PEMERINTAH KABUPATEN GIANYAR

DINAS KESEHATAN
BUKU PENERIMAAN/PENYETORAN
BENDAHARA PEMBANTU PENERIMAAN
SKPD : UPT. KESMAS SUKAWATI II
Periode : Januari TA. 2017

Penerimaan
No Cara Kode
Tgl. No. Bukt Uraian Jumlah
Pembayaran Rekening
1 2 3 4 5 6 7
1 2/1/2017 BP/001/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 795,000.00
2 3/1/2017 BP/002/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,120,000.00
3 4/1/2017 BP/003/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 890,000.00
4 5/1/2017 BP/004/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,175,000.00
transfer dari Pendapatan Klaim IVA BPJS
5 5/1/2017 BP/005/I/2017 rek.BPJS 900,000.00
4.1.4.16.01 bulan Oktober 2016
transfer dari Pendapatan Klaim KB BPJS
6 5/1/2017 BP/006/I/2017 30,000.00
rek.BPJS 4.1.4.16.01 bulan Oktober 2016
7 6/1/2017 BP/007/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 850,000.00
8 7/1/2017 BP/008/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,050,000.00
9 9/1/2017 BP/009/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,635,000.00
10 10/1/2017 BP/010/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,770,000.00
11 11/1/2017 BP/011/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,335,000.00
12 12/1/2017 BP/012/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 975,000.00
13 13/1/2017 BP/013/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,255,000.00
transfer dari Kapitasi BPJS bulan Januari
14 13/1/2017 BP/014/I/2017 49,099,000.00
rek.BPJS 4.1.4.16.01 2017
15 14/1/2017 BP/015/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 875,000.00
16 16/12017 BP/016/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,485,000.00
17 17/1/2017 BP/017/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 905,000.00
18 18/1/2017 BP/018/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,165,000.00
19 19/1/2017 BP/019/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,210,000.00
20 20/1/2017 BP/020/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 765,000.00
21 23/1/2017 BP/021/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,610,000.00
transfer dari Pendapatan Klaim KB BPJS
22 23/1/2017 BP/022/I/2017 405,000.00
rek.BPJS 4.1.4.16.01 bulan Nopember 2016
23 24/1/2017 BP/023/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,060,000.00
24 26/1/2017 BP/024/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 745,000.00
25 27/1/2017 BP/025/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 570,000.00
26 30/1/2017 BP/026/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 1,665,000.00
27 31/1/2017 BP/027/I/2017 tunai 4.1.4.16.01 Pendapatan yankes umum 675,000.00
28 31/1/2017 BP/028/I/2017 4.1.4.16.01 Jasa Giro bulan Januari 2017 285,341.92
JUMLAH 76,299,341.92

Jumlah Penerimaan : Rp. 76.299.341,92

Jumlah yang disetorkan : Rp. 76.299.341,92
Saldo Kas di Bendahara Penerimaan : Rp. 0;
Terdiri atas :
a. Tunai sebesar Rp. 0;
b. Bank sebesar Rp. 0;
c. Lainnya Rp. 0;

Mengetahui
Kuasa Pengguna Anggaran
( dr. Ida Bagus Ketut Sugamia )
NIP. 19680914 19903 1 008
IANYAR

ETORAN
ERIMAAN

Penyetoran
Tgl. No. STS Jumlah Ket

8 9 10 11
3/1/2017 STS/001/I/2017 795,000.00
3/1/2017 STS/002/I/2017 1,120,000.00
4/1/2017 STS/003/I/2017 890,000.00
5/1/2017 STS/004/I/2017 1,175,000.00
900,000.00
5/1/2017 STS/005/I/2017
30,000.00
5/1/2017 STS/006/I/2017
6/1/2017 STS/007/I/2017 850,000.00
9/1/2017 STS/008/I/2017 1,050,000.00
9/1/2017 STS/009/I/2017 1,635,000.00
10/1/2017 STS/010/I/2017 1,770,000.00
11/1/2017 STS/011/I/2017 1,335,000.00
12/1/2017 STS/012/I/2017 975,000.00
13/1/2017 STS/013/I/2017 1,255,000.00
13/1/2017 STS/014/I/2017 49,099,000.00

16/1/2017 STS/015/I/2017 875,000.00

16/1/2017 STS/016/I/2017 1,485,000.00
17/1/2017 STS/017/2017 905,000.00
18/1/2017 STS/018/I/2017 1,165,000.00
19/12017 STS/019/I/2017 1,210,000.00
20/1/2017 STS/020/I/2017 765,000.00
23/1/2017 STS/021/I/2017 1,610,000.00

23/1/2017 STS/022/I/2017 405,000.00

24/1/2017 STS/023/I/2017 1,060,000.00

26/1/2017 STS/024/I/2017 745,000.00
27/1/2017 STS/025/I/2017 570,000.00
30/1/2017 STS/026/I/2017 1,665,000.00
31/1/2017 STS/027/I/2017 675,000.00
31/1/2017 STS/028/I/2017 285,341.92
76,299,341.92

Gianyar, 31 Januari 2017

Bendahara Pembantu Penerimaan
Ni Wayan Eka Juniawati, A.Md.Kep
NIP. 19840608 200604 2 013
 PEMERINTAH KABUPATEN GIANYAR
DINAS KESEHATAN
BUKU PENERIMAAN/PENYETORAN
BENDAHARA PEMBANTU PENERIMAAN
SKPD : UPT. KESMAS SUKAWATI II
Periode : Februari TA. 2017

Penerimaan
No Cara Kode
Tgl. No. Bukt Uraian Jumlah
Pembayaran Rekening
1 2 3 4 5 6 7
1 1-Feb-17 BP/029/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,040,000.00
2 2-Feb-17 BP/030/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 740,000.00
3 3-Feb-17 BP/030/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 830,000.00
4 4-Feb-17 BP/031/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tgl Rp 605,000.00
5 6-Feb-17 BP/032/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,515,000.00

transfer dari 4.1.4.16.01 Pendapatan Piutang Klaim KB Rp

6 6-Feb-17 BP/033/II/2017 120,000.00
rek.BPJS BPJS bulan Agustus 2016

7 7-Feb-17 BP/034/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,140,000.00

Pendapatan Piutang Klaim
transfer dari
8 7-Feb-17 BP/035/II/2017 4.1.4.16.01 IVA BPJS bulan Desember Rp 225,000.00
rek.BPJS 2016

transfer dari 4.1.4.16.01 Pendapatan Piutang Klaim KB Rp

9 7-Feb-17 BP/036/II/2017 130,000.00
rek.BPJS BPJS bulan Desember 2016

10 8-Feb-17 BP/037/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,185,000.00

11 9-Feb-17 BP/038/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,240,000.00
12 10-Feb-17 BP/039/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 830,000.00
13 11-Feb-17 BP/040/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tangRp 600,000.00
14 13-Feb-17 BP/041/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,295,000.00
15 14-Feb-17 BP/042/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 905,000.00
4.1.4.16.01 Kapitasi BPJS bulan Februari Rp 50,269,000.00
16 14-Feb-17 BP/043/II/2017 tunai 2017
17 16-Feb-17 BP/044/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,310,000.00
18 17-Feb-17 BP/045/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,040,000.00
19 18-Feb-17 BP/046/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tangRp 770,000.00
20 20-Feb-17 BP/047/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,485,000.00
21 21-Feb-17 BP/048/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,530,000.00
22 22-Feb-17 BP/049/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 770,000.00
23 23-Feb-17 BP/050/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,315,000.00
24 24-Feb-17 BP/051/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 940,000.00
25 25-Feb-17 BP/052/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tangRp 895,000.00
26 27-Feb-17 BP/053/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,525,000.00
27 28-Feb-17 BP/054/II/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 810,000.00
28 28-Feb-17 BP/055/II/2017 4.1.4.16.01 Jasa Giro bulan Februari 2017 Rp 441,745.09

JUMLAH Rp 75,500,745.09

Jumlah Penerimaan Rp 75,500,745.09

Jumlah yang disetorkan Rp 75,500,745.09
Saldo Kas di Bendahara Penerimaan Rp -
Terdiri atas :
a. Tunai sebesar Rp. 0;
b. Bank sebesar Rp. 0;
c. Lainnya Rp. 0;
 Mengetahui
Kuasa Pengguna Anggaran

( dr. Ida Bagus Ketut Sugamia )

NIP. 19680914 19903 1 008
IANYAR

ETORAN
ERIMAAN

Penyetoran
Tgl. No. STS Jumlah Ket

8 9 10 11
1-Feb-17 STS/029/II/2017 Rp 1,040,000.00
2-Feb-17 STS/030/II/2017 Rp 740,000.00
3-Feb-17 STS/030/II/2017 Rp 830,000.00
6-Feb-17 STS/031/II/2017 Rp 605,000.00
6-Feb-17 STS/032/II/2017 Rp 1,515,000.00

6-Feb-17 STS/033/II/2017 Rp 120,000.00

7-Feb-17 STS/034/II/2017 Rp 1,140,000.00

7-Feb-17 STS/035/II/2017 Rp 225,000.00

7-Feb-17 STS/036/II/2017 Rp 130,000.00

8-Feb-17 STS/037/II/2017 Rp 1,185,000.00

9-Feb-17 STS/038/II/2017 Rp 1,240,000.00
10-Feb-17 STS/039/II/2017 Rp 830,000.00
13-Feb-17 STS/040/II/2017 Rp 600,000.00
13-Feb-17 STS/041/II/2017 Rp 1,295,000.00
14-Feb-17 STS/042/II/2017 Rp 905,000.00

14-Feb-17 STS/043/II/2017 Rp 50,269,000.00

16-Feb-17 STS/044/II/2017 Rp 1,310,000.00

17-Feb-17 STS/045/II/2017 Rp 1,040,000.00
20-Feb-17 STS/046/II/2017 Rp 770,000.00
20-Feb-17 STS/047/II/2017 Rp 1,485,000.00
21-Feb-17 STS/048/II/2017 Rp 1,530,000.00
22-Feb-17 STS/049/II/2017 Rp 770,000.00
23-Feb-17 STS/050/II/2017 Rp 1,315,000.00
24-Feb-17 STS/051/II/2017 Rp 940,000.00
27-Feb-17 STS/052/II/2017 Rp 895,000.00
27-Feb-17 STS/053/II/2017 Rp 1,525,000.00
28-Feb-17 STS/054/II/2017 Rp 810,000.00

28-Feb-17 STS/055/II/2017 Rp 441,745.09

Rp 75,500,745.09
 Gianyar, 31 Januari 2017
Bendahara Pembantu Penerimaan

Ni Wayan Eka Juniawati, A.Md.Kep

NIP. 19840608 200604 2 013
 PEMERINTAH KABUPATEN GIANYAR
DINAS KESEHATAN
BUKU PENERIMAAN/PENYETORAN
BENDAHARA PEMBANTU PENERIMAAN
SKPD : UPT. KESMAS SUKAWATI II
Periode : Maret TA. 2017

Penerimaan
No Cara Kode
Tgl. No. Bukt Uraian Jumlah
Pembayaran Rekening
1 2 3 4 5 6 7
1 1-Mar-17 BP/056/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 795,000.00
2 2-Mar-17 BP/057/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,120,000.00
3 3-Mar-17 BP/058/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 660,000.00
4 4-Mar-17 BP/059/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tanRp 1,005,000.00
5 6-Mar-17 BP/060/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,385,000.00
6 7-Mar-17 BP/061/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,015,000.00
7 8-Mar-17 BP/062/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,550,000.00
8 9-Mar-17 BP/063/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 880,000.00
9 10-Mar-17 BP/064/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 935,000.00
10 11-Mar-17 BP/065/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tan Rp 820,000.00
11 13-Mar-17 BP/066/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,550,000.00
12 14-Mar-17 BP/067/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 890,000.00
13 15-Mar-17 BP/068/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 600,000.00
transfer dari 4.1.4.16.01 Kapitasi BPJS bulan Maret
14 15-Mar-17 BP/069/III/2017 Rp 53,407,000.00
rek.BPJS 2017
15 16-Mar-17 BP/070/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 820,000.00
16 17-Mar-17 BP/071/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 920,000.00
17 18-Mar-17 BP/072/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tan Rp 605,000.00
18 20-Mar-17 BP/073/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,255,000.00
19 21-Mar-17 BP/074/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,650,000.00
20 22-Mar-17 BP/075/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 820,000.00
21 23-Mar-17 BP/076/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,125,000.00
22 24-Mar-17 BP/077/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 875,000.00
23 25-Mar-17 BP/078/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tan Rp 590,000.00
24 30-Mar-17 BP/079/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 900,000.00
25 31-Mar-17 BP/080/III/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 690,000.00
26 31-Mar-17 BP/081/III/2017 4.1.4.16.01 JAGIR Bulan Maret 2016 Rp 564,346.44
JUMLAH Rp 77,426,346.44

Jumlah Penerimaan Rp 77,426,346.44

Jumlah yang disetorkan Rp 77,426,346.44
Saldo Kas di Bendahara Penerimaan Rp -
Terdiri atas :
a. Tunai sebesar Rp. 0;
b. Bank sebesar Rp. 0;
c. Lainnya Rp. 0;

Mengetahui
Kuasa Pengguna Anggaran

( dr. Ida Bagus Ketut Sugamia )

NIP. 19680914 19903 1 008
IANYAR

ETORAN
ERIMAAN

Penyetoran
Tgl. No. STS Jumlah Ket

8 9 10 11
1-Mar-17 STS/056/III/2017 Rp 795,000.00
2-Mar-17 STS/057/III/2017 Rp 1,120,000.00
3-Mar-17 STS/058/III/2017 Rp 660,000.00
6-Mar-17 STS/059/III/2017 Rp 1,005,000.00
6-Mar-17 STS/060/III/2017 Rp 1,385,000.00
7-Mar-17 STS/061/III/2017 Rp 1,015,000.00
8-Mar-17 STS/062/III/2017 Rp 1,550,000.00
9-Mar-17 STS/063/III/2017 Rp 880,000.00
10-Mar-17 STS/064/III/2017 Rp 935,000.00
13-Mar-17 STS/065/III/2017 Rp 820,000.00
13-Mar-17 STS/066/III/2017 Rp 1,550,000.00
14-Mar-17 STS/067/III/2017 Rp 890,000.00
15-Mar-17 STS/068/III/2017 Rp 600,000.00

15-Mar-17 STS/069/III/2017 Rp 53,407,000.00

16-Mar-17 STS/070/III/2017 Rp 820,000.00

17-Mar-17 STS/071/III/2017 Rp 920,000.00
20-Mar-17 STS/072/III/2017 Rp 605,000.00
20-Mar-17 STS/073/III/2017 Rp 1,255,000.00
21-Mar-17 STS/074/III/2017 Rp 1,650,000.00
22-Mar-17 STS/075/III/2017 Rp 820,000.00
23-Mar-17 STS/076/III/2017 Rp 1,125,000.00
24-Mar-17 STS/077/III/2017 Rp 875,000.00
30-Mar-17 STS/078/III/2017 Rp 590,000.00
30-Mar-17 STS/079/III/2017 Rp 900,000.00
31-Mar-17 STS/080/III/2017 Rp 690,000.00
31-Mar-17 STS/081/III/2017 Rp 564,346.44
Rp 77,426,346.44

Gianyar, 31 Januari 2017

Bendahara Pembantu Penerimaan

Ni Wayan Eka Juniawati, A.Md.Kep

NIP. 19840608 200604 2 013
 PEMERINTAH KABUPATEN GIANYAR
DINAS KESEHATAN
BUKU PENERIMAAN/PENYETORAN
BENDAHARA PEMBANTU PENERIMAAN
SKPD : UPT. KESMAS SUKAWATI II
Periode : April TA. 2017

Penerimaan
No Cara Kode
Tgl. No. Bukt Uraian Jumlah
Pembayaran Rekening
1 2 3 4 5 6 7
1 3-Apr-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tangRp 670,000.00
2 3-Apr-17 BP/083/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,040,000.00
transfer dari 4.1.4.16.01 Pendapatan Klaim KB BPJS
3 4-Apr-17 BP/084/IV/2017 Rp 55,000.00
rek.BPJS bulan Januari 2017
4 7-Apr-17 BP/085/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 750,000.00
5 10-Apr-17 BP/086/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tangRp 725,000.00
6 10-Apr-17 BP/087/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,820,000.00
7 11-Apr-17 BP/088/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,140,000.00
8 12-Apr-17 BP/089/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 805,000.00
9 13-Apr-17 BP/090/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,145,000.00
transfer dari 4.1.4.16.01 Pendapatan Kapitasi BPJS
10 13-Apr-17 Rp 52,053,100.00
BP/091/IV/2017 rek.BPJS bulan April 2017
11 17-Apr-17 BP/092/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,495,000.00
12 18-Apr-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,255,000.00
13 19-Apr-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,300,000.00
14 20-Apr-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 960,000.00
15 21-Apr-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 625,000.00
16 25-Apr-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 780,000.00
17 25-Apr-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 985,000.00
18 26-Apr-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 890,000.00
19 27-Apr-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,190,000.00
20 28-Apr-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 960,000.00
21 28-Apr-17 BP/082/IV/2017 4.1.4.16.01 Jagir Bulan April 2017 Rp 510,959.33
JUMLAH Rp 71,154,059.33

Jumlah Penerimaan Rp 71,154,059.33

Jumlah yang disetorkan Rp 71,154,059.33
Saldo Kas di Bendahara Penerimaan Rp -
Terdiri atas :
a. Tunai sebesar Rp. 0;
b. Bank sebesar Rp. 0;
c. Lainnya Rp. 0;

Mengetahui
Kuasa Pengguna Anggaran

( dr. Ida Bagus Ketut Sugamia )

NIP. 19680914 19903 1 008
IANYAR

ETORAN
ERIMAAN

Penyetoran
Tgl. No. STS Jumlah Ket

8 9 10 11
3-Apr-17 STS/056/IIII/2017 Rp 670,000.00
3-Apr-17 STS/057/IIII/2017 Rp 1,040,000.00

4-Apr-17 STS/058/IIII/2017 Rp 55,000.00

7-Apr-17 STS/059/IIII/2017 Rp 750,000.00

10-Apr-17 STS/060/IIII/2017 Rp 725,000.00
10-Apr-17 STS/061/IIII/2017 Rp 1,820,000.00
11-Apr-17 STS/062/IIII/2017 Rp 1,140,000.00
12-Apr-17 STS/063/IIII/2017 Rp 805,000.00
13-Apr-17 STS/064/IIII/2017 Rp 1,145,000.00

13-Apr-17 STS/065/IIII/2017 Rp 52,053,100.00

17-Apr-17 STS/066/IIII/2017 Rp 1,495,000.00

18-Apr-17 STS/067/IIII/2017 Rp 1,255,000.00
19-Apr-17 STS/068/IIII/2017 Rp 1,300,000.00
20-Apr-17 STS/069/IIII/2017 Rp 960,000.00
21-Apr-17 STS/070/IIII/2017 Rp 625,000.00
25-Apr-17 STS/071/IIII/2017 Rp 780,000.00
25-Apr-17 STS/072/IIII/2017 Rp 985,000.00
26-Apr-17 STS/073/IIII/2017 Rp 890,000.00
27-Apr-17 STS/074/IIII/2017 Rp 1,190,000.00
28-Apr-17 STS/075/IIII/2017 Rp 960,000.00
28-Apr-17 STS/076/IIII/2017 Rp 510,959.33
Rp 71,154,059.33

Gianyar, 31 Januari 2017

Bendahara Pembantu Penerimaan

Ni Wayan Eka Juniawati, A.Md.Kep

NIP. 19840608 200604 2 013
 PEMERINTAH KABUPATEN GIANYAR
DINAS KESEHATAN
BUKU PENERIMAAN/PENYETORAN
BENDAHARA PEMBANTU PENERIMAAN
SKPD : UPT. KESMAS SUKAWATI II
Periode : Mei TA. 2017

Penerimaan
No Cara Kode
Tgl. No. Bukt Uraian Jumlah
Pembayaran Rekening
1 2 3 4 5 6 7
1 2-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tangRp 440,000.00
2 2-May-17 BP/083/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,415,000.00
3 3-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,290,000.00
4 4-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 905,000.00
5 5-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 955,000.00
6 8-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tan Rp 970,000.00
7 8-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,760,000.00
8 9-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 760,000.00
9 10-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 940,000.00
10 12-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,025,000.00
11 15-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tanRp 1,040,000.00
12 15-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,215,000.00
transfer dari
13 15-May-17 BP/082/IV/2017 4.1.4.16.01 Kapitasi BPJS bulan Mei 2017 Rp 51,420,550.00
rek.BPJS
14 16-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,235,000.00
15 17-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 910,000.00
16 18-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,265,000.00
17 19-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,000,000.00
18 22-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum tan Rp 545,000.00
19 22-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 1,345,000.00
20 23-May-17 BP/082/IV/2017 tunai 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 865,000.00
21 24-May-17 BP/082/IV/2017 4.1.4.16.01 Pendapatan Yan Kes Umum Rp 875,000.00
22 26-May-17 Pendapatan Yan Kes Umum Rp 620,000.00
23 29-May-17 Pendapatan Yan Kes Umum tan Rp 470,000.00
24 29-May-17 Pendapatan Yan Kes Umum Rp 1,500,000.00
25 30-May-17 Pendapatan Yan Kes Umum Rp 620,000.00
26 31-May-17 Pendapatan Yan Kes Umum Rp 580,000.00
27 31-May-17 Jasa Giro bulan Mei 2017 Rp 545,256.98
JUMLAH Rp 72,175,550.00

Jumlah Penerimaan ###

Jumlah yang disetorkan ###
Saldo Kas di Bendahara Penerimaan Rp -
Terdiri atas :
a. Tunai sebesar Rp. 0;
b. Bank sebesar Rp. 0;
c. Lainnya Rp. 0;

Mengetahui
Kuasa Pengguna Anggaran

( dr. Ida Bagus Ketut Sugamia )

NIP. 19680914 19903 1 008
IANYAR

ETORAN
ERIMAAN

Penyetoran
Tgl. No. STS Jumlah Ket

8 9 10 11
3-Apr-17 STS/056/IIII/2017 Rp 440,000.00
3-Apr-17 STS/057/IIII/2017 Rp 1,415,000.00
4-Apr-17 STS/058/IIII/2017 Rp 1,290,000.00
7-Apr-17 STS/059/IIII/2017 Rp 905,000.00
10-Apr-17 STS/060/IIII/2017 Rp 955,000.00
10-Apr-17 STS/061/IIII/2017 Rp 970,000.00
11-Apr-17 STS/062/IIII/2017 Rp 1,760,000.00
12-Apr-17 STS/063/IIII/2017 Rp 760,000.00
13-Apr-17 STS/064/IIII/2017 Rp 940,000.00
13-Apr-17 STS/065/IIII/2017 Rp 1,025,000.00
17-Apr-17 STS/066/IIII/2017 Rp 1,040,000.00
18-Apr-17 STS/067/IIII/2017 Rp 1,215,000.00

19-Apr-17 STS/068/IIII/2017 Rp 51,420,550.00

20-Apr-17 STS/069/IIII/2017 Rp 1,235,000.00

21-Apr-17 STS/070/IIII/2017 Rp 910,000.00
25-Apr-17 STS/071/IIII/2017 Rp 1,265,000.00
25-Apr-17 STS/072/IIII/2017 Rp 1,000,000.00
26-Apr-17 STS/073/IIII/2017 Rp 545,000.00
27-Apr-17 STS/074/IIII/2017 Rp 1,345,000.00
28-Apr-17 STS/075/IIII/2017 Rp 865,000.00
28-Apr-17 STS/076/IIII/2017 Rp 875,000.00
Rp 620,000.00
Rp 470,000.00
Rp 1,500,000.00
Rp 620,000.00
Rp 580,000.00
Rp 545,256.98
Rp 72,175,550.00

Gianyar, 31 Januari 2017

Bendahara Pembantu Penerimaan

Ni Wayan Eka Juniawati, A.Md.Kep

NIP. 19840608 200604 2 013