DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS

DALAM RANGKA KEGIATAN PELAYANAN SDIDTK DI POSYANDU

PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

Tanggal: 1, 2, 4, 6, 7, 8, 9, 11, 13, 14, 15, 16, 17, 18, 20, 21, 22, 23, 24, 25,27, 28
UANG
JUMLAH
JML. TRANSP JML. UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI ORT/HAR TRANSPORT
TERIMA
I
1 2 3 4 5 6 7 8
1 Wiwin Ratna Utami Bidan 9 30,000 270,000 270,000 1. __________
2 Bq. Husnul Khotimah Bidan 3 15,000 45,000 45,000 2 ___________
3 Yuli Hariani Bidan 3 15,000 45,000 45,000 3. __________
4 Nurul Husna Bidan 4 15,000 60,000 60,000 4 ___________
5 Desi Arisanti Bidan 3 15,000 45,000 45,000 5. __________
6 Nila Sari Bidan 8 15,000 120,000 120,000 6 ___________
7 Ayati Bidan 5 15,000 75,000 75,000 7. ___________
8 Sri Hayuni Bidan 4 15,000 60,000 60,000 8. ___________
9 Bq. Laxmi Zahara Bidan 9 15,000 135,000 135,000 9. __________
10 Ririn Yuliari Bidan 5 15,000 75,000 75,000 10 ___________
11 Jalilatussa'ni Bidan 5 15,000 75,000 75,000 11. __________
12 Daeng Sri Handayani Bidan 3 15,000 45,000 45,000 12___________
13 Bq. Nurdiana Bidan 3 15,000 45,000 45,000 13. ___________
14 Nurul Hidayati Bidan 8 15,000 120,000 120,000 14. ___________
15 Luqluil Wardah Bidan 4 15,000 60,000 60,000 15. __________
16 Irma Januarti Bidan 8 15,000 120,000 120,000 16 ___________
17 Fitria Susana Dewi Bidan 7 15,000 105,000 105,000 17. ___________
18 Fatimatuzzuhrah Bidan 5 15,000 75,000 75,000 18. ___________
JUMLAH 1,575,000
Terbilang: Dua Juta Tiga Ratus Tujuh Puluh Lima Ribu Rupiah
 Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

H. SEJARAH, S.Sos NURHAYATI, ST

NIP. 19661231 198603 1 093 NIP. 19751212 199603 2 002
 DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS
DALAM RANGKA KEGIATAN PELAYANAN IMUNISASI RUTIN DI POSYANDU
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

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. TRANSP JML. UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI ORT/HAR TRANSPORT
TERIMA
I
1 2 3 4 5 6 7 8
1 H. Seman Vaksinator 15 25,000 375,000 375,000 1. __________
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. ___________
JUMLAH 2,375,000
Terbilang: Dua Juta Tiga Ratus Tujuh Puluh Lima Ribu Rupiah

Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

HJ. BARI'AH, S.Kep NURHAYATI, ST

NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
 DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS
DALAM RANGKA KEGIATAN PELAYANAN IMUNISASI RUTIN DI POSYANDU
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

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. TRANSP JML. UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI ORT/HAR TRANSPORT
TERIMA
I
1 2 3 4 5 6 7 8
1 H. Seman Vaksinator 15 25,000 375,000 375,000 1. __________
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. ___________
JUMLAH 2,375,000
Terbilang: Dua Juta Tiga Ratus Tujuh Puluh Lima Ribu Rupiah

Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas
 HJ. BARI'AH, S.Kep NURHAYATI, ST
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002

DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS

DALAM RANGKA KEGIATAN PELAYANAN IMUNISASI RUTIN DI POSYANDU
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

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. TRANSP JML. UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI ORT/HAR TRANSPORT
TERIMA
I
1 2 3 4 5 6 7 8
1 H. Seman Vaksinator 15 25,000 375,000 375,000 1. __________
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'ut 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. ___________
JUMLAH 2,375,000
Terbilang: Dua Juta Tiga Ratus Tujuh Puluh Lima Ribu Rupiah

Selong,
 Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

HJ. BARI'AH, S.Kep NURHAYATI, ST

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

DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS

DALAM RANGKA KEGIATAN PELAYANAN IMUNISASI RUTIN DI POSYANDU
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

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. TRANSP JML. UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI ORT/HAR TRANSPORT
TERIMA
I
1 2 3 4 5 6 7 8
1 H. Seman Vaksinator 15 25,000 375,000 375,000 1. __________
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'ut 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. ___________
 JUMLAH 2,375,000
Terbilang: Dua Juta Tiga Ratus Tujuh Puluh Lima Ribu Rupiah

Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

HJ. BARI'AH, S.Kep NURHAYATI, ST

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

DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS

DALAM RANGKA KEGIATAN PELAYANAN IMUNISASI RUTIN DI POSYANDU
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

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. TRANSP JML. UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI ORT/HAR TRANSPORT
TERIMA
I
1 2 3 4 5 6 7 8
1 H. Seman Vaksinator 15 25,000 375,000 375,000 1. __________
2 H. Hernan Perawat 18 25,000 450,000 450,000 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'ut Jayapura Perawat 8 25,000 200,000 200,000 6 ___________
7 Lalu Wathoni Usman Perawat 15 25,000 375,000 375,000 7. ___________
JUMLAH 2,375,000
Terbilang: Dua Juta Tiga Ratus Tujuh Puluh Lima Ribu Rupiah

Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

HJ. BARI'AH, S.Kep NURHAYATI, ST

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

DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS

DALAM RANGKA KEGIATAN PELAYANAN BULAN IMUNISASI ANAK SEKOLAH (BIAS) SD / MI
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

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. TRANSP JML. UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI ORT/HAR TRANSPORT
TERIMA
I
1 2 3 4 5 6 7 8
1 H. Seman Vaksinator 7 25,000 175,000 175,000 1. __________
2 H. Ridwan Perawat 7 25,000 175,000 175,000 2 ___________
 3 Lalu Wathoni Usman Perawat 4 25,000 100,000 100,000 3. __________
4 Rena Noviarni Perawat 4 25,000 100,000 100,000 4 ___________
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,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

H. SEJARAH, S.Sos NURHAYATI, ST

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

DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS

DALAM RANGKA KEGIATAN PELAYANAN BULAN IMUNISASI ANAK SEKOLAH (BIAS) SD / MI
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR
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. TRANSP JML. UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI ORT/HAR TRANSPORT
TERIMA
I
1 2 3 4 5 6 7 8
1 H. Seman Vaksinator 7 25,000 175,000 175,000 1. __________
2 H. Ridwan Perawat 7 25,000 175,000 175,000 2 ___________
3 Lalu Wathoni Usman Perawat 4 25,000 100,000 100,000 3. __________
4 Rena Noviarni Perawat 4 25,000 100,000 100,000 4 ___________
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,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas
 HJ. BARI'AH, S.Kep NURHAYATI, ST
NIP. 19641231 198511 2 040 NIP. 19751212 199603 2 002
 DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS
DALAM RANGKA KEGIATAN PELAYANAN P4K DI DESA SAKRA BARAT
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

Tanggal: 1, 2, 3, 4, 6, 7, 8, 9, 10, 11, 13, 14, 15, 16, 17, 18, 20, 21, 22, 23, 24, 25, 27 Februari 2017
JML.
UANG JUMLAH
JML. UANG
NO NAMA JABATAN TRANSPO UANG DI TANDA TANGAN
HARI TRANSPO
RT/HARI TERIMA
RT
1 2 3 4 5 6 7 8
1 Nurul Hikmah Bidan 9 30,000 270,000 270,000 1. __________
2 Bq. Husnul Khotimah Bidan 3 15,000 45,000 45,000 2 ___________
3 Yuli Hariani Bidan 3 15,000 45,000 45,000 3. __________
4 Sami Hartini Bidan 4 15,000 60,000 60,000 4 ___________
5 Desi Arisanti Bidan 3 15,000 45,000 45,000 5. __________
6 Dyta Ayu F. Bidan 8 15,000 120,000 120,000 6 ___________
7 Ayati Bidan 5 15,000 75,000 75,000 7. ___________
8 Sri Hayuni Bidan 4 15,000 60,000 60,000 8. ___________
9 Bq. Laxmi Zahara Bidan 9 15,000 135,000 135,000 9. __________
10 Ririn Yuliari Bidan 5 15,000 75,000 75,000 10 ___________
11 Jalilatussa'ni Bidan 5 15,000 75,000 75,000 11. __________
12 Daeng Sri Handayani Bidan 3 15,000 45,000 45,000 12___________
13 Bq. Nurdiana Bidan 3 15,000 45,000 45,000 13. ___________
14 Riza Novatul H. Bidan 8 15,000 120,000 120,000 14. ___________
15 Luqluil Wardah Bidan 4 15,000 60,000 60,000 15. __________
16 Irma Januarti Bidan 8 15,000 120,000 120,000 16 ___________
17 Siti Rabiatun A. Bidan 7 15,000 105,000 105,000 17. ___________
18 Fatimatuzzuhrah Bidan 5 15,000 75,000 75,000 18. ___________
JUMLAH 1,575,000
Terbilang: Satu juta lima ratus tujuh puluh lima ribu rupiah
 Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

H. SEJARAH, S.Sos NURHAYATI, ST

NIP. 19661231 198603 1 093 NIP. 19751212 199603 2 002
 DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS
DALAM RANGKA KEGIATAN PELAYANAN SDIDTK DI POSYANDU
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

Tanggal: 1, 2, 4, 6, 7, 8, 9, 11, 13, 14, 15, 16, 18, 20, 21, 22, 23, 25, 27
UANG JML.
JUMLAH
JML. TRANS UANG
NO NAMA JABATAN UANG DI
HARI PORT/ TRANSPO
TERIMA
HARI RT
1 2 3 4 5 6 7
1 Wiwin Ratna Utami Bidan 9 30,000 270,000 270,000
2 Bq. Husnul Khotimah Bidan 3 15,000 45,000 45,000
3 Yuli Hariani Bidan 3 15,000 45,000 45,000
4 Nurul Husna Bidan 4 15,000 60,000 60,000
5 Zulfira Riasitafani Bidan 3 15,000 45,000 45,000
6 Nila Sari Bidan 8 15,000 120,000 120,000
7 Ayati Bidan 5 15,000 75,000 75,000
8 Sri Hayuni Bidan 4 15,000 60,000 60,000
9 Bq. Laxmi Zahara Bidan 9 15,000 135,000 135,000
10 Ririn Yuliari Bidan 5 15,000 75,000 75,000
11 Ida Yulianti Bidan 5 15,000 75,000 75,000
12 Hidayati Bidan 3 15,000 45,000 45,000
13 Hidayati Bidan 3 15,000 45,000 45,000
14 Nurul Hidayati Bidan 8 15,000 120,000 120,000
15 Nurlina Assauni Bidan 4 15,000 60,000 60,000
16 Een Aprianti Bidan 8 15,000 120,000 120,000
17 Fitria Susana Dewi Bidan 7 15,000 105,000 105,000
18 Fatimatuzzuhrah Bidan 5 15,000 75,000 75,000
JUMLAH 1,575,000
Terbilang: Satu juta lima ratus tujuh puluh lima ribu ru

Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

H. SEJARAH, S.Sos NURHAYATI, ST

NIP. 19661231 198603 1 093 NIP. 19751212 199603 2 002
LANAN PETUGAS
DTK DI POSYANDU
MBOK TIMUR

TANDA TANGAN

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

ratus tujuh puluh lima ribu rupiah

LUNAS DIBAYAR
Bendahara BOK Puskesmas

NURHAYATI, ST
NIP. 19751212 199603 2 002
 DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS
DALAM RANGKA KEGIATAN PELAYANAN ANC IBU HAMIL DI DESA SAKRA BARAT
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

Tanggal: 1, 2, 4, 6, 7, 8, 9, 11, 13, 14, 15, 16, 18, 20, 21, 22, 23, 25,27 Maret 2017
UANG
JML. UANG JUMLAH
JML. TRANSP
NO NAMA JABATAN TRANSPOR UANG DI TANDA TANGAN
HARI ORT/HAR
T TERIMA
I
1 2 3 4 5 6 7 8
1 Nurul Hikmah Bidan 9 30,000 270,000 270,000 1. __________
2 Sami Hartini Bidan 3 15,000 45,000 45,000 2 ___________
3 Novi Rizkia H. Bidan 3 15,000 45,000 45,000 3. __________
4 Sami Hartini Bidan 4 15,000 60,000 60,000 4 ___________
5 Desi Arisanti Bidan 3 15,000 45,000 45,000 5. __________
6 Dyta Ayu F. Bidan 8 15,000 120,000 120,000 6 ___________
7 Hidayati Bidan 5 15,000 75,000 75,000 7. ___________
8 Muslihan Bidan 4 15,000 60,000 60,000 8. ___________
9 Dita puspita H. Bidan 9 15,000 135,000 135,000 9. __________
10 Ida yulianti Bidan 5 15,000 75,000 75,000 10 ___________
11 Jalilatussa'ni Bidan 5 15,000 75,000 75,000 11. __________
12 Daeng Sri Handayani Bidan 3 15,000 45,000 45,000 12___________
13 Bq. Nurdiana Bidan 3 15,000 45,000 45,000 13. ___________
14 Riza Novatul H. Bidan 8 15,000 120,000 120,000 14. ___________
15 Luqluil Wardah Bidan 4 15,000 60,000 60,000 15. __________
16 Irma Januarti Bidan 8 15,000 120,000 120,000 16 ___________
17 Siti Rabiatun A. Bidan 7 15,000 105,000 105,000 17. ___________
18 Siti Rabiatun A. Bidan 5 15,000 75,000 75,000 18. ___________
JUMLAH 1,575,000
Terbilang: Satu juta lima ratus tujuh puluh lima ribu rupiah
 Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

H. SEJARAH, S.Sos NURHAYATI, ST

NIP. 19661231 198603 1 093 NIP. 19751212 199603 2 002
 DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS
DALAM RANGKA KEGIATAN PELAYANAN SDIDTK DI POSYANDU
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

Tanggal: 3, 4, 5, 6, 8, 10, 11, 12, 13, 15, 17, 18, 19, 20, 22, 25, 26 dan 27 April 2017
UANG JML.
JUMLAH
JML. TRANSP UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI ORT/HA TRANSPO
TERIMA
RI RT
1 2 3 4 5 6 7 8
1 Wiwin Ratna Utami Bidan 9 30,000 270,000 270,000 1. __________
2 Hidayati Bidan 3 15,000 45,000 45,000 2 ___________
3 Novi Rizki H. Bidan 3 15,000 45,000 45,000 3. __________
4 Sami Hartini Bidan 4 15,000 60,000 60,000 4 ___________
5 Zulfira Riasitafani Bidan 3 15,000 45,000 45,000 5. __________
6 Nila Sari Bidan 8 15,000 120,000 120,000 6 ___________
7 Ayati Bidan 5 15,000 75,000 75,000 7. ___________
8 Sri Hayuni Bidan 4 15,000 60,000 60,000 8. ___________
9 Bq. Laxmi Zahara Bidan 9 15,000 135,000 135,000 9. __________
10 Lia Mardiana Bidan 5 15,000 75,000 75,000 10 ___________
11 Ida Yulianti Bidan 5 15,000 75,000 75,000 11. __________
12 Hidayati Bidan 3 15,000 45,000 45,000 12___________
13 Hidayati Bidan 3 15,000 45,000 45,000 13. ___________
14 Nurul Hidayati Bidan 8 15,000 120,000 120,000 14. ___________
15 Sisririn Nahrul H. Bidan 4 15,000 60,000 60,000 15. __________
16 Siti Rauhul H. Bidan 8 15,000 120,000 120,000 16 ___________
17 Fitria Susana Dewi Bidan 7 15,000 105,000 105,000 17. ___________
18 Siti Factmayaro Haar Bidan 5 15,000 75,000 75,000 18. ___________
JUMLAH 1,575,000
Terbilang: Satu juta lima ratus tujuh puluh lima ribu rupiah
 Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

H. SEJARAH, S.Sos NURHAYATI, ST

NIP. 19661231 198603 1 093 NIP. 19751212 199603 2 002
 DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS
DALAM RANGKA KEGIATAN PELAYANAN ANC IBU HAMIL DI DESA SAKRA BARAT
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

Tanggal: 3, 4, 5, 6, 8, 10, 11, 12, 13, 15, 17, 18, 19, 20, 22, 25, 26 dan 27 April 2017
UANG JML.
JUMLAH
JML. TRANSP UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI ORT/HA TRANSPO
TERIMA
RI RT
1 2 3 4 5 6 7 8
1 Nurul Hikmah Bidan 9 30,000 270,000 270,000 1. __________
2 Bq. Husnul Khotimah Bidan 3 15,000 45,000 45,000 2 ___________
3 Juli Hariani Bidan 3 15,000 45,000 45,000 3. __________
4 Nurul Husna Bidan 4 15,000 60,000 60,000 4 ___________
5 Desi Arisanti Bidan 3 15,000 45,000 45,000 5. __________
6 Dyta Ayu F. Bidan 8 15,000 120,000 120,000 6 ___________
7 Zulfira Riasitafani Bidan 5 15,000 75,000 75,000 7. ___________
8 Muslihan Bidan 4 15,000 60,000 60,000 8. ___________
9 Dita puspita H. Bidan 9 15,000 135,000 135,000 9. __________
10 Ririn Yuliari Bidan 5 15,000 75,000 75,000 10 ___________
11 Jalilatussa'ni Bidan 5 15,000 75,000 75,000 11. __________
12 Daeng Sri Handayani Bidan 3 15,000 45,000 45,000 12___________
13 Bq. Nurdiana Bidan 3 15,000 45,000 45,000 13. ___________
14 Riza Novatul H. Bidan 8 15,000 120,000 120,000 14. ___________
15 Luqluil Wardah Bidan 4 15,000 60,000 60,000 15. __________
16 Irma Januarti Bidan 8 15,000 120,000 120,000 16 ___________
17 Siti Rabiatun A. Bidan 7 15,000 105,000 105,000 17. ___________
18 Fatimatuzzohrah Bidan 5 15,000 75,000 75,000 18. ___________
JUMLAH 1,575,000
Terbilang: Satu juta lima ratus tujuh puluh lima ribu rupiah
 Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

H. SEJARAH, S.Sos NURHAYATI, ST

NIP. 19661231 198603 1 093 NIP. 19751212 199603 2 002
 DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS
DALAM RANGKA KEGIATAN PELAYANAN SDIDTK DI POSYANDU
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

Tanggal:2, 3, 4, 5, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 20, 22, 23, 24,26, 27, 29, 30 dan 31 Mei 2017
UANG JML.
JUMLAH
JML. TRANS UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI PORT/ TRANSPO
TERIMA
HARI RT
1 2 3 4 5 6 7 8
1 Wiwin Ratna Utami Bidan 9 30,000 270,000 270,000 1. __________
2 Sami Hartini Bidan 3 15,000 45,000 45,000 2 ___________
3 Novi Rizki H. Bidan 3 30,000 90,000 90,000 3. __________
4 Sami Hartini Bidan 4 15,000 60,000 60,000 4 ___________
5 Zulfira Riasitafani Bidan 3 30,000 90,000 90,000 5. __________
6 Dyta Ayu F. Bidan 8 15,000 120,000 120,000 6 ___________
7 Ayati Bidan 5 15,000 75,000 75,000 7. ___________
8 Muslihan Bidan 4 30,000 120,000 120,000 8. ___________
9 Bq. Laxmi Zahara Bidan 9 15,000 135,000 135,000 9. __________
10 Lia Mardiana Bidan 5 30,000 150,000 150,000 10 ___________
11 Ida Yulianti Bidan 5 30,000 150,000 150,000 11. __________
12 Hidayati Bidan 3 30,000 90,000 90,000 12___________
13 Hidayati Bidan 3 15,000 45,000 45,000 13. ___________
14 Riza Novatul H. Bidan 8 15,000 120,000 120,000 14. ___________
15 Sisririn Nahrul H. Bidan 4 30,000 120,000 120,000 15. __________
16 Irma Januarti Bidan 8 15,000 120,000 120,000 16 ___________
17 Fitria Susana Dewi Bidan 7 15,000 105,000 105,000 17. ___________
18 Siti Factmayaro Haar Bidan 5 15,000 75,000 75,000 18. ___________
JUMLAH 1,980,000
Terbilang: Satu juta sembilan ratus delapan puluh ribu rupiah
 Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

H. SEJARAH, S.Sos NURHAYATI, ST

NIP. 19661231 198603 1 093 NIP. 19751212 199603 2 002
 DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS
DALAM RANGKA KEGIATAN PELAYANAN ANC IBU HAMIL DI DESA SAKRA BARAT
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

Tanggal:2, 3, 4, 5, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 20, 22, 23, 24,26, 27, 29, 30 dan 31 Mei 2017
UANG JML.
JUMLAH
JML. TRANS UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI PORT/ TRANSPOR
TERIMA
HARI T
1 2 3 4 5 6 7 8
1 Nurul Hikmah Bidan 9 30,000 270,000 270,000 1. __________
2 Bq. Husnul Khotimah Bidan 3 15,000 45,000 45,000 2 ___________
3 Juli Hariani Bidan 3 15,000 45,000 45,000 3. __________
4 Nurul Husna Bidan 4 15,000 60,000 60,000 4 ___________
5 Desi Arisanti Bidan 3 15,000 45,000 45,000 5. __________
6 Nila Sari Bidan 8 15,000 120,000 120,000 6 ___________ p
7 Zulfira Riasitafani Bidan 5 15,000 75,000 75,000 7. ___________
8 Bq. Susiarni Bidan 4 15,000 60,000 60,000 8. ___________
9 Dita puspita H. Bidan 9 15,000 135,000 135,000 9. __________
10 Zulfira Riasitafani Bidan 5 15,000 75,000 75,000 10 ___________
11 Jalilatussa'ni Bidan 5 15,000 75,000 75,000 11. __________
12 Daeng Sri Handayani Bidan 3 15,000 45,000 45,000 12___________
13 Bq. Nurdiana Bidan 3 15,000 45,000 45,000 13. ___________
14 Nurul Hidayati Bidan 8 15,000 120,000 120,000 14. ___________
15 Luqluil Wardah Bidan 4 15,000 60,000 60,000 15. __________
16 Siti Rauhil H. Bidan 8 15,000 120,000 120,000 16 ___________
17 Siti Rabiatun A. Bidan 7 15,000 105,000 105,000 17. ___________
18 Fatimatuzzohrah Bidan 5 15,000 75,000 75,000 18. ___________
JUMLAH 1,575,000
Terbilang: Satu juta lima ratus tujuh puluh lima ribu rupiah
 Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

H. SEJARAH, S.Sos NURHAYATI, ST

NIP. 19661231 198603 1 093 NIP. 19751212 199603 2 002
 DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS
DALAM RANGKA KEGIATAN PELAYANAN SDIDTK DI POSYANDU
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

Tanggal: 3, 5, 6, 7, 8, 10, 12, 13, 14, 15, 16, 17, 19, 20, 21, dan 22 Juni 2017
UANG JML.
JUMLAH
JML. TRANSP UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI ORT/HA TRANSPO
TERIMA
RI RT
1 2 3 4 5 6 7 8
1 Wiwin Ratna Utami Bidan 9 30,000 270,000 270,000 1. __________
2 Een Aprianti Bidan 3 15,000 45,000 45,000 2 ___________
3 Novi Rizki H. Bidan 3 15,000 45,000 45,000 3. __________
4 Sami Hartini Bidan 4 15,000 60,000 60,000 4 ___________
5 Zulfira Riasitafani Bidan 3 15,000 45,000 45,000 5. __________
6 Nila Sari Bidan 8 15,000 120,000 120,000 6 ___________
7 Ayati Bidan 5 15,000 75,000 75,000 7. ___________
8 Bq. Susiyarni Bidan 4 15,000 60,000 60,000 8. ___________
9 Bq. Laxmi Zahara Bidan 9 15,000 135,000 135,000 9. __________
10 Lia Mardiana Bidan 5 15,000 75,000 75,000 10 ___________
11 Ida Yulianti Bidan 5 15,000 75,000 75,000 11. __________
12 Hidayati Bidan 3 15,000 45,000 45,000 12___________
13 Nurlina Assauni Bidan 3 15,000 45,000 45,000 13. ___________
14 Riza Novatul H. Bidan 8 15,000 120,000 120,000 14. ___________
15 Sisririn Nahrul H. Bidan 4 15,000 60,000 60,000 15. __________
16 Irma Januarti Bidan 8 15,000 120,000 120,000 16 ___________
17 Fitria Susana Dewi Bidan 7 15,000 105,000 105,000 17. ___________
18 Siti Factmayaro Haar Bidan 5 15,000 75,000 75,000 18. ___________
JUMLAH 1,575,000
Terbilang: Satu juta lima ratus tujuh puluh lima ribu rupiah
 Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

H. SEJARAH, S.Sos NURHAYATI, ST

NIP. 19661231 198603 1 093 NIP. 19751212 199603 2 002
 DAFTAR PENERIMAAN TRANSPORT PERJALANAN PETUGAS
DALAM RANGKA KEGIATAN PELAYANAN ANC IBU HAMIL DI DESA SAKRA BARAT
PUSKESMAS RENSING KABUPATEN LOMBOK TIMUR

Tanggal: 3, 5, 6, 7, 8, 10, 12, 13, 14, 15, 16, 17, 19, 20, 21, dan 22 Juni 2017
UANG JML.
JUMLAH
JML. TRANSP UANG
NO NAMA JABATAN UANG DI TANDA TANGAN
HARI ORT/HA TRANSP
TERIMA
RI ORT
1 2 3 4 5 6 7 8
1 Nurul Hikmah Bidan 9 30,000 270,000 270,000 1. __________
2 Bq. Husnul Khotimah Bidan 3 15,000 45,000 45,000 2 ___________
3 Juli Hariani Bidan 3 15,000 45,000 45,000 3. __________
4 Nurul Husna Bidan 4 15,000 60,000 60,000 4 ___________
5 Desi Arisanti Bidan 3 15,000 45,000 45,000 5. __________
6 Dyta Ayu Fitriana Bidan 8 15,000 120,000 120,000 6 ___________
7 Zulfira Riasitafani Bidan 5 15,000 75,000 75,000 7. ___________
8 Sri Hayuni Bidan 4 15,000 60,000 60,000 8. ___________
9 Dita puspita H. Bidan 9 15,000 135,000 135,000 9. __________
10 Zulfira Riasitafani Bidan 5 15,000 75,000 75,000 10 ___________
11 Jalilatussa'ni Bidan 5 15,000 75,000 75,000 11. __________
12 Daeng Sri Handayani Bidan 3 15,000 45,000 45,000 12___________
13 Bq. Nurdiana Bidan 3 15,000 45,000 45,000 13. ___________
14 Nurul Hidayati Bidan 8 15,000 120,000 120,000 14. ___________
15 Luqluil Wardah Bidan 4 15,000 60,000 60,000 15. __________
16 Siti Rauhil H. Bidan 8 15,000 120,000 120,000 16 ___________
17 Siti Rabiatun A. Bidan 7 15,000 105,000 105,000 17. ___________
18 Fatimatuzzohrah Bidan 5 15,000 75,000 75,000 18. ___________
JUMLAH 1,575,000
Terbilang: Satu juta lima ratus tujuh puluh lima ribu rupiah
 Selong,
Setuju Dibayar LUNAS DIBAYAR
Kepala Puskesmas Rensing Bendahara BOK Puskesmas

H. SEJARAH, S.Sos NURHAYATI, ST

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