Lampiran Surat Tugas Nomor : / UN3.1.

14 / PPd / 2018
Tentang: Dosen Pembimbing Praktik Kerja Lapangan (PKL)/Praktik Klinik Keperawatan (PKK)

DOSEN PENGUJI PRAKTIK KLINIK KEPERAWATAN (PKK) KELUARGA

PROGRAM STUDI D-III KEPERAWATAN
SEMESTER V T.A. 2018/2019
FAKULTAS VOKASI UNIVERITAS AIRLANGGA

DAFTAR KELOMPOK PKK KELUARGA DESA RANCANG KENCONO LAMONGAN

NO TANGGAL NIM NAMA MAHASISWA DOSEN PEMBIMBING NIP

1 8-13 151611913030 DITA KHOIRUN NI'AM ENDAH SRI WIJAYANTI, 197008111994012001
Oktober 151611913062 MAR'ATUS SHOLIKHAH S.ST., M.Kes.
2018 151611913063 MAULIDATUL FARIKHAH
151611913064 MEGA SILVIA PUTRI
151611913065 MEIKA AFIFAH
151611913057 LUKMAN ADI JAYA SAPUTRA
151611913061 MAR'ATUS SHOLICHA KHOTIBUL UMAM, 197308231998031008
151611913066 MITA NUR HABIBAH S.Kep., Ns., M.Kes.
151611913070 MONICA PUTRI RAGIL
151611913073 NELA AMILATUS SHOLIKHAH
151611913060 M. NOR RIZQI ANTA
151611913074 NELI YULIA TSANI
151611913075 NINE MAHARDIKA SARI
151611913076 NISAK RACHMAWATI D. P. ISWATUN, S.Kep., M.Kes. 197203311994032004
151611913077 NITA HABIBA
151611913067 M. SAIFUL MAULUDIN B. U.
151611913078 NITA SARI AGUSTIN
151611913079 NORMA KHOIRUL HUDA
151611913080 NOVITA PUJI ELSA
2 19-24 151611913015 ANJAYA PRATAMA PUTRA ENDAH SRI WIJAYANTI, 197008111994012001
November 151611913044 FIRDA EKA SAPUTRI S.ST., M.Kes.
2018 151611913045 FIRDATUS SHOLIHAH
151611913046 FIRLA ISFIANA AYU W.
151611913047 FISSELLA ANGGRAINI
151611913020 BAGUS ADI UTAMA
151611913048 FITRI FADLILATUN NI'MAH KHOTIBUL UMAM, 197308231998031008
151611913049 FITRIYAH RIZKA APRILIA S.Kep., Ns., M.Kes.
151611913050 GALAU RIKA AKANA K. M.
151611913051 HALIMATUS SA'DIYAH
151611913021 BAYU CANDRA IRAWAN
151611913052 I'ANATUL KHILMIYAH
151611913053 IKA MEISTIFAYATIN
151611913054 INTAN PURNAMASARI ISWATUN, S.Kep., M.Kes. 197203311994032004
151611913055 KHARISMA CHERLYN M.
151611913025 DAVID CHANIAGO SAPUTRA
151611913056 LATIFATUL LAILIA
151611913058 LULUK QOMARIA
151611913059 LUTHFIAH WIDYA R.
3 3-8 151611913081 NUR AIDA ENDAH SRI WIJAYANTI, 197008111994012001
Desember 151611913082 NUR ILMA RAMADHANTI S.ST., M.Kes.
 2018 151611913083 NURUL IZZAH
151611913084 ONNY OKTAVIANI
151611913069 MOH. NUSCHUL IBAD
151611913085 PUTRI DWI LESTARI
151611913087 RENI FEBRY ANDRIANI
151611913088 RIKASIH
151611913089 RIZKA EMILIAH
151611913071 MUHAMMAD FADHIL I.
151611913090 RIZQY AMILIYAH
151611913091 RUMIATI DEVI ANISA
151611913092 SASGIA ARUM MAYANGSARI KHOTIBUL UMAM, 197308231998031008
151611913093 SETYANI YOHANES R. S.Kep., Ns., M.Kes.
151611913072 MUHAMMAD YOGGI R. P.
151611913095 SISKA RISMAWATI
151611913096 SITI KHODIJAH
151611913097 SITI NURIL HIDAYAH
151611913086 QOSIM NUR KHOLIS
151611913098 SOFIA DWI WAHYUNI
151611913099 SULVIAN AYU VITA A.
151611913094 SYLVIA WIDYATI
151611913101 TUHFATUL HANA
151611913100 TRI INDRA AJI PUTRA
151611913102 UNY ASTIYANI MESWARI
151611913103 VENI DWI ALIFATUN ISWATUN, S.Kep., M.Kes. 197203311994032004
151611913104 VIDIA DINDA SAKTI
151611913105 VITA MARIA DWI PUSPITA S.
151611913109 YONGKY RAVINDA
151611913062 VIVI NUR INDAH SARI
151611913063 WAHYUNI PUSPITA N.
151611913064 YOLANDA DWI SAFITRI
151611913110 YUNITA
151611913112 ZULFIAN RIFQI NOVANDY
151611913111 YUSVIYAH NURHIDAYATI
151611913113 ZUMROTUL FITRIYANTI
151611913114 EFI YULIANI
4 17-22 151611913001 ABDUL HAQ AL-ASRORI ENDAH SRI WIJAYANTI, 197008111994012001
Desember 151611913005 AFIFATUL MAHMUDAH S.ST., M.Kes.
2018 151611913010 ALFIA IMA FAUZIA N.
151611913011 ALFIANTI INDAH CAHYANI
151611913012 ALFIATUL SAPUTRI
151611913002 ACHMAD JIHANSYAH PUTRA
151611913013 AMALIA NURUL ADZHANI
151611913014 ANJARWATI
151611913016 ARISKA SEPTIAN D. I. P.
151611913017 AVIVA APRILLIA DEVI
151611913003 ACHSAN TUDHONNY
151611913018 AYU PUJI LESTARI
151611913019 AZMIL MUFTACHORRO KHOTIBUL UMAM, 197308231998031008
151611913022 BERNADHITA AJUNY FIRDA S.Kep., Ns., M.Kes.
151611913023 CHRISTINA YUNI AVISAH
151611913004 ADE ANANTA BOGA
151611913024 CINDY OKTAFIANI
151611913026 DENES EKA PRATIWI
151611913027 DEVITA DWI FERONIKA
151611913006 AGUS SETIAWAN
151611913028 DIANA YULI ROHMAWATI
151611913029 DITA ARDYANA DWI C.
151611913031 DWI DAMAYANTI
151611913032 DWI NUR ANUGRAH PUTRI
151611913007 AHMAD FAIQ KAUTSAR
151611913033 DWI REFORMANIA A.M ISWATUN, S.Kep., M.Kes. 197203311994032004
151611913034 EKA LAILI HIDAYATI M.
151611913035 EKA NUR FARIDA
151611913036 ELMA NINDI LARASATI
151611913008 AHRIAN YUDHO PRAKOSO
151611913037 ELOK NUR CAHYATI
151611913038 ELVIN NARINDA IRAWATI
151611913039 EVIANA NUR AFIF A'YUNI
151611913040 FADLILATUL QO'IMAH
151611913009 AIK BERLIAN INDRIANSYAH
151611913041 FARIDATUN NASICHAH
151611913042 FELLIA NURDIANA LATHIFAH
151611913043 FIFI LINDA FATMAWATI

a.n Dekan
Wakil Dekan I

Prof. Dr. Retna Apsari.,M.Si

NIP. 196806261993032003
Lampiran Surat Tugas Nomor : / UN3.1.14 / PPd / 2018
Tentang: Dosen Pembimbing Praktik Kerja Lapangan (PKL)/Praktik Klinik Keperawatan (PKK)

DOSEN PENGUJI PRAKTIK KLINIK KEPERAWATAN (PKK) KELUARGA

PROGRAM STUDI D-III KEPERAWATAN
SEMESTER V T.A. 2018/2019
FAKULTAS VOKASI UNIVERITAS AIRLANGGA

DAFTAR KELOMPOK PKK KELUARGA DESA BANJARSARI CERME

NO TANGGAL NIM NAMA MAHASISWA DOSEN PEMBIMBING NIP

1 8-13 151611913149 NURUL AMINAH ENDAH SRI WIJAYANTI, 197008111994012001
Oktober 151611913150 PUTRI DELIA ROSIDAH S.ST., M.Kes.
2018 151611913153 RIDWAN MAULANA
151611913152 REDITA RESTIFANY
151611913151 QOURYATI FILAZI HATTA
151611913154 RISKA PURIJAYANTI
151611913159 SISKA KHUMAIROH
151611913156 RIZKY ADELLIA ROSSYDA
151611913157 ROHADATUL 'AISY
151611913158 ROSALINA DEWI MARSITA
151611913155 RISQI SURYA ILLAHI
151611913160 THORFA ELFIANAH KHOTIBUL UMAM, 197308231998031008
151611913161 VIRANIDA RISTHA ANGGITA S.Kep., Ns., M.Kes.
151611913162 WACHIDATUL MAULIDA
151611913163 ZAHROTUL FIRDAUSIYAH
151611913175 DINA RIZKY FEBRIANA
151611913166 ALFIANTI DWI ROCHMA
151611913167 ANA MU'JIZATULLAILI
151611913164 PRASETYO BAGUS WIBISONO
151611913183 INDAH FITRIYAH
151611913217 YASINTHA DWI ANDRIANA
151611913171 AULIA DINDA MARINDA
151611913172 BELLA DWI KURNIA PUTRI ISWATUN, S.Kep., M.Kes. 197203311994032004
151611913173 DEVIA DWI RAMADANTY
151611913174 DEWI NAWANG SARI
151611913169 ARIF PRANANDA
151611913177 DYAH AYU ANGGRAINI
151611913178 EKA DESY KHUSMARWATI
151611913179 FAHMIATUS SHOFAH
151611913180 FAUZIYAH EVA ANDRIANI
151611913181 FITRI DWI HERLIYANI
151611913182 HANNAH WAFIYAH A.
151611913168 ANDIKA DWI PUTRA
2 5-10 151611913184 INTAN INDRAWATI ENDAH SRI WIJAYANTI, 197008111994012001
November 151611913185 IRA TANIAH S.ST., M.Kes.
2018 151611913201 OVI TAZKIYATUL UYUN
151611913187 KHOLIFATUL FAIZAH
151611913188 LAILATUL FAJRIYAH
151611913189 LILIS FAIZAH
151611913190 MA'RIFATUL ISLAMIYAH
 151611913193 MUHAMMAD RIZAL P.
151611913194 NABILA AUDIA
151611913195 NIA AMBARWATI
151611913196 NIMAS BELA WARDANI KHOTIBUL UMAM, 197308231998031008
151611913197 NISFUL LAILIYAH S.Kep., Ns., M.Kes.
151611913198 NUR FARIDATUL KHASANAH
151611913199 NURMARIKE ISMALA F.
151611913200 NURUL ISTIQOMAH
151611913186 KAMAL HASBULLAH
151611913202 QORI'ATUL MASLUHAH
151611913203 RESTU AIVI MUCHLISOH
151611913204 RIANI APRILIA
151611913205 RIFA HIDAYATUL
151611913206 RISMA MIRAUNA
151611913207 RIZKI DEWI LESTARI ISWATUN, S.Kep., M.Kes. 197203311994032004
151611913208 ROBI ALAMSYAH
151611913209 ROSA CLAUDIA PUTRI
151611913210 SHODIFATIN LAILIYAH
151611913211 SITI ROUDHO
151611913212 STEFANI KURNIAWATI S
151611913213 VIANNI RATIH PUSPA
151611913214 VIRMA INDRIANTI
151611913170 ARJUNOVA WICAKSONO
151611913216 WINDA TRI AYU NINGSIH
151611913215 WARDATUL AFFA
3 3-8 151611913115 ABID IBNU ABDILLAH ENDAH SRI WIJAYANTI, 197008111994012001
Desember 151611913116 ANGGUN JELITA FATMAWATI S.ST., M.Kes.
2018 151611913118 ANNISA ASHARI
151611913129 FADILLA NOVELLIA F
151611913120 ARYNTA MEGA RIANDINI
151611913121 BELLA DWI APRILLIA
151611913122 CHUSNUL RIZAL
151611913123 DEVI PURBANDARI REGITA C.
151611913124 DEWI MASITHOH
151611913125 DINDA DEVINA FEBRIANTI
151611913126 DITA RISWANDA
151611913127 DWI FITROTUN NISA KHOTIBUL UMAM, 197308231998031008
151611913128 ERIKA PONI ASTUTIK S.Kep., Ns., M.Kes.
151611913119 ARI WAHYUDI PUTRA
151611913130 FEBY IRVINA SAFITRI
151611913131 FIRDA AYU SURYANI
151611913132 GRENNADA ERTA RENDITA
151611913133 INDAH SULISTIYAWATI
151611913134 INTAN PUTRI MAULIDYAH
151611913137 LAELA INTAN PERMATASARI
151611913136 IVVA ROSYIDA
151611913143 MOH. ZAINUR FAHMI
151611913138 LAILATUL NIKMAH ISWATUN, S.Kep., M.Kes. 197203311994032004
151611913139 LINDA SYAVIRA PRATITISKA
151611913140 MARIA ULFA
151611913141 MEIKA FIRDALIYA
151611913145 NAURA ROYYANI D.
151611913135 IRA DWI JAYANTI
151611913144 M. RIFKI MAULANA ABDI
151611913142 MISLAHAH
151611913146 NIKKE FATIMATUL AFRIZZA
151611913147 NOVI KURNIA SRI W.
151611913148 NUR AVNI FITRIYAH

a.n Dekan
Wakil Dekan I

Prof. Dr. Retna Apsari.,M.Si

NIP. 196806261993032003
Lampiran Surat Tugas Nomor : / UN3.1.14 / PPd / 2018
Tentang: Dosen Pembimbing Praktik Kerja Lapangan (PKL)/Praktik Klinik Keperawatan (PKK)

DOSEN PENGUJI PRAKTIK KLINIK KEPERAWATAN (PKK) ANAK

PROGRAM STUDI D-III KEPERAWATAN
SEMESTER V T.A. 2018/2019
FAKULTAS VOKASI UNIVERITAS AIRLANGGA

DAFTAR KELOMPOK PKK ANAK RSUD Dr. SOETOMO SURABAYA

DOSEN PEMBIMBING/
NO TANGGAL NIM NAMA MAHASISWA NIP
RUANGAN
1 8-13 151611913008 AHRIAN YUDHO PRAKOSO LAILATUL FADHLIYAH, 197301192002122001
Oktober 151611913005 AFIFATUL MAHMUDAH S. ST., M. Kes./
2018 151611913010 ALFIA IMA FAUZIA NINGTYAS R. Bona 1
151611913038 ELVIN NARINDA IRAWATI
151611913039 EVIANA NUR AFIF A'YUNI
151611913009 AIK BERLIAN INDRIANSYAH LAILATUL FADHLIYAH, 197301192002122001
151611913041 FARIDATUN NASICHAH S. ST., M. Kes./
151611913043 FIFI LINDA FATMAWATI R. Bona 2
151611913011 ALFIANTI INDAH CAHYANI
151611913012 ALFIATUL SAPUTRI
151611913015 ANJAYA PRATAMA PUTRA LAILATUL FADHLIYAH, SST., 197301192002122001
151611913014 ANJARWATI S. ST., M. Kes./
151611913045 FIRDATUS SHOLIHAH Poli Anak
151611913046 FIRLA ISFIANA AYU WARDANI
151611913047 FISSELLA ANGGRAINI
151611913020 BAGUS ADI UTAMA AMELLIA MARDHIKA, 198509012009022012
151611913017 AVIVA APRILLIA DEVI S.Kep., Ns., M.Kes./
151611913018 AYU PUJI LESTARI Poli Anak
151611913048 FITRI FADLILATUN NI'MAH
151611913049 FITRIYAH RIZKA APRILIA
151611913021 BAYU CANDRA IRAWAN AMELLIA MARDHIKA, 198509012009022012
151611913052 I'ANATUL KHILMIYAH S.Kep., Ns., M.Kes./
151611913053 IKA MEISTIFAYATIN R. Bobo
151611913054 INTAN PURNAMASARI
151611913055 KHARISMA CHERLYN M.
151611913025 DAVID CHANIAGO SAPUTRA AMELLIA MARDHIKA, 198509012009022012
151611913056 LATIFATUL LAILIA S.Kep., Ns., M.Kes./
151611913058 LULUK QOMARIA NICU
151611913050 GALAU RIKA AKANA K. M.
151611913059 LUTHFIAH WIDYA R.
2 22-27 151611913002 ACHMAD JIHANSYAH PUTRA AMELLIA MARDHIKA, 198509012009022012
Oktober 151611913016 ARISKA SEPTIAN DEWI I. P S.Kep., Ns., M.Kes./
2018 151611913037 ELOK NUR CAHYATI Poli Anak
151611913040 FADLILATUL QO'IMAH
151611913051 HALIMATUS SA'DIYAH
151611913006 AGUS SETIAWAN AMELLIA MARDHIKA, 198509012009022012
151611913013 AMALIA NURUL ADZHANI S.Kep., Ns., M.Kes./
151611913019 AZMIL MUFTACHORRO R. Bobo
151611913042 FELLIA NURDIANA LATHIFAH
151611913007 AHMAD FAIQ KAUTSAR AMELLIA MARDHIKA, 198509012009022012
 151611913034 EKA LAILI HIDAYATI M. S.Kep., Ns., M.Kes./
151611913035 EKA NUR FARIDA NICU
151611913044 FIRDA EKA SAPUTRI
151611913004 ADE ANANTA BOGA LAILATUL FADHLIYAH, SST., 197301192002122001
151611913024 CINDY OKTAFIANI S. ST., M. Kes./
151611913026 DENES EKA PRATIWI Poli Anak
151611913027 DEVITA DWI FERONIKA
151611913001 ABDUL HAQ AL-ASRORI LAILATUL FADHLIYAH, SST., 197301192002122001
151611913028 DIANA YULI ROHMAWATI S. ST., M. Kes./
151611913029 DITA ARDYANA DWI C. R. Bona 1
151611913031 DWI DAMAYANTI
151611913032 DWI NUR ANUGRAH PUTRI
151611913003 ACHSAN TUDHONNY LAILATUL FADHLIYAH, SST., 197301192002122001
151611913022 BERNADHITA AJUNY FIRDA S. ST., M. Kes./
151611913023 CHRISTINA YUNI AVISAH R. Bona 2
151611913033 DWI REFORMANIA A.M
151611913036 ELMA NINDI LARASATI
3 5-10 151611913074 NELI YULIA TSANI LAILATUL FADHLIYAH, SST., 197301192002122001
November 151611913075 NINE MAHARDIKA SARI S. ST., M. Kes./
2018 151611913092 SASGIA ARUM MAYANGSARI R. Bona 1
151611913093 SETYANI YOHANES R.
151611913113 ZUMROTUL FITRIYANTI
151611913072 MUHAMMAD YOGGI R. P. LAILATUL FADHLIYAH, SST., 197301192002122001
151611913095 SISKA RISMAWATI S. ST., M. Kes./
151611913079 NORMA KHOIRUL HUDA R. Bona 2
151611913098 SOFIA DWI WAHYUNI
1516119130109 YONGKY RAVINDA LAILATUL FADHLIYAH, SST., 197301192002122001
151611913112 ZULFIAN RIFQI NOVANDY S. ST., M. Kes./
151611913082 NUR ILMA RAMADHANTI Poli Anak
151611913094 SYLVIA WIDYATI
151611913101 TUHFATUL HANA
151611913057 LUKMAN ADI JAYA SAPUTRA AMELLIA MARDHIKA, 198509012009022012
151611913096 SITI KHODIJAH S.Kep., Ns., M.Kes./
151611913087 RENI FEBRY ANDRIANI Poli Anak
151611913102 UNY ASTIYANI MESWARI
151611913065 MEIKA AFIFAH
151611913086 QOSIM NUR KHOLIS AMELLIA MARDHIKA, 198509012009022012
151611913064 MEGA SILVIA PUTRI S.Kep., Ns., M.Kes./
151611913061 MAR'ATUS SHOLICHA NICU
151611913103 VENI DWI ALIFATUN
151611913106 VIVI NUR INDAH SARI
151611913097 SITI NURIL HIDAYAH AMELLIA MARDHIKA, 198509012009022012
151611913108 YOLANDA DWI SAFITRI S.Kep., Ns., M.Kes./
151611913110 YUNITA R. Bobo
151611913111 YUSVIYAH NURHIDAYATI
151611913114 EFI YULIANI
4 19-24 151611913030 DITA KHOIRUN NI'AM AMELLIA MARDHIKA, 198509012009022012
November 151611913080 NOVITA PUJI ELSA S.Kep., Ns., M.Kes./
2018 151611913099 SULVIAN AYU VITA ARVIANTI NICU
151611913107 WAHYUNI PUSPITA N.
151611913100 TRI INDRA AJI PUTRA AMELLIA MARDHIKA, 198509012009022012
151611913085 PUTRI DWI LESTARI S.Kep., Ns., M.Kes./
151611913104 VIDIA DINDA SAKTI R. Bobo
151611913105 VITA MARIA DWI PUSPITA S.
151611913067 M. SAIFUL MAULUDIN B. U. AMELLIA MARDHIKA, 198509012009022012
151611913062 MAR'ATUS SHOLIKHAH S.Kep., Ns., M.Kes./
151611913063 MAULIDATUL FARIKHAH Poli Anak
151611913076 NISAK RACHMAWATI DITA P.
151611913077 NITA HABIBA
151611913060 M. NOR RIZQI ANTA LAILATUL FADHLIYAH, SST., 197301192002122001
151611913078 NITA SARI AGUSTIN S. ST., M. Kes./
151611913088 RIKASIH Poli Anak
151611913089 RIZKA EMILIAH
151611913071 MUHAMMAD FADHIL I. LAILATUL FADHLIYAH, SST., 197301192002122001
151611913081 NUR AIDA S. ST., M. Kes./
151611913067 MITA NUR HABIBAH R. Bona 1
151611913083 NURUL IZZAH
151611913084 ONNY OKTAVIANI
151611913069 MOH. NUSCHUL IBAD LAILATUL FADHLIYAH, SST., 197301192002122001
151611913070 MONICA PUTRI RAGIL S. ST., M. Kes./
151611913073 NELA AMILATUS SHOLIKHAH R. Bona 2
151611913090 RIZQY AMILIYAH
151611913091 RUMIATI DEVI ANISA

a.n Dekan
Wakil Dekan I

Prof. Dr. Retna Apsari.,M.Si

NIP. 196806261993032003
Lampiran Surat Tugas Nomor : / UN3.1.14 / PPd / 2018
Tentang: Dosen Pembimbing Praktik Kerja Lapangan (PKL)/Praktik Klinik Keperawatan (PKK)

DOSEN PENGUJI PRAKTIK KLINIK KEPERAWATAN (PKK) ANAK

PROGRAM STUDI D-III KEPERAWATAN
SEMESTER V T.A. 2018/2019
FAKULTAS VOKASI UNIVERITAS AIRLANGGA

DAFTAR KELOMPOK PKK ANAK DI RSUD IBNU SINA GRESIK

NO TANGGAL NIM NAMA MAHASISWA DOSEN PEMBIMBING NIP

1 8-13 Okt 151611913184 INTAN INDRAWATI LAILATUL FADHLIYAH, 197301192002122001
2018 151611913185 IRA TANIAH S. ST., M. Kes./
151611913201 OVI TAZKIYATUL UYUN Klinik Anak
151611913187 KHOLIFATUL FAIZAH LAILATUL FADHLIYAH, 197301192002122001
151611913188 LAILATUL FAJRIYAH S. ST., M. Kes./
151611913189 LILIS FAIZAH Klinik Tumbang
151611913190 MA'RIFATUL ISLAMIYAH LAILATUL FADHLIYAH, 197301192002122001
151611913193 MUHAMMAD RIZAL PRATAMA S. ST., M. Kes./
151611913194 NABILA AUDIA R. Anggrek
151611913195 NIA AMBARWATI
151611913196 NIMAS BELA WARDANI
151611913197 NISFUL LAILIYAH AMELLIA MARDHIKA, 198509012009022012
151611913198 NUR FARIDATUL KHASANAH S. Kep.,Ns., M. Kes/
151611913199 NURMA RIKE ISMALA FITRIANI NICU
151611913200 NURUL ISTIQOMAH
151611913186 KAMAL HASBULLAH
151611913202 QORI'ATUL MASLUHAH AMELLIA MARDHIKA, 198509012009022012
151611913203 RESTU AIVI MUCHLISOH S. Kep.,Ns., M. Kes/
151611913204 RIANI APRILIA R. Anggrek
151611913205 RIFA HIDAYATUL
151611913206 RISMA MIRAUNA
2 22-27 Okt 151611913149 NURUL AMINAH LAILATUL FADHLIYAH, 197301192002122001
2018 151611913150 PUTRI DELIA ROSIDAH S. ST., M. Kes./
151611913153 RIDWAN MAULANA Klinik Anak
151611913152 REDITA RESTIFANY LAILATUL FADHLIYAH, 197301192002122001
151611913151 QOURYATI FILAZI HATTA S. ST., M. Kes./
151611913154 RISKA PURIJAYANTI Klinik Tumbang
151611913159 SISKA KHUMAIROH LAILATUL FADHLIYAH, 197301192002122001
151611913156 RIZKY ADELLIA ROSSYDA S. ST., M. Kes./
151611913157 ROHADATUL'AISY R. Anggrek
151611913158 ROSALINA DEWI MARSITA
151611913155 RISQI SURYA ILLAHI
151611913160 THORFA ELFIANAH
151611913164 PRASETYO BAGUS WIBISONO AMELLIA MARDHIKA, 198509012009022012
151611913183 INDAH FITRIYAH S. Kep.,Ns., M. Kes/
151611913217 YASINTHA DWI ANDRIANA NICU
151611913171 AULIA DINDA MARINDA
151611913172 BELLA DWI KURNIA PUTRI
151611913173 DEVIA DWI RAMADANTY AMELLIA MARDHIKA, 198509012009022012
151611913174 DEWI NAWANG SARI S. Kep.,Ns., M. Kes/
 151611913169 ARIF PRANANDA R. Anggrek
151611913177 DYAH AYU ANGGRAINI
151611913178 EKA DESY KHUSMARWATI
3 05-10 Nov 151611913115 ABID IBNU ABDILLAH LAILATUL FADHLIYAH, 197301192002122001
2018 151611913116 ANGGUN JELITA FATMAWATI S. ST., M. Kes./
151611913118 ANNISA ASHARI R. Anggrek
151611913129 FADILLA NOVELLIA F
151611913120 ARYNTA MEGA RIANDINI
151611913172 BELLA DWI APRILLIA
151611913122 CHUSNUL RIZAL LAILATUL FADHLIYAH, 197301192002122001
151611913123 DEVI PURBANDARI REGITA C S. ST., M. Kes./
151611913124 DEWI MASITHOH NICU
151611913125 DINDA DEVINA FEBRIANTI
151611913126 DITA RISWANDA
151611913127 DWI FITROTUN NISA
151611913179 FAHMIATUS SHOFAH AMELLIA MARDHIKA, 198509012009022012
151611913180 FAUZIYAH EVA ANDRIANI S. Kep.,Ns., M. Kes/
151611913181 FITRI DWI HERLIYANI R. Anggrek
151611913182 HANNAH WAFIYAH AL DIBAH
151611913168 ANDIKA DWI PUTRA
4 19-24 Nov 151611913128 ERIKA PONI ASTUTIK AMELLIA MARDHIKA, 198509012009022012
2018 151611913119 ARI WAHYUDI PUTRA S. Kep.,Ns., M. Kes/
151611913130 FEBY IRVINA SAFITRI R. Anggrek
151611913131 FIRDA AYU SURYANI
151611913132 GRENNADA ERTA RENDITA
151611913133 INDAH SULISTIYAWATI
151611913134 INTAN PUTRI MAULIDYAH LAILATUL FADHLIYAH, 197301192002122001
151611913137 LAELA INTAN PERMATASARI S. ST., M. Kes./
151611913136 IVVA ROSYIDA Klinik Anak
151611913143 MOH. ZAINUR FAHMI LAILATUL FADHLIYAH, 197301192002122001
151611913138 LAILATUL NIKMAH S. ST., M. Kes./
Klinik Tumbang
151611913139 LINDA SYAVIRA PRATITISKA LAILATUL FADHLIYAH, 197301192002122001
151611913140 MARIA ULFA S. ST., M. Kes./
151611913141 MEIKA FIRDALIYA NICU
151611913145 NAURA ROYYANI D.
151611913135 IRA DWI JAYANTI
151611913144 M. RIFKI MAULANA ABDI AMELLIA MARDHIKA, 198509012009022012
151611913142 MISLAHAH S. Kep.,Ns., M. Kes/
151611913146 NIKKE FATIMATUL AFRIZZA R. Anggrek
151611913147 NOVI KURNIA SRI WULANDARI
151611913148 NUR AVNI FITRIYAH
5 03-08 Des 151611913161 VIRANIDA RISTHA ANGGITA AMELLIA MARDHIKA, 198509012009022012
2018 151611913162 WACHIDATUL MAULIDA S. Kep.,Ns., M. Kes/
151611913163 ZAHROTUL FIRDAUSIYAH NICU
151611913175 DINA RIZKY FEBRIANA
151611913166 ALFIANTI DWI ROCHMA
151611913167 ANA MU'JIZATULLAILI
151611913207 RIZKI DEWI LESTARI LAILATUL FADHLIYAH, 197301192002122001
151611913208 ROBI ALAMSYAH S. ST., M. Kes./
151611913209 ROSA CLAUDIA PUTRI R. Anggrek
151611913210 SHODIFATIN LAILIYAH
151611913211 SITI ROUDHO
151611913212 STEFANI KURNIAWATI S LAILATUL FADHLIYAH, 197301192002122001
151611913213 VIANNI RATIH PUSPA S. ST., M. Kes./
151611913214 VIRMA INDRIANTI R. Anggrek
151611913170 ARJUNOVA WICAKSONO
151611913216 WINDA TRI AYU NINGSIH
151611913215 WARDATUL AFFA

a.n Dekan
Wakil Dekan I

Prof. Dr. Retna Apsari.,M.Si

NIP. 196806261993032003
Lampiran Surat Tugas Nomor : / UN3.1.14 / PPd / 2018
Tentang: Dosen Pembimbing Praktik Kerja Lapangan (PKL)/Praktik Klinik Keperawatan (PKK)

DOSEN PEMBIMBING PRAKTIK KLINIK KEPERAWATAN (PKK) MEDIKAL BEDAH II

PROGRAM STUDI D-III KEPERAWATAN
SEMESTER V T.A. 2018/2019
FAKULTAS VOKASI UNIVERITAS AIRLANGGA

DAFTAR KELOMPOK PKK MEDIKAL BEDAH II RSUD Dr. SOEGIRI LAMONGAN

DOSEN PEMBIMBING/
NO TANGGAL NIM NAMA MAHASISWA NIP
RUANGAN
1 22-27 151611913081 NUR AIDA FANNI OKVIASANTI, 198604082009122003
Oktober 151611913082 NUR ILMA RAMADHANTI S.Kep., Ns., M.Kep./
2018 151611913083 NURUL IZZAH R. Seroja
151611913084 ONNY OKTAVIANI
151611913069 MOH. NUSCHUL IBAD FANNI OKVIASANTI, 198604082009122003
151611913085 PUTRI DWI LESTARI S.Kep., Ns., M.Kep./
151611913087 RENI FEBRY ANDRIANI R. Teratai
151611913088 RIKASIH
151611913089 RIZKA EMILIAH
151611913071 MUHAMMAD FADHIL I. FANNI OKVIASANTI, 198604082009122003
151611913090 RIZQY AMILIYAH S.Kep., Ns., M.Kep./
151611913091 RUMIATI DEVI ANISA R. Kemuning
151611913092 SASGIA ARUM MAYANGSARI
151611913093 SETYANI YOHANES R.
151611913072 MUHAMMAD YOGGI R. P. FANNI OKVIASANTI, 198604082009122003
151611913095 SISKA RISMAWATI S.Kep., Ns., M.Kep./
151611913096 SITI KHODIJAH R. Dahlia 1
151611913097 SITI NURIL HIDAYAH
151611913086 QOSIM NUR KHOLIS CUCUK RAHMADI P., S.Kp., 196802151992031001
151611913098 SOFIA DWI WAHYUNI M.Kes./R. Dahlia 3
151611913099 SULVIAN AYU VITA ARVIANTI
151611913094 SYLVIA WIDYATI
151611913101 TUHFATUL HANA
151611913100 TRI INDRA AJI PUTRA CUCUK RAHMADI P., S.Kp., 196802151992031001
151611913102 UNY ASTIYANI MESWARI M.Kes./R. Dahlia 4
151611913103 VENI DWI ALIFATUN
151611913104 VIDIA DINDA SAKTI
151611913105 VITA MARIA DWI PUSPITA S.
151611913109 YONGKY RAVINDA CUCUK RAHMADI P., S.Kp., 196802151992031001
151611913062 VIVI NUR INDAH SARI M.Kes./R. Bougenville 1
151611913063 WAHYUNI PUSPITA NINGRUM
151611913064 YOLANDA DWI SAFITRI
151611913110 YUNITA
151611913112 ZULFIAN RIFQI NOVANDY CUCUK RAHMADI P., S.Kp., 196802151992031001
151611913111 YUSVIYAH NURHIDAYATI M.Kes./R. Bougenville 4
151611913113 ZUMROTUL FITRIYANTI
151611913114 EFI YULIANI
2 5-10 151611913015 ANJAYA PRATAMA PUTRA FANNI OKVIASANTI, 198604082009122003
November 151611913044 FIRDA EKA SAPUTRI S.Kep., Ns., M.Kep./
2018 151611913045 FIRDATUS SHOLIHAH R. Seroja
 151611913046 FIRLA ISFIANA AYU WARDANI
151611913047 FISSELLA ANGGRAINI
151611913020 BAGUS ADI UTAMA FANNI OKVIASANTI, 198604082009122003
151611913048 FITRI FADLILATUN NI'MAH S.Kep., Ns., M.Kep./
151611913049 FITRIYAH RIZKA APRILIA R. Teratai
151611913050 GALAU RIKA AKANA KABUL M.
151611913051 HALIMATUS SA'DIYAH
151611913021 BAYU CANDRA IRAWAN CUCUK RAHMADI P., S.Kp., 196802151992031001
151611913052 I'ANATUL KHILMIYAH M.Kes./R. Dahlia 3
151611913053 IKA MEISTIFAYATIN
151611913054 INTAN PURNAMASARI
151611913055 KHARISMA CHERLYN MEYLINA
151611913025 DAVID CHANIAGO SAPUTRA CUCUK RAHMADI P., S.Kp., 196802151992031001
151611913056 LATIFATUL LAILIA M.Kes./R. Dahlia 4
151611913058 LULUK QOMARIA
151611913059 LUTHFIAH WIDYA R.
3 19-24 151611913001 ABDUL HAQ AL-ASRORI FANNI OKVIASANTI, 198604082009122003
November 151611913005 AFIFATUL MAHMUDAH S.Kep., Ns., M.Kep./
2018 151611913010 ALFIA IMA FAUZIA NINGTYAS R. Seroja
151611913011 ALFIANTI INDAH CAHYANI
151611913012 ALFIATUL SAPUTRI
151611913002 ACHMAD JIHANSYAH PUTRA FANNI OKVIASANTI, 198604082009122003
151611913013 AMALIA NURUL ADZHANI S.Kep., Ns., M.Kep./
151611913014 ANJARWATI R. Teratai
151611913016 ARISKA SEPTIAN DEWI I. P.
151611913017 AVIVA APRILLIA DEVI
151611913003 ACHSAN TUDHONNY FANNI OKVIASANTI, 198604082009122003
151611913018 AYU PUJI LESTARI S.Kep., Ns., M.Kep./
151611913019 AZMIL MUFTACHORRO R. Kemuning
151611913022 BERNADHITA AJUNY FIRDA
151611913023 CHRISTINA YUNI AVISAH
151611913004 ADE ANANTA BOGA FANNI OKVIASANTI, 198604082009122003
151611913024 CINDY OKTAFIANI S.Kep., Ns., M.Kep./
151611913026 DENES EKA PRATIWI R. Dahlia 1
151611913027 DEVITA DWI FERONIKA
151611913006 AGUS SETIAWAN CUCUK RAHMADI P., S.Kp., 196802151992031001
151611913028 DIANA YULI ROHMAWATI M.Kes./R. Dahlia 3
151611913029 DITA ARDYANA DWI CAHYANI
151611913031 DWI DAMAYANTI
151611913032 DWI NUR ANUGRAH PUTRI
151611913007 AHMAD FAIQ KAUTSAR CUCUK RAHMADI P., S.Kp., 196802151992031001
151611913033 DWI REFORMANIA A.M M.Kes./R. Dahlia 4
151611913034 EKA LAILI HIDAYATI M.
151611913035 EKA NUR FARIDA
151611913036 ELMA NINDI LARASATI
151611913008 AHRIAN YUDHO PRAKOSO CUCUK RAHMADI P., S.Kp., 196802151992031001
151611913037 ELOK NUR CAHYATI M.Kes./R. Bougenville 1
151611913038 ELVIN NARINDA IRAWATI
151611913039 EVIANA NUR AFIF A'YUNI
151611913040 FADLILATUL QO'IMAH
151611913009 AIK BERLIAN INDRIANSYAH CUCUK RAHMADI P., S.Kp., 196802151992031001
151611913041 FARIDATUN NASICHAH M.Kes./R. Bougenville 4
151611913042 FELLIA NURDIANA LATHIFAH
 151611913043 FIFI LINDA FATMAWATI
4 17-22 151611913030 DITA KHOIRUN NI'AM FANNI OKVIASANTI, 198604082009122003
Desember 151611913062 MAR'ATUS SHOLIKHAH S.Kep., Ns., M.Kep./
2018 151611913063 MAULIDATUL FARIKHAH R. Kemuning
151611913064 MEGA SILVIA PUTRI
151611913065 MEIKA AFIFAH
151611913057 LUKMAN ADI JAYA SAPUTRA FANNI OKVIASANTI, 198604082009122003
151611913061 MAR'ATUS SHOLICHA S.Kep., Ns., M.Kep./
151611913066 MITA NUR HABIBAH R. Dahlia 1
151611913070 MONICA PUTRI RAGIL
151611913073 NELA AMILATUS SHOLIKHAH
151611913060 M. NOR RIZQI ANTA CUCUK RAHMADI P., S.Kp., 196802151992031001
151611913074 NELI YULIA TSANI M.Kes./R. Bougenville 1
151611913075 NINE MAHARDIKA SARI
151611913076 NISAK RACHMAWATI DITA P.
151611913077 NITA HABIBA
151611913067 MOCH. SAIFUL MAULUDIN BU CUCUK RAHMADI P., S.Kp., 196802151992031001
151611913078 NITA SARI AGUSTIN M.Kes./R. Bougenville 4
151611913079 NORMA KHOIRUL HUDA
151611913080 NOVITA PUJI ELSA

a.n Dekan
Wakil Dekan I

Prof. Dr. Retna Apsari.,M.Si

NIP. 196806261993032003
Lampiran Surat Tugas Nomor : / UN3.1.14 / PPd / 2018
Tentang: Dosen Pembimbing Praktik Kerja Lapangan (PKL)/Praktik Klinik Keperawatan (PKK)

DOSEN PENGUJI PRAKTIK KLINIK KEPERAWATAN (PKK) MEDIKAL BEDAH II

PROGRAM STUDI D-III KEPERAWATAN
SEMESTER V T.A. 2018/2019
FAKULTAS VOKASI UNIVERITAS AIRLANGGA

DAFTAR KELOMPOK PKK MEDIKAL BEDAH II RSUD IBNU SINA GRESIK

DOSEN PEMBIMBING/
NO TANGGAL NIM NAMA MAHASISWA NIP
RUANGAN
151611913161 VIRANIDA RISTHA ANGGITA Susilo Harianto, 19660414 199203 1 010
151611913162 WACHIDATUL MAULIDA S. Kep., Ns., M. Kep./
1 5-10 Nop 18 151611913163 ZAHROTUL FIRDAUSIYAH R. Dahlia
151611913175 DINA RIZKY FEBRIANA
151611913166 ALFIANTI DWI ROCHMA
151611913167 ANA MU'JIZATULLAILI
151611913207 RIZKI DEWI LESTARI Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
151611913208 ROBI ALAMSYAH Ns.,M.Kep.,Sp.Kep.M.B./
2 19-24 Nop 18 151611913209 ROSA CLAUDIA PUTRI R. Edelweis
151611913210 SHODIFATIN LAILIYAH
151611913211 SITI ROUDHO
151611913212 STEFANI KURNIAWATI S Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
151611913213 VIANNI RATIH PUSPA Ns.,M.Kep.,Sp.Kep.M.B./
3 19-24 Nop 18 151611913214 VIRMA INDRIANTI R. Gardena
151611913170 ARJUNOVA WICAKSONO
151611913216 WINDA TRI AYU NINGSIH
151611913215 WARDATUL AFFA
151611913149 NURUL AMINAH Susilo Harianto, 19660414 199203 1 010
151611913150 PUTRI DELIA ROSIDAH S. Kep., Ns., M. Kep./
4 3-8 Des 18 151611913153 RIDWAN MAULANA R. Edelweis
151611913152 REDITA RESTIFANY
151611913151 QOURYATI FILAZI HATTA
151611913154 RISKA PURIJAYANTI
151611913159 SISKA KHUMAIROH Susilo Harianto, 19660414 199203 1 010
151611913156 RIZKY ADELLIA ROSSYDA S. Kep., Ns., M. Kep./
5 3-8 Des 18 151611913157 ROHADATUL 'AISY R. Hemodialisa
151611913158 ROSALINA DEWI MARSITA
151611913155 RISQI SURYA ILLAHI
151611913160 THORFA ELFIANAH
151611913164 PRASETYO BAGUS WIBISONO Susilo Harianto, 19660414 199203 1 010
151611913183 INDAH FITRIYAH S. Kep., Ns., M. Kep./
6 3-8 Des 18 151611913217 YASINTHA DWI ANDRIANA R. Hemodialisa
151611913171 AULIA DINDA MARINDA
151611913172 BELLA DWI KURNIA PUTRI
151611913173 DEVIA DWI RAMADANTY Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
151611913174 DEWI NAWANG SARI Ns.,M.Kep.,Sp.Kep.M.B./
7 3-8 Des 18 151611913169 ARIF PRANANDA R. Cempaka
151611913177 DYAH AYU ANGGRAINI
151611913178 EKA DESY KHUSMARWATI
151611913179 FAHMIATUS SHOFAH Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
8 3-8 Des 18 151611913180 FAUZIYAH EVA ANDRIANI
151611913181 FITRI DWI HERLIYANI
9 3-8 Des 18 151611913182 HANNAH WAFIYAH AL A.
151611913168 ANDIKA DWI PUTRA
151611913184 INTAN INDRAWATI
151611913185 IRA TANIAH
10 3-8 Des 18 151611913201 OVI TAZKIYATUL UYUN
151611913187 KHOLIFATUL FAIZAH
151611913188 LAILATUL FAJRIYAH
151611913189 LILIS FAIZAH
151611913190 MA'RIFATUL ISLAMIYAH
151611913193 MUHAMMAD RIZAL PRATAMA
11 3-8 Des 18 151611913194 NABILA AUDIA
151611913195 NIA AMBARWATI
151611913196 NIMAS BELA WARDANI
151611913197 NISFUL LAILIYAH
12 3-8 Des 18 151611913198 NUR FARIDATUL KHASANAH
151611913199 NURMARIKE ISMALA FITRIANI
13 3-8 Des 18 151611913200 NURUL ISTIQOMAH
151611913186 KAMAL HASBULLAH
151611913202 QORI'ATUL MASLUHAH
151611913203 RESTU AIVI MUCHLISOH
14 3-8 Des 18 151611913204 RIANI APRILIA
151611913205 RIFA HIDAYATUL
151611913206 RISMA MIRAUNA
151611913115 ABID IBNU ABDILLAH
15 17-22 Des 18 151611913117 ANGGUN JELITA FATMAWATI
151611913118 ANNISA ASHARI
151611913129 FADILLA NOVELLIA F
16 17-22 Des 18 151611913120 ARYNTA MEGA RIANDINI
151611913121 BELLA DWI APRILLIA
151611913122 CHUSNUL RIZAL
151611913123 DEVI PURBANDARI REGITA C
17 17-22 Des 18 151611913124 DEWI MASITHOH
151611913125 DINDA DEVINA FEBRIANTI
151611913126 DITA RISWANDA
151611913127 DWI FITROTUN NISA
151611913128 ERIKA PONI ASTUTIK
151611913119 ARI WAHYUDI PUTRA
18 17-22 Des 18 151611913130 FEBY IRVINA SAFITRI
151611913131 FIRDA AYU SURYANI
151611913132 GRENNADA ERTA RENDITA
151611913133 INDAH SULISTIYAWATI
151611913134 INTAN PUTRI MAULIDYAH
151611913137 LAELA INTAN PERMATASARI
19 17-22 Des 18 151611913136 IVVA ROSYIDA
151611913143 MOH. ZAINUR FAHMI
151611913138 LAILATUL NIKMAH
151611913139 LINDA SYAVIRA PRATITISKA
151611913140 MARIA ULFA
20 17-22 Des 18 151611913141 MEIKA FIRDALIYA
Ns.,M.Kep.,Sp.Kep.M.B./
Klinik Bedah
Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
Ns.,M.Kep.,Sp.Kep.M.B./
Klinik Syaraf
Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
Ns.,M.Kep.,Sp.Kep.M.B./
R. Wijaya Kusuma
Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
Ns.,M.Kep.,Sp.Kep.M.B./
R. Cempaka
Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
Ns.,M.Kep.,Sp.Kep.M.B./
Klinik Bedah
Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
Ns.,M.Kep.,Sp.Kep.M.B./
Klinik Mata
Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
Ns.,M.Kep.,Sp.Kep.M.B./
R. Edelweis
Susilo Harianto, 19660414 199203 1 010
S. Kep., Ns., M. Kep./
Klinik Bedah
Susilo Harianto, 19660414 199203 1 010
S. Kep., Ns., M. Kep./
Klinik Syaraf
Susilo Harianto, 19660414 199203 1 010
S. Kep., Ns., M. Kep./
R. Dahlia
Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
Ns.,M.Kep.,Sp.Kep.M.B./
R. Cempaka
Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
Ns.,M.Kep.,Sp.Kep.M.B./
R. Hemodialisa
Susilo Harianto, 19660414 199203 1 010
S. Kep., Ns., M. Kep./
R. Edelweis
 151611913145 NAURA ROYYANI D.
151611913135 IRA DWI JAYANTI
151611913144 M. RIFKI MAULANA ABDI Hafna Ilmy Muhalla, S.Kep., 19781220 200604 2 026
151611913142 MISLAHAH Ns.,M.Kep.,Sp.Kep.M.B./
21 17-22 Des 18 151611913146 NIKKE FATIMATUL AFRIZZA R. Gardena
151611913147 NOVI KURNIA SRI W.
151611913148 NUR AVNI FITRIYAH

a.n Dekan
Wakil Dekan I

Prof. Dr. Retna Apsari.,M.Si

NIP. 196806261993032003
010

026

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010

010

010

026

026
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026

026

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010

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010
026
Lampiran Surat Tugas Nomor : / UN3.1.14 / PPd / 2018
Tentang: Dosen Pembimbing Praktik Kerja Lapangan (PKL)/Praktik Klinik Keperawatan (PKK)

DOSEN PENGUJI PRAKTIK KLINIK KEPERAWATAN (PKK) JIWA

PROGRAM STUDI D-III KEPERAWATAN
SEMESTER V T.A. 2018/2019
FAKULTAS VOKASI UNIVERITAS AIRLANGGA

DAFTAR KELOMPOK PKK JIWA RS MENUR SURABAYA

DOSEN PEMBIMBING/
NO TANGGAL NIM NAMA MAHASISWA RUANGAN
1 8-13 151611913069 MOH. NUSCHUL IBAD ALI SAIROZI,
Oktober 151611913081 NUR AIDA S.KM., S.Kep.,Ns., M.Kes.
2018 151611913082 NUR ILMA RAMADHANTI PURI KENARI
151611913083 NURUL IZZAH
151611913084 ONNY OKTAVIANI
151611913085 PUTRI DWI LESTARI
151611913072 MUHAMMAD YOGGI R. P. ALI SAIROZI,
151611913086 QOSIM NUR KHOLIS S.KM., S.Kep.,Ns., M.Kes.
151611913097 SITI NURIL HIDAYAH PURI FLAMBOYAN
151611913096 SITI KHODIJAH
151611913095 SISKA RISMAWATI
151611913093 SETYANI YOHANES ROSALINDA
151611913091 RUMIATI DEVI ANISA ALI SAIROZI,
151611913087 RENI FEBRY ANDRIANI S.KM., S.Kep.,Ns., M.Kes.
151611913090 RIZQY AMILIYAH PURI GELATIK
151611913089 RIZKA EMILIAH
151611913092 SASGIA ARUM MAYANGSARI
151611913071 MUHAMMAD FADHIL I.
151611913088 RIKASIH
151611913098 SOFIA DWI WAHYUNI ENDAH SRI WIJAYANTI,
151611913099 SULVIAN AYU VITA ARVIANTI S.ST., M.Kes.
151611913094 SYLVIA WIDYATI PURI WIJAYA KUSUMA
151611913101 TUHFATUL HANA
151611913100 TRI INDRA AJI PUTRA
151611913102 UNY ASTIYANI MESWARI
151611913103 VENI DWI ALIFATUN ENDAH SRI WIJAYANTI,
151611913104 VIDIA DINDA SAKTI S.ST., M.Kes.
151611913105 VITA MARIA DWI PUSPITA SARI PURI ANGGREK
151611913109 YONGKY RAVINDA
151611913062 VIVI NUR INDAH SARI
151611913063 WAHYUNI PUSPITA NINGRUM
151611913064 YOLANDA DWI SAFITRI ENDAH SRI WIJAYANTI,
151611913110 YUNITA S.ST., M.Kes.
151611913112 ZULFIAN RIFQI NOVANDY PURI MITRA
151611913111 YUSVIYAH NURHIDAYATI
 151611913113 ZUMROTUL FITRIYANTI
151611913114 EFI YULIANI
2 22-27 151611913115 ABID IBNU ABDILLAH ABD. NASIR,
Oktober 151611913117 ANGGUN JELITA FATMAWATI S. Kep., Ns., M. Kep.
2018 151611913118 ANNISA ASHARI PURI KENARI
151611913129 FADILLA NOVELLIA F
151611913120 ARYNTA MEGA RIANDINI
151611913121 BELLA DWI APRILLIA
151611913128 ERIKA PONI ASTUTIK ABD. NASIR,
151611913119 ARI WAHYUDI PUTRA S. Kep., Ns., M. Kep.
151611913130 FEBY IRVINA SAFITRI PURI FLAMBOYAN
151611913131 FIRDA AYU SURYANI
151611913132 GRENNADA ERTA RENDITA
151611913133 INDAH SULISTIYAWATI
151611913139 LINDA SYAVIRA PRATITISKA ABD. NASIR,
151611913140 MARIA ULFA S. Kep., Ns., M. Kep.
151611913141 MEIKA FIRDALIYA PURI MITRA
151611913145 NAURA ROYYANI D.
151611913135 IRA DWI JAYANTI
151611913122 CHUSNUL RIZAL RINDAYATI,
151611913123 DEVI PURBANDARI REGITA C S. Kep., Ns., M. Kep.
151611913124 DEWI MASITHOH PURI GELATIK
151611913125 DINDA DEVINA FEBRIANTI
151611913126 DITA RISWANDA
151611913127 DWI FITROTUN NISA
151611913134 INTAN PUTRI MAULIDYAH RINDAYATI,
151611913137 LAELA INTAN PERMATASARI S. Kep., Ns., M. Kep.
151611913136 IVVA ROSYIDA PURI ANGGREK
151611913143 MOH. ZAINUR FAHMI
151611913138 LAILATUL NIKMAH
151611913144 M. RIFKI MAULANA ABDI RINDAYATI,
151611913142 MISLAHAH S. Kep., Ns., M. Kep.
151611913146 NIKKE FATIMATUL AFRIZZA PURI WIJAYA KUSUMA
151611913147 NOVI KURNIA SRI WULANDARI
151611913148 NUR AVNI FITRIYAH
3 5-10 151611913001 ABDUL HAQ AL-ASRORI ALI SAIROZI,
November 151611913005 AFIFATUL MAHMUDAH S.KM., S.Kep.,Ns., M.Kes.
2018 151611913010 ALFIA IMA FAUZIA NINGTYAS PURI KENARI
151611913011 ALFIANTI INDAH CAHYANI
151611913012 ALFIATUL SAPUTRI
151611913002 ACHMAD JIHANSYAH PUTRA
151611913013 AMALIA NURUL ADZHANI ALI SAIROZI,
151611913014 ANJARWATI S.KM., S.Kep.,Ns., M.Kes.
151611913016 ARISKA SEPTIAN DEWI I. PURI FLAMBOYAN
151611913017 AVIVA APRILLIA DEVI
151611913003 ACHSAN TUDHONNY
151611913018 AYU PUJI LESTARI
151611913019 AZMIL MUFTACHORRO
 151611913022 BERNADHITA AJUNY FIRDA ENDAH SRI WIJAYANTI,
151611913023 CHRISTINA YUNI AVISAH S.ST., M.Kes.
151611913004 ADE ANANTA BOGA PURI MITRA
151611913024 CINDY OKTAFIANI
151611913026 DENES EKA PRATIWI
151611913027 DEVITA DWI FERONIKA
151611913006 AGUS SETIAWAN ENDAH SRI WIJAYANTI,
151611913028 DIANA YULI ROHMAWATI S.ST., M.Kes.
151611913029 DITA ARDYANA DWI CAHYANI PURI GELATIK
151611913031 DWI DAMAYANTI
151611913032 DWI NUR ANUGRAH PUTRI
151611913007 AHMAD FAIQ KAUTSAR
151611913033 DWI REFORMANIA A.M ENDAH SRI WIJAYANTI,
151611913034 EKA LAILI HIDAYATI MASLUKHAH S.ST., M.Kes.
151611913035 EKA NUR FARIDA PURI ANGGREK
151611913036 ELMA NINDI LARASATI
151611913008 AHRIAN YUDHO PRAKOSO
151611913037 ELOK NUR CAHYATI
151611913038 ELVIN NARINDA IRAWATI
151611913039 EVIANA NUR AFIF A'YUNI ENDAH SRI WIJAYANTI,
151611913040 FADLILATUL QO'IMAH S.ST., M.Kes.
151611913009 AIK BERLIAN INDRIANSYAH PURI WIJAYA KUSUMA
151611913041 FARIDATUN NASICHAH
151611913042 FELLIA NURDIANA LATHIFAH
151611913043 FIFI LINDA FATMAWATI
4 19-24 151611913159 SISKA KHUMAIROH RINDAYATI,
November 151611913156 RIZKY ADELLIA ROSSYDA S. Kep., Ns., M.Kep.
2018 151611913157 ROHADATUL 'AISY PURI KENARI
151611913158 ROSALINA DEWI MARSITA
151611913155 RISQI SURYA ILLAHI
151611913160 THORFA ELFIANAH
151611913164 PRASETYO BAGUS WIBISONO RINDAYATI,
151611913183 INDAH FITRIYAH S. Kep., Ns., M.Kep.
151611913217 YASINTHA DWI ANDRIANA PURI FLAMBOYAN
151611913171 AULIA DINDA MARINDA
151611913172 BELLA DWI KURNIA PUTRI
151611913179 FAHMIATUS SHOFAH RINDAYATI,
151611913180 FAUZIYAH EVA ANDRIANI S. Kep., Ns., M.Kep.
151611913181 FITRI DWI HERLIYANI PURI MITRA
151611913182 HANNAH WAFIYAH AL ADIBAH
151611913168 ANDIKA DWI PUTRA
151611913149 NURUL AMINAH
151611913150 PUTRI DELIA ROSIDAH ABD. NASIR
151611913153 RIDWAN MAULANA S.Kep.Ns., M.Kep
151611913152 REDITA RESTIFANY PURI GELATIK
151611913151 QOURYATI FILAZI HATTA
151611913154 RISKA PURIJAYANTI
151611913161 VIRANIDA RISTHA ANGGITA ABD. NASIR
 151611913162 WACHIDATUL MAULIDA S.Kep.Ns., M.Kep
151611913163 ZAHROTUL FIRDAUSIYAH PURI ANGGREK
151611913175 DINA RIZKY FEBRIANA
151611913166 ALFIANTI DWI ROCHMA
151611913167 ANA MU'JIZATULLAILI
151611913173 DEVIA DWI RAMADANTY ABD. NASIR
151611913174 DEWI NAWANG SARI S.Kep.Ns., M.Kep
151611913169 ARIF PRANANDA PURI WIJAYA KUSUMA
151611913177 DYAH AYU ANGGRAINI
151611913178 EKA DESY KHUSMARWATI
5 3-8 151611913015 ANJAYA PRATAMA PUTRA ABD. NASIR
Desember 151611913044 FIRDA EKA SAPUTRI S.Kep.Ns., M.Kep
2018 151611913045 FIRDATUS SHOLIHAH PURI KENARI
151611913046 FIRLA ISFIANA AYU WARDANI
151611913047 FISSELLA ANGGRAINI
151611913020 BAGUS ADI UTAMA
151611913048 FITRI FADLILATUN NI'MAH
151611913049 FITRIYAH RIZKA APRILIA ABD. NASIR
151611913050 GALAU RIKA AKANA KABUL M. S.Kep.Ns., M.Kep
151611913051 HALIMATUS SA'DIYAH PURI FLAMBOYAN
151611913021 BAYU CANDRA IRAWAN
151611913052 I'ANATUL KHILMIYAH
151611913053 IKA MEISTIFAYATIN
151611913054 INTAN PURNAMASARI ABD. NASIR
151611913055 KHARISMA CHERLYN MEYLINA S.Kep.Ns., M.Kep
151611913025 DAVID CHANIAGO SAPUTRA PURI MITRA
151611913056 LATIFATUL LAILIA
151611913058 LULUK QOMARIA
151611913059 LUTHFIAH WIDYA R.
151611913030 DITA KHOIRUN NI'AM ENDAH SRI WIJAYANTI,
151611913062 MAR'ATUS SHOLIKHAH S.ST., M.Kes.
151611913063 MAULIDATUL FARIKHAH PURI GELATIK
151611913064 MEGA SILVIA PUTRI
151611913065 MEIKA AFIFAH
151611913057 LUKMAN ADI JAYA SAPUTRA
151611913061 MAR'ATUS SHOLICHA RINDAYATI,
151611913066 MITA NUR HABIBAH S. Kep., Ns., M.Kep.
151611913070 MONICA PUTRI RAGIL PURI ANGGREK
151611913073 NELA AMILATUS SHOLIKHAH
151611913060 M. NOR RIZQI ANTA
151611913074 NELI YULIA TSANI
151611913075 NINE MAHARDIKA SARI
151611913076 NISAK RACHMAWATI DITA P. RINDAYATI,
151611913077 NITA HABIBA S. Kep., Ns., M.Kep.
151611913067 MOCH. SAIFUL MAULUDIN B.U. PURI WIJAYA KUSUMA
151611913078 NITA SARI AGUSTIN
151611913079 NORMA KHOIRUL HUDA
151611913080 NOVITA PUJI ELSA
6 17-22 151611913184 INTAN INDRAWATI ABD. NASIR
Desember 151611913185 IRA TANIAH S.Kep.Ns., M.Kep
2018 151611913201 OVI TAZKIYATUL UYUN PURI KENARI
151611913187 KHOLIFATUL FAIZAH
151611913188 LAILATUL FAJRIYAH
151611913189 LILIS FAIZAH
151611913198 NUR FARIDATUL KHASANAH ABD. NASIR
151611913199 NURMARIKE ISMALA FITRIANI S.Kep.Ns., M.Kep
151611913200 NURUL ISTIQOMAH PURI FLAMBOYAN
151611913186 KAMAL HASBULLAH
151611913202 QORI'ATUL MASLUHAH
151611913208 ROBI ALAMSYAH ABD. NASIR
151611913209 ROSA CLAUDIA PUTRI S.Kep.Ns., M.Kep
151611913210 SHODIFATIN LAILIYAH PURI MITRA
151611913211 SITI ROUDHO
151611913212 STEFANI KURNIAWATI S
151611913190 MA'RIFATUL ISLAMIYAH RINDAYATI,
151611913193 MUHAMMAD RIZAL PRATAMA S. Kep., Ns., M.Kep.
151611913194 NABILA AUDIA PURI GELATIK
151611913195 NIA AMBARWATI
151611913196 NIMAS BELA WARDANI
151611913197 NISFUL LAILIYAH
151611913203 RESTU AIVI MUCHLISOH RINDAYATI,
151611913204 RIANI APRILIA S. Kep., Ns., M.Kep.
151611913205 RIFA HIDAYATUL PURI ANGGREK
151611913206 RISMA MIRAUNA
151611913207 RIZKI DEWI LESTARI
151611913213 VIANNI RATIH PUSPA RINDAYATI,
151611913214 VIRMA INDRIANTI S. Kep., Ns., M.Kep.
151611913170 ARJUNOVA WICAKSONO PURI WIJAYA KUSUMA
151611913216 WINDA TRI AYU NINGSIH
151611913215 WARDATUL AFFA

a.n Dekan
Wakil Dekan I

Prof. Dr. Retna Apsari.,M.Si

NIP. 196806261993032003
rawatan (PKK)

KK) JIWA

AYA

NIP

197502121999031001

197502121999031001

197502121999031001

197008111994012001

197008111994012001

197008111994012001
196806281991031006

196806281991031006

196806281991031006

196101251980122003

196101251980122003

196101251980122003

197502121999031001

197502121999031001
197008111994012001

197008111994012001

197008111994012001

197008111994012001

196101251980122003

196101251980122003

196101251980122003

196806281991031006

196806281991031006
196806281991031006

196806281991031006

196806281991031006

196806281991031006

197008111994012001

196101251980122003

196101251980122003
 196806281991031006

196806281991031006

196806281991031006

196101251980122003

196101251980122003

196101251980122003

Apsari.,M.Si
1993032003
Lampiran Surat Tugas Nomor : / UN3.1.14 / PPd / 2018
Tentang: Dosen Pembimbing Praktik Kerja Lapangan (PKL)/Praktik Klinik Keperawatan (PKK)

DOSEN PENGUJI PRAKTIK KLINIK KEPERAWATAN (PKK) GERONTIK

PROGRAM STUDI D-III KEPERAWATAN
SEMESTER V T.A. 2018/2019
FAKULTAS VOKASI UNIVERITAS AIRLANGGA

DAFTAR KELOMPOK PKK DESA BANJARSARI CERME

NO TANGGAL NIM NAMA MAHASISWA DOSEN PEMBIMBING NIP

1 8-13 151611913149 NURUL AMINAH RINDAYATI, 196101251982122003
Oktober 151611913150 PUTRI DELIA ROSIDAH S. Kep., Ns., M.Kep.
2018 151611913153 RIDWAN MAULANA
151611913152 REDITA RESTIFANY
151611913151 QOURYATI FILAZI HATTA
151611913154 RISKA PURIJAYANTI
151611913159 SISKA KHUMAIROH
151611913156 RIZKY ADELLIA ROSSYDA
151611913157 ROHADATUL 'AISY
151611913158 ROSALINA DEWI MARSITA KHOTIBUL UMAM, 197308231998031008
151611913155 RISQI SURYA ILLAHI S.Kep., Ns., M.Kes.
151611913160 THORFA ELFIANAH
151611913161 VIRANIDA RISTHA ANGGITA
151611913162 WACHIDATUL MAULIDA
151611913163 ZAHROTUL FIRDAUSIYAH
151611913175 DINA RIZKY FEBRIANA
151611913166 ALFIANTI DWI ROCHMA
151611913167 ANA MU'JIZATULLAILI ALI SAIROZI, 197502121999031001
151611913164 PRASETYO BAGUS WIBISONO S.KM., S.Kep.,Ns., M.Kes.
151611913183 INDAH FITRIYAH
151611913217 YASINTHA DWI ANDRIANA
151611913171 AULIA DINDA MARINDA
151611913172 BELLA DWI KURNIA PUTRI
151611913173 DEVIA DWI RAMADANTY
151611913174 DEWI NAWANG SARI
151611913169 ARIF PRANANDA RINDAYATI, 196101251982122003
151611913177 DYAH AYU ANGGRAINI S. Kep., Ns., M.Kep.
151611913178 EKA DESY KHUSMARWATI
151611913179 FAHMIATUS SHOFAH
151611913180 FAUZIYAH EVA ANDRIANI
151611913181 FITRI DWI HERLIYANI
151611913182 HANNAH WAFIYAH A.
151611913168 ANDIKA DWI PUTRA
2 5-10 151611913184 INTAN INDRAWATI RINDAYATI, 196101251982122003
November 151611913185 IRA TANIAH S. Kep., Ns., M.Kep.
2018 151611913201 OVI TAZKIYATUL UYUN
151611913187 KHOLIFATUL FAIZAH
151611913188 LAILATUL FAJRIYAH
151611913189 LILIS FAIZAH
151611913190 MA'RIFATUL ISLAMIYAH
 151611913193 MUHAMMAD RIZAL P.
151611913194 NABILA AUDIA
151611913195 NIA AMBARWATI KHOTIBUL UMAM, 197308231998031008
151611913196 NIMAS BELA WARDANI S.Kep., Ns., M.Kes.
151611913197 NISFUL LAILIYAH
151611913198 NUR FARIDATUL KHASANAH
151611913199 NURMARIKE ISMALA F.
151611913200 NURUL ISTIQOMAH RINDAYATI, 196101251982122003
151611913186 KAMAL HASBULLAH S. Kep., Ns., M.Kep.
151611913202 QORI'ATUL MASLUHAH
151611913203 RESTU AIVI MUCHLISOH
151611913204 RIANI APRILIA
151611913205 RIFA HIDAYATUL
151611913206 RISMA MIRAUNA
151611913207 RIZKI DEWI LESTARI ALI SAIROZI, 197502121999031001
151611913208 ROBI ALAMSYAH S.KM., S.Kep.,Ns., M.Kes.
151611913209 ROSA CLAUDIA PUTRI
151611913210 SHODIFATIN LAILIYAH
151611913211 SITI ROUDHO Dr. JONI HARYANTO, 19630608 199103 1002
151611913212 STEFANI KURNIAWATI S S.Kp., M.Si.
151611913213 VIANNI RATIH PUSPA
151611913214 VIRMA INDRIANTI
151611913170 ARJUNOVA WICAKSONO
151611913216 WINDA TRI AYU NINGSIH
151611913215 WARDATUL AFFA
3 3-8 151611913115 ABID IBNU ABDILLAH RINDAYATI, 196101251982122003
Desember 151611913116 ANGGUN JELITA FATMAWATI S. Kep., Ns., M.Kep.
2018 151611913118 ANNISA ASHARI
151611913129 FADILLA NOVELLIA F
151611913120 ARYNTA MEGA RIANDINI
151611913121 BELLA DWI APRILLIA
151611913122 CHUSNUL RIZAL
151611913123 DEVI PURBANDARI REGITA C.
151611913124 DEWI MASITHOH
151611913125 DINDA DEVINA FEBRIANTI KHOTIBUL UMAM, 197308231998031008
151611913126 DITA RISWANDA S.Kep., Ns., M.Kes.
151611913127 DWI FITROTUN NISA
151611913128 ERIKA PONI ASTUTIK
151611913119 ARI WAHYUDI PUTRA
151611913130 FEBY IRVINA SAFITRI RINDAYATI, 196101251982122003
151611913131 FIRDA AYU SURYANI S. Kep., Ns., M.Kep.
151611913132 GRENNADA ERTA RENDITA
151611913133 INDAH SULISTIYAWATI
151611913134 INTAN PUTRI MAULIDYAH
151611913137 LAELA INTAN PERMATASARI
151611913136 IVVA ROSYIDA
151611913143 MOH. ZAINUR FAHMI
151611913138 LAILATUL NIKMAH
151611913139 LINDA SYAVIRA PRATITISKA
151611913140 MARIA ULFA
151611913141 MEIKA FIRDALIYA
151611913145 NAURA ROYYANI D. Dr. JONI HARYANTO, 19630608 199103 1002
151611913135 IRA DWI JAYANTI S.Kp., M.Si.
151611913144 M. RIFKI MAULANA ABDI
151611913142 MISLAHAH
151611913146 NIKKE FATIMATUL AFRIZZA
151611913147 NOVI KURNIA SRI W.
151611913148 NUR AVNI FITRIYAH
151611913116 ALFARGANI YUWONO

a.n Dekan
Wakil Dekan I

Prof. Dr. Retna Apsari.,M.Si

NIP. 196806261993032003
002

002
Lampiran Surat Tugas Nomor : / UN3.1.14 / PPd / 2018
Tentang: Dosen Pembimbing Praktik Kerja Lapangan (PKL)/Praktik Klinik Keperawatan (PKK)

DOSEN PEMBIMBING PRAKTIK KLINIK KEPERAWATAN (PKK) GERONTIK

PROGRAM STUDI D-III KEPERAWATAN
SEMESTER V T.A. 2018/2019
FAKULTAS VOKASI UNIVERITAS AIRLANGGA

DAFTAR KELOMPOK PKK DESA RANCANG KENCONO LAMONGAN

NO TANGGAL NIM NAMA MAHASISWA DOSEN PEMBIMBING NIP

1 1-13 151611913030 DITA KHOIRUN NI'AM RINDAYATI, 196101251982122003
Oktober 151611913062 MAR'ATUS SHOLIKHAH S. Kep., Ns., M.Kep.
2018 151611913063 MAULIDATUL FARIKHAH
151611913064 MEGA SILVIA PUTRI
151611913065 MEIKA AFIFAH
151611913057 LUKMAN ADI JAYA SAPUTRA KHOTIBUL UMAM, 197308231998031008
151611913061 MAR'ATUS SHOLICHA S.Kep., Ns., M.Kes.
151611913066 MITA NUR HABIBAH
151611913070 MONICA PUTRI RAGIL
151611913073 NELA AMILATUS SHOLIKHAH
151611913060 M. NOR RIZQI ANTA ALI SAIROZI, 197502121999031001
151611913074 NELI YULIA TSANI S.KM., S.Kep.,Ns., M.Kes.
151611913075 NINE MAHARDIKA SARI
151611913076 NISAK RACHMAWATI D. P.
151611913077 NITA HABIBA
151611913067 M. SAIFUL MAULUDIN B. U. RINDAYATI, 196101251982122003
151611913078 NITA SARI AGUSTIN S. Kep., Ns., M.Kep.
151611913079 NORMA KHOIRUL HUDA
151611913080 NOVITA PUJI ELSA
2 12-24 151611913015 ANJAYA PRATAMA PUTRA RINDAYATI, 196101251982122003
November 151611913044 FIRDA EKA SAPUTRI S. Kep., Ns., M.Kep.
2018 151611913045 FIRDATUS SHOLIHAH
151611913046 FIRLA ISFIANA AYU WARDANI
151611913047 FISSELLA ANGGRAINI
151611913020 BAGUS ADI UTAMA KHOTIBUL UMAM, 197308231998031008
151611913048 FITRI FADLILATUN NI'MAH S.Kep., Ns., M.Kes.
151611913049 FITRIYAH RIZKA APRILIA
151611913050 GALAU RIKA AKANA K. M.
151611913051 HALIMATUS SA'DIYAH
151611913021 BAYU CANDRA IRAWAN RINDAYATI, 196101251982122003
151611913052 I'ANATUL KHILMIYAH S. Kep., Ns., M.Kep.
151611913053 IKA MEISTIFAYATIN
151611913054 INTAN PURNAMASARI
151611913055 KHARISMA CHERLYN M.
151611913025 DAVID CHANIAGO SAPUTRA KHOTIBUL UMAM, 197308231998031008
151611913056 LATIFATUL LAILIA S.Kep., Ns., M.Kes.
151611913058 LULUK QOMARIA
151611913059 LUTHFIAH WIDYA R.
3 26 November- 151611913081 NUR AIDA RINDAYATI, 196101251982122003
8 Desember 151611913082 NUR ILMA RAMADHANTI S. Kep., Ns., M.Kep.
 2018 151611913083 NURUL IZZAH
151611913084 ONNY OKTAVIANI
151611913069 MOH. NUSCHUL IBAD
151611913085 PUTRI DWI LESTARI
151611913087 RENI FEBRY ANDRIANI
151611913088 RIKASIH RINDAYATI, 196101251982122003
151611913089 RIZKA EMILIAH S. Kep., Ns., M.Kep.
151611913071 MUHAMMAD FADHIL I.
151611913090 RIZQY AMILIYAH
151611913091 RUMIATI DEVI ANISA
151611913092 SASGIA ARUM MAYANGSARI
151611913093 SETYANI YOHANES R.
151611913072 MUHAMMAD YOGGI R. P.
151611913095 SISKA RISMAWATI
151611913096 SITI KHODIJAH KHOTIBUL UMAM, 197308231998031008
151611913097 SITI NURIL HIDAYAH S.Kep., Ns., M.Kes.
151611913086 QOSIM NUR KHOLIS
151611913098 SOFIA DWI WAHYUNI
151611913099 SULVIAN AYU VITA ARVIANTI
151611913094 SYLVIA WIDYATI
151611913101 TUHFATUL HANA
151611913100 TRI INDRA AJI PUTRA ALI SAIROZI, 197502121999031001
151611913102 UNY ASTIYANI MESWARI S.KM., S.Kep.,Ns., M.Kes.
151611913103 VENI DWI ALIFATUN
151611913104 VIDIA DINDA SAKTI
151611913105 VITA MARIA DWI PUSPITA S.
151611913109 YONGKY RAVINDA
151611913062 VIVI NUR INDAH SARI Dr. JONI HARYANTO, 19630608 199103 1002
151611913063 WAHYUNI PUSPITA N. S.Kp., M.Si.
151611913064 YOLANDA DWI SAFITRI
151611913110 YUNITA
151611913112 ZULFIAN RIFQI NOVANDY
151611913111 YUSVIYAH NURHIDAYATI
151611913113 ZUMROTUL FITRIYANTI
151611913114 EFI YULIANI
4 10-22 151611913001 ABDUL HAQ AL-ASRORI RINDAYATI, 196101251982122003
Desember 151611913005 AFIFATUL MAHMUDAH S. Kep., Ns., M.Kep.
2018 151611913010 ALFIA IMA FAUZIA NINGTYAS
151611913011 ALFIANTI INDAH CAHYANI
151611913012 ALFIATUL SAPUTRI
151611913002 ACHMAD JIHANSYAH PUTRA
151611913013 AMALIA NURUL ADZHANI
151611913014 ANJARWATI KHOTIBUL UMAM, 197308231998031008
151611913016 ARISKA SEPTIAN D. I. P. S.Kep., Ns., M.Kes.
151611913017 AVIVA APRILLIA DEVI
151611913003 ACHSAN TUDHONNY
151611913018 AYU PUJI LESTARI
151611913019 AZMIL MUFTACHORRO RINDAYATI, 196101251982122003
151611913022 BERNADHITA AJUNY FIRDA S. Kep., Ns., M.Kep.
151611913023 CHRISTINA YUNI AVISAH
151611913004 ADE ANANTA BOGA
151611913024 CINDY OKTAFIANI
151611913026 DENES EKA PRATIWI
151611913027 DEVITA DWI FERONIKA
151611913006 AGUS SETIAWAN KHOTIBUL UMAM, 197308231998031008
151611913028 DIANA YULI ROHMAWATI S.Kep., Ns., M.Kes.
151611913029 DITA ARDYANA DWI CAHYANI
151611913031 DWI DAMAYANTI
151611913032 DWI NUR ANUGRAH PUTRI
151611913007 AHMAD FAIQ KAUTSAR
151611913033 DWI REFORMANIA A.M
151611913034 EKA LAILI HIDAYATI M. ALI SAIROZI, 197502121999031001
151611913035 EKA NUR FARIDA S.KM., S.Kep.,Ns., M.Kes.
151611913036 ELMA NINDI LARASATI
151611913008 AHRIAN YUDHO PRAKOSO
151611913037 ELOK NUR CAHYATI
151611913038 ELVIN NARINDA IRAWATI Dr. JONI HARYANTO, 19630608 199103 1002
151611913039 EVIANA NUR AFIF A'YUNI S.Kp., M.Si.
151611913040 FADLILATUL QO'IMAH
151611913009 AIK BERLIAN INDRIANSYAH
151611913041 FARIDATUN NASICHAH
151611913042 FELLIA NURDIANA LATHIFAH
151611913043 FIFI LINDA FATMAWATI

a.n Dekan
Wakil Dekan I

Prof. Dr. Retna Apsari.,M.Si

NIP. 196806261993032003
002
002
Lampiran Surat Tugas Nomor : / UN3.1.14 / PPd / 2018
Tentang: Dosen Pembimbing Praktik Kerja Lapangan (PKL)/Praktik Klinik Keperawatan (PKK)

DOSEN PENGUJI PRAKTIK KLINIK KEPERAWATAN (PKK) DASAR II

PROGRAM STUDI D-III KEPERAWATAN
SEMESTER III T.A. 2018/2019
FAKULTAS VOKASI UNIVERITAS AIRLANGGA

DAFTAR KELOMPOK PKK DASAR II RSUD Dr. SOEGIRI LAMONGAN

DOSEN PEMBIMBING/
NO TANGGAL NIM NAMA MAHASISWA NIP
RUANGAN
1 26 Nov- 151711913001 A. KHIKAM MUDIN
1 Des 2018 151711913035 ILHAM BAYU SETYA PRATAMA CUCUK RAHMADI P., 196802151992031001
151711913095 ERVI TIKO NURHARVIAN S.Kp., M.Kes.
151711913006 ALDA MIFTACHUL QIROM R. DAHLIA
151711913007 ALDIAH PUTRI ANGGRAYNI
151711913008 ANASTASIA MEGA ANANDA
151711913010 AYU PUSPITASARI
151711913012 DEVITA WAHYU TRI WULANDARI
151711913002 ABDULLAH FAQIH
2 26 Nov- 151711913042 KEVIN AGASTIAN SARYONO
1 Des 2018 151711913013 DEWI HANUM NUR AINI AMELLIA MARDHIKA, 198509012009022012
151711913014 DIA AYU ANGGRAINI S.Kep., Ns., M.Kes.
151711913015 DIAH PUSPITA RACHMAWATI R. LAVENDER
151711913016 DIANA DWI YUSMITA SARI
151711913018 DINA DWI SHOFIANA
151711913019 DITA NOVITA SARI
3 26 Nov- 151711913003 ACHMAD AFANDI
1 Des 2018 151711913043 KHIZQIL ZEAN RAMADHAN ENDAH SRI WIJAYANTI, 197008111994012001
151711913020 DWI CHOIRUN NUPUS S.ST., M.Kes.
151711913021 EKA FATMAH FUJIYAH R. SEROJA
151711913022 EKA PUTRI NUR WANTI
151711913024 EVA LITA WULANDARI HASARI
151711913025 FADHILA OKTAVIAN
4 26 Nov- 151711913004 ACHMAD TEGAR AFFANDI
1 Des 2018 151711913050 M. AGUNG MAHENDRA ISWATUN, 197203311994032004
151711913026 FATKHIYATUL FITRIA S.Kep., Ns., M.Kes.
151711913027 FERINA CHAYANTI R. BOUGENVILLE
151711913029 GITA DIAN NAVELA
151711913030 HALIMATUS SYA'DIAH
151711913033 IGA MAYANK ANGGRAINI
5 26 Nov- 151711913005 AHMAD SYAIFUL ANIF
1 Des 2018 151711913051 M. SHOLAHUDIN SYAIFULLAH ALI SAIROZI, S.KM., 197502121999031001
151711913034 IKA KHOLIFATUL MAR'AH S.Kep., Ns., M.Kes.
151711913036 INDAH DWI LESTARI R. TERATAI
151711913037 INDAH MENIK PATMAWATI
151711913038 INDAH WIDYA NINGRUM
151711913039 IZZATA AULIA KHOIRUNNISA'
6 26 Nov- 151711913009 ANGGA TRI SETYAWAN
1 Des 2018 151711913055 MOH. FEBRI SECTIO NUGROHO KHOTIBUL UMAM, 197308231998031008
151711913040 JIHAN NURFANING HIU S.Kep., Ns., M.Kes.
 151711913041 KARTIKA DAMAYANTI R. FLAMBOYAN
151711913044 KIKI OKTAVIANI WINDI ASTUTI
151711913045 KURROTUL AINI
151711913046 LAILATUL FITRIA ROSA
7 26 Nov- 151711913011 CAHYO KUNCORO
1 Des 2018 151711913058 NANDA DWI SATRIO P. FANNI OKVIASANTI, 198604082009122003
151711913047 LAILATUL FITRIYAH S.Kep., Ns., M.Kep.
151711913048 LILIS NUR AZIZAH R. KEMUNING
151711913049 LITA ROHMAWATI
151711913052 MAHMUDA
151711913053 MELATI DEWI WARTIKA L.
8 26 Nov- 151711913017 DICKY ALIFFIYAN SAPUTRA
1 Des 2018 151711913067 PANCA ADE KURNIAWAN LAILATUL FADHLIYAH, 197301192002122001
151711913054 MIFTACHUL JANAH S.ST., M.Kes.
151711913056 NABILA PRAMESHELLA A. R. ANGGREK
151711913057 NADHIATUN NABILLA
151711913059 NI'MATUS SOLICHAH
151711913060 NILA ALFINA
9 26 Nov- 151711913023 ERWIN ARDIANSYAH
1 Des 2018 151711913076 SATRIYA AGUNG WICAKSONO ENDAH SRI WIJAYANTI, 197008111994012001
151711913061 NOVIA WAHYU NINGSRI S.ST., M.Kes.
151711913062 NUR AIDA RAHMAH AGUSTIN R. MELATI
151711913063 NUR FARADIS RAHMAH
151711913064 NUR KUMALA SARI
151711913065 NUR WAHYU PUTRI LESTARI

a.n Dekan
Wakil Dekan I

Prof. Dr. Retna Apsari.,M.Si

NIP. 196806261993032003
Lampiran Surat Tugas Nomor : / UN3.1.14 / PPd / 2018
Tentang: Dosen Pembimbing Praktik Kerja Lapangan (PKL)/Praktik Klinik Keperawatan (PKK)

DOSEN PENGUJI PRAKTIK KLINIK KEPERAWATAN (PKK) DASAR II

PROGRAM STUDI D-III KEPERAWATAN
SEMESTER III T.A. 2018/2019
FAKULTAS VOKASI UNIVERITAS AIRLANGGA

DAFTAR KELOMPOK PKK DASAR II RSI NASHRUL UMMAH LAMONGAN

DOSEN PEMBIMBING/
NO TANGGAL NIM NAMA MAHASISWA RUANGAN
1 26 Nov- 151711913028 GANIUSA MUKLISON
1 Des 2018 151711913084 TRI MIRZA CARISMA ISWATUN,
151711913066 NUR WIDYA RAHAYU S.Kep., Ns., M.Kes.
151711913068 PURNAMA RAHAYU R. SEDAP MALAM
151711913069 PUTRI KHOIRUN NISA
151711913070 PUTRI WAHYU LESTARI
2 26 Nov- 151711913071 QURROTA A'YUN
1 Des 2018 151711913031 HELMI DWI ADHI SATRIYO ALI SAIROZI, S.KM.,
151711913092 YUAN BAGUS DWI SAPUTRO S. S.Kep., Ns., M.Kes.
151711913072 RIFATUN ALIYAH R. MAWAR
151711913073 RIZADIA IFA ROSYIDAH
151711913074 RIZKY NUR AMALIA GESTIAFANI
3 26 Nov- 151711913075 SANIA INDAH OKTAVIA
1 Des 2018 151711913077 SITI AISYAH NURVIANTI KHOTIBUL UMAM,
151711913032 HERI KUSNANDAR S.Kep., Ns., M.Kes.
151711913093 ZAIDUL KHOIR R. ANGGREK
151711913078 SITI ERICA EMILIANA
151711913079 SITI MAESAROH
4 26 Nov- 151711913080 SITI NUR AFITA
1 Des 2018 151711913081 SUHAPRILYANAH EKA REPSYAH LAILATUL FADHLIYAH,
151711913082 TINA DWI TISNAWATI S.ST., M.Kes.
151711913083 TITIS MEY DITA NOFARISKAH R. SAKURA
151711913085 TSUROYYA NUR HABIBAH I.
151711913086 UMI MAMLU'UL HIKMAH
5 26 Nov- 151711913087 VIVI DWI PATMA
1 Des 2018 151711913088 WARDANI KUSUMANINGTYAS FANNI OKVIASANTI,
151711913089 WILDA RACHMATUL PRATIWI S.Kep., Ns., M.Kep.
151711913090 WIWIT R. MELATI
151711913091 WUKIRASIH UTARI RISANGAYU
151711913094 ZULFATUL FA'IZAH

a.n Dekan
Wakil Dekan I
Prof. Dr. Retna Apsari.,M.Si
NIP. 196806261993032003
rawatan (PKK)

K) DASAR II

AMONGAN

NIP

197203311994032004

197502121999031001

197308231998031008

197301192002122001

198604082009122003
na Apsari.,M.Si
261993032003
Lampiran Surat Tugas Nomor : / UN3.1.14 / PPd / 2018
Tentang: Dosen Pembimbing Praktik Kerja Lapangan (PKL)/Praktik Klinik Keperawatan (PKK)

DOSEN PENGUJI PRAKTIK KLINIK KEPERAWATAN (PKK) DASAR II

PROGRAM STUDI D-III KEPERAWATAN
SEMESTER III T.A. 2018/2019
FAKULTAS VOKASI UNIVERITAS AIRLANGGA

DAFTAR KELOMPOK PKK DASAR II RSUD IBNU SINA GRESIK

DOSEN PEMBIMBING/
NO TANGGAL NIM NAMA MAHASISWA NIP
RUANGAN
1 26 Nov- 151711913096 ADELSY UCHA YULITA
1 Des 2018 151711913120 MOHAMMAD FAHMI WAHYUDI RINDAYATI,
151711913099 AMELIA FIRDATIN NISA' S. Kep., Ns., M. Kep. 196101251980122003
151711913099 ANIK ISWATIH R. GARDENA
151711913102 ARIE SUYITNO
151711913101 ANTIKA CAHYANI
2 26 Nov- 151711913100 ANISAH FIRDAUS DWI A P
1 Des 2018 151711913103 AVINIA WIDYA SARI RINDAYATI,
151711913109 FANNI DYAH EKA SAPUTRI S. Kep., Ns., M. Kep. 196101251980122003
151711913106 DITA ANJELINA F. R. WIJAYA KUSUMA
151711913107 DWI INDAH RATNASARI
3 26 Nov- 151711913108 ERLINA MAULIDDYAH
1 Des 2018 151711913104 BAGUS SURYA RAMADHAN ABD. NASIR,
151711913110 FARIKHATUN JANNAH S. Kep., Ns., M. Kep. 196806281991031006
151711913111 FAUZIA WIDI ANDARI R. HELICONIA
151711913112 HUDZAIFAH SALSABILLA N.
4 26 Nov- 151711913113 HULIYATUN NAFISAH
1 Des 2018 151711913114 INTAN PUTRI RAMADHANI ABD. NASIR,
151711913129 RIFDLATUL KHURIN'IN S. Kep., Ns., M. Kep. 196806281991031006
151711913116 IZA DIANA MANZIL R. GARDENA
151711913117 KHIKMATUL MUNAWAROH
5 26 Nov- 151711913125 NUR EZZATI
1 Des 2018 151611913165 AGUS GUMILANG SUSILO HARIANTO,
151611913116 ALFARGHANI YOWONO S. Kep., Ns., M. Kep. 196604141992031010
151611913191 MAULANA SAPUTRA R. DAHLIA
151711913119 LENNI SHINTIANI SUCITRA S
6 26 Nov- 151711913097 AMBAR AYU OKTAVIANTI
1 Des 2018 151711913121 NAHDIYA NUR EL KAUSAR
151711913123 NOVIFAH ARIFIN SUSILO HARIANTO, 196604141992031010
151711913124 NOVITA DWI SUHARTINI S. Kep., Ns., M. Kep.
151711913127 RAHMAWATI FIRDAUSI R. DAHLIA
151711913126 NURJIHAN AMIRYYAH
7 26 Nov- 151711913118 LANGGENG WAHYU PRASETYO HAFNA ILMY
1 Des 2018 151711913128 REZA KRISYULIANTI MUHALLA,
151711913115 IWAN ABDUL GHONI S. Kep., Ns., M. Kep. 197812202006042026
151711913130 RIKHATUL JANNAH F. Sp. Kep. M.B.
151711913131 ROCHMANIYA EKA D. IGD
151711913132 SALSABILA AULYA FIRLI
8 26 Nov- 151711913133 SIGIT HENDRA WAHYUDI HAFNA ILMY
1 Des 2018 151711913134 SISKA FIRLY AZIZAH MUHALLA,
151711913135 SYARIFATUZ ZAHROH S. Kep., Ns., M. Kep. 197812202006042026
151711913136 VIDYA AYU PANGESTIKA Sp. Kep. M.B.
151711913137 VIKY SUGIARTO IGD
151711913138 WAHYU RAHMATULLAH

a.n Dekan
Wakil Dekan I

Prof. Dr. Retna Apsari.,M.Si

NIP. 196806261993032003