3 Sugirah Tawarsari 3
4 Suratinah Tawarsari 4
7 Saponiyati Purbosari 7
8 Supatmi Purbosari 8
10 Rumini Madusari 10
13 Sajem Ngelorejo 13
14 Wartini Ngelorejo 14
17 Sarniyati Jatirejo 17
18 Harmiyati Jatirejo 18
PPH Ps. 21
No Nama Alamat Penerimaan Terima Bersih Tanda Tangan
6%
1 Utik Sri W Piyaman II Rp 20,000 Rp 1,200 Rp 18,800 1
PPH Ps.
Penerimaan Terima Bersih
No Nama Alamat 21 6% Tanda Tangan
(Rp) (Rp)
(Rp)
Nurhasan, AMKL.SST
dr.Jolanda Barahama NIP.19701007 199503 1001
NIP.19650701 200212 2 001
DAFTAR PENERIMAAN TRANSPORT KADER DALAM RANGKA PENDATAAN PHBS TERINTEGRASI
DI DESA KEPEK UPT PUSKESMAS WONOSARI II TANGGAL MEI 2014
Penerimaa
No Nama Alamat Tanda Tangan
n
JUMLAH 405,000
Nurhasan, AMKL.SST
NIP.19701007 199503 1001
DAFTAR HADIR PERTEMUAN KADER POSYANDU DESA : GARI
UPT PUSKESMAS WONOSARI II TANGGAL : BULAN: TAHUN 2014
28 Sumartini Karangtengah II 28
29 Suhartini Karangtengah II 29
30 Ratmini Karangtengah II 30
31 Wulandari Kajar I 31
32 Ramiyatun Kajar I 32
33 Suswantini Kajar I 33
34 Supraptinah Kajar I 34
35 Susiani Kajar I 35
36 Rukinah Duwetrejo 36
37 Bastini Duwetrejo 37
38 Sulastri Duwetrejo 38
39 Ngatemi Duwetrejo 39
40 Paini Duwetrejo 40
41 Jumiyem Karangtengah I 41
42 Sugini Karangtengah I 42
43 Ninik Suryati Karangtengah I 43
Nurhasan, AMKL.SST
NIP.19701007 199503 1001
DAFTAR HADIR PERTEMUAN KADER POSYANDU DESA : PIYAMAN
UPT PUSKESMAS WONOSARI II TANGGAL : BULAN: TAHUN 2014
No Nama Alamat Tanda Tangan
1 Utik Sri W Piyaman II 1
2 Rini Haryati Piyaman II 2
3 Sri Muryani Piyaman II 3
4 Supartini Piyaman II 4
5 Wiwit Mar Sigit Piyaman II 5
6 Ib. Sangidu Kemorosari II A 6
7 Supinah Kemorosari II A 7
8 Sugiyati Kemorosari II A 8
9 Purwanti Kemorosari II A 9
10 Badriyah Kemorosari II A 10
11 Muji Lestari Ngerboh II 11
12 Chalifah Ngerboh II 12
13 Wartini Ngerboh II 13
14 Tugiran Ngerboh II 14
15 Sri Ningsih Ngerboh II 15
16 Rumiyati Ngemplek 16
17 Karminem Ngemplek 17
18 Suti Hartini Ngemplek 18
19 Suratmiyati Ngemplek 19
20 Supinem Ngemplek 20
21 Widyaningsih Kemorosari II B 21
22 Suhartini Kemorosari II B 22
23 Sudarmini Kemorosari II B 23
24 Ngatemi Kemorosari II B 24
25 Ita Dwi wati Kemorosari II B 25
26 Rinawati Budegan I 26
27 Supadmi Budegan I 27
28 Tentrem Budegan I 28
29 Ngateni Budegan I 29
30 Legi Budegan I 30
31 Tri Nuryani Ngerboh I 31
32 Gunik Astuti Ngerboh I 32
33 Sukamti Ngerboh I 33
34 Suciati Ngerboh I 34
35 Turut Tri Baryati Ngerboh I 35
36 Suparmiyati Pakelrejo 36
37 Ismiyati Pakelrejo 37
38 Sugiyem Pakelrejo 38
39 Suprihatin Pakelrejo 39
40 Th. Sukartini Pakelrejo 40
41 Sri Sugiyanti Kemorosari I 41
42 Suprapti Kemorosari I 42
43 Kasmiyati Kemorosari I 43
44 Partini Kemorosari I 44
45 Susanti Kemorosari I 45
46 Marini Pakeljaluk 46
47 Samiyem Pakeljaluk 47
48 Suliyem Pakeljaluk 48
49 Rubini Pakeljaluk 49
50 Sarmiati Pakeljaluk 50
51 Painah Budegan II 51
52 Sawiyem Budegan II 52
53 Temu Budegan II 53
54 Sartini Budegan II 54
55 Yuliati Budegan II 55
56 Sukasmi Piyaman I 56
57 Wartini Piyaman I 57
58 Rubinah Piyaman I 58
59 Susi Haryati Piyaman I 59
60 Sukimah Piyaman I 60
JUMLAH
Mengetahui 2014
Ka.Puskesmas Wonosari II Penyelenggara
PPH Ps. 21
No Nama Alamat Penerimaan Terima Bersih Tanda Tangan
6%
1 Siti Khalimah, SPd. Trimulyo I 30,000 1,800 28,200 1
2 Retno Mulatsih Trimulyo I 30,000 1,800 28,200 2
3 Ngatinem Marjono Trimulyo I 30,000 1,800 28,200 3
4 Larsi Suwanto Trimulyo I 30,000 1,800 28,200 4
5 Anjar Suprihatin Trimulyo I 30,000 1,800 28,200 5
6 Suprapti Bansari 30,000 1,800 28,200 6
7 Lasmiyati Bansari 30,000 1,800 28,200 7
8 Sudiyaningsih Bansari 30,000 1,800 28,200 8
9 Tri Iswanti Bansari 30,000 1,800 28,200 9
10 Sudarmi Bansari 30,000 1,800 28,200 10
11 Purwantiningsih Kranon 30,000 1,800 28,200 11
12 Supiyah Kranon 30,000 1,800 28,200 12
13 Suwoto Kranon 30,000 1,800 28,200 13
14 Supadmi Kranon 30,000 1,800 28,200 14
15 Sri Pratiwi Kranon 30,000 1,800 28,200 15
16 Murni Tegalmulyo 30,000 1,800 28,200 16
17 Rumiyati Tegalmulyo 30,000 1,800 28,200 17
18 Esti Tegalmulyo 30,000 1,800 28,200 18
19 Siti Nurhayati Tegalmulyo 30,000 1,800 28,200 19
20 Daryati Tegalmulyo 30,000 1,800 28,200 20
21 Muslihah Ledoksari 30,000 1,800 28,200 21
22 Sri Sumaryati Ledoksari 30,000 1,800 28,200 22
23 Tuminiyati Ledoksari 30,000 1,800 28,200 23
24 Samiyati Ledoksari 30,000 1,800 28,200 24
25 Wagiyem Ledoksari 30,000 1,800 28,200 25
26 Supeni Indiyati Trimulyo II 30,000 1,800 28,200 26
27 Karminah Trimulyo II 30,000 1,800 28,200 27
28 Suharti Trimulyo II 30,000 1,800 28,200 28
29 Erni Kurniati Trimulyo II 30,000 1,800 28,200 29
30 Ela Hayati Trimulyo II 30,000 1,800 28,200 30
31 Eliyanah Isyadi Puri Handayani 30,000 1,800 28,200 31
32 Rudiatini Sarino Puri Handayani 30,000 1,800 28,200 32
33 Sukarni Suroyo Puri Handayani 30,000 1,800 28,200 33
34 Rini Karyati Bambang Puri Handayani 30,000 1,800 28,200 34
35 Dwi Handayani Puri Handayani 30,000 1,800 28,200 35
36 Sri Hardimah Kepek I 30,000 1,800 28,200 36
37 Suminem Kepek I 30,000 1,800 28,200 37
38 Siti Bisrochah Kepek I 30,000 1,800 28,200 38
39 Suparti Kepek I 30,000 1,800 28,200 39
40 Iin Alwi Kepek I 30,000 1,800 28,200 40
41 Ismiyati Kepek II 30,000 1,800 28,200 41
42 Susiawati Kepek II 30,000 1,800 28,200 42
43 Aminati Kepek II 30,000 1,800 28,200 43
44 Sulastri Kepek II 30,000 1,800 28,200 44
45 Sriyati Kepek II 30,000 1,800 28,200 45
46 Siti Sudarmi Sumbermulyo 30,000 1,800 28,200 46
47 Suwarmiyati Sumbermulyo 30,000 1,800 28,200 47
48 Suharti Sumbermulyo 30,000 1,800 28,200 48
49 Maryati Sumbermulyo 30,000 1,800 28,200 49
50 Sarmini Sumbermulyo 30,000 1,800 28,200 50
51 Ngadiyanto Jeruk Kepek 30,000 1,800 28,200 51
52 Iswahyuni Jeruk Kepek 30,000 1,800 28,200 52
53 Nunuk Salami Jeruk Kepek 30,000 1,800 28,200 53
54 Sri Hidayati Jeruk Kepek 30,000 1,800 28,200 54
55 Surahmi Jeruk Kepek 30,000 1,800 28,200 55
Rp 1,650,000 Rp 99,000 Rp 1,551,000
PPH Ps.
Penerimaan Terima Bersih
No Nama Alamat 21 6% Tanda Tangan
(Rp) (Rp)
(Rp)
1 Tris Yuani Rejosari 30,000 1,800 28,200 1
2 Puji Suatmi Rejosari 30,000 1,800 28,200 2
3 Sukartinah Rejosari 30,000 1,800 28,200 3
4 Kartinem Rejosari 30,000 1,800 28,200 4
5 Utami Rejosari 30,000 1,800 28,200 5
6 Sri Mudiati Purwosari 30,000 1,800 28,200 6
7 Kaminah Purwosari 30,000 1,800 28,200 7
8 Aryati Purwosari 30,000 1,800 28,200 8
9 Sadiyem Purwosari 30,000 1,800 28,200 9
10 Neneng Rohimah Purwosari 30,000 1,800 28,200 10
11 Suhardani Mulyosari 30,000 1,800 28,200 11
12 Maryatun Mulyosari 30,000 1,800 28,200 12
13 Sulastri Mulyosari 30,000 1,800 28,200 13
14 Ngatinem Mulyosari 30,000 1,800 28,200 14
15 Tri Kusdiyati Mulyosari 30,000 1,800 28,200 15
16 Puji Asri Wukirsari 30,000 1,800 28,200 16
17 Sumartinah Wukirsari 30,000 1,800 28,200 17
18 Widyaningsih Wukirsari 30,000 1,800 28,200 18
19 Puji Astuti Wukirsari 30,000 1,800 28,200 19
20 Suwarti Wukirsari 30,000 1,800 28,200 20
21 Sumiyati Gedangsari 30,000 1,800 28,200 21
22 Supriyati Gedangsari 30,000 1,800 28,200 22
23 Musjiyati Tumiran Gedangsari 30,000 1,800 28,200 23
24 Th. Ngatinah Gedangsari 30,000 1,800 28,200 24
25 Supinah Gedangsari 30,000 1,800 28,200 25
26 Dyah Winarsih Polres 30,000 1,800 28,200 26
27 Sutarsih Polres 30,000 1,800 28,200 27
28 Hepy Sugeng Polres 30,000 1,800 28,200 28
29 Elita Polres 30,000 1,800 28,200 29
30 Purwanti Polres 30,000 1,800 28,200 30
JUMLAH 900,000 54,000 846,000
Nurhasan, AMKL.SST
NIP.19701007 199503 1001
DAFTAR PENERIMAAN HONOR KADER POSYANDU DESA GARI
UPT PUSKESMAS WONOSARI II TRIBULAN TAHUN 2014
PPH Ps.
No Nama Alamat Penerimaan Terima Bersih Tanda Tangan
21 6%
1 Suhartatik Kajar III 30,000 1,800 28,200 1
2 Sugiyanti B Kajar III 30,000 1,800 28,200 2
3 Sugiyanti C Kajar III 30,000 1,800 28,200 3
4 Kasini Kajar III 30,000 1,800 28,200 4
5 Martini Kajar III 30,000 1,800 28,200 5
6 Rosi Lestari Sidorejo 30,000 1,800 28,200 6
7 Supraptinah Sidorejo 30,000 1,800 28,200 7
8 Jumini Sidorejo 30,000 1,800 28,200 8
9 Umi Lestari Sidorejo 30,000 1,800 28,200 9
10 Siti Suharni Sidorejo 30,000 1,800 28,200 10
11 Mariyati Kedung II 30,000 1,800 28,200 11
12 Sri Suyatini Kedung II 30,000 1,800 28,200 12
13 Muji Rahayu Kedung II 30,000 1,800 28,200 13
14 Ngadirahayu Kedung II 30,000 1,800 28,200 14
15 Suliyem Kedung II 30,000 1,800 28,200 15
16 Sri Alfiatun Kajar II 30,000 1,800 28,200 16
17 Sri Lestari Kajar II 30,000 1,800 28,200 17
18 Suyahmi Kajar II 30,000 1,800 28,200 18
19 Sofiatun Kajar II 30,000 1,800 28,200 19
20 Etik Setiyani Kajar II 30,000 1,800 28,200 20
21 Murni Lestari Kedung I 30,000 1,800 28,200 21
22 Samiyah Kedung I 30,000 1,800 28,200 22
23 Ngadisah Kedung I 30,000 1,800 28,200 23
24 Wakisah Kedung I 30,000 1,800 28,200 24
25 Mintarti Kedung I 30,000 1,800 28,200 25
26 Sumarah Karangtengah II 30,000 1,800 28,200 26
27 Sutini Karangtengah II 30,000 1,800 28,200 27
28 Sumartini Karangtengah II 30,000 1,800 28,200 28
29 Suhartini Karangtengah II 30,000 1,800 28,200 29
30 Ratmini Karangtengah II 30,000 1,800 28,200 30
31 Wulandari Kajar I 30,000 1,800 28,200 31
32 Ramiyatun Kajar I 30,000 1,800 28,200 32
33 Suswantini Kajar I 30,000 1,800 28,200 33
34 Supraptinah Kajar I 30,000 1,800 28,200 34
35 Susiani Kajar I 30,000 1,800 28,200 35
36 Rukinah Duwetrejo 30,000 1,800 28,200 36
37 Bastini Duwetrejo 30,000 1,800 28,200 37
38 Sulastri Duwetrejo 30,000 1,800 28,200 38
39 Ngatemi Duwetrejo 30,000 1,800 28,200 39
40 Paini Duwetrejo 30,000 1,800 28,200 40
41 Jumiyem Karangtengah I 30,000 1,800 28,200 41
42 Sugini Karangtengah I 30,000 1,800 28,200 42
43 Ninik Suryati Karangtengah I 30,000 1,800 28,200 43
44 Sri Suhartini Karangtengah I 30,000 1,800 28,200 44
45 Rini Pratiwi Karangtengah I 30,000 1,800 28,200 45
46 Jumi Karangtengah III 30,000 1,800 28,200 46
47 Sudarsi Karangtengah III 30,000 1,800 28,200 47
48 Puji Lestari Karangtengah III 30,000 1,800 28,200 48
49 Wariyah Karangtengah III 30,000 1,800 28,200 49
50 Wartini Karangtengah III 30,000 1,800 28,200 50
Rp 1,500,000 Rp 90,000 Rp 1,410,000
Nurhasan, AMKL.SST
NIP.19701007 199503 1001
DAFTAR PENERIMAAN HONOR KADER POSYANDU DESA PIYAMAN
UPT PUSKESMAS WONOSARI II TRIBULAN Th.2014
No Nama Alamat Penerimaan PPH Ps. 21 6% Terima Bersih Tanda Tangan
1 Utik Sri W Piyaman II 30,000 Rp 1,800 Rp 28,200 1
2 Rini Haryati Piyaman II 30,000 Rp 1,800 Rp 28,200 2
3 Sri Muryani Piyaman II 30,000 Rp 1,800 Rp 28,200 3
4 Supartini Piyaman II 30,000 Rp 1,800 Rp 28,200 4
5 Wiwit Mar Sigit Piyaman II 30,000 Rp 1,800 Rp 28,200 5
6 Ib. Sangidu Kemorosari II A 30,000 Rp 1,800 Rp 28,200 6
7 Supinah Kemorosari II A 30,000 Rp 1,800 Rp 28,200 7
8 Sugiyati Kemorosari II A 30,000 Rp 1,800 Rp 28,200 8
9 Purwanti Kemorosari II A 30,000 Rp 1,800 Rp 28,200 9
10 Badriyah Kemorosari II A 30,000 Rp 1,800 Rp 28,200 10
11 Muji Lestari Ngerboh II 30,000 Rp 1,800 Rp 28,200 11
12 Chalifah Ngerboh II 30,000 Rp 1,800 Rp 28,200 12
13 Wartini Ngerboh II 30,000 Rp 1,800 Rp 28,200 13
14 Tugiran Ngerboh II 30,000 Rp 1,800 Rp 28,200 14
15 Sri Ningsih Ngerboh II 30,000 Rp 1,800 Rp 28,200 15
16 Rumiyati Ngemplek 30,000 Rp 1,800 Rp 28,200 16
17 Karminem Ngemplek 30,000 Rp 1,800 Rp 28,200 17
18 Suti Hartini Ngemplek 30,000 Rp 1,800 Rp 28,200 18
19 Suratmiyati Ngemplek 30,000 Rp 1,800 Rp 28,200 19
20 Supinem Ngemplek 30,000 Rp 1,800 Rp 28,200 20
21 Widyaningsih Kemorosari II B 30,000 Rp 1,800 Rp 28,200 21
22 Suhartini Kemorosari II B 30,000 Rp 1,800 Rp 28,200 22
23 Sudarmini Kemorosari II B 30,000 Rp 1,800 Rp 28,200 23
24 Ngatemi Kemorosari II B 30,000 Rp 1,800 Rp 28,200 24
25 Ita Dwi wati Kemorosari II B 30,000 Rp 1,800 Rp 28,200 25
26 Rinawati Budegan I 30,000 Rp 1,800 Rp 28,200 26
27 Supadmi Budegan I 30,000 Rp 1,800 Rp 28,200 27
28 Tentrem Budegan I 30,000 Rp 1,800 Rp 28,200 28
29 Ngateni Budegan I 30,000 Rp 1,800 Rp 28,200 29
30 Legi Budegan I 30,000 Rp 1,800 Rp 28,200 30
31 Tri Nuryani Ngerboh I 30,000 Rp 1,800 Rp 28,200 31
32 Gunik Astuti Ngerboh I 30,000 Rp 1,800 Rp 28,200 32
33 Sukamti Ngerboh I 30,000 Rp 1,800 Rp 28,200 33
34 Suciati Ngerboh I 30,000 Rp 1,800 Rp 28,200 34
35 Turut Tri Baryati Ngerboh I 30,000 Rp 1,800 Rp 28,200 35
36 Suparmiyati Pakelrejo 30,000 Rp 1,800 Rp 28,200 36
37 Ismiyati Pakelrejo 30,000 Rp 1,800 Rp 28,200 37
38 Sugiyem Pakelrejo 30,000 Rp 1,800 Rp 28,200 38
39 Suprihatin Pakelrejo 30,000 Rp 1,800 Rp 28,200 39
40 Th. Sukartini Pakelrejo 30,000 Rp 1,800 Rp 28,200 40
41 Sri Sugiyanti Kemorosari I 30,000 Rp 1,800 Rp 28,200 41
42 Suprapti Kemorosari I 30,000 Rp 1,800 Rp 28,200 42
43 Kasmiyati Kemorosari I 30,000 Rp 1,800 Rp 28,200 43
44 Partini Kemorosari I 30,000 Rp 1,800 Rp 28,200 44
45 Susanti Kemorosari I 30,000 Rp 1,800 Rp 28,200 45
46 Marini Pakeljaluk 30,000 Rp 1,800 Rp 28,200 46
47 Samiyem Pakeljaluk 30,000 Rp 1,800 Rp 28,200 47
48 Suliyem Pakeljaluk 30,000 Rp 1,800 Rp 28,200 48
49 Rubini Pakeljaluk 30,000 Rp 1,800 Rp 28,200 49
50 Sarmiati Pakeljaluk 30,000 Rp 1,800 Rp 28,200 50
51 Painah Budegan II 30,000 Rp 1,800 Rp 28,200 51
52 Sawiyem Budegan II 30,000 Rp 1,800 Rp 28,200 52
53 Temu Budegan II 30,000 Rp 1,800 Rp 28,200 53
54 Sartini Budegan II 30,000 Rp 1,800 Rp 28,200 54
55 Yuliati Budegan II 30,000 Rp 1,800 Rp 28,200 55
56 Sukasmi Piyaman I 30,000 Rp 1,800 Rp 28,200 56
57 Wartini Piyaman I 30,000 Rp 1,800 Rp 28,200 57
58 Rubinah Piyaman I 30,000 Rp 1,800 Rp 28,200 58
59 Susi Haryati Piyaman I 30,000 Rp 1,800 Rp 28,200 59
60 Sukimah Piyaman I 30,000 Rp 1,800 Rp 28,200 60
JUMLAH Rp 1,800,000 Rp 108,000 Rp 1,692,000
PPH Ps. 21
No Nama Alamat Penerimaan Terima Bersih Tanda Tangan
6%
1 Susilah Selang III 30,000 1,800 28,200 1
2 Wartiyem Selang III 30,000 1,800 28,200 2
3 Sri Lestari Selang III 30,000 1,800 28,200 3
4 Tri Haryati Selang III 30,000 1,800 28,200 4
5 Supiah Selang III 30,000 1,800 28,200 5
6 Tugiyem Selang V 30,000 1,800 28,200 6
7 Marsiyem Selang V 30,000 1,800 28,200 7
8 Lulun K Selang V 30,000 1,800 28,200 8
9 Endang Suprihatin Selang V 30,000 1,800 28,200 9
10 Endah Purwani Selang V 30,000 1,800 28,200 10
11 Sulamini Selang IV 30,000 1,800 28,200 11
12 Setiyatmi Selang IV 30,000 1,800 28,200 12
13 Sukarmi Selang IV 30,000 1,800 28,200 13
14 Tumilah Selang IV 30,000 1,800 28,200 14
15 Sumiyati Selang IV 30,000 1,800 28,200 15
16 Kusminiyati Selang II 30,000 1,800 28,200 16
17 Sugirahayu Selang II 30,000 1,800 28,200 17
18 Wasriyani Selang II 30,000 1,800 28,200 18
19 Sarinah Selang II 30,000 1,800 28,200 19
20 Siti M Selang II 30,000 1,800 28,200 20
21 Sukartinah Selang I 30,000 1,800 28,200 21
22 Bety Susanti Selang I 30,000 1,800 28,200 22
23 Wasikem Selang I 30,000 1,800 28,200 23
24 Emisari Utami Selang I 30,000 1,800 28,200 24
25 Kemiyati Selang I 30,000 1,800 28,200 25
26 Sugiyanti Randukuning II 30,000 1,800 28,200 26
27 Tumiyati Randukuning II 30,000 1,800 28,200 27
28 Ngatilah Randukuning II 30,000 1,800 28,200 28
29 Watiyem Randukuning II 30,000 1,800 28,200 29
30 Danik Randukuning II 30,000 1,800 28,200 30
31 Catur P Randukuning I 30,000 1,800 28,200 31
32 Nurjanah Randukuning I 30,000 1,800 28,200 32
33 Paniyem Randukuning I 30,000 1,800 28,200 33
34 Trimiyati Randukuning I 30,000 1,800 28,200 34
35 Amin Randukuning I 30,000 1,800 28,200 35
36 Setiti Randukuning III 30,000 1,800 28,200 36
37 Endang RW Randukuning III 30,000 1,800 28,200 37
38 Giyem Randukuning III 30,000 1,800 28,200 38
39 Suryani Randukuning III 30,000 1,800 28,200 39
40 Paikem Randukuning III 30,000 1,800 28,200 40
41 Sumarni Mokol 30,000 1,800 28,200 41
42 Tatik Winarti Mokol 30,000 1,800 28,200 42
43 Rusmiyati Mokol 30,000 1,800 28,200 43
44 Winarsih Mokol 30,000 1,800 28,200 44
45 Tuginah Mokol 30,000 1,800 28,200 45
JUMLAH Rp 1,350,000 Rp 81,000 Rp 1,269,000