DAFTAR URUT KEPANGKATAN PEGAWAI PUSKESMAS SUMBERJAYA

PERIODE JANUARI 2019

NO NAMA NIP PANGKAT/ TMT PANGKAT JABATAN TMT MASA KERJA LATIHAN TAHUN PEND TAHUN
GOLONGAN JABATAN JABATAN UMUM
TAHUN BULAN

1 2 3 4 5 6 7 8 9 10 11 12 13
1 Subiyanto, S.Kep 19720628199803100 4 III/d 4/1/2014 Ka. Puskesmas 8/10/2018 20 10 Diklat PIM 2018 s1
2 Wasiyem 19630423 198503 2003 III/c 1/10/2013 Kasubbag TU 1/10/2010 33 10 Prajabatan 1988 SMEA 1983
3 dr. Madina Firdaus 19691202 200212 2003 IV/b 1/4/2016 Dokter Puskes 1/1/2016 16 1 Prajabatan 2003 Kedokteran 1994
4 Asrullah 19661021 198701 1001 III/d 1/4/2012 P. Gigi 1/4/2012 32 0 Prajabatan 1988 SPRG 1986
5 Syaifudin, Amd.Kep 19650524 198703 1001 III/d 1/4/2016 Perawat 1/4/2012 31 10 Prajabatan 1988 AKPER 2003
6 Opang Bambang 19730120 199501 1001 III/d 1/4/2016 Perawat 1/7/2012 24 0 Prajabatan 1988 AKPER 1993
7 Iskandar mega 19700717 199203 1004 III/d 1/10/2018 Farmasi 1/10/2013 26 11 Prajabatan 1996 SAA 1993
8 Trisno 19720208 199402 1006 III/d 10/1/2018 Perawat 1/4/2008 24 11 Prajabatan 1991 AKPER 1989
9 Dwi Prihandoko, S.Kep.Ners 19820118 200902 1001 III/d 10/1/2017 Perawat 10/4/2017 9 11 Prajabatan 1993 S.KEP 1991
10 Susiyanti, S.Kep 19830924 200804 2001 III/d 01-04-2018 Perawat 1/10/2013 10 8 Prajabatan 1993 S.KEP 1994
11 Ependi, Amd.Kep 19720520 199403 1007 III/d 1/10/2013 Perawat 1/10/2013 24 10 Prajabatan 1996 SPK 1994
12 Toil Ansori, Amd.Kep 19690603 199202 1001 III/c 1/10/2015 Perawat 1/10/2013 26 11 Prajabatan 1996 AKPER 1991
13 Nita Yulita, SKM 19850107 200604 2002 III/c 10/1/2017 Kebidanan 1/4/2012 12 9 Prajabatan 2010 KESMAS 2010
14 Dina Prihatin, s.Kep. Ners 821102 201101 2003 III/c 10/1/2017 Perawat 4/1/2012 8 0 Prajabatan 2009 S.Kep 1992
15 Eva Indriyanti, SKM., M.M 19409042006042 007 III/b 4/1/2016 11 0 prajabatan 2016 MM 2015
16 Titin Aryantini, Amd.Gz 19693012 198902 2004 III/b 4/1/2008 Gizi 1/10/2013 29 11 Prajabatan 1993 SPAG 1989
17 Dini andriani, Amd.Keb 198500119 200804 2002 III/b 10/1/2017 Kebidanan 1/4/2014 10 9 Prajabatan 2007 AKBID 2007
18 Silvi Septiana, AMAK 19850918 200904 2002 III/b 10/1/2017 Laboratorium 1/10/2014 9 9 Prajabatn 2007 AMAK 2014
19 Nani Kurniah, SST 19750504 200604 2015 III/b 10/1/2017 Bidan Desa 1/4/2014 12 9 Prajabatan 2009 SST 2014
20 Asifa Permatasari, Amd.Keb 19860907 200902 2002 III/b 10/1/2017 Bidan 4/1/2016 9 11 Prajabatn 2006 AKBID 2004
21 Yosi Kasari, Amd.Keb 19880918 201101 2006 III/a 1/4/2014 Bidan 1/4/2013 8 0 Prajabatan 2010 AKBID 2007
22 Neneng Tati sumirah 19770831 200701 2007 III/a 10/1/2017 Bidan 1/4/2014 12 0 Prajabatan 2012 AKBID 2009
23 Asnawati 19770621 200604 2020 III/a 10/1/2017 Bidan 1/4/2011 12 9 Prajabatan 1993 AKBID 2015
24 Novita haasda, Amd.Keb 19871122 201101 2004 III/a 10/1/2017 Perawat 1/4/2014 8 0 Prajabatn 2012 AKPER 2010
25 Ayu Anggraeni, Amd.Keb 19900413 201402 2001 II/d 10/1/2017 Bidan 1/4/2012 4 11 Prajabatan 2007 AKBID 1989
26 Miharti, Amd.Kep 19851215 201402 2001 II/d 10/1/2017 Perawat 1/4/2013 4 11 Prajabatan 2008 AKPER 2007
27 Eman Dasman, Amd.Kep 19720809 201407 10001 II/d 10/1/2017 Perawat 1/2/2014 4 6 Prajabtan 2015 AKPER 2000
28 Adi nuryadi, Amd.Kep 19751217 201417 1001 II/d 10/1/2017 Perawat 1/2/2014 4 6 Prajabatan 2015 AKPER 2004
29 Leni Patriawati 19831127 201001 2011 II/d 10/1/2017 Perawat 1/4/2013 9 0 Prajabatan 2011 AKPER
30 Canndra Dewi 19800408 201101 2013 II/c 4/1/2017 Perawat 4/1/2014 8 0 Prajabatan 2011 AKPER
31 Nining Nuraini, Amd.Keb 19890411201705200 5 II/c 8/1/2018 Bidan Desa 8/1/2018 1 8 Prajabatan 2018 AKBID 2010
32 Eva Santi, Amd.Keb 19900219201705200 1 II/c 8/1/2018 Bidan Desa 8/1/2018 1 8 Prajabatan 2018 AKBID 2011
33 Yesi desi sandi, Amd.Keb 19861223201705200 3 II/c 8/1/2018 Bidan Desa 8/1/2018 1 8 Prajabatan 2018 AKBID 2008
34 Neni Sumartini, Amd.Keb 19870321 201705200 3 II/c 8/1/2018 Bidan Desa 8/1/2018 1 8 Prajabatan 2018 AKBID 2008
35 Desi Rahmawati, Amd.Keb 19901208201705200 2 II/c 8/1/2018 Bidan Desa 8/1/2018 1 8 Prajabatan 2018 AKBID 2011
36 Desfilia Pratiwi, Amd.Keb 1990120772017 052001 II/c 8/1/2018 Bidan 8/1/2018 1 8 Prajabatan 2018 AKBID 2010
TANGGAL CATATAN
LAHIR MUTASI
KEPEGAWAIA
N
14 15
6/28/1972 8/10/2018
4/23/1963 10/10/1989
2/12/1969
21-10-1966
5/24/1965
10/20/1973
07/17/1970
8/2/1972
2/18/1982
9/24/1983
20-05-1972
20-10-1973
18-01-1982
24-09-1983
9/4/1984
12/30/1968
1/7/1985
4/5/1975
19-07-1985
7/1/1981
7/9/1986
22-11-1987
8/31/1977
18-09-1988
21-06-1977
31-08-1977
13-04-1990
15-12-1985
27-11-1983
8/4/1980
4/11/1989
19-021990
12/23/1986
3/21/1987
12/8/1990
12/7/1990
 DAFTAR URUT KEPANGKATAN PEGAWAI PUS
PERIODE JANUARI 201

NO NAMA NIP PANGKAT/ TMT PANGKAT

GOLONGAN

1 2 3 4 5
1 yetty susanti, SST.,M.Kes 197403 III/b 8/1/2017
2 Wasiyem 19630423 198503 2003 III/c 1/10/2013
3 dr. Madina Firdaus 19691202 200212 2003 IV/b 1/4/2016
4 Asrullah 19661021 198701 1001 III/d 1/4/2012
5 Syaifudin, Amd.Kep 19650524 198703 1001 III/d 1/4/2016
6 Opang Bambang 19730120 199501 1001 III/d 1/4/2016
7 Iskandar mega 19700717 199203 1004 III/d 1/10/2018
8 Trisno 19720208 199402 1006 III/d 10/1/2018
9 Dwi Prihandoko, S.Kep.Ners 19820118 200902 1001 III/d 10/1/2017
10 Susiyanti, S.Kep 19830924 200804 2001 III/d 01-04-2018
11 Ependi, Amd.Kep 19720520 199403 1007 III/d 1/10/2013
12 Toil Ansori, Amd.Kep 19690603 199202 1001 III/c 1/10/2015
13 Nita Yulita, SKM 19850107 200604 2002 III/c 10/1/2017
14 Dina Prihatin, s.Kep. Ners 821102 201101 2003 III/c 10/1/2017
15 Titin Aryantini, Amd.Gz 19693012 198902 2004 III/b 4/1/2008
16 Dini andriani, Amd.Keb 198500119 200804 2002 III/b 10/1/2017
17 Silvi Septiana, AMAK 19850918 200904 2002 III/b 10/1/2017
18 Nani Kurniah, SST 19750504 200604 2015 III/b 10/1/2017
19 Asifa Permatasari, Amd.Keb 19860907 200902 2002 III/b 10/1/2017
20 Yosi Kasari, Amd.Keb 19880918 201101 2006 III/a 1/4/2014
21 Neneng Tati sumirah 19770831 200701 2007 III/a 10/1/2017
22 Asnawati 19770621 200604 2020 III/a 10/1/2017
23 Novita haasda, Amd.Keb 19871122 201101 2004 III/a 10/1/2017
24 Ayu Anggraeni, Amd.Keb 19900413 201402 2001 II/d 10/1/2017
25 Miharti, Amd.Kep 19851215 201402 2001 II/d 10/1/2017
26 Eman Dasman, Amd.Kep 19720809 201407 10001 II/d 10/1/2017
27 Adi nuryadi, Amd.Kep 19751217 201417 1001 II/d 10/1/2017
28 Leni Patriawati 19831127 201001 2011 II/d 10/1/2017
29 Canndra Dewi 19800408 201101 2013 II/c 4/1/2017
30 Nining Nuraini, Amd.Keb 19890411201705200 5 II/c 8/1/2018
31 Eva Santi, Amd.Keb 19900219201705200 1 II/c 8/1/2018
32 Yesi desi sandi, Amd.Keb 19861223201705200 3 II/c 8/1/2018
33 Neni Sumartini, Amd.Keb 19870321 201705200 3 II/c 8/1/2018
34 Desi Rahmawati, Amd.Keb 19901208201705200 2 II/c 8/1/2018
35 Desfilia Pratiwi, Amd.Keb 1990120772017 052001 II/c 8/1/2018
RUT KEPANGKATAN PEGAWAI PUSKESMAS SUMBERJAYA
PERIODE JANUARI 2018

JABATAN TMT MASA KERJA LATIHAN TAHUN PEND TAHUN

JABATAN JABATAN UMUM
TAHUN BULAN

6 7 8 9 10 11 12 13
Ka. Puskesmas 8/1/2017 20 10 prajabatan 2018 s2 2018
Kasubbag TU 1/10/2010 33 10 Prajabatan 1988 SMEA 1983
Dokter Puskes 1/1/2016 16 1 Prajabatan 2003 Kedokteran 1994
P. Gigi 1/4/2012 32 0 Prajabatan 1988 SPRG 1986
Perawat 1/4/2012 31 10 Prajabatan 1988 AKPER 2003
Perawat 1/7/2012 24 0 Prajabatan 1988 AKPER 1993
Farmasi 1/10/2013 26 11 Prajabatan 1996 SAA 1993
Perawat 1/4/2008 24 11 Prajabatan 1991 AKPER 1989
Perawat 10/4/2017 9 11 Prajabatan 1993 S.KEP 1991
Perawat 1/10/2013 10 8 Prajabatan 1993 S.KEP 1994
Perawat 1/10/2013 24 10 Prajabatan 1996 SPK 1994
Perawat 1/10/2013 26 11 Prajabatan 1996 AKPER 1991
Kebidanan 1/4/2012 12 9 Prajabatan 2010 KESMAS 2010
Perawat 4/1/2012 8 0 Prajabatan 2009 S.Kep 1992
Gizi 1/10/2013 29 11 Prajabatan 1993 SPAG 1989
Kebidanan 1/4/2014 10 9 Prajabatan 2007 AKBID 2007
Laboratorium 1/10/2014 9 9 Prajabatn 2007 AMAK 2014
Bidan Desa 1/4/2014 12 9 Prajabatan 2009 SST 2014
Bidan 4/1/2016 9 11 Prajabatn 2006 AKBID 2004
Bidan 1/4/2013 8 0 Prajabatan 2010 AKBID 2007
Bidan 1/4/2014 12 0 Prajabatan 2012 AKBID 2009
Bidan 1/4/2011 12 9 Prajabatan 1993 AKBID 2015
Perawat 1/4/2014 8 0 Prajabatn 2012 AKPER 2010
Bidan 1/4/2012 4 11 Prajabatan 2007 AKBID 1989
Perawat 1/4/2013 4 11 Prajabatan 2008 AKPER 2007
Perawat 1/2/2014 4 6 Prajabtan 2015 AKPER 2000
Perawat 1/2/2014 4 6 Prajabatan 2015 AKPER 2004
Perawat 1/4/2013 9 0 Prajabatan 2011 AKPER
Perawat 4/1/2014 8 0 Prajabatan 2011 AKPER
Bidan Desa 8/1/2018 1 8 Prajabatan 2018 AKBID 2010
Bidan Desa 8/1/2018 1 8 Prajabatan 2018 AKBID 2011
Bidan Desa 8/1/2018 1 8 Prajabatan 2018 AKBID 2008
Bidan Desa 8/1/2018 1 8 Prajabatan 2018 AKBID 2008
Bidan Desa 8/1/2018 1 8 Prajabatan 2018 AKBID 2011
Bidan 8/1/2018 1 8 Prajabatan 2018 AKBID 2010

Mengetahui,
Ka. UPT Puskesmas Sumberjaya
Subiyanto, S.Kep
NIP.19720628 1998031004
 TANGGAL CATATAN
LAHIR MUTASI
KEPEGAWAIA
N
14 15

4/23/1963 10/10/1989
2/12/1969
21-10-1966
5/24/1965
10/20/1973
07/17/1970
8/2/1972
2/18/1982
9/24/1983
20-05-1972
20-10-1973
18-01-1982
24-09-1983
12/30/1968
1/7/1985
4/5/1975
19-07-1985
7/1/1981
7/9/1986
22-11-1987
8/31/1977
18-09-1988
21-06-1977
31-08-1977
13-04-1990
15-12-1985
27-11-1983
8/4/1980
4/11/1989
19-021990
12/23/1986
3/21/1987
12/8/1990
12/7/1990

s Sumberjaya
 DAFTAR URUT KEPANGKATAN PEGAWAI PUSKESMAS SUMBERJAYA
PERIODE JANUARI 2017

PANGKAT/
TMT
NO NAMA NIP GOLONGA JABATAN TMT JABATAN MASA KERJA
PANGKAT
N

TAHUN
1 2 3 4 5 6 7 8
1 Novi andry, SKM.MM 19741121 199402 1004 III/d 4/1/2014 Ka. Puskesmas 6/23/2015
2 Wasiyem 19630423 198503 2003 III/c 1/10/2013 Kasubbag TU 1/10/2010 25
3 dr. Madina Firdaus 19691202 200212 2003 IV/b 1/4/2016 Dokter Puskes 1/1/2016
4 Asrullah 19661021 198701 1001 III/d 1/4/2012 P. Gigi 1/4/2012
5 Syaifudin 19650524 198703 1001 III/d 1/4/2016 Perawat 1/4/2012
6 Hendra B . Santoso 19740731 199403 1001 III/d 1/4/2016 Perawat 1/4/2012
7 Opang Bambang 19730120 199501 1001 III/d 1/4/2016 Pelak . Perawat 1/7/2012
8 Ependi 19720520 199403 1007 III/c 1/10/2013 Perawat 1/10/2013 20
9 Toil Ansori 19690603 199202 1001 III/c 1/10/2015 Perawat 1/10/2013 20
10 Iskandar mega 19700717 199203 1004 III/c 1/10/2013 Pelak. Farmasi 1/10/2013 14
11 Trisno 19720208 199402 1006 III/c 10/1/2015 Perawat 1/4/2008 20
12 Dwi Prihandoko, S.Kep.Ners 19820118 200902 1001 III/b 1/4/2015 Perawat 1/4/2012 18
13 Susiyanti, S.Kep 19830924 200804 2001 III/c 01-10-2015 Perawat 1/10/2013 20
14 Titin Aryantini 19693012 198902 2004 III/b 4/1/2008 Pelak. Gizi 1/10/2013 22
15 Dina Prihatin, s.Kep. Ners 821102 201101 2003 III/b 1/4/2014 Perawat 01-04-2012 5
16 Nita Yulita, SKM 19850107 200604 2002 III/b 1/4/2014 P. Kebidanan 1/4/2012 3
17 Dini andriani, Amd.Keb 198500119 200804 2002 III/b 1/4/2014 Pel.Kebidanan 1/4/2014 6
18 Lucia Aranita M, S.Kep 19890915 201101 2002 III/a 1/4/2014 Perawat 1/1/2012 4
19 Nani Kurniah, SST 19750504 200604 2015 III/a 1/10/2014 Bidan Desa 1/4/2014 4
20 Trio Kusworo, Amd.Kep 19810107 200501 1001 III/a 1/10/2014 Perawat 1/10/2014 1
21 Silvi Septiana, AMAK 19850918 200904 2002 III/b Laboratorium 1/10/2014 15
22 Asifa Permatasari, Amd.Keb 19860907 200902 2002 III/a 1/4/2013 Pelak. Bidan 4/1/2016
23 Yosi Kasari, Amd.Keb 19880918 201101 2006 III/a 1/4/2014 Pelak. Bidan 1/4/2013 7
24 Novita haasda, Amd.Keb 19871122 201101 2004 II/d 1/4/2014 Pelak Perawat 1/4/2014 6
25 Neneng Tati sumirah 19770831 200701 2007 II/d 1/4/2011 Pelak. Bidan 1/4/2014 6
26 Asnawati 19770621 200604 2020 II/c 1/4/2012 Bides S. Sari 1/4/2011
27 Ayu Anggraeni, Amd.Keb 19900413 201402 2001 II/c 1/4/2013 Pelak Bidan 1/4/2012
28 Miharti, Amd.Kep 19851215 201402 2001 II/c 1/2/2014 Pelak Perawat 1/4/2013 9
29 Eman Dasman, Amd.Kep 19720809 201407 10001 II/c 1/2/2014 Pelak Perawat 1/2/2014
30 Adi nuryadi, Amd.Kep 19751217 201417 1001 II/c 1/10/2014 Perawat 1/2/2014
31 Helen Diana, Amd.Kep 19790307 201417 2007 II/c 1/4/2013 Perawat 1/10/2014 3
32 Leni Patriawati 19831127 201001 2011 II/c 4/1/2014 Perawat 1/4/2013
33 Canndra Dewi 19800408 201101 2001 II/b 1/10/2014 Pelak Perawat 4/1/2014
PUSKESMAS SUMBERJAYA
017

CATATAN
LATIHAN PEND MUTASI
MASA KERJA TAHUN TAHUN Tgl Lahir KET
JABATAN UMUM KEPEGAWAIA
N

BULAN
9 10 11 12 13 14 15 16
Diklat PIM 2013 S2 2010 11/21/1974 6/23/2015
3 Prajabatan 1988 SMEA 1983 4/23/1963 10/10/1989
Prajabatan 2003 Kedokteran 1994 2/12/1969
10 Prajabatan 1988 SPRG 1986 21-10-1966
Prajabatan 1988 AKPER 2003 5/24/1965
9 Prajabatan 1988 SMAK 1992 7/31/1974
11 Prajabatan 1988 SPK 1993 10/20/1973
0 Prajabatan 1996 SPK 1994 20-05-1972
0 Prajabatan 1996 AKPER 1991 20-10-1973
7 Prajabatan 1996 SAA 1993 07/17/1970
0 Prajabatan 1991 SPK 1989 8/2/1972
8 Prajabatan 1993 S.KEP 1991 2/18/1982
0 Prajabatan 1993 S.KEP 1994 9/24/1983
0 Prajabatn 1993 SPAG 1989 12/30/1968
10 Prajabatan 2009 S.Kep 1992 24-09-1983
8 Prajabatan 2010 KESMAS 2010 18-01-1982
6 Prajabatan 2007 AKBID 2007 1/7/1985
0 Prajabatan 2012 S.Kep 2014 9/20/1985
6 Prajabatan 2009 SST 2014 19-07-1985
9 Prajabatn 2012 Amd.Kep 2004 15-08-1989
0 Prajabatn 2007 AMAK 2014 4/5/1975
Prajabatn 2006 AKBID 2004 7/1/1981
2 Prajabatan 2010 AKBID 2007 7/9/1986
3 Prajabatn 2012 AKPER 2010 18-09-1988
3 Prajabatan 2012 AKBID 2009 22-11-1987
Prajabatan 1993 KEBIDANAN 2015 8/31/1977
Prajabatan 2007 AKBID 1989 21-06-1977
1 Prajabatan 2008 AKPER 2007 31-08-1977
Prajabtan AKPER 2000 13-04-1990
Prajabatan AKPER 2004 15-12-1985
9 Prajabatan 2012 AKPER 8/4/1980
Prajabatan 2011 AKPER 27-11-1983
Prajabatan 2011 SPK 8/4/1980

SumberjSumberjaya, januari 2017

Kepala UPT. Puskesmas Sumberjaya
Novi Andry, SKM.MM
NIP.197411211994031004
 DAFTAR URUT KEPANGKATAN PEGAWAI PUSKESMAS SUMBERJAYA
PERIODE JANUARI 2019

MASA TANGGAL
NO NAMA NIP/NRPTT PANGKAT/GOL TMT PANGKAT JABATAN DALAM SK TERAKHIR
KERJA LAHIR

1 dr. Madina Firdaus 19691202 200212 2003 IV/b 1/4/2016 Dokter Ahli Madya 19 Thn 5 Bln 2/12/1969
2 Subiyanto, S.Kep 19720628 199803 1004 Penata TK I, III/d 4/1/2014 Kepala Puskesmas 19 thn 2 bln 6/28/1972
3 Asrullah 19661021 198701 1001 Penata TK I,III/d 1/4/2012 Perawat Penyelia 26 Thn 7 Bln 10/21/1966
4 Syaifudin, Amd.Kep 19650524 198703 1001 Penata TK I,III/d 1/4/2016 Perawat Penyelia 27thn 2 bln 5/24/1965
5 Opang Bambang 19731020 199502 1001 Penata TK I,III/d 1/4/2016 Perawat Penyelia 19 Thn 3 Bln 10/20/1973
6 Iskandar mega 19700717 199203 1004 Penata TK I,III/d 1/10/2018 Asisten Apoteker Penyelia 22 Th 2 Bln 7/17/1970
7 Trisno 19720208 199402 1006 Penata TK I,III/d 10/1/2018 Perawat Penyelia 20 thn 2 bln 2/8/1972
8 Dwi Prihandoko, S.Kep.Ners 19820118 200902 1001 Penata TK I,III/d 10/1/2017 perawat Muda 10 Thn 3 Bln 1/18/1982
9 Susiyanti, S.Kep 19830924 200804 2001 Penata TK I,III/d 01-04-2018 perawat Muda 11 Thn 1 Bln 9/24/1983
10 Ependi, Amd.Kep 19720520 199403 1007 Penata TK I,III/d 1/10/2013 Perawat Penyelia 19 Thn 6 Bln 5/20/1972
11 Wasiyem 19630423 198503 2003 Penata, III/c 1/10/2013 Kasubbag Tata Usaha 34 Thn 9 Bln 4/23/1963
12 Toil Ansori, Amd.Kep 19690603 199202 1001 Penata , III/c 1/10/2015 Perawat Penyelia 25 Thn, 3 Bln 6/2/1969
13 Nita Yulita, SKM 19850701 200604 2005 Penata , III/c 10/1/2017 Bidan lanjutan 11 Thn 1 Bln 7/1/1985
14 Dina Prihatin, s.Kep. Ners 19820211 201101 2003 Penata , III/c 10/1/2017 perawat Muda 8 Th 4 Bln 2/11/1982
15 Eva Indriyanti, SKM., M.M 19840904 200604 2005 Penata Muda Tk I, III/b 4/1/2016 11 Thn 1 Bln 9/4/1984
16 Titin Aryantini, Amd.Gz 19683012 198902 2004 Penata Muda Tk I, III/b 4/1/2008 Pelaksana Gizi 25 Thn 3 Bln 12/30/1968
17 Dini andriani, Amd.Keb 19850719 200804 2002 Penata Muda Tk I, III/b 10/1/2017 Bidan Pelaksana Lanjutan 9 Thn 1 Bln 6/19/1985
18 Silvi Septiana, AMAK 19850918 200904 2002 Penata Muda Tk I, III/b 10/1/2017 Pranata Laboratorium Kes. Pelaksana 8 Thn 2 Bln 9/18/1985
19 Nani Kurniah, SST 19750504 200604 2015 Penata Muda Tk I, III/b 10/1/2017 Bidan Pertama 19 Thn 7 Bln 5/4/1975
20 Asifa Permatasari, Amd.Keb 19860907 200902 2006 Penata Muda Tk I, III/b 10/1/2017 Bidan Ahli Pertama 8 Thn 3 Bln 9/7/1986
21 Yosi Kasari, Amd.Keb 19880918 201101 2006 Penata Muda, III/a 1/4/2014 Bidan Pelaksana Lanjutan 6 Thn 4 Bln 9/18/1988
22 Neneng Tati sumirah 19770831 200701 2007 Penata Muda, III/a 10/1/2017 Bidan pelaksana 10 Thn 2 Bln 8/31/1977
23 Asnawati 19770621 200604 2020 Penata Muda, III/a 10/1/2017 Bidan pelaksana 17Thn 3 Bln 6/21/1977
24 Novita haasda, Amd.Kep 19871122 201101 2007 Penata Muda, III/a 10/1/2017 Perawat pelaksana lanjutan 6 Thn 4 Bln 11/22/1987
25 Ayu Anggraeni, Amd.Keb 19900413 201402 2001 Pengatur TK I, II/d 10/1/2017 Bidan pelaksana 8 Thn 3 Bln 4/13/1990
26 Miharti, Amd.Kep 19851215 201402 2001 Pengatur TK I, II/d 10/1/2017 Perawat Pelaksana 8 Thn 4 Bln 12/15/1985
27 Eman Dasman, Amd.Kep 19720809 201407 1001 Pengatur TK I, II/d 10/1/2017 Perawat Pelaksana 20 Thn 8 Bln 8/9/1972
28 Adi nuryadi, Amd.Kep 19751217 201417 1001 Pengatur TK I, II/d 10/1/2017 Perawat Pelaksana 18 Thn 2 Bln 12/17/1975
29 Leni Patriawati 19831127 201001 2011 Pengatur TK I, II/d 10/1/2017 Perawat Pelaksana 9 Thn 5 Bln 11/27/1983
30 Canndra Dewi 19800408 201101 2013 pengatur, II/c 4/1/2017 Perawat Pelaksana 8 Thn 4 Bln 4/8/1980
31 Nining Nuraini, Amd.Keb 19890411 201705 2005 pengatur, II/c 8/1/2018 Bidan pelaksana 10 Thn 11 Bln 4/11/1989
32 Eva Santi, Amd.Keb 19900219 201705 2001 pengatur, II/c 8/1/2018 Bidan pelaksana 9 Thn 7 Bln 2/19/1990
33 Yesi desi sandi, Amd.Keb 19861223 201705 2003 pengatur, II/c 8/1/2018 Bidan pelaksana 12 Thn 11 Bln 12/23/1986
34 Neni Sumartini, Amd.Keb 19870321 201705200 3 pengatur, II/c 8/1/2018 Bidan pelaksana 13 thn 0 bln 3/21/1987
35 Desi Rahmawati, Amd.Keb 19901208 201705 2002 pengatur, II/c 8/1/2018 Bidan pelaksana 9 Thn 7 Bln 12/8/1990
36 Desfilia Pratiwi, Amd.Keb 199012077 201705 2001 pengatur, II/c 8/1/2018 Bidan pelaksana 10 Thn 9 Bln 12/7/1990
37 Dr. Yudha Astipamara Panjaya 19870612.03.10 PTTD DOKTER 01/01/2018
38 Lita Pertmatasari, Amd.Keb 19900121.02.10 PTTD BIDAN 03/03/2012
39 Lena Roza Leni,Amd.kep 800/58/IV.04/2018 PTTD PERAWAT 19/12/2014
40 Shandy Praditia,Amd.kep 800/58/IV.04/2018 PTTD PERAWAT 16/12/2011
41 Asep Suhendar,Amd.kep 800/58/IV.04/2018 PTTD PERAWAT 07/10/2010
42 edi rusmianto, Amd.kep 800/58/IV.04/2018 PTTD PERAWAT 28/01/2007
43 Sely Frisca, Amd.Kep PKD 26/10/2015
44 Yaumil Annisa, Amd.Gz 08.7.0803576 NS 12/11/2018
45 Hendri Johan THLS CS 16/06/2000
46 Fitriyani.S, Amd.KL THLS SANITASI 17/03/2008
47 Novi Haryanti, Amd.Keb THLS BIDAN 05/09/2012
48 Nurhikmah januarti, Amd.Keb THLS BIDAN 12/10/2012
49 Cepi Irawan, Amd.kep THLS PERAWAT 06/04/2013
50 Feby Ayu Ningsetia, Amd.keb THLS BIDAN 01/12/2014
51 Siti Kholifah, Amd.Keb THLS BIDAN 03/02/2015
52 Kiki Kamila, SST THLS BIDAN 26/10/2015
53 Odi Junaedi THLS CS 21/12/2015
54 Elly Irmajayanti, Amd.Kep THLS PERAWAT 01/10/2016
55 Cucu Garnasih, Amd.Keb THLS BIDAN 14/10/2016
56 Eka Kusuma wardani, Amd.Keb THLS BIDAN 07/12/2016
57 Retno Wijanti, Amd.Kep THLS PERAWAT 19/12/2016
58 Nurul Fadhilah, Amd.Keb THLS BIDAN 02/01/2017
59 Eli Susanti, Amd.Kep THLS BIDAN 03/02/2017
60 Yolanda Praditya Putri, Amd.Keb THLS BIDAN 05/06/2017
61 Eli Purwati, amd.Keb THLS BIDAN 12/07/2017
62 Desenta Amilia, Str.Keb THLS BIDAN 01/08/2017
63 Riva Raintina, Amd.Keb THLS BIDAN 28/09/2017
64 Ani Melinawati, Str.Keb THLS BIDAN 14/01/2019
65 Sintia Aulia Yuniawan, Amd.Kep THLS PERAWAT 04/03/2019
66 Deni Efendi THLS DRIVE 12/2/2017

Mengetahui,
Ka. UPT Puskesmas Sumberjaya

SUBIYANTO,S.KEP
NIP.19740628 199803 1 004
 PENDIDIKAN SAAT PENDIDIKAN DALAM SK
PENGANGKATAN TERAKHIR

S1 Kedokteran S1 Kedokteran
DIII Keperawatan S1 Keperawatan
SPRG SPRG
Pekarya DIII Akper
SPK SPK
SMF SMF
SPK SPK
S1 Keperawatan + Ners S1 Keperawatan + Ners
S1 Keperawatan S1 Keperawatan
SPK SPK
SMEA SMEA
DIII Akper DIII Akper
DIII Kebidanan SKM
S1 Keperawatan + Ners S1 Keperawatan + Ners
S2 Magister Manajemen
SPAG SPAG
DIII Kebidanan DIII Kebidanan
DIII Analis DIII Analis
D1 Kebidanan DIV Kebidanan
DIII Kebidanan S1 Sarjana Sains Terapan
DIII Kebidanan DIII Kebidanan
DI Kebidanan DI Kebidanan
DI Kebidanan DI Kebidanan
DIII Akper DIII Akper
DIII Kebidanan DIII Kebidanan
DIII Akper DIII Akper
DIII Akper DIII Akper
DIII Akper DIII Akper
SPK SPK
SPK SPK
DIII Kebidanan DIII Kebidanan
DIII Kebidanan DIII Kebidanan
DIII Kebidanan DIII Kebidanan
DIII Kebidanan DIII Kebidanan
DIII Kebidanan DIII Kebidanan
DIII Kebidanan DIII Kebidanan
as Sumberjaya

P
9803 1 004
NO NAMA NIP/NRPTT PANGKAT/GOL

1 Subiyanto, S.Kep 19720628199803100 4 Penata TK I, III/d

2 Wasiyem 19630423 198503 2003 Penata, III/c
3 dr. Madina Firdaus 19691202 200212 2003 IV/b
4 Asrullah 19661021 198701 1001 Penata TK I,III/d
5 Syaifudin, Amd.Kep 19650524 198703 1001 Penata TK I,III/d
6 Opang Bambang 19731020 199502 1001 Penata TK I,III/d
7 Iskandar mega 19700717 199203 1004 Penata TK I,III/d
8 Trisno 19720208 199402 1006 Penata TK I,III/d
9 Dwi Prihandoko, S.Kep.Ners 19820118 200902 1001 Penata TK I,III/d
10 Susiyanti, S.Kep 19830924 200804 2001 Penata TK I,III/d
11 Ependi, Amd.Kep 19720520 199403 1007 Penata TK I,III/d
12 Toil Ansori, Amd.Kep 19690603 199202 1001 Penata , III/c
13 Nita Yulita, SKM 19850701 200604 2005 Penata , III/c
14 Dina Prihatin, s.Kep. Ners 19820211 201101 2003 Penata , III/c
15 Eva Indriyanti, SKM., M.M 19840904 200604 2005 Penata Muda Tk I, III/b
16 Titin Aryantini, Amd.Gz 19683012 198902 2004 Penata Muda Tk I, III/b
17 Dini andriani, Amd.Keb 19850719 200804 2002 Penata Muda Tk I, III/b
18 Silvi Septiana, AMAK 19850918 200904 2002 Penata Muda Tk I, III/b
19 Nani Kurniah, SST 19750504 200604 2015 Penata Muda Tk I, III/b
20 Asifa Permatasari, Amd.Keb 19860907 200902 2006 Penata Muda Tk I, III/b
21 Yosi Kasari, Amd.Keb 19880918 201101 2006 Penata Muda, III/a
22 Neneng Tati sumirah 19770831 200701 2007 Penata Muda, III/a
23 Asnawati 19770621 200604 2020 Penata Muda, III/a
24 Novita haasda, Amd.Keb 19871122 201101 2007 Penata Muda, III/a
25 Ayu Anggraeni, Amd.Keb 19900413 201402 2001 Pengatur TK I, II/d
26 Miharti, Amd.Kep 19851215 201402 2001 Pengatur TK I, II/d
27 Eman Dasman, Amd.Kep 19720809 201407 1001 Pengatur TK I, II/d
28 Adi nuryadi, Amd.Kep 19751217 201417 1001 Pengatur TK I, II/d
29 Leni Patriawati 19831127 201001 2011 Pengatur TK I, II/d
30 Canndra Dewi 19800408 201101 2013 pengatur, II/c
31 Nining Nuraini, Amd.Keb 19890411 201705 2005 pengatur, II/c
32 Eva Santi, Amd.Keb 19900219 201705 2001 pengatur, II/c
33 Yesi desi sandi, Amd.Keb 19861223201705200 3 pengatur, II/c
34 Neni Sumartini, Amd.Keb 19870321 201705200 3 pengatur, II/c
35 Desi Rahmawati, Amd.Keb 19901208201705200 2 pengatur, II/c
36 Desfilia Pratiwi, Amd.Keb 199012077 201705 2001 pengatur, II/c
37 Dr. Yudha Astipamara Panjaya 19870612.03.10 PTTD
38 Lita Pertmatasari, Amd.Keb 19900121.02.10 PTTD
39 Lena Roza Leni,Amd.kep 800/58/IV.04/2018 PTTD
40 Shandy Praditia,Amd.kep 800/58/IV.04/2018 PTTD
41 Asep Suhendar,Amd.kep 800/58/IV.04/2018 PTTD
42 edi rusmianto, Amd.kep 800/58/IV.04/2018 PTTD
43 Sely Frisca, Amd.Kep 441/020/lll.02/2019 TKD
44 Yaumil Annisa, Amd.Gz 08.7.0803576 Nusantara Sehat

Nita Yulita, SKM 100252218-1518164

Dina Prihatin, s.Kep. Ners 100172119-2440466
Eva Indriyanti, SKM., M.M
Titin Aryantini, Amd.Gz
Dini andriani, Amd.Keb
Silvi Septiana, AMAK
Nani Kurniah, SST
Asifa Permatasari, Amd.Keb
Yosi Kasari, Amd.Keb
Neneng Tati sumirah
Asnawati
Novita haasda, Amd.Keb
Ayu Anggraeni, Amd.Keb
Miharti, Amd.Kep
Eman Dasman, Amd.Kep
Adi nuryadi, Amd.Kep
Leni Patriawati
Canndra Dewi
Nining Nuraini, Amd.Keb
Eva Santi, Amd.Keb
Yesi desi sandi, Amd.Keb
Neni Sumartini, Amd.Keb
Desi Rahmawati, Amd.Keb
Desfilia Pratiwi, Amd.Keb
Dr. Yudha Astipamara Panjaya
Lita Pertmatasari, Amd.Keb
-
100932112-0140760
100252218-1518162
101452118-2364161
100252218-1518165
1002522-181518163
100232218-1518161
100252117-1459224
100232218-1518267
100152112-0337621
100252116-1171371
100152112-0342857
100151219-2440527
100122112=0337668
10 01 22115-1033487
100252218-1518160
100252218-1518157
100252218-1518158
100252218-1518166
100252218-1518159
100252114-0725689
34111001161623 61
100252218-1518090
 MASA PENDIDIKAN SAAT
JABATAN DALAM SK TERAKHIR TTL
KERJA PENGANGKATAN
Kepala Puskesmas 19thn 2 bln 6/28/1972 DIII Keperawatan
Kasubbag Tata Usaha 34 Thn 9 Bln 4/23/1963 SMEA
Dokter Madya 19 Thn 5 Bln 2/12/1969 S1 Kedokteran
Perawat Penyelia 26 Thn 7 Bln 10/21/1966 SPRG
Perawat Penyelia 27thn 2 bln 5/24/1965 Pekarya
Perawat Penyelia 19 Thn 3 Bln 10/20/1973 SPK
Asisten Apoteker Penyelia 22 Th 2 Bln 7/17/1970 SMF
Perawat Penyelia 20 thn 2 bln 2/8/1972 SPK
perawat Muda 10 Thn 3 Bln 1/18/1982 S1 Keperawatan + Ners
perawat Muda 11 Thn 1 Bln 9/24/1983 S1 Keperawatan
Perawat Penyelia 19 Thn 6 Bln 5/20/1972 SPK
Perawat Penyelia 25 Thn, 3 Bln 6/2/1969 DIII Akper
Bidan lanjutan 11 Thn 1 Bln 7/1/1985 DIII Kebidanan
perawat Muda 8 Th 4 Bln 2/11/1982 S1 Keperawatan + Ners
11 Thn 1 Bln 9/4/1984
25 Thn 3 Bln 12/30/1968 SPAG
Bidan Pelaksana Lanjutan 9 Thn 1 Bln 6/19/1985 DIII Kebidanan
Pranata Laboratorium Kes. Pelaksana 8 Thn 2 Bln 9/18/1985 D3
Bidan Pertama 19 Thn 7 Bln 5/4/1975 D1 Kebidanan
Bidan Ahli Pertama 8 Thn 3 Bln 9/7/1986 DIII Kebidanan
Bidan Pelaksana Lanjutan 6 Thn 4 Bln 9/18/1988 DIII Kebidanan
Bidan Pelaksana 10 Thn 2 Bln 8/31/1977 DI Kebidanan
Bidan Pelaksana 17Thn 3 Bln 6/21/1977 DI Kebidanan
Perawat pelaksana lanjutan 6 Thn 4 Bln 11/22/1987 DIII Akper
Bidan Pelaksana 8 Thn 3 Bln 4/13/1990 DIII Kebidanan
Perawat Pelaksana 8 Thn 4 Bln 12/15/1985 DIII Akper
Perawat Pelaksana 20 Thn 8 Bln 8/9/1972 DIII Akper
Perawat Pelaksana 18 Thn 2 Bln 12/17/1975 DIII Akper
Perawat Pelaksana 9 Thn 5 Bln 11/27/1983 SPK
perawat pelaksana pemula 8 Thn 4 Bln 4/8/1980 SPK
Bidan Pelaksana 10 Thn 11 Bln 4/11/1989 DIII Kebidanan
Bidan Pelaksana 9 Thn 7 Bln 2/19/1990 DIII Kebidanan
Bidan Pelaksana 12 Thn 11 Bln 12/23/1986 DIII Kebidanan
Bidan Pelaksana 13 thn 0 bln 3/21/1987 DIII Kebidanan
Bidan Pelaksana 9 Thn 7 Bln 12/8/1990 DIII Kebidanan
Bidan Pelaksana 10 Thn 9 Bln 12/7/1990 DIII Kebidanan
Dokter kedokteran
Bidan DIII Kebidanan
Perawat DIII Akper
Perawat DIII Akper
Perawat DIII Akper
Perawat DIII Akper
Perawat DIII Akper
Gizi DIII Gizi

Sely Frisca, Amd.Kep

Kiki Kamila, S.ST
siti Kholifah,A.md.Keb
Nurul Fadilah,AmdKeb
Eka kusuma wardani,Amd.Keb
Eli purwanti,Amd.Keb
eli susanti,Amd.keb
cucu garnasih,Amd.Keb
nurhikmah januarti,Amd.Keb
novi Haryanti,Amd.Keb
Feby ayu ning tias,Amd.keb
Lena Roza Leni,Amd.kep
Retno wijanti,Amd.kep
Cepi irawan,Amd.kep
Shandy Praditia,Amd.kep
Asep Suhendar,Amd.kep
Fitriyani.S, Amd,KL
Eli Irmajayanti, Amd.Kep
Desenta Amiliya, S.ST
Yolanda Praditia Putri,Amd.Keb
edi rusmianto, Amd.kep
hendri johan
Riva Raintina, Amd.Keb
odi junaedi
Nelsa Merliani Irawan, Amd.keb
Ani Melinawati, SST
Yaumil Annisa, Amd.Gz
 MASA MASA
PENDIDIKAN DALAM SK
NO.STR BERLAKU NO.SIP BERLAKU
TERAKHIR
STR SIP
S1 Keperawatan 100151217-2127780 6/28/2022 - -
SMEA - - - -
S1 Kedokteran 35211003170230 40 2/12/2023 800/124/SIP/111.02/2017 2/12/2023
SPRG 100421114-0825310 10/21/2019 - -
DIII Akper 100151112-0365853 9/24/2012 - -
SPK 100121112-0337681 9/24/2021 - -
SMF - - - -
SPK - -
S1 Keperawatan + Ners 100171219-2440573 1/18/2024 - -
S1 Keperawatan - - - -
SPK 100121112-0337687 9/25/2012 - -
DIII Akper 100151116-1112101 6/2/2021 800/167/SIKP/III/02/2017 6/2/2021
SKM 100252218-1518164 7/1/2023 503/143/SIPB/III.15/2019 7/1/2023
S1 Keperawatan + Ners 100172119-2440466 2/11/2024 - -
S2 Magister Manajemen - - - -
SPAG 100932112-0140760 11/25/2024 - -
DIII Kebidanan 100252218-1518162 7/19/2023 - -
101452118-2364161 9/18/2023 503/05/SIP-ATLM/III.15/2 9/18/2023
DIV Kebidanan 100252218-1518165 5/4/2023 503/151/SIPB/III.15/2020 5/4/2023
S1 Sarjana Sains Terapan 1002522-181518163 1/22/2018
DIII Kebidanan 100232218-1518161 9/18/2023 503/148/SIPB/III.15/2018 9/18/2023
DI Kebidanan 100252117-1459224 8/31/2022 503/126/SIPB/III.15/2018 8/31/2022
DI Kebidanan 100232218-1518267 6/21/2020 503/152/SIPD/III.15/2018 6/21/2020
DIII Akper 100152112-0337621 11/22/2017 - -
DIII Kebidanan 100252116-1171371 4/13/2021 800/404/SIPB/III.02/2017 4/13/2021
DIII Akper 100152112-0342857 - -
DIII Akper - -
DIII Akper 100151219-2440527 12/17/2024 - -
SPK 100122112=0337668 11/27/2017 - -
SPK 10 01 22115-1033487 9/22/2019 - -
DIII Kebidanan 100252218-1518160 4/11/2023 503/140/SIPB/III.15/2022 4/11/2023
DIII Kebidanan 100252218-1518157 9/19/2023 503/142/SIPB/II.15/2018 9/19/2023
DIII Kebidanan 100252218-1518158 12/23/2023 503/149/SIPB/III.15/2018 12/23/2023
DIII Kebidanan 100252218-1518166 3/21/2023 503/141/SIPB/III.15/2018 3/21/2023
DIII Kebidanan 100252218-1518159 12/8/2023 503/146/SIPB/III.15/2018 12/8/2023
DIII Kebidanan 100252114-0725689 12/7/2019 503/38/SIPB/III.15/2018 12/7/2019
kedokteran 34111001161623 61 6/12/2021 503/19/SIPD/III.15/2020 6/12/2021
DIII Kebidanan 100252218-1518090 1/22/2023 503/139/SIPB/III.15/2018 1/21/2023
DIII Akper 1001521151-030399 9/4/2020 - -
DIII Akper 100151112-0337616 10/18/2023 - -
DIII Akper 100151118-2286956 4/6/2023 - -
DIII Akper 100151117-2127751 30/2/2021 - -
DIII Akper 100152116-1274125 5/30/2021 - -
DIII Gizi 090952218-1577415 9/29/2023 - -

100152116-1274125 12/1/2016
130252116-1192055 6/8/2016
 100252115-0983354 5/28/2015
100252117-2101176 7/25/2017
ardani,Amd.Keb 100252117-2101160 7/25/2017
100252117-2070528 5/5/2017
1002521-172065982 4/27/2017
150252115-1012454 7/28/2015
uarti,Amd.Keb 100252115-0896992 2/5/2015
100252116-1171370 5/18/2016
tias,Amd.keb 100152115-1030399 7/25/2016
1001521151-030399 9/4/2015
100152112-057342 4/25/2013
100151112-0577430 4/25/2013
100151112-0337616
100151118-2286956 4/6/2018
101252112-0108145 4/1/2017
100152115-0897154 2/5/2015
100252112-0571914 6/10/2014
a Putri,Amd.Keb 050252117-1304885 2/3/2017
100151117-2127751

Irawan, Amd.keb 10052116-1111049 2/29/2016

100252117-2070493 5/5/2017
090952218-1577415 9/29/2018
 DATA TENAGA KESEHATAN YANG MELAKUKAN PRAKTEK MANDIRI
NO NAMA TENAGA KESEHATAN JENIS TENAGA ALAMAT

1 Dr.Madina Firdaus Dokter Umum Simpang Gadis

2 dr. Yudha Astipamara Panjaya Dokter Umum Simpang Gadis
3 Nani Kurniah, SST Bides Sukapura Pekon Sukapura
4 Desi Rahmawati, Amd.Keb Bides Tugusari Kel. Tugusari
5 Nining Nuraeni, Amd.Keb Bides Way Petai P. Way Petai
6 Lita Permatasari, Amd.Keb Bides Simpangsari p. Simpangsari
7 Neni Sumartini, Amd.Keb Bides Sukajaya Pekon Sukajaya
8 Yesi Desi Sandi, Amd.Keb Bides P. Sindang P Pekon S. Pagar
9 Eva Santi, Amd.Keb Bides S.P/Selingkut U S.P PEKON s.Mpagar
10 Agnes Sri Amainah Bidan Kel. Tugusari
11 Nita Yulita, SKM Bidan P. mandiri Kel. Tugusari
12 Subiyanto, S.Kep Perawat Pekon Sukapura
13 Opang Bambang, Amd.Kep Perawat Kel. Tugusari
14 Candra Dewi, Amd. Kep Perawat Pekon Sukapura
15 Toil Ansori, Amd.Kep Perawat Kel. Tugusari
16 Effendi, Amd.Kep Perawat Pekon Sukajaya
17
UKAN PRAKTEK MANDIRI
TANGGAL MASA NO IZIN NOMOR STR
BERLAKU ( sip,sipp,sipb dll )
2/12/2023 SIP
12 - -06-2021 SIP

3/21/2023 SIPB 10 -02 522 18-1518166