,000
18 1 Hr 30,000 30,000 30,000
19 1 Hr 30,000 30,000 30,000
20 1 Hr 30,000 30,000 30,000
21 1 Hr 30,000 30,000 30,000
22 1 Hr 30,000 30,000 30,000
23 1 Hr 30,000 30,000 30,000
24 1 Hr 30,000 30,000 30,000
25 1 Hr 30,000 30,000 30,000
26 1 Hr 30,000 30,000 30,000
27 1 Hr 30,000 30,000 30,000
28 1 Hr 30,000 30,000 30,000
29 1 Hr 30,000 30,000 30,000
30 1 Hr 30,000 30,000 30,000
31 1 Hr 30,000 30,000 30,000
32 1 Hr 30,000 30,000 30,000
33 1 Hr 30,000 30,000 30,000
34 1 Hr 30,000 30,000 30,000
35 1 Hr 30,000 30,000 30,000
36 1 Hr 30,000 30,000 30,000
37 1 Hr 30,000 30,000 30,000
38 1 Hr 30,000 30,000 30,000
39 1 Hr 30,000 30,000 30,000
UANG
ARI ( RP )
40 1 Hr 30,000 30,000 30,000
41 1 Hr 30,000 30,000 30,000
42 1 Hr 30,000 30,000 30,000
43 1 Hr 30,000 30,000 30,000
44 1 Hr 30,000 30,000 30,000
45 1 Hr 30,000 30,000 30,000
46 1 Hr 30,000 30,000 30,000
47 1 Hr 30,000 30,000 30,000
48 1 Hr 30,000 30,000 30,000
49 1 Hr 30,000 30,000 30,000
50 1 Hr 30,000 30,000 30,000
UANG
ARI ( RP )
51 1 Hr 30,000 30,000 30,000
52 1 Hr 30,000 30,000 30,000
53 1 Hr 30,000 30,000 30,000
54 1 Hr 30,000 30,000 30,000
55 1 Hr 30,000 30,000 30,000
56 1 Hr 30,000 30,000 30,000
57 1 Hr 30,000 30,000 30,000
58 1 Hr 30,000 30,000 30,000
59 1 Hr 30,000 30,000 30,000
60 1 Hr 30,000 30,000 30,000
61 1 Hr 30,000 30,000 30,000
62 1 Hr 30,000 30,000 30,000
63 1 Hr 30,000 30,000 30,000
64 1 Hr 30,000 30,000 30,000
65 1 Hr 30,000 30,000 30,000
66 1 Hr 30,000 30,000 30,000
67 1 Hr 30,000 30,000 30,000
68 1 Hr 30,000 30,000 30,000
69 1 Hr 30,000 30,000 30,000
70 1 Hr 30,000 30,000 30,000
71 1 Hr 30,000 30,000 30,000
72 1 Hr 30,000 30,000 30,000
73 1 Hr 30,000 30,000 30,000
74 1 Hr 30,000 30,000 30,000
75 1 Hr 30,000 30,000 30,000
76 1 Hr 30,000 30,000 30,000
77 1 Hr 30,000 30,000 30,000
78 1 Hr 30,000 30,000 30,000
79 1 Hr 30,000 30,000 30,000
80 1 Hr 30,000 30,000 30,000
81 1 Hr 30,000 30,000 30,000
82 1 Hr 30,000 30,000 30,000
83 1 Hr 30,000 30,000 30,000
84 1 Hr 30,000 30,000 30,000
85 1 Hr 30,000 30,000 30,000
86 1 Hr 30,000 30,000 30,000
87 1 Hr 30,000 30,000 30,000
88 1 Hr 30,000 30,000 30,000
89 1 Hr 30,000 30,000 30,000
90 1 Hr 30,000 30,000 30,000
91 1 Hr 30,000 30,000 30,000
92 1 Hr 30,000 30,000 30,000
93 1 Hr 30,000 30,000 30,000
94 1 Hr 30,000 30,000 30,000
UANG
ARI ( RP )
95 1 Hr 30,000 30,000 30,000
JUMLAH 2,850,000
Terbilang: Dua Juta Delapan Ratus Lima Puluh Rib

Bendahara BOK Pusk

NIP.19661231 198803 1 306 NIP. 19751212 19960
AN TRANSPORT PETUGAS
AAN PEKAN IMUNISASI NASIONAL (PIN) POLIO
G KECAMATAN SAKRA BARAT
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
TANDA TANGAN
40
41
42
43
44
45
46
47
48
49
50
TANDA TANGAN
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
TANDA TANGAN
95
1,050,000
bilang: Dua Juta Delapan Ratus Lima Puluh Ribu Rupiah
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PELAKSANAAN PEKAN IMUNISASI NASIONAL (PIN) P
UANG
NO NAMA JABATAN TRANPORT/
HARI ( RP )
1 1 Hr 15,000 15,000 15,000

2 1 Hr 15,000 15,000 15,000
3 1 Hr 15,000 15,000 15,000
4 1 Hr 15,000 15,000 15,000
5 1 Hr 15,000 15,000 15,000
6 1 Hr 15,000 15,000 15,000
7 1 Hr 15,000 15,000 15,000
8 1 Hr 15,000 15,000 15,000
9 1 Hr 15,000 15,000 15,000
10 1 Hr 15,000 15,000 15,000
11 1 Hr 15,000 15,000 15,000
12 1 Hr 15,000 15,000 15,000
13 1 Hr 15,000 15,000 15,000
14 1 Hr 15,000 15,000 15,000
15 1 Hr 15,000 15,000 15,000
16 1 Hr 15,000 15,000 15,000
17 1 Hr 15,000 15,000 15,000
18 1 Hr 15,000 15,000 15,000
19 1 Hr 15,000 15,000 15,000
20 1 Hr 15,000 15,000 15,000
21 1 Hr 15,000 15,000 15,000
22 1 Hr 15,000 15,000 15,000
23 1 Hr 15,000 15,000 15,000
24 1 Hr 15,000 15,000 15,000
25 1 Hr 15,000 15,000 15,000
26 1 Hr 15,000 15,000 15,000
27 1 Hr 15,000 15,000 15,000
28 1 Hr 15,000 15,000 15,000
29 1 Hr 15,000 15,000 15,000
30 1 Hr 15,000 15,000 15,000
31 1 Hr 15,000 15,000 15,000
32 1 Hr 15,000 15,000 15,000
33 1 Hr 15,000 15,000 15,000
34 1 Hr 15,000 15,000 15,000
35 1 Hr 15,000 15,000 15,000
36 1 Hr 15,000 15,000 15,000
37 1 Hr 15,000 15,000 15,000
UANG
HARI ( RP )
38 1 Hr 15,000 15,000 15,000

39 1 Hr 15,000 15,000 15,000
40 1 Hr 15,000 15,000 15,000
41 1 Hr 15,000 15,000 15,000
42 1 Hr 15,000 15,000 15,000
43 1 Hr 15,000 15,000 15,000
44 1 Hr 15,000 15,000 15,000
45 1 Hr 15,000 15,000 15,000
46 1 Hr 15,000 15,000 15,000
47 1 Hr 15,000 15,000 15,000
48 1 Hr 15,000 15,000 15,000
49 1 Hr 15,000 15,000 15,000
50 1 Hr 15,000 15,000 15,000
51 1 Hr 15,000 15,000 15,000
52 1 Hr 15,000 15,000 15,000
53 1 Hr 15,000 15,000 15,000
UANG
HARI ( RP )
54 1 Hr 15,000 15,000 15,000

55 1 Hr 15,000 15,000 15,000
56 1 Hr 15,000 15,000 15,000
57 1 Hr 15,000 15,000 15,000
58 1 Hr 15,000 15,000 15,000
59 1 Hr 15,000 15,000 15,000
60 1 Hr 15,000 15,000 15,000
61 1 Hr 15,000 15,000 15,000
62 1 Hr 15,000 15,000 15,000
63 1 Hr 15,000 15,000 15,000
64 1 Hr 15,000 15,000 15,000
65 1 Hr 15,000 15,000 15,000
66 1 Hr 15,000 15,000 15,000
67 1 Hr 15,000 15,000 15,000
68 1 Hr 15,000 15,000 15,000
69 1 Hr 15,000 15,000 15,000
70 1 Hr 15,000 15,000 15,000
71 1 Hr 15,000 15,000 15,000
72 1 Hr 15,000 15,000 15,000
73 1 Hr 15,000 15,000 15,000
74 1 Hr 15,000 15,000 15,000
75 1 Hr 15,000 15,000 15,000
76 1 Hr 15,000 15,000 15,000
77 1 Hr 15,000 15,000 15,000
78 1 Hr 15,000 15,000 15,000
79 1 Hr 15,000 15,000 15,000
80 1 Hr 15,000 15,000 15,000
81 1 Hr 15,000 15,000 15,000
82 1 Hr 15,000 15,000 15,000
83 1 Hr 15,000 15,000 15,000
84 1 Hr 15,000 15,000 15,000
85 1 Hr 15,000 15,000 15,000
86 1 Hr 15,000 15,000 15,000
87 1 Hr 15,000 15,000 15,000
88 1 Hr 15,000 15,000 15,000
89 1 Hr 15,000 15,000 15,000
90 1 Hr 15,000 15,000 15,000
91 1 Hr 15,000 15,000 15,000
92 1 Hr 15,000 15,000 15,000
93 1 Hr 15,000 15,000 15,000
94 1 Hr 15,000 15,000 15,000
95 1 Hr 15,000 15,000 15,000
UANG
HARI ( RP )
JUMLAH 1,425,000
Terbilang: Satu Juta Empat Ratus Dua Puluh Lima

Bendahara BOK Pusk

NIP.19661231 198803 1 306 NIP. 19751212 199603
AAN TRANSPORT KADER
AAN PEKAN IMUNISASI NASIONAL (PIN) POLIO
G KECAMATAN SAKRA BARAT
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
TANDA TANGAN
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
TANDA TANGAN
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
TANDA TANGAN
525,000
bilang: Satu Juta Empat Ratus Dua Puluh Lima Ribu Rupiah
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENDATAAN SASARAN PEKAN IMUNISASI NASIONAL (PIN) P
Tanggal: 2, 4, 5, 6, 7, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, dan 23 Januari 2016
UANG
ARI ( RP )
1 1 Hr 15,000 15,000 15,000
2 1 Hr 15,000 15,000 15,000
3 1 Hr 15,000 15,000 15,000
4 1 Hr 15,000 15,000 15,000
5 1 Hr 15,000 15,000 15,000
6 1 Hr 15,000 15,000 15,000
7 1 Hr 15,000 15,000 15,000
8 1 Hr 15,000 15,000 15,000
9 1 Hr 15,000 15,000 15,000
10 1 Hr 15,000 15,000 15,000
11 1 Hr 15,000 15,000 15,000
12 1 Hr 15,000 15,000 15,000
13 1 Hr 15,000 15,000 15,000
14 1 Hr 15,000 15,000 15,000
15 1 Hr 15,000 15,000 15,000
16 1 Hr 15,000 15,000 15,000
17 1 Hr 15,000 15,000 15,000
18 1 Hr 15,000 15,000 15,000
19 1 Hr 15,000 15,000 15,000
20 1 Hr 15,000 15,000 15,000
21 1 Hr 15,000 15,000 15,000
22 1 Hr 15,000 15,000 15,000
23 1 Hr 15,000 15,000 15,000
24 1 Hr 15,000 15,000 15,000
25 1 Hr 15,000 15,000 15,000
26 1 Hr 15,000 15,000 15,000
27 1 Hr 15,000 15,000 15,000
28 1 Hr 15,000 15,000 15,000
29 1 Hr 15,000 15,000 15,000
30 1 Hr 15,000 15,000 15,000
31 1 Hr 15,000 15,000 15,000
32 1 Hr 15,000 15,000 15,000
33 1 Hr 15,000 15,000 15,000
34 1 Hr 15,000 15,000 15,000
35 1 Hr 15,000 15,000 15,000
36 1 Hr 15,000 15,000 15,000
37 1 Hr 15,000 15,000 15,000
38 1 Hr 15,000 15,000 15,000
39 1 Hr 15,000 15,000 15,000
40 1 Hr 15,000 15,000 15,000
41 1 Hr 15,000 15,000 15,000
42 1 Hr 15,000 15,000 15,000
43 1 Hr 15,000 15,000 15,000
44 1 Hr 15,000 15,000 15,000
45 1 Hr 15,000 15,000 15,000
46 1 Hr 15,000 15,000 15,000
47 1 Hr 15,000 15,000 15,000
48 1 Hr 15,000 15,000 15,000
49 1 Hr 15,000 15,000 15,000
50 1 Hr 15,000 15,000 15,000
51 1 Hr 15,000 15,000 15,000
52 1 Hr 15,000 15,000 15,000
UANG
ARI ( RP )
53 1 Hr 15,000 15,000 15,000
54 1 Hr 15,000 15,000 15,000
55 1 Hr 15,000 15,000 15,000
56 1 Hr 15,000 15,000 15,000
57 1 Hr 15,000 15,000 15,000
58 1 Hr 15,000 15,000 15,000
59 1 Hr 15,000 15,000 15,000
60 1 Hr 15,000 15,000 15,000
900,000
61 1 Hr 15,000 15,000 15,000

62 1 Hr 15,000 15,000 15,000
63 1 Hr 15,000 15,000 15,000
64 1 Hr 15,000 15,000 15,000
65 1 Hr 15,000 15,000 15,000
66 1 Hr 15,000 15,000 15,000
67 1 Hr 15,000 15,000 15,000
68 1 Hr 15,000 15,000 15,000
69 1 Hr 15,000 15,000 15,000
70 1 Hr 15,000 15,000 15,000
71 1 Hr 15,000 15,000 15,000
72 1 Hr 15,000 15,000 15,000
73 1 Hr 15,000 15,000 15,000
74 1 Hr 15,000 15,000 15,000
75 1 Hr 15,000 15,000 15,000
76 1 Hr 15,000 15,000 15,000
77 1 Hr 15,000 15,000 15,000
78 1 Hr 15,000 15,000 15,000
79 1 Hr 15,000 15,000 15,000
80 1 Hr 15,000 15,000 15,000
81 1 Hr 15,000 15,000 15,000
82 1 Hr 15,000 15,000 15,000
83 1 Hr 15,000 15,000 15,000
84 1 Hr 15,000 15,000 15,000
85 1 Hr 15,000 15,000 15,000
86 1 Hr 15,000 15,000 15,000
87 1 Hr 15,000 15,000 15,000
88 1 Hr 15,000 15,000 15,000
89 1 Hr 15,000 15,000 15,000
90 1 Hr 15,000 15,000 15,000
91 1 Hr 15,000 15,000 15,000
92 1 Hr 15,000 15,000 15,000
93 1 Hr 15,000 15,000 15,000
94 1 Hr 15,000 15,000 15,000
95 1 Hr 15,000 15,000 15,000
JUMLAH 1,425,000

UANG
ARI ( RP )

NIP.19661231 198803 1 306 NIP. 19751212 199603 2 0
TRANSPORT KADER
RAN PEKAN IMUNISASI NASIONAL (PIN) POLIO
ECAMATAN SAKRA BARAT
TANDA TANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
TANDA TANGAN
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
525,000
TANDA TANGAN
LUNAS DIBAYAR
( NURHAYATI, ST )
NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PEMERIKSAAN IBU HAMIL / ANC DI POSYANDU
Tanggal: 13, 14, 15, 17, 18, 19, 20, 21, 22, 24, dan 25 Februari 2014
UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Muliatun Bidan Puskesmas 6 25,000 150,000 150,000 1.
2 Nila Sari Bides Mt. Beter 4 25,000 100,000 100,000 2
3 Desi Arisanti Bides Pematung 2 25,000 50,000 50,000 3
4 Ririn Yuliari Bides Peng. Mas 1 25,000 25,000 25,000 4
5 Sofa Hariani Bides Kembang are sampe 3 25,000 75,000 75,000 5
6 Siti Aisyah Bides Rensing bat 3 25,000 75,000 75,000 6
7 Sumiati Bides Sukarara 2 25,000 50,000 50,000 7
8 Ina Haji Eta Bides Bungtiang 6 25,000 150,000 150,000 8
9 Zulfira Riasitafani Bides Mengkuru 4 25,000 100,000 100,000 9
10 Fatimatuzzahrah Bides Pejaring 2 25,000 50,000 50,000 10
11 Sri Hayuni Bides Tn. Kaken 4 25,000 100,000 100,000 11
12 Widya Astuti Bides Gadung mas 3 25,000 75,000 75,000 12
13
14
15
16
17
18
JUMLAH 1,000,000
Terbilang: Satu Juta Rupiah
Selong,
HJ. BARI'AH, S.Kep MARLINA HIDAYATI, A.MKL
NIP. 19641231 198511 2 040 NIP. 19810327 200801 2 023
DALAM RANGKA KEGIATAN SURVEY PERUMAHAN DAN LINGKUNGAN (SPL)
Tanggal: 1, 2, 4, 6, 7, 8, 9, 10, 11, 13, dan 14 April 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 2 25,000 50,000 50,000 1.
2 2 25,000 50,000 50,000 2
3 2 25,000 50,000 50,000 3
4 2 25,000 50,000 50,000 4
5 2 25,000 50,000 50,000 5
6 2 25,000 50,000 50,000 6
7 2 25,000 50,000 50,000 7
8 2 25,000 50,000 50,000 8
9 2 25,000 50,000 50,000 9
10 2 25,000 50,000 50,000 10
11 2 25,000 50,000 50,000 11
JUMLAH 550,000
Terbilang: Lima Ratus Lima Puluh Ribu Rupiah

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 6, 7, 8, 9, 10, dan 11 Juli 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 2 25,000 50,000 50,000 1.
2 2 25,000 50,000 50,000 2
3 2 25,000 50,000 50,000 3
4 2 25,000 50,000 50,000 4
5 2 25,000 50,000 50,000 5
6 2 25,000 50,000 50,000 6
JUMLAH 300,000

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 002
Tanggal: 1, 3, 4, 5, 6, 8, 9, 10, 11, 13, 15, 16, dan 17 Juni 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 2 25,000 50,000 50,000 1.
2 2 25,000 50,000 50,000 2
3 2 25,000 50,000 50,000 3
4 2 25,000 50,000 50,000 4
5 2 25,000 50,000 50,000 5
6 2 25,000 50,000 50,000 6
7 2 25,000 50,000 50,000 7
8 2 25,000 50,000 50,000 8
9 2 25,000 50,000 50,000 9
10 2 25,000 50,000 50,000 10
11 2 25,000 50,000 50,000 11
12 2 25,000 50,000 50,000 12
13 2 25,000 50,000 50,000 13
JUMLAH 650,000

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 2 25,000 50,000 50,000 1.
2 2 25,000 50,000 50,000 2
3 2 25,000 50,000 50,000 3
4 2 25,000 50,000 50,000 4
5 2 25,000 50,000 50,000 5
6 2 25,000 50,000 50,000 6
7 2 25,000 50,000 50,000 7
JUMLAH 350,000

NIP.19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN OTOPSI VERBAL KEMATIAN NEONATAL
Tanggal: 1 dan 2 Juni 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Bq. Sri Utari RN, A.Md. Keb Bidan Pusksmas 2 25,000 50,000 50,000 1.
2 Nurhayati, A.MKL Surveilans 2 25,000 50,000 50,000 2
JUMLAH 100,000
Selong,
HJ. BARI'AH, S.Kep ( NURHAYATI, ST )

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023
Tanggal: 1, 2, 3, 4, 24, dan 25 Juli 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Lathifah, SKM Bidan Puskesmas 6 25,000 150,000 150,000 1.
2 Nurhayati, ST Surveilans 6 25,000 150,000 150,000 2
JUMLAH 300,000
Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023
Tanggal: 14 dan 15 Agustus 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 100,000
Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 100,000
Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023

Tanggal: 6 dan 7 Nopember 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
2 Desi Arisanti, A.Md. Keb Bides Pematung 1 25,000 25,000 25,000 2
3 Nila Sari, A.Md. Keb Bides Mt. Beter 1 25,000 25,000 25,000
JUMLAH 100,000
Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023


UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Lathifah, SKM Bidan Koordinator 2 25,000 50,000 50,000 1.
JUMLAH 100,000

Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023
DALAM RANGKA KEGIATAN PELAYANAN P4K

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Bq. Sri Utari RN Bidan Puskesmas Rensing 1 25,000 25,000 25,000 1.
JUMLAH 50,000
Terbilang: Lima Puluh Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Rijaliana Bidan Desa Jerogunung 1 25,000 25,000 25,000 1.
JUMLAH 50,000
Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023
Tanggal: 2 dan 22 Juni 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 50,000
Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023
Tanggal: 10 dan 11 Juli 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Rijaliana, A.Md. Keb Bidan Desa Mt. Beter 1 25,000 25,000 25,000 1.
2 Ayati, A.Md. Keb Bidan Desa Mengkuru 1 25,000 25,000 25,000 2
JUMLAH 50,000
Selong,
NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023

Tanggal: 10 dan 20 Agustus 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Fatimatuzzahrah, A.Md. Keb Bidan Desa Pejaring 1 25,000 25,000 25,000 1.
2 Fitria Susana Dewi, A.Md. Keb Bidan Desa Sukarara 1 25,000 25,000 25,000 2
JUMLAH 50,000
Selong,
NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023


UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Daeng Sri Handayani Bidan Desa Gadung mas 1 25,000 25,000 25,000 1.
2 Jalilatus sa'ani Bidan Desa Grisak S. 1 25,000 25,000 25,000 2
JUMLAH 50,000
Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023

Tanggal: 9 dan 28 Oktober 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Nurul Hidayati Bidan Desa Bungtiang 1 25,000 25,000 25,000 1.

2 Siti Rabihatun Adawiyah Bidan Puskesmas 1 25,000 25,000 25,000 2
JUMLAH 50,000
Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023

Tanggal: 9 dan 19 Nopember 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Luqluil Wardah Bidan Desa Boyemare 1 25,000 25,000 25,000 1.
JUMLAH 50,000
Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Nila Sari, A.Md. Keb Bidan Desa Mt. Beter 1 25,000 25,000 25,000 1.
2 Bq. Laxmi Zahara, A.Md. Keb Bidan Desa Gn. Rajak 1 25,000 25,000 25,000 2
JUMLAH 50,000
Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023


UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Nila Sari, A.Md. Keb Bidan Desa Mt. Beter 1 25,000 25,000 25,000 1.
2 Bq. Laxmi Zahara, A.Md. Keb Bidan Desa Gn. Rajak 1 25,000 25,000 25,000 2
JUMLAH 50,000
Selong,

NIP. 19641231 198511 2 040 NIP.NIP.
19751212
19810327 200801 2 023
DALAM RANGKA KEGIATAN DISKUSI REFLEKSI KASUS (DRK) TK. PUSKESMAS RENSING

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Hj. Nurul Fajri, SST Staf Kesga 1 50,000 50,000 50,000 1.
2 Mustika Nurlaili, SST Staf Kesga 1 50,000 50,000 50,000 2
JUMLAH 100,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PENCEGAHAN DAN PENANGANAN ANEMIA PADA BUMIL

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 540,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN ORIENTASI SUPERVISI FASILITATIF (SUFAS)

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 540,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN DISKUSI REFLEKSI KASUS (DRK) TK. PUSKESMAS RENSING

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
5 Siti Rabihatun Adawiyah Bides Kmbg. Are Sampai 1 30,000 30,000 30,000 5
JUMLAH 540,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PERTEMUAN EVALUASI PELAKSANAAN MTBS

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
5 Siti Rabihatun A. Bides Kmbg. Are Sampai 1 30,000 30,000 30,000 5
19 Nurul Hikmah Bidan Puskesmas 1 30,000 30,000 30,000 19
20 Zulfira Riasitafani Bidan Puskesmas 1 30,000 30,000 30,000 20
18 JUMLAH 600,000
Selong,
NIP. 19641231 1988803 1 306 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN EVALUASI PELAKSANAAN MTBS

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Hj. Nurul Fajri, SST Staf Kesga 1 50,000 50,000 50,000 1.
2 Mustika Nurlaili, SST Staf Kesga 1 50,000 50,000 50,000 2
3 Hj. Nurhidayati, SST Staf Kesga 1 50,000 50,000 50,000 3
JUMLAH 150,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PERTEMUAN EVALUASI PELAKSANAAN P4K
Tanggal: 17 Oktober 2015

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
5 Ida Royani Bides Kmbg. Are Sampai 1 25,000 25,000 25,000 5
18 JUMLAH 450,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
18 JUMLAH 450,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002


UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Mustika Nurlaili, SST Staf Kesga 1 50,000 50,000 50,000 1.
2 Hj. Nurul Fajri, SST Staf Kesga 1 50,000 50,000 50,000 2
3 Hj. Nurhidayati, SST Staf Kesga 1 50,000 50,000 50,000 3
JUMLAH 150,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN PERTEMUAN EVALUASI PENANGANAN ANEMIA PADA IBU HAMIL

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
4 Fatimatuzzahrah Bidan Desa Pejaring 1 25,000 25,000 25,000 4
11 Juli Hariani Bidan Desa Jerogunung 1 25,000 25,000 25,000 11
18 JUMLAH 450,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN SDIDTK DI POSYANDU
Tanggal: 2, 4, 5, 6, 7, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, dan 23 Januari 2016
UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Wiwin Ratna Utami Bidan Puskesmas Rensing 9 30,000 270,000 270,000 1.
2 Nila Sari Bidan Desa Mt. Beter 8 30,000 240,000 240,000 2
14 Fitriana Susana Dewi Bidan Desa Sukarara 7 30,000 210,000 210,000 14
16 Bq. Laksmi Zahara Bidan Desa Gn. Rajak 9 30,000 270,000 270,000 16
17 Nurul Husna Biden Desa Rensing raya 4 30,000 120,000 120,000 17
JUMLAH 2,850,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 1, 2, 3, 4, 6, 9, 10, 11, 12, 13, 15, 16, 17, 18, 20, 22, 23, 24, 25, 27, dan 29 Februari 2016
UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 2,850,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 5, 7, 8, 9, 10, 11, 12, 14, 15, 16, 17, 18, 19, 21, 22, 23, 24, 26, dan 28 Maret 2016
UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 2,850,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 2, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14, 16, 18, 19, 20, 21, dan 23 April 2016
UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 2,850,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 9, 10, 11, 12, 14, 16, 17, 18, 19, 21, 23, 24, 25, 26, dan 28 Mei 2016
UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 2,850,000
Selong,

NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002
Tanggal: 2, 3, 5, 7, 8, 9, 10, 12, 14, 15, 16, 17, 18, 19, 21, 22, 23, 25, 26, dan 28 September 2015
UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Miskiah Bidan Puskesmas Rensing 9 25,000 225,000 225,000 1.
JUMLAH 2,375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 3, 5, 6, 7, 8, 9, 10, 12, 13, 14, 15, 17, 19, 20, 21, 22, 23, 24, 26, 27, 28, 29, dan 31 Oktober 2015
UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 2,375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 2,375,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

Tanggal: 1, 2, 3, 5, 7, 8, 10, 11, 12, 14, 15, 16, 17, 18, 19, 21, 22, 23, 26, 28, 29, dan 30 Desember 2015
UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
JUMLAH 2,375,000
Selong,
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
DALAM RANGKA KEGIATAN SDIDTK DI PAUD
Tanggal: 12, 14, 15, 17, 18, 19, 21, 23, 24, 26, , 28, 29, dan 31 Maret 2016
UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Nurul Hikmah Bidan Puskesmas Rensing 2 30,000 60,000 60,000 1.
23 JUMLAH 690,000
Selong,
NIP. 19661231 198803 1 306 NIP. 19751212 199603 2 002

Tanggal: 2, 4, 5, 6, 7, 9, 11, 12, 13, 18, 19, 20, 21, 23, 25, 26, 27, dan 28 Mei 2015
UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Husnaini Bidan Puskesmas Rensing 9 25,000 225,000 225,000 1.
14 Nurlina Septiana Bidan Desa Sukarara 6 25,000 150,000 150,000 14
15 Rijaliana Bidan Desa Jerogunung 3 25,000 75,000 75,000 17
JUMLAH 1,800,000
Terbilang: Satu Juta Delapan Ratus Ribu Rupiah
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

DALAM RANGKA KEGIATAN SDIDTK DI DI TK/PAUD
Tanggal: 5, 6, 8, 9, 10, 11, 13, 16, 19, 23, 24, dan 29 Juni 2015
UANG JUMLAH
JML. JML. UANG
OH TRANSPORT
RT/HARI TERIMA
1 2 3 4 5 6 7 8
1 Sumiati Bidan Puskesmas Rensing 6 25,000 150,000 150,000 1.
JUMLAH 500,000
Selong,

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

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DAFTAR PENERIMAAN TRANSPORT DALAM RANGKA KONSULTASI BOK KE DIKES KAB.

Tanggal: 27 dan 28 September 2016

1 Suhardi Teknisi BOK 2 35,000 35,000 70,000 1

2 Nurhayati, ST Bendahara BOK 2 35,000 35,000 70,000 2

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal: 27 dan 28 Oktober 2016

1 Suhardi Teknisi BOK 2 35,000 35,000 70,000 1

2 Nurhayati, ST Bendahara BOK 2 35,000 35,000 70,000 2

Terbilang: Seratus Empat Puluh Ribu Rupiah

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal: 28 dan 29 November 2016

1 Suhardi Teknisi BOK 2 35,000 35,000 70,000 1

2 Nurhayati, ST Bendahara BOK 2 35,000 35,000 70,000 2

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal: 27 dan 28 Desember 2016

1 Suhardi Teknisi BOK 2 35,000 35,000 70,000 1

2 Nurhayati, ST Bendahara BOK 2 35,000 35,000 70,000 2

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal: 25 Juli 2016

1 H. Ahmat, S.Kep, MM Ka. Pusk. Rensing 1 200,000 200,000 200,000 1

2 Nurhayati, ST Bendahara BOK 1 200,000 200,000 200,000 2

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal : 30 Agustus 2016

1 H. Ahmat, S.Kep, MM Ka. Pusk. Rensing 1 200,000 200,000 200,000 1

2 Nurhayati, ST Bendahara BOK 1 200,000 200,000 200,000 2

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal : 28 September 2016

1 H. Ahmat, S.Kep, MM Ka. Pusk. Rensing 1 200,000 200,000 200,000 1

2 Nurhayati, ST Bendahara BOK 1 200,000 200,000 200,000 2

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal : 25 Oktober 2016

1 H. Ahmat, S.Kep, MM Ka. Pusk. Rensing 1 200,000 200,000 200,000 1

2 Nurhayati, ST Bendahara BOK 1 200,000 200,000 200,000 2

Terbilang: Empat Ratus Lima Puluh Ribu Rupiah

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal : 18 Mei 2016

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal : 18 Mei 2016

1 H. Ahmat, S.Kep, MM Ka. Pusk. Rensing 1 30,000 30,000 30,000 1

2 Nurhayati, ST Sanitarian 1 30,000 30,000 30,000 2

3 Siti Emiyati, A.MKL Sanitarian 1 30,000 30,000 30,000 3

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal : 18 Juni 2016

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal : 18 Juni 2016

1 H. Ahmat A, S.Kep, MM Ka. Pusk. Rensing 1 30,000 30,000 30,000 1

2 Nurhayati, ST Sanitarian 1 30,000 30,000 30,000 2

3 Siti Emiyati, A.MKL Sanitarian 1 30,000 30,000 30,000 3

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal : 2 dan 3 Juni 2016

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal : 01 Juni 2016

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal : 25 Juni 2016

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal : 18 April 2016

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal: 18 April 2016

2 Ahmad Daenuri, SKM Staf P2PL 1 50,000 50,000 50,000 2 ___________

H. AHMAT A, S.Kep, MM NURHAYATI, ST

Tanggal: 18 April 2016

1 H. Ahmat A, S.Kep, MM Ka. Pusk. Rensing 1 30,000 30,000 30,000 1. __________

2 Nurhayati, ST Sanitarian 1 30,000 30,000 30,000 2 ___________

3 Siti Emiyati, A.Md. KL Sanitarian 1 30,000 30,000 30,000