Nama Puskesmas : Puskesmas Watas Marga

Variabel Ketenagaan
Persentase

Jenis Ketenagaan
KEHADIRAN

Tanggung Jawab

(1+2+5+6 )
Rangkap Tugas
Kehadiran

Jumlah Point
Masa Kerja
Pendidikan

Masuk Kerja
NOMOR

Jumlah Hari

Hari Kerja
Jumlah
NAMA PEGAWAI JABATAN % Pembagian
Kolom 3
Kolom 4
1 2 3 4 5 6 7 8
1 Yuniarti Emilia N, SKM Ka.Puskesmas S1 80 10 25 25 100 190 100%
2 Rosidah Asisten Tenaga Kes D1 25 25 25 25 10 60 100%
3 Warjiya Ningsih Asisten Tenaga Kes D1 25 25 25 25 10 60 100%
4 Akmal Damiri,S.Sos. TU S1 80 25 25 25 105 100%
5 Syamsri.Ar Kesling D1 25 25 25 25 10 60 100%
6 Komisa Yanti, SST bidan D4 80 25 25 25 105 100%
7 Karman, S.Sos Ka.Tata Usaha S1 80 20 25 25 30 130 100%
8 dr. Rini Karmila Dokter Umum S1 150 5 23 25 155 92%
9 Rukhza Tri Yunita, Am.Keb Bidan D3 60 15 25 25 75 100%
10 Tuti Gustianingsih, SST Bidan / Koordinator D4 80 15 25 25 10 105 100%
11 Desmi H, S.Kep, Ns Perawat S1 80 20 22 25 100 88%
12 Sugiarti, S.Kep Perawat S1 80 10 25 25 10 100 100%
13 Mardiana, SKM Promkes S1 80 15 25 25 10 105 100%
14 Yuliansyah , S.Kep Perawat S1 80 5 25 25 10 95 100%
15 Wince Yulianti, SKM Promkes S1 80 15 25 25 10 105 100%
16 Heni Yuliyanti, S.Kep Perawat S1 80 10 25 25 10 100 100%
17 Nani Setiawati, Amd.Kep Perawat D3 60 5 25 25 10 75 100%
18 Resi, Am.Kep Perawat D3 60 5 25 25 65 100%
19 Yenila Agustina, Am.Keb Bidan D3 60 5 25 25 10 75 100%
20 Choralisa Eliagita, SST Bidan D4 80 5 23 25 50 10 145 92%
21 Mulyani Harsa, S.Farm, Apt Apoteker S1 80 5 25 25 85 100%
22 Ns. Eka Fitriyanie, S.Kep Perawat S1 80 5 25 25 10 95 100%
23 M.Alamsyah, Amd.Kep Perawat D3 60 5 25 25 10 75 100%
24 Laita Laita, Am.Kep Perawat D3 60 5 25 25 10 75 100%
25 Nita Hartati , Am.Keb Bidan D3 60 10 25 25 10 80 100%
26 Tri Yunila, Amd.Keb Bidan D3 60 20 25 25 10 90 100%
27 Eva Susanti, Am.Keb Bidan D3 60 15 25 25 75 100%
28 Ria Jatmike, Am.Kep Perawat D3 60 5 25 25 10 75 100%
29 Marini, AMG Tenaga Gizi D3 60 5 25 25 10 75 100%
30 Ettri Oktarianse, Am.Kep Perawat D3 60 5 23 25 10 75 92%
31 Lensiana Asisten Tenaga Kes D1 25 20 25 25 10 55 100%
32 Rawina Jayanti Bidan D3 25 10 25 25 35 100%
33 Sri Hartati S, Am.Keb Bidan PTT D3 60 0 25 25 60 100%
34 Pera Rosita, Am.Keb Bidan D3 60 0 25 25 60 100%
35 Rima Aprilia, Am.Keb Bidan D3 60 0 25 25 60 100%
36 Wijayanti, Am.Kep Perawat D3 60 0 25 25 60 100%
37 Dedek Febriyani, Am.Keb Bidan D3 60 0 25 25 60 100%
38 Peki Fitria M, Am.Keb Bidan D3 60 0 25 25 60 100%
39 Ns. Rio Pasaribu, S.Kep Perawat S1 80 0 25 25 80 100%
40 Pusda Sari, SKM Kesehatan Masyaraka S1 80 0 25 25 80 100%
41 Nita Pebriyani, Am.Kep Perawat D3 60 0 25 25 60 100%
42 Riko Tenaga Non kesehata SLTA 25 0 25 25 25 100%
43 Junida Tenaga Non kesehata SLTA 25 0 25 25 25 100%
JUMLAH

MENGETAHUI/MENYETUJUI
KEPALA FASILITAS KESEHATAN TINGKAT PERTAMA
WATAS MARGA

Yuniarti Emilia Nugroho, SKM

NIP: 19800615 200604 2 022
 Jumlah Penerimaan Kapitasi Jasa Pelayanan

Jumlah Terima
Seluruh Dengan Jumlah Peserta Yang Diterima

Biaya Operasional
Jasa Pelayanan

Point Dengan Peserta

Tanda Tangan
( 80% )

( 20% )
Pajak
(8 x 7 ) (Klm 9 x Klm 10 5%
Jml Kolom 9 )
9 10 11 12 13 14 15
190 11,260,082 2,815,021 613,365 30,668 582,696 1
60 11,260,082 2,815,021 193,694 9,685 184,009 2
60 11,260,082 2,815,021 193,694 9,685 184,009 3
105 11,260,082 2,815,021 338,965 16,948 322,016 4
60 11,260,082 2,815,021 193,694 9,685 184,009 5
105 11,260,082 2,815,021 338,965 50,845 288,120 6
130 11,260,082 2,815,021 419,671 20,984 398,687 7
143 11,260,082 2,815,021 460,346 23,017 437,329 8
75 11,260,082 2,815,021 242,118 12,106 230,012 9
105 11,260,082 2,815,021 338,965 16,948 322,016 10
88 11,260,082 2,815,021 284,085 14,204 269,880 11
100 11,260,082 2,815,021 322,823 16,141 306,682 12
105 11,260,082 2,815,021 338,965 16,948 322,016 13
95 11,260,082 2,815,021 306,682 15,334 291,348 14
105 11,260,082 2,815,021 338,965 16,948 322,016 15
100 11,260,082 2,815,021 322,823 16,141 306,682 16
75 11,260,082 2,815,021 242,118 12,106 230,012 17
65 11,260,082 2,815,021 209,835 10,492 199,343 18
75 11,260,082 2,815,021 242,118 12,106 230,012 19
133 11,260,082 2,815,021 430,647 21,532 409,114 20
85 11,260,082 2,815,021 274,400 13,720 260,680 21
95 11,260,082 2,815,021 306,682 15,334 291,348 22
75 11,260,082 2,815,021 242,118 0 242,118 23
75 11,260,082 2,815,021 242,118 0 242,118 24
80 11,260,082 2,815,021 258,259 12,913 245,346 25
90 11,260,082 2,815,021 290,541 14,527 276,014 26
75 11,260,082 2,815,021 242,118 12,106 230,012 27
75 11,260,082 2,815,021 242,118 0 242,118 28
75 11,260,082 2,815,021 242,118 0 242,118 29
69 11,260,082 2,815,021 222,748 11,137 211,611 30
55 11,260,082 2,815,021 177,553 0 177,553 31
35 11,260,082 2,815,021 112,988 0 112,988 32
60 11,260,082 2,815,021 193,694 0 193,694 33
60 11,260,082 2,815,021 193,694 0 193,694 34
 60 11,260,082 2,815,021 193,694 0 193,694 35
60 11,260,082 2,815,021 193,694 0 193,694 36
60 11,260,082 2,815,021 193,694 0 193,694 37
60 11,260,082 2,815,021 193,694 0 193,694 38
80 11,260,082 2,815,021 258,259 0 258,259 39
80 11,260,082 2,815,021 258,259 0 258,259 40
60 11,260,082 2,815,021 193,694 0 193,694 41
25 11,260,082 2,815,021 80,706 0 80,706 42
25 11,260,082 2,815,021 80,706 0 80,706 43
Sebelas Juta Dua Ratus Enam
3,488 11,260,082 2,815,021 11,260,082 432,261 10,827,822 Puluh Ribu Delapan Puluh
Dua Rupiah

Curup, Nopember 2018

LUNAS BAYAR
BENDAHARA JKN
PUSKESMAS WATAS MARGA

Choralisa Eliagita, SST

NIP. 19871018 200903 2 004
 PEMBAGIAN JASA KESEHATAN PETUGAS
PUSKESMAS WATAS MARGA

Bulan : Desember 2018

Jumlah

Variabel Ketenagaan
Jenis Ketenagaan

Tanggung Jawab

(1+2+5+6 )

Jumlah Terima
Seluruh

Jumlah Point
Jasa Yang

Masa Kerja
Pendidikan
Point Diterima
NOMOR

Persentase Pembagian
Kehadiran Jasa PAD Tanda Tangan
NAMA PEGAWAI JABATAN Pajak
(4 x 5) (Klm 6 x Klm 5 5%
Jml Kolom 6 )
1 2 3 4 5 6 7 8 9 10 11
1 Yuniarti Emilia N, SKM Ka.Puskesmas S1 80 10 100 190 100% 190 2,520,000 122,927 6,146 116,780 1
2 Rosidah Bidan D3 60 25 10 95 100% 95 2,520,000 61,463 3,073 58,390 2
3 Warjiya Ningsih Bidan D3 60 25 10 95 100% 95 2,520,000 61,463 3,073 58,390 3
4 Akmal Damiri,S.Sos. TU S1 80 25 105 100% 105 2,520,000 67,933 3,397 64,537 4
5 Syamsri.Ar Kesling D3 60 25 10 95 100% 95 2,520,000 61,463 3,073 58,390 5
6 Komisa Yanti, SST bidan D4 80 25 105 100% 105 2,520,000 67,933 10,190 57,743 6
7 Karman, S.Sos Ka.Tata Usaha S1 80 20 30 130 100% 130 2,520,000 84,108 4,205 79,902 7
8 dr. Rini Karmila Dokter Umum S1 150 5 155 100% 155 2,520,000 100,282 5,014 95,268 8
9 Rukhza Tri Yunita, Am.Keb Bidan S1 80 15 95 100% 95 2,520,000 61,463 3,073 58,390 9
10 Tuti Gustianingsih, SST Bidan / Koordinator D4 80 15 10 105 100% 105 2,520,000 67,933 3,397 64,537 10
11 Desmi H, S.Kep, Ns Perawat S1 80 20 100 100% 100 2,520,000 64,698 3,235 61,463 11
12 Sugiarti, S.Kep Perawat S1 80 10 10 100 100% 100 2,520,000 64,698 3,235 61,463 12
13 Mardiana, SKM Promkes S1 80 15 10 105 100% 105 2,520,000 67,933 3,397 64,537 13
14 Yuliansyah , S.Kep Bendahara Barang S1 80 5 60 145 100% 145 2,520,000 93,813 4,691 89,122 14
15 Wince Yulianti, SKM Promkes S1 80 15 10 105 100% 105 2,520,000 67,933 3,397 64,537 15
16 Heni Yuliyanti, S.Kep Perawat S1 80 10 10 100 100% 100 2,520,000 64,698 3,235 61,463 16
17 Nani Setiawati, Amd.Kep Perawat D3 60 5 10 75 100% 75 2,520,000 48,524 2,426 46,098 17
18 Resi, Am.Kep Perawat D3 60 5 65 100% 65 2,520,000 42,054 2,103 39,951 18
19 Yenila Agustina, Am.Keb Bendahara BOK D3 60 5 60 125 100% 125 2,520,000 80,873 4,044 76,829 19
20 Choralisa Eliagita, SST Bendahara JKN D4 80 5 60 145 100% 145 2,520,000 93,813 4,691 89,122 20
21 Mulyani Harsa, S.Farm, Apt Apoteker S1 80 5 85 100% 85 2,520,000 54,994 2,750 52,244 21
22 Ns. Eka Fitriyanie, S.Kep Perawat S1 80 5 10 95 100% 95 2,520,000 61,463 3,073 58,390 22
23 M.Alamsyah, Amd.Kep Perawat D3 60 5 10 75 100% 75 2,520,000 48,524 0 48,524 23
24 Laita Laita, Am.Kep Bendahara Penerimaan D3 60 5 60 125 100% 125 2,520,000 80,873 0 80,873 24
25 Nita Hartati , Am.Keb Bidan D3 60 10 10 80 100% 80 2,520,000 51,759 2,588 49,171 25
26 Tri Yunila, Amd.Keb Bidan D3 60 20 10 90 100% 90 2,520,000 58,228 2,911 55,317 26
27 Eva Susanti, Am.Keb Bidan S1 80 15 95 100% 95 2,520,000 61,463 3,073 58,390 27
28 Ria Jatmike, Am.Kep Perawat D3 60 5 10 75 100% 75 2,520,000 48,524 0 48,524 28
29 Marini, AMG Tenaga Gizi D3 60 5 10 75 100% 75 2,520,000 48,524 0 48,524 29
30 Ettri Oktarianse, Am.Kep Perawat D3 60 5 10 75 100% 75 2,520,000 48,524 2,426 46,098 30
31 Lensiana Bidan D3 60 20 10 90 100% 90 2,520,000 58,228 0 58,228 31
32 Rawina Jayanti Bidan D3 60 10 70 100% 70 2,520,000 45,289 0 45,289 32
33 Sri Hartati S, Am.Keb Bidan PTT D3 60 0 60 100% 60 2,520,000 38,819 0 38,819 33
34 Pera Rosita, Am.Keb Bidan D3 60 0 60 100% 60 2,520,000 38,819 0 38,819 34
35 Rima Aprilia, Am.Keb Bidan D3 60 0 60 100% 60 2,520,000 38,819 0 38,819 35
36 Wijayanti, Am.Kep Perawat D3 60 0 60 100% 60 2,520,000 38,819 0 38,819 36
37 Dedek Febriyani, Am.Keb Bidan D3 60 0 60 100% 60 2,520,000 38,819 0 38,819 37
38 Peki Fitria M, Am.Keb Bidan D3 60 0 60 100% 60 2,520,000 38,819 0 38,819 38
39 Ns. Rio Pasaribu, S.Kep Perawat S1 80 0 80 100% 80 2,520,000 51,759 0 51,759 39
40 Pusda Sari, SKM Kesehatan Masyarakat S1 80 0 80 100% 80 2,520,000 51,759 0 51,759 40
41 Nita Pebriyani, Am.Kep Perawat D3 60 0 60 100% 60 2,520,000 38,819 0 38,819 41
42 Riko Tenaga Non kesehatan SLTA 25 0 25 100% 25 2,520,000 16,175 0 16,175 42
43 Junida Tenaga Non kesehatan SLTA 25 0 25 100% 25 2,520,000 16,175 0 16,175 43

Dua Juta Lima Ratus Dua Puluh

JUMLAH 3,895 2,520,000 2,520,000 95,915 2,424,085 Ribu Rupiah

MENGETAHUI/MENYETUJUI
KEPALA UPT PUSKESMAS WATAS MARGA

Yuniarti Emilia Nugroho, SKM

NIP: 19800615 200604 2 022
 Harga
Jumlah Harga
No Nama Barang Banyaknya Satuan
(Rp)
(Rp)
1 Kertas HVS Folio 70 gr 5 Rim 46,000 230,000

2 Kertas HVS Folio A4 70 gr 2 Rim 40,000 80,000

3 Tinta Printer Hitam 3 Botol 40,000 120,000

4 Tinta Printer Warna 3 Botol 40,000 120,000
5 Balpoint 8 Lusin 15,000 120,000
6 Isi Staples Kecil 12 Ktk 2,500 30,000
7 Buku Folio Isi 100 lembar 20 Buah 10,000 200,000
JUMLAH 900,000