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PLAN OF ACTION (POA) PROGRAM BANTUAN OPERASIONAL KESEHATAN (BOK)

DI WILAYAH UPT. PUSKESMAS TELUK BELENGKONG


BULAN JANUARI 2018

BENTUK SASARAN JUMLAH BIAYA


NO KEGIATAN LOKASI JADWAL PENANGGUNG JAWAB
KEGIATAN KELOMPOK VOLUME SATUAN JUMLAH TOTAL
1 2 3 4 5 6 7 8 9 10 11
1 Kegaitan yg berdaya ungkit tinggi Lokakarya Mini Bulanan Petugas Ahmad Faisal SST. Msi
Terhadap MDGS Kesehatan
Staf Iinduk 19 orang UPT Puskesmas
Staf Pustu 18 orang Teluk Belengkong
Snack 38 ktk 12,000.00 456,000.00
Makan Siang 38 ktk 28,000.00 1,064,000.00
1,520,000.00
Transport 2 org nakes 67,500.00 135,000.00
Petugas 18 org nakes 105,000.00 1,890,000.00
2,025,000.00

Pengantaran SPJ dan Laporan BOK Petugas Ns.Afrianda Fajri,S.Kep


Kesehatan
Transport 1 org nakes DINKES 360,000.00 360,000.00
Penginapan 1 org nakes 200,000.00 200,000.00
Uang harian 1 org nakes 930,000.00 930,000.00
1,490,000.00

2 Pelayanan Kesehatan Ibu Kelas Ibu Hamil Snack 130 ktk 12,000.00 1,560,000.00
1,560,000.00
ATK 715,000.00
715,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00
Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00

Kelas Ibu Balita Snack 195 ktk 12,000.00 2,340,000.00


2,340,000.00
ATK 942,500.00
942,500.00
Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00
Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00

Pelaksanaan P4K Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Kunjungan Ibu Nifas Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

3 Upaya Kesehatan Anak Pemantuan Status Gizi 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
balita dan pra sekolah Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Griya Mukti jaya
2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

4 Upaya kesehatan anak sekolah Pemberian Tablet Fe Siswa/Siswi 16 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 1,080,000
dan usia remaja SMP

8 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 540,000


Desa Tunggal Rahayu Jaya

8 0rang SMP Ari Setyaningsih Rp 67,500 Rp 540,000


Desa Indra Sarri Jaya

4 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


Desa Beringin Mulya

8 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 540,000


Desa Hibrida Jaya

4 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 1,680,000

Siswa/siswi 4 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


MTs Desa Beringin Mulya

8 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 540,000


Desa Griya Mukti jaya

4 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Makmur Jaya

8 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 540,000


Desa Hibrida Mulya

Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


SMA Desa Beringin Mulya

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Jaya
16 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 1,080,000
Rp 8,160,000

5 Imunisasi Pendistribusian vaksin Petugas 1 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 105,000 Rp 105,000
dari induk ke Pustu Kesehatan Teluk Belengkong
1 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 105,000 Rp 105,000
Transport Teluk Belengkong
Petugas 1 org nakes UPT Puskesmas Ari Setyaningsih Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Sudiharsono,Amk Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Santi N,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Rekha De Sagita Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nurmala Dewi,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong Rp 1,290,000

Posyandu Balita Petugas 2 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 67,500 Rp 135,000
Kesehatan Teluk Belengkong
2 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 67,500 Rp 135,000
Transport Teluk Belengkong
Petugas 2 org nakes UPT Puskesmas Ari Setyaningsih Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 105,000 Rp 210,000
Teluk Belengkong
2 org nakes UPT Puskesmas Sudiharsono,Amk Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Rekha De Sagita Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong Rp 2,250,000

Sweeping Imunisasi Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

6 Upaya Kesehatan Lanjut Usia Pemantuan Lansia Resti Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Posyandu Lansia Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

7 Upaya Kesehatan Lingkungan HSP di Sekolah Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000
SD Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500


1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

2 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 135,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Siswa/Siswi 4 orang SMP Sakarotan dr Riska Yuliana Sari Rp 67,500 Rp 270,000


SMP

2 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 135,000


Desa Tunggal Rahayu Jaya

2 0rang SMP Ari Setyaningsih Rp 67,500 Rp 135,000


Desa Indra Sarri Jaya

1 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


1 Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


Desa Hibrida Jaya

1 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 0rang SMP Cendana Dewi Sartika Rp 67,500 Rp 270,000

Siswa/siswi 1 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


MTs 1 Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000


Desa Griya Mukti jaya

1 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Makmur Jaya Rp 105,000 Rp 105,000

2 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 135,000


Desa Hibrida Mulya

Siswa/siswi 1 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


SMA 1 Desa Beringin Mulya Rp 105,000 Rp 105,000

1 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 org SMA Teluk Belengkong Herni Usmi,Amd.Keb Rp 67,500 Rp 270,000


Rp 4,695,000

Pemicuan Masyarakat 5 org Desa Sakarotan ambok tang,Amd.KL Rp 67,500 Rp 337,500


Rp 337,500
8 Upaya Promosi Kesehatan Honor Petugas Promkes Petugas 1 org Desa Sakarotan ambok tang,Amd.KL Rp 2,300,000 Rp 2,300,000
Kesehatan Rp 2,300,000

Saka Bakti Husada Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000
SMA 4 Desa Beringin Mulya Rp 105,000 Rp 420,000

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


4 Desa Sumber Jaya Rp 105,000 Rp 420,000

8 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 540,000


Rp 1,920,000

Snack 750 ktk 12,000.00 9,000,000.00


9,000,000.00
Penyuluhan Di Sekolah Dasar Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000
SD Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

4 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 270,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Rp 2,310,000

9 Upaya pencegahan dan Pemantauan Pasien Kusta Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
pengendalian penyakit Petugas Tunggal Rahayu Jaya 67,500.00 67,500.00
Menular langsuung 105,000.00 105,000.00
240,000.00
10 Upaya pencegahan dan Pelaksanaan Posbindu PTM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
pengendalian penyakit Kesehatan Tunggal Rahayu Jaya
Tidak menular 2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

11 Upaya Kesehatan jiwa Kunjungan rumah ODGJ Transport 2 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu jaya 67,500.00 67,500.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan 67,500.00 67,500.00
67,000.00 67,000.00

3 org nakes Desa Dewi Sartika 105,000.00 105,000.00


Gembaran 105,000.00 105,000.00
105,000.00 105,000.00

Rp 652,000

JUMLAH Rp 61,102,000

DIKETAHUI/DISETUJUI TELUK BELENGKONG, JANUARI 2018


KEPALA DINAS KESEHATAN KABUPATEN INDRAGIRI HILIR KEPALA UPT PUSKESMAS TELUK BELENGKONG

H.ZAINAL ARIFIN, SKM.M.Kes AHMAD FAISAL,SST.MSi


NIP.19740226 199703 1 002
NIP.19700405 198912 1 001
KET

12

3,545,000.00
5,620,000.00
6,627,500.00
JANUARI 2018
ELUK BELENGKONG

L,SST.MSi
9703 1 002
PLAN OF ACTION (POA) PROGRAM BANTUAN OPERASIONAL KESEHATAN (BOK)
DI WILAYAH UPT. PUSKESMAS TELUK BELENGKONG
BULAN FEBRUARI 2018

BENTUK SASARAN JUMLAH BIAYA


NO KEGIATAN LOKASI JADWAL PENANGGUNG JAWAB
KEGIATAN KELOMPOK VOLUME SATUAN JUMLAH TOTAL
1 2 3 4 5 6 7 8 9 10 11
1 Manajemen Puskesmas Lokakarya Mini Bulanan Petugas Ahmad Faisal SST. Msi
Kesehatan
Staf Iinduk 19 orang UPT Puskesmas
Staf Pustu 18 orang Teluk Belengkong
Snack 38 ktk 12,000.00 456,000.00
Makan Siang 38 ktk 28,000.00 1,064,000.00
1,520,000.00
Transport 2 org nakes 67,500.00 135,000.00
Petugas 18 org nakes 105,000.00 1,890,000.00
2,025,000.00

Pengantaran SPJ dan Laporan BOK Petugas Ns.Afrianda Fajri,S.Kep


Kesehatan
Transport 1 org nakes DINKES 360,000.00 360,000.00
Penginapan 1 org nakes 200,000.00 200,000.00
Uang harian 1 org nakes 930,000.00 930,000.00
1,490,000.00

2 Pelayanan Kesehatan Ibu Kelas Ibu Hamil Snack 130 ktk 12,000.00 1,560,000.00
1,560,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00
Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00

Kelas Ibu Balita Snack 195 ktk 12,000.00 2,340,000.00


2,340,000.00
Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00
Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00

Pelaksanaan P4K Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000
Kunjungan Ibu Nifas Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

3 Upaya Kesehatan Anak Sweeping Vit A 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
balita dan pra sekolah Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Griya Mukti jaya
2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
2 org nakes Desa Retno Wulandari,Amd.Keb 67,500 135,000
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
2 org nakes Desa Yelis Dametri,Amd.Keb 67,500 135,000
Sumber Jaya
2 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 135,000
Sumber Sari Jaya
2 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 135,000
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,755,000

4 Upaya kesehatan anak sekolah Pemberian Tablet Fe Siswa/Siswi 16 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 1,080,000
dan usia remaja SMP

8 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 540,000


Desa Tunggal Rahayu Jaya

8 0rang SMP Ari Setyaningsih Rp 67,500 Rp 540,000


Desa Indra Sarri Jaya

4 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


Desa Beringin Mulya
8 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 540,000
Desa Hibrida Jaya

4 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 1,680,000

Siswa/siswi 4 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


MTs Desa Beringin Mulya

8 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 540,000


Desa Griya Mukti jaya

4 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Makmur Jaya

8 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 540,000


Desa Hibrida Mulya

Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


SMA Desa Beringin Mulya

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 1,080,000


Rp 8,160,000

5 Imunisasi Pendistribusian vaksin Petugas 1 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 105,000 Rp 105,000
dari induk ke Pustu Kesehatan Teluk Belengkong
1 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 105,000 Rp 105,000
Transport Teluk Belengkong
Petugas 1 org nakes UPT Puskesmas Ari Setyaningsih Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Sudiharsono,Amk Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Santi N,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Rekha De Sagita Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nurmala Dewi,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong Rp 1,290,000

Posyandu Balita Petugas 2 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 67,500 Rp 135,000
Kesehatan Teluk Belengkong
2 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 67,500 Rp 135,000
Transport Teluk Belengkong
Petugas 2 org nakes UPT Puskesmas Ari Setyaningsih Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 105,000 Rp 210,000
Teluk Belengkong
2 org nakes UPT Puskesmas Sudiharsono,Amk Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Rekha De Sagita Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong Rp 2,250,000

6 Upaya Kesehatan Usia Reproduksi Penyuluhan Reproduksi Di Sekolah Snack 700 ktk 12,000.00 8,400,000.00
8,400,000.00
Siswa/Siswi 4 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 270,000
SMP

2 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 135,000


Desa Tunggal Rahayu Jaya

2 0rang SMP Ari Setyaningsih Rp 67,500 Rp 135,000


Desa Indra Sarri Jaya

1 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


Desa Hibrida Jaya

1 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500


Desa Sumber Jaya Rp 105,000 Rp 105,000

4 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 420,000

Siswa/siswi 1 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


MTs Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000


Desa Griya Mukti jaya

1 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


Desa Sumber Makmur Jaya Rp 105,000 Rp 105,000

2 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 135,000


Desa Hibrida Mulya

Siswa/siswi 1 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


SMA Desa Beringin Mulya Rp 105,000 Rp 105,000

1 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000
4 org SMA Teluk Belengkong Herni Usmi,Amd.Keb Rp 67,500 Rp 270,000 Rp 2,670,000

7 Upaya Kesehatan Lanjut Usia Pemantuan Lansia Resti Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Posyandu Lansia Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

7 Upaya Promosi Kesehatan Honor Petugas Promkes Petugas 1 org Desa Sakarotan ambok tang,Amd.KL Rp 2,300,000 Rp 2,300,000
Kesehatan Rp 2,300,000

Saka Bakti Husada Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000
SMA 4 Desa Beringin Mulya Rp 105,000 Rp 420,000

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


4 Desa Sumber Jaya Rp 105,000 Rp 420,000

8 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 540,000


Rp 1,920,000

Penyegaran Kader Posyandu Lansia Snack 100 ktk Rp 12,000 Rp 1,200,000


Makan Siang 100 bks Rp 28,000 Rp 2,800,000
Rp 4,000,000
ATK Rp 413,000 Rp 413,000
Transport 80 org UPT Puskesmas Santi,AMK Rp 105,000 Rp 8,400,000
Petugas 10 org Teluk Belengkong Rp 67,500 Rp 675,000
Kader Rp 9,075,000

8 Upaya pencegahan dan Pemantauan Pasien Kusta Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
pengendalian penyakit Petugas Tunggal Rahayu Jaya 67,500.00 67,500.00
Menular langsuung 105,000.00 105,000.00
240,000.00
9 Upaya pencegahan dan Pelaksanaan Posbindu PTM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
pengendalian penyakit Kesehatan Tunggal Rahayu Jaya
Tidak menular 2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

10 Upaya Kesehatan jiwa Kunjungan rumah ODGJ Transport 2 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu jaya 67,500.00 67,500.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan 67,500.00 67,500.00
67,000.00 67,000.00

3 org nakes Desa Dewi Sartika 105,000.00 105,000.00


Gembaran 105,000.00 105,000.00
105,000.00 105,000.00

Rp 652,000

11 Upaya Kesehatan Lainnya Pembinaan Kes Olah Raga Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000
Transport petugas SD kls I Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb
1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

2 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 135,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Siswa/Siswi 4 orang SMP Sakarotan dr Riska Yuliana Sari Rp 67,500 Rp 270,000


SMP

2 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 135,000


Desa Tunggal Rahayu Jaya

2 0rang SMP Ari Setyaningsih Rp 67,500 Rp 135,000


Desa Indra Sarri Jaya

1 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


1 Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


Desa Hibrida Jaya

1 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 0rang SMP Cendana Dewi Sartika Rp 67,500 Rp 270,000

Siswa/siswi 1 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


MTs 1 Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000


Desa Griya Mukti jaya

1 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Makmur Jaya Rp 105,000 Rp 105,000

2 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 135,000


Desa Hibrida Mulya
Siswa/siswi 1 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500
SMA 1 Desa Beringin Mulya Rp 105,000 Rp 105,000

1 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 270,000


Rp 4,695,000

JUMLAH Rp 71,140,000

DIKETAHUI/DISETUJUI TELUK BELENGKONG, FEBRUARI 2018


KEPALA DINAS KESEHATAN KABUPATEN INDRAGIRI HILIR KEPALA UPT PUSKESMAS TELUK BELENGKONG

H.ZAINAL ARIFIN, SKM.M.Kes AHMAD FAISAL,SST.MSi


NIP.19740226 199703 1 002
NIP.19700405 198912 1 001
KET

12

3,545,000.00
4,905,000.00
5,685,000.00
EBRUARI 2018
LUK BELENGKONG

L,SST.MSi
9703 1 002
PLAN OF ACTION (POA) PROGRAM BANTUAN OPERASIONAL KESEHATAN (BOK)
DI WILAYAH UPT. PUSKESMAS TELUK BELENGKONG
BULAN MARET 2018

BENTUK SASARAN JUMLAH BIAYA


NO KEGIATAN LOKASI JADWAL PENANGGUNG JAWAB KET
KEGIATAN KELOMPOK VOLUME SATUAN JUMLAH TOTAL
1 2 3 4 5 6 7 8 9 10 11 12
1 Manajemen Puskesmas Lokakarya Mini Bulanan Petugas Ahmad Faisal SST. Msi
Kesehatan
Staf Iinduk 19 orang UPT Puskesmas
Staf Pustu 18 orang Teluk Belengkong
Snack 38 ktk 12,000.00 456,000.00
Makan Siang 38 ktk 28,000.00 1,064,000.00
1,520,000.00
Transport 2 org nakes 67,500.00 135,000.00
Petugas 18 org nakes 105,000.00 1,890,000.00
2,025,000.00
3,545,000.00

Pengantaran SPJ dan Laporan BOK Petugas Ns.Afrianda Fajri,S.Kep


Kesehatan
Transport 1 org nakes DINKES 360,000.00 360,000.00
Penginapan 1 org nakes 200,000.00 200,000.00
Uang harian 1 org nakes 930,000.00 930,000.00
1,490,000.00

2 Pelayanan Kesehatan Ibu Kelas Ibu Hamil Snack 130 ktk 12,000.00 1,560,000.00
1,560,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00
Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
4,905,000.00

Kelas Ibu Balita Snack 195 ktk 12,000.00 2,340,000.00


2,340,000.00
Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00
Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
5,685,000.00

Pelaksanaan P4K Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000
Kunjungan Ibu Nifas Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

3 Upaya kesehatan anak sekolah Pemberian Tablet Fe Siswa/Siswi 16 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 1,080,000
dan usia remaja SMP

8 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 540,000


Desa Tunggal Rahayu Jaya
8 0rang SMP Ari Setyaningsih Rp 67,500 Rp 540,000
Desa Indra Sarri Jaya

4 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


Desa Beringin Mulya

8 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 540,000


Desa Hibrida Jaya

4 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 1,680,000

Siswa/siswi 4 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


MTs Desa Beringin Mulya

8 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 540,000


Desa Griya Mukti jaya

4 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Makmur Jaya

8 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 540,000


Desa Hibrida Mulya

Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


SMA Desa Beringin Mulya

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 1,080,000


Rp 8,160,000

4 Imunisasi Pendistribusian vaksin Petugas 1 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 105,000 Rp 105,000
dari induk ke Pustu Kesehatan Teluk Belengkong
1 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 105,000 Rp 105,000
Transport Teluk Belengkong
Petugas 1 org nakes UPT Puskesmas Ari Setyaningsih Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Sudiharsono,Amk Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Santi N,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Rekha De Sagita Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nurmala Dewi,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong Rp 1,290,000

Posyandu Balita Petugas 2 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 67,500 Rp 135,000
Kesehatan Teluk Belengkong
2 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 67,500 Rp 135,000
Transport Teluk Belengkong
Petugas 2 org nakes UPT Puskesmas Ari Setyaningsih Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 105,000 Rp 210,000
Teluk Belengkong
2 org nakes UPT Puskesmas Sudiharsono,Amk Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Rekha De Sagita Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong Rp 2,250,000

5 Upaya Kesehatan Lanjut Usia Pemantuan Lansia Resti Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Posyandu Lansia Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

6 Upaya Promosi Kesehatan Honor Petugas Promkes Petugas 1 org Desa Sakarotan Rp 2,300,000 Rp 2,300,000
Kesehatan Rp 2,300,000

Saka Bakti Husada Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000
SMA 4 Desa Beringin Mulya Rp 105,000 Rp 420,000

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


4 Desa Sumber Jaya Rp 105,000 Rp 420,000

8 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 540,000


Rp 1,920,000

Penyegaran Kader PHBS Snack 280 ktk Rp 12,000 Rp 3,360,000


Makan Siang 280 bks Rp 28,000 Rp 7,840,000
Rp 11,200,000
ATK Rp 1,350,000 Rp 1,350,000
Transport 231 org UPT Puskesmas Santi,AMK Rp 105,000 Rp 24,255,000
Petugas 41 org Teluk Belengkong Rp 67,500 Rp 2,767,500
Kader Rp 27,022,500

CTPS di Sekolah dasar Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000
SD Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500
2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

4 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 270,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Rp 2,310,000
Bahan Pembersih Rp 300,000
Rp 300,000

Sikat gigi masal di Sekolah dasar Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000
SD Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

4 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 270,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Rp 2,310,000
Bahan Pembersih Rp 1,200,000
Rp 1,200,000

7 Upaya pencegahan dan Pemantauan Pasien Kusta Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
pengendalian penyakit Petugas Tunggal Rahayu Jaya 67,500.00 67,500.00
Menular langsuung 105,000.00 105,000.00
240,000.00

8 Upaya pencegahan dan Penyuluhan Kelompok Snack 650 Ktk 12,000.00 7,800,000.00
pengendalian penyakit 7,800,000.00
Menular vektor dan zoonotik Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

8 Upaya pencegahan dan Pelaksanaan Posbindu PTM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
pengendalian penyakit Kesehatan Tunggal Rahayu Jaya
Tidak menular 2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

10 Upaya Kesehatan jiwa Kunjungan rumah ODGJ Transport 2 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu jaya 67,500.00 67,500.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan 67,500.00 67,500.00
67,000.00 67,000.00
3 org nakes Desa Dewi Sartika 105,000.00 105,000.00
Gembaran 105,000.00 105,000.00
105,000.00 105,000.00

Rp 652,000

JUMLAH Rp 95,244,500

DIKETAHUI/DISETUJUI TELUK BELENGKONG, MARET 2018


KEPALA DINAS KESEHATAN KABUPATEN INDRAGIRI HILIR KEPALA UPT PUSKESMAS TELUK BELENGKONG

H.ZAINAL ARIFIN, SKM.M.Kes AHMAD FAISAL,SST.MSi


NIP.19740226 199703 1 002
NIP.19700405 198912 1 001
PLAN OF ACTION (POA) PROGRAM BANTUAN OPERASIONAL KESEHATAN (BOK)
DI WILAYAH UPT. PUSKESMAS TELUK BELENGKONG
BULAN APRIL 2018

BENTUK SASARAN JUMLAH BIAYA


NO KEGIATAN LOKASI JADWAL PENANGGUNG JAWAB KET
KEGIATAN KELOMPOK VOLUME SATUAN JUMLAH TOTAL
1 2 3 4 5 6 7 8 9 10 11 12
1 Manajemen Puskesmas Lokakarya Mini Bulanan Petugas Ahmad Faisal SST. Msi
Kesehatan
Staf Iinduk 19 orang UPT Puskesmas
Staf Pustu 18 orang Teluk Belengkong
Snack 38 ktk 12,000.00 456,000.00
Makan Siang 38 ktk 28,000.00 1,064,000.00
1,520,000.00
Transport 2 org nakes 67,500.00 135,000.00
Petugas 18 org nakes 105,000.00 1,890,000.00
2,025,000.00
3,545,000.00

Lokakarya Mini Tahunan Petugas Ahmad Faisal SST. Msi


Kesehatan
Snack 126 ktk 12,000.00 1,512,000.00
Makan Siang 126 ktk 28,000.00 3,528,000.00
5,040,000.00
Transport 14 org nakes UPT Puskesmas 67,500.00 945,000.00
Petugas 84 org nakes Teluk Belengkong 105,000.00 8,820,000.00
Kader 9,765,000.00
Toma

Pengantaran SPJ dan Laporan BOK Petugas Ns.Afrianda Fajri,S.Kep


Kesehatan
Transport 1 org nakes DINKES 360,000.00 360,000.00
Penginapan 1 org nakes 200,000.00 200,000.00
Uang harian 1 org nakes 930,000.00 930,000.00
1,490,000.00

2 Pelayanan Kesehatan Ibu Kelas Ibu Hamil Snack 130 ktk 12,000.00 1,560,000.00
1,560,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00
Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
4,905,000.00

Kelas Ibu Balita Snack 195 ktk 12,000.00 2,340,000.00


2,340,000.00
Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00
Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
5,685,000.00

Pelaksanaan P4K Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Kunjungan Ibu Nifas Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

3 Upaya kesehatan anak sekolah Pemberian Tablet Fe Siswa/Siswi 16 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 1,080,000
dan usia remaja SMP

8 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 540,000


Desa Tunggal Rahayu Jaya

8 0rang SMP Ari Setyaningsih Rp 67,500 Rp 540,000


Desa Indra Sarri Jaya

4 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


Desa Beringin Mulya

8 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 540,000


Desa Hibrida Jaya

4 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 1,680,000

Siswa/siswi 4 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


MTs Desa Beringin Mulya

8 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 540,000


Desa Griya Mukti jaya
4 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000
Desa Sumber Makmur Jaya

8 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 540,000


Desa Hibrida Mulya

Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


SMA Desa Beringin Mulya

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 1,080,000


Rp 8,160,000

4 Imunisasi Pendistribusian vaksin Petugas 1 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 105,000 Rp 105,000
dari induk ke Pustu Kesehatan Teluk Belengkong
1 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 105,000 Rp 105,000
Transport Teluk Belengkong
Petugas 1 org nakes UPT Puskesmas Ari Setyaningsih Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Sudiharsono,Amk Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Santi N,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Rekha De Sagita Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nurmala Dewi,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong Rp 1,290,000

Posyandu Balita Petugas 2 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 67,500 Rp 135,000
Kesehatan Teluk Belengkong
2 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 67,500 Rp 135,000
Transport Teluk Belengkong
Petugas 2 org nakes UPT Puskesmas Ari Setyaningsih Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 105,000 Rp 210,000
Teluk Belengkong
2 org nakes UPT Puskesmas Sudiharsono,Amk Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Rekha De Sagita Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong Rp 2,250,000

5 Upaya Kesehatan Lanjut Usia Pemantuan Lansia Resti Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000
Posyandu Lansia Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

6 Upaya Promosi Kesehatan Honor Petugas Promkes Petugas 1 org Desa Sakarotan Rp 2,300,000 Rp 2,300,000
Kesehatan Rp 2,300,000

Saka Bakti Husada Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000
SMA 4 Desa Beringin Mulya Rp 105,000 Rp 420,000
4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000
4 Desa Sumber Jaya Rp 105,000 Rp 420,000

8 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 540,000


Rp 1,920,000

Penyegaran Kader Posyandu Snack 100 ktk Rp 12,000 Rp 1,200,000


Makan Siang 100 bks Rp 28,000 Rp 2,800,000
Rp 4,000,000
ATK Rp 413,000 Rp 413,000
Transport 80 org UPT Puskesmas Santi,AMK Rp 105,000 Rp 8,400,000
Petugas 10 org Teluk Belengkong Rp 67,500 Rp 675,000
Kader Rp 9,075,000

CTPS di TK Siswa/siswi 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


TK Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Griya Mukti jaya
2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
3 org nakes Desa Herni Usmi,Amd.Keb 67,500 202,500
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,552,500
Bahan Pembersih Rp 260,000
Rp 260,000

CTPS di PAUD Siswa/siswi 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


PAUD Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Griya Mukti jaya
2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
2 org nakes Desa Siti Aisyah,Amd.Keb 105,000 210,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 67,500
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
1,087,500
Bahan Pembersih Rp 260,000
Rp 260,000
Sikat gigi masala di TK Siswa/siswi 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
TK Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Griya Mukti jaya
2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
3 org nakes Desa Herni Usmi,Amd.Keb 67,500 202,500
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,552,500
Bahan Pembersih Rp 585,000
Rp 585,000

Sikat gigi masal di PAUD Siswa/siswi 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
PAUD Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Griya Mukti jaya
2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
2 org nakes Desa Siti Aisyah,Amd.Keb 105,000 210,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 67,500
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
1,087,500
Bahan Pembersih Rp 585,000
Rp 585,000

Penyuluhan disekolah dasar Snack 750 ktk Rp 12,000 Rp 9,000,000


Rp 9,000,000
Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000
SD Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000
Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

4 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 270,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Rp 2,310,000

7 Upaya pencegahan dan Penyuluhan HIV AIDS Di Sekolah Snack 700 ktk 12,000.00 8,400,000.00
pengendalian penyakit 8,400,000.00
Menular langsuung Siswa/Siswi 4 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 270,000
SMP

2 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 135,000


Desa Tunggal Rahayu Jaya

2 0rang SMP Ari Setyaningsih Rp 67,500 Rp 135,000


Desa Indra Sarri Jaya

1 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


Desa Hibrida Jaya

1 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500


Desa Sumber Jaya Rp 105,000 Rp 105,000

4 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 420,000

Siswa/siswi 1 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


MTs Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000


Desa Griya Mukti jaya

1 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


Desa Sumber Makmur Jaya Rp 105,000 Rp 105,000

2 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 135,000


Desa Hibrida Mulya
Siswa/siswi 1 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500
SMA Desa Beringin Mulya Rp 105,000 Rp 105,000

1 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 org SMA Teluk Belengkong Herni Usmi,Amd.Keb Rp 67,500 Rp 270,000 Rp 2,670,000

Pemantauan Pasien Kusta Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu Jaya 67,500.00 67,500.00
105,000.00 105,000.00
240,000.00

8 Upaya pencegahan dan Pelaksanaan Posbindu PTM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
pengendalian penyakit Kesehatan Tunggal Rahayu Jaya
Tidak menular 2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

10 Upaya Kesehatan jiwa Kunjungan rumah ODGJ Transport 2 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu jaya 67,500.00 67,500.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan 67,500.00 67,500.00
67,000.00 67,000.00

3 org nakes Desa Dewi Sartika 105,000.00 105,000.00


Gembaran 105,000.00 105,000.00
105,000.00 105,000.00

Rp 652,000

JUMLAH Rp 97,775,000

DIKETAHUI/DISETUJUI TELUK BELENGKONG, APRIL 2018


KEPALA DINAS KESEHATAN KABUPATEN INDRAGIRI HILIR KEPALA UPT PUSKESMAS TELUK BELENGKONG

H.ZAINAL ARIFIN, SKM.M.Kes AHMAD FAISAL,SST.MSi


NIP.19740226 199703 1 002
NIP.19700405 198912 1 001
PLAN OF ACTION (POA) PROGRAM BANTUAN OPERASIONAL KESEHATAN (BOK)
DI WILAYAH UPT. PUSKESMAS TELUK BELENGKONG
BULAN MEI 2018

BENTUK SASARAN JUMLAH BIAYA


NO KEGIATAN LOKASI JADWAL PENANGGUNG JAWAB KET
KEGIATAN KELOMPOK VOLUME SATUAN JUMLAH TOTAL
1 2 3 4 5 6 7 8 9 10 11 12
1 Manajemen Puskesmas Lokakarya Mini Bulanan Petugas Ahmad Faisal SST. Msi
Kesehatan
Staf Iinduk 18 orang UPT Puskesmas
Staf Pustu 20 orang Teluk Belengkong
Snack 38 ktk 12,000.00 456,000.00
Makan Siang 38 ktk 28,000.00 1,064,000.00
1,520,000.00
Transport 2 org nakes 67,500.00 135,000.00
Petugas 18 org nakes 105,000.00 1,890,000.00
2,025,000.00
3,545,000.00

Pengantaran SPJ dan Laporan BOK Petugas Ns.Afrianda Fajri,S.Kep


Kesehatan
Transport 1 org nakes DINKES 360,000.00 360,000.00
Penginapan 1 org nakes 200,000.00 200,000.00
Uang harian 1 org nakes 930,000.00 930,000.00
1,490,000.00

2 Pelayanan Kesehatan Ibu Kelas Ibu Hamil Snack 130 ktk 12,000.00 1,560,000.00
1,560,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00
Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
4,905,000.00

Kelas Ibu Balita Snack 195 ktk 12,000.00 2,340,000.00


2,340,000.00
Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00
Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
5,685,000.00

Pelaksanaan P4K Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000
Kunjungan Ibu Nifas Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

3 Upaya kesehatan anak sekolah Pemberian Tablet Fe Siswa/Siswi 16 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 1,080,000
dan usia remaja SMP

8 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 540,000


Desa Tunggal Rahayu Jaya
8 0rang SMP Ari Setyaningsih Rp 67,500 Rp 540,000
Desa Indra Sarri Jaya

4 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


Desa Beringin Mulya

8 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 540,000


Desa Hibrida Jaya

4 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 1,680,000

Siswa/siswi 4 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


MTs Desa Beringin Mulya

8 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 540,000


Desa Griya Mukti jaya

4 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Makmur Jaya

8 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 540,000


Desa Hibrida Mulya

Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


SMA Desa Beringin Mulya

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 1,080,000


Rp 8,160,000

4 Imunisasi Pendistribusian vaksin Petugas 1 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 105,000 Rp 105,000
dari induk ke Pustu Kesehatan Teluk Belengkong
1 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 105,000 Rp 105,000
Transport Teluk Belengkong
Petugas 1 org nakes UPT Puskesmas Ari Setyaningsih Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Sudiharsono,Amk Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Santi N,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Rekha De Sagita Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nurmala Dewi,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong Rp 1,290,000

Posyandu Balita Petugas 2 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 67,500 Rp 135,000
Kesehatan Teluk Belengkong
2 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 67,500 Rp 135,000
Transport Teluk Belengkong
Petugas 2 org nakes UPT Puskesmas Ari Setyaningsih Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 105,000 Rp 210,000
Teluk Belengkong
2 org nakes UPT Puskesmas Sudiharsono,Amk Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Rekha De Sagita Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong Rp 2,250,000

Sweeping Imunisasi Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

5 Upaya Kesehatan Lanjut Usia Pemantuan Lansia Resti Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Posyandu Lansia Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

6 Upaya Promosi Kesehatan Honor Petugas Promkes Petugas 1 org Desa Sakarotan Rp 2,300,000 Rp 2,300,000
Kesehatan Rp 2,300,000

Saka Bakti Husada Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000
SMA 4 Desa Beringin Mulya Rp 105,000 Rp 420,000

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


4 Desa Sumber Jaya Rp 105,000 Rp 420,000

8 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 540,000


Rp 1,920,000

Penyegaran Kader Posbindu Snack 100 ktk Rp 12,000 Rp 1,200,000


Makan Siang 100 bks Rp 28,000 Rp 2,800,000
Rp 4,000,000
ATK Rp 413,000 Rp 413,000
Transport 80 org UPT Puskesmas Santi,AMK Rp 105,000 Rp 8,400,000
Petugas 10 org Teluk Belengkong Rp 67,500 Rp 675,000
Kader Rp 9,075,000
Survey PHBS Penggandaan 3000 Rp 350 Rp 1,050,000
ATK 26 Rp 20,000 Rp 520,000
Rp 1,570,000
Kader 18 org nakes Desa Rosmiati,Amd.Keb 67,500 1,215,000
PHBS Tunggal Rahayu Jaya
18 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 1,215,000
Transport Griya Mukti jaya
Petugas 18 org nakes Desa Ari Setyaningsih 67,500 1,215,000
Indra Sari jaya
18 org nakes Desa Retno Wulandari,Amd.Keb 67,500 1,215,000
Beringin Mulya
18 org nakes Desa Siti Aisyah,Amd.Keb 67,500 1,215,000
Gembaran
18 org nakes Desa Sudiharsono,Amk 67,500 1,215,000
Hibrida Mulya
18 org nakes Desa Nurhidayah,Amd.Keb 67,500 1,215,000
Hibrida jaya
19 org nakes Desa Yelis Dametri,Amd.Keb 67,500 1,282,500
Sumber Jaya
19 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 1,282,500
Sumber Sari Jaya
19 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 1,282,500
Sumber Makmur jaya
19 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 1,282,500
Sapta Mulya Jaya
19 org nakes Desa Herni Usmi,Amd.Keb 67,500 1,282,500
Sakarotan
19 org nakes Desa Nella Sari,Amd.Keb 67,500 1,282,500
Kelapa Patih Jaya 16,200,000

7 Upaya pencegahan dan Pemantauan Pasien Kusta Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
pengendalian penyakit Petugas Tunggal Rahayu Jaya 67,500.00 67,500.00
Menular langsuung 105,000.00 105,000.00
240,000.00

8 Upaya pencegahan dan Pelaksanaan Posbindu PTM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
pengendalian penyakit Kesehatan Tunggal Rahayu Jaya
Tidak menular 2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

10 Upaya Kesehatan jiwa Kunjungan rumah ODGJ Transport 2 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu jaya 67,500.00 67,500.00
3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00
Sakarotan 67,500.00 67,500.00
67,000.00 67,000.00

3 org nakes Desa Dewi Sartika 105,000.00 105,000.00


Gembaran 105,000.00 105,000.00
105,000.00 105,000.00

Rp 652,000
11 Upaya Kesehatan Lingkungan Pemicuan Masyarakat 5 org Desa Sakarotan ambok tang,Amd.KL Rp 67,500 Rp 337,500
Rp 337,500

JUMLAH Rp 73,212,500

DIKETAHUI/DISETUJUI TELUK BELENGKONG, MEI 2018


KEPALA DINAS KESEHATAN KABUPATEN INDRAGIRI HILIR KEPALA UPT PUSKESMAS TELUK BELENGKONG

H.ZAINAL ARIFIN, SKM.M.Kes AHMAD FAISAL,SST.MSi


NIP.19740226 199703 1 002
NIP.19700405 198912 1 001
PLAN OF ACTION (POA) PROGRAM BANTUAN OPERASIONAL KESEHATAN (BOK)
DI WILAYAH UPT. PUSKESMAS TELUK BELENGKONG
BULAN JUNI 2018

BENTUK SASARAN JUMLAH BIAYA


NO KEGIATAN LOKASI JADWAL PENANGGUNG JAWAB KET
KEGIATAN KELOMPOK VOLUME SATUAN JUMLAH TOTAL
1 2 3 4 5 6 7 8 9 10 11 12
1 Manajemen Puskesmas Lokakarya Mini Bulanan Petugas Ahmad Faisal SST. Msi
Kesehatan
Staf Iinduk 18 orang UPT Puskesmas
Staf Pustu 20 orang Teluk Belengkong
Snack 38 ktk 12,000.00 456,000.00
Makan Siang 38 ktk 28,000.00 1,064,000.00
1,520,000.00
Transport 2 org nakes 67,500.00 135,000.00
Petugas 18 org nakes 105,000.00 1,890,000.00
2,025,000.00
3,545,000.00

Pengantaran SPJ dan Laporan BOK Petugas Ns.Afrianda Fajri,S.Kep


Kesehatan
Transport 1 org nakes DINKES 360,000.00 360,000.00
Penginapan 1 org nakes 200,000.00 200,000.00
Uang harian 1 org nakes 930,000.00 930,000.00
1,490,000.00

2 Pelayanan Kesehatan Ibu Kelas Ibu Hamil Snack 130 ktk 12,000.00 1,560,000.00
1,560,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00
Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
4,905,000.00

Kelas Ibu Balita Snack 195 ktk 12,000.00 2,340,000.00


2,340,000.00
Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00
Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
5,685,000.00

Pelaksanaan P4K Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000
Kunjungan Ibu Nifas Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

3 Upaya kesehatan anak sekolah Pemberian Tablet Fe Siswa/Siswi 16 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 1,080,000
dan usia remaja SMP

8 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 540,000


Desa Tunggal Rahayu Jaya
8 0rang SMP Ari Setyaningsih Rp 67,500 Rp 540,000
Desa Indra Sarri Jaya

4 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


Desa Beringin Mulya

8 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 540,000


Desa Hibrida Jaya

4 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 1,680,000

Siswa/siswi 4 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


MTs Desa Beringin Mulya

8 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 540,000


Desa Griya Mukti jaya

4 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Makmur Jaya

8 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 540,000


Desa Hibrida Mulya

Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


SMA Desa Beringin Mulya

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 1,080,000


Rp 8,160,000

4 Imunisasi Pendistribusian vaksin Petugas 1 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 105,000 Rp 105,000
dari induk ke Pustu Kesehatan Teluk Belengkong
1 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 105,000 Rp 105,000
Transport Teluk Belengkong
Petugas 1 org nakes UPT Puskesmas Ari Setyaningsih Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Sudiharsono,Amk Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Santi N,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Rekha De Sagita Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nurmala Dewi,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong Rp 1,290,000

Posyandu Balita Petugas 2 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 67,500 Rp 135,000
Kesehatan Teluk Belengkong
2 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 67,500 Rp 135,000
Transport Teluk Belengkong
Petugas 2 org nakes UPT Puskesmas Ari Setyaningsih Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 105,000 Rp 210,000
Teluk Belengkong
2 org nakes UPT Puskesmas Sudiharsono,Amk Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Rekha De Sagita Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong Rp 2,250,000

5 Upaya Kesehatan Lanjut Usia Pemantuan Lansia Resti Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Posyandu Lansia Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

6 Upaya Kesehatan lingkungan Inspeksi TTU Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

Inspeksi TPM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

7 Upaya Promosi Kesehatan Honor Petugas Promkes Petugas 1 org Desa Sakarotan Rp 2,300,000 Rp 2,300,000
Kesehatan Rp 2,300,000

Saka Bakti Husada Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000
SMA 4 Desa Beringin Mulya Rp 105,000 Rp 420,000

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


4 Desa Sumber Jaya Rp 105,000 Rp 420,000

8 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 540,000


Rp 1,920,000

8 Upaya pencegahan dan Pemantauan Pasien Kusta Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
pengendalian penyakit Petugas Tunggal Rahayu Jaya 67,500.00 67,500.00
Menular langsuung 105,000.00 105,000.00
240,000.00

9 Upaya pencegahan dan Pelaksanaan Posbindu PTM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
pengendalian penyakit Kesehatan Tunggal Rahayu Jaya
Tidak menular 2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

10 Upaya Kesehatan jiwa Kunjungan rumah ODGJ Transport 2 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu jaya 67,500.00 67,500.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan 67,500.00 67,500.00
67,000.00 67,000.00

3 org nakes Desa Dewi Sartika 105,000.00 105,000.00


Gembaran 105,000.00 105,000.00
105,000.00 105,000.00

Rp 652,000

Penyuluhan Jiwa dan NAPZA Di Sekolah Snack 700 ktk 12,000.00 8,400,000.00
8,400,000.00
Siswa/Siswi 4 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 270,000
SMP

2 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 135,000


Desa Tunggal Rahayu Jaya

2 0rang SMP Ari Setyaningsih Rp 67,500 Rp 135,000


Desa Indra Sarri Jaya

1 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


Desa Hibrida Jaya

1 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500


Desa Sumber Jaya Rp 105,000 Rp 105,000

4 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 420,000

Siswa/siswi 1 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


MTs Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000


Desa Griya Mukti jaya

1 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


Desa Sumber Makmur Jaya Rp 105,000 Rp 105,000

2 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 135,000


Desa Hibrida Mulya
Siswa/siswi 1 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500
SMA Desa Beringin Mulya Rp 105,000 Rp 105,000

1 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 org SMA Teluk Belengkong Herni Usmi,Amd.Keb Rp 67,500 Rp 270,000 Rp 2,670,000

JUMLAH Rp 54,442,000

DIKETAHUI/DISETUJUI TELUK BELENGKONG, JUNI 2018


KEPALA DINAS KESEHATAN KABUPATEN INDRAGIRI HILIR KEPALA UPT PUSKESMAS TELUK BELENGKONG

H.ZAINAL ARIFIN, SKM.M.Kes AHMAD FAISAL,SST.MSi


NIP.19740226 199703 1 002
NIP.19700405 198912 1 001
PLAN OF ACTION (POA) PROGRAM BANTUAN OPERASIONAL KESEHATAN (BOK)
DI WILAYAH UPT. PUSKESMAS TELUK BELENGKONG
BULAN JULI 2018

BENTUK SASARAN JUMLAH BIAYA


NO KEGIATAN LOKASI JADWAL PENANGGUNG JAWAB KET
KEGIATAN KELOMPOK VOLUME SATUAN JUMLAH TOTAL
1 2 3 4 5 6 7 8 9 10 11 12
1 Manajemen Puskesmas Lokakarya Mini Bulanan Petugas Ahmad Faisal SST. Msi
Kesehatan
Staf Iinduk 19 orang UPT Puskesmas
Staf Pustu 18 orang Teluk Belengkong
Snack 38 ktk 12,000.00 456,000.00
Makan Siang 38 ktk 28,000.00 1,064,000.00
1,520,000.00
Transport 2 org nakes 67,500.00 135,000.00
Petugas 18 org nakes 105,000.00 1,890,000.00
2,025,000.00
3,545,000.00

Konsultasi SPJ dan Laporan BOK Petugas Ns.Afrianda Fajri,S.Kep


Kesehatan
Transport 1 org nakes DINKES 360,000.00 360,000.00
Penginapan 1 org nakes 200,000.00 200,000.00
Uang harian 1 org nakes 930,000.00 930,000.00
1,490,000.00

2 Pelayanan Kesehatan Ibu Kelas Ibu Hamil Snack 130 ktk 12,000.00 1,560,000.00
1,560,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00
Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
4,905,000.00

Kelas Ibu Balita Snack 195 ktk 12,000.00 2,340,000.00


2,340,000.00
Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00
Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
5,685,000.00

Pelaksanaan P4K Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000
Kunjungan Ibu Nifas Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

3 Upaya kesehatan anak sekolah Pemberian Tablet Fe Siswa/Siswi 16 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 1,080,000
dan usia remaja SMP

8 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 540,000


Desa Tunggal Rahayu Jaya
8 0rang SMP Ari Setyaningsih Rp 67,500 Rp 540,000
Desa Indra Sarri Jaya

4 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


Desa Beringin Mulya

8 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 540,000


Desa Hibrida Jaya

4 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 1,680,000

Siswa/siswi 4 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


MTs Desa Beringin Mulya

8 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 540,000


Desa Griya Mukti jaya

4 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Makmur Jaya

8 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 540,000


Desa Hibrida Mulya

Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


SMA Desa Beringin Mulya

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 1,080,000


Rp 8,160,000

Pemantuan Status Gizi 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Griya Mukti jaya
2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

4 Imunisasi Pendistribusian vaksin Petugas 1 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 105,000 Rp 105,000
dari induk ke Pustu Kesehatan Teluk Belengkong
1 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 105,000 Rp 105,000
Transport Teluk Belengkong
Petugas 1 org nakes UPT Puskesmas Ari Setyaningsih Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Sudiharsono,Amk Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Santi N,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Rekha De Sagita Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nurmala Dewi,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong Rp 1,290,000

Posyandu Balita Petugas 2 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 67,500 Rp 135,000
Kesehatan Teluk Belengkong
2 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 67,500 Rp 135,000
Transport Teluk Belengkong
Petugas 2 org nakes UPT Puskesmas Ari Setyaningsih Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 105,000 Rp 210,000
Teluk Belengkong
2 org nakes UPT Puskesmas Sudiharsono,Amk Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Rekha De Sagita Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong Rp 2,250,000

5 Upaya Kesehatan Usia Reproduksi Pemerikasaan Iva Petugas org nakes UPT Puskesmas Rp 4,503,000
Kesehatan Teluk Belengkong Rp 4,503,000

6 Upaya Kesehatan Lanjut Usia Pemantuan Lansia Resti Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Posyandu Lansia Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

6 Upaya Kesehatan lingkungan HSP di Sekolah Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000
SD Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

2 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 135,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Siswa/Siswi 4 orang SMP Sakarotan dr Riska Yuliana Sari Rp 67,500 Rp 270,000


SMP

2 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 135,000


Desa Tunggal Rahayu Jaya

2 0rang SMP Ari Setyaningsih Rp 67,500 Rp 135,000


Desa Indra Sarri Jaya
1 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500
1 Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


Desa Hibrida Jaya

1 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 0rang SMP Cendana Dewi Sartika Rp 67,500 Rp 270,000

Siswa/siswi 1 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


MTs 1 Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000


Desa Griya Mukti jaya

1 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Makmur Jaya Rp 105,000 Rp 105,000

2 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 135,000


Desa Hibrida Mulya

Siswa/siswi 1 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


SMA 1 Desa Beringin Mulya Rp 105,000 Rp 105,000

1 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 org SMA Teluk Belengkong Herni Usmi,Amd.Keb Rp 67,500 Rp 270,000


Rp 4,695,000

7 Upaya Promosi Kesehatan Honor Petugas Promkes Petugas 1 org Desa Sakarotan Rp 2,300,000 Rp 2,300,000
Kesehatan Rp 2,300,000

Saka Bakti Husada Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000
SMA 4 Desa Beringin Mulya Rp 105,000 Rp 420,000

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


4 Desa Sumber Jaya Rp 105,000 Rp 420,000

8 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 540,000


Rp 1,920,000

Pembinaan Posyandu Snack 165 ktk 12,000.00 1,980,000.00


1,980,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Lusi,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya 105,000.00 105,000.00
105,000.00 105,000.00
3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00
Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nurbani Lailatul Qodriah,Am 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Ignatia Putri Suraya,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Ns Siti Nurbaiti,S.Kep 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
4,072,500.00

Pembinaan Posbindu Snack 165 ktk 12,000.00 1,980,000.00


1,980,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Lusi,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00
3 org nakes Desa Nurbani Lailatul Qodriah,Am 67,500.00 67,500.00
Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Ignatia Putri Suraya,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Ns Siti Nurbaiti,S.Kep 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
4,072,500.00

Pembinaan Posbindu Lansia Snack 165 ktk 12,000.00 1,980,000.00


1,980,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Lusi,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nurbani Lailatul Qodriah,Am 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Ignatia Putri Suraya,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya 105,000.00 105,000.00
105,000.00 105,000.00
3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00
Sapta Mulya jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Ns Siti Nurbaiti,S.Kep 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
4,072,500.00

Pembinaan Posbindu Lansia Snack 347 ktk 12,000.00 4,164,000.00


4,164,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Lusi,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nurbani Lailatul Qodriah,Am 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00
3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00
Sumber Sari Jaya Ignatia Putri Suraya,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Ns Siti Nurbaiti,S.Kep 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
4,072,500.00

8 Upaya pencegahan dan Pemantauan Pasien Kusta Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
pengendalian penyakit Petugas Tunggal Rahayu Jaya 67,500.00 67,500.00
Menular langsuung 105,000.00 105,000.00
240,000.00

9 Upaya pencegahan dan Pelaksanaan Posbindu PTM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
pengendalian penyakit Kesehatan Tunggal Rahayu Jaya
Tidak menular 2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

Penyuluhan Kelompok Snack 650 Ktk 12,000.00 7,800,000.00


7,800,000.00
Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

10 Upaya Kesehatan jiwa Kunjungan rumah ODGJ Transport 2 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu jaya 67,500.00 67,500.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan 67,500.00 67,500.00
67,000.00 67,000.00

3 org nakes Desa Dewi Sartika 105,000.00 105,000.00


Gembaran 105,000.00 105,000.00
105,000.00 105,000.00

Rp 652,000

JUMLAH Rp 86,629,000

DIKETAHUI/DISETUJUI TELUK BELENGKONG, JULI 2018


KEPALA DINAS KESEHATAN KABUPATEN INDRAGIRI HILIR KEPALA UPT PUSKESMAS TELUK BELENGKONG

H.ZAINAL ARIFIN, SKM.M.Kes AHMAD FAISAL,SST.MSi


NIP.19740226 199703 1 002
NIP.19700405 198912 1 001
PLAN OF ACTION (POA) PROGRAM BANTUAN OPERASIONAL KESEHATAN (BOK)
DI WILAYAH UPT. PUSKESMAS TELUK BELENGKONG
BULAN AGUSTUS 2018

BENTUK SASARAN JUMLAH BIAYA


NO KEGIATAN LOKASI JADWAL PENANGGUNG JAWAB KET
KEGIATAN KELOMPOK VOLUME SATUAN JUMLAH TOTAL
1 2 3 4 5 6 7 8 9 10 11 12
1 Manajemen Puskesmas Lokakarya Mini Bulanan Petugas Ahmad Faisal SST. Msi
Kesehatan
Staf Iinduk 19 orang UPT Puskesmas
Staf Pustu 18 orang Teluk Belengkong
Snack 38 ktk 12,000.00 456,000.00
Makan Siang 38 ktk 28,000.00 1,064,000.00
1,520,000.00
Transport 2 org nakes 67,500.00 135,000.00
Petugas 18 org nakes 105,000.00 1,890,000.00
2,025,000.00
3,545,000.00

Pengantaran SPJ dan Laporan BOK Petugas Ns.Afrianda Fajri,S.Kep


Kesehatan
Transport 1 org nakes DINKES 360,000.00 360,000.00
Penginapan 1 org nakes 200,000.00 200,000.00
Uang harian 1 org nakes 930,000.00 930,000.00
1,490,000.00

2 Pelayanan Kesehatan Ibu Kelas Ibu Hamil Snack 130 ktk 12,000.00 1,560,000.00
1,560,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00
Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
4,905,000.00

Kelas Ibu Balita Snack 195 ktk 12,000.00 2,340,000.00


2,340,000.00
Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
5,685,000.00

Pelaksanaan P4K Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Kunjungan Ibu Nifas Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Upaya Kesehatan Anak Sweeping Vit A 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
balita dan pra sekolah Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Griya Mukti jaya
2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
2 org nakes Desa Retno Wulandari,Amd.Keb 67,500 135,000
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
2 org nakes Desa Yelis Dametri,Amd.Keb 67,500 135,000
Sumber Jaya
2 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 135,000
Sumber Sari Jaya
2 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 135,000
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,755,000

3 Upaya kesehatan anak sekolah Pemberian Tablet Fe Siswa/Siswi 16 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 1,080,000
dan usia remaja SMP
8 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 540,000
Desa Tunggal Rahayu Jaya

8 0rang SMP Ari Setyaningsih Rp 67,500 Rp 540,000


Desa Indra Sarri Jaya

4 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


Desa Beringin Mulya

8 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 540,000


Desa Hibrida Jaya

4 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 1,680,000

Siswa/siswi 4 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


MTs Desa Beringin Mulya

8 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 540,000


Desa Griya Mukti jaya

4 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Makmur Jaya

8 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 540,000


Desa Hibrida Mulya

Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


SMA Desa Beringin Mulya

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Jaya
16 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 1,080,000
Rp 8,160,000

Penjaringan Anak Sekolah Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000
Transport petugas SD kls I Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000
4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

2 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 135,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Siswa/Siswi 4 orang SMP Sakarotan dr Riska Yuliana Sari Rp 67,500 Rp 270,000


SMP

2 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 135,000


Desa Tunggal Rahayu Jaya

2 0rang SMP Ari Setyaningsih Rp 67,500 Rp 135,000


Desa Indra Sarri Jaya

1 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


1 Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


Desa Hibrida Jaya

1 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 0rang SMP Cendana Dewi Sartika Rp 67,500 Rp 270,000

Siswa/siswi 1 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


MTs 1 Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000


Desa Griya Mukti jaya
1 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Desa Sumber Makmur Jaya Rp 105,000 Rp 105,000

2 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 135,000


Desa Hibrida Mulya

Siswa/siswi 1 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


SMA 1 Desa Beringin Mulya Rp 105,000 Rp 105,000

1 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 270,000


Rp 4,695,000

Penggandaan
Fc Blangko Penjaringan 500 Siswa Rp 700 Rp 350,000 Rp 350,000
ATK
Pena 6 lusin Rp 30,000 Rp 180,000
Map Plastik 32 buah Rp 3,000 Rp 96,000
Rp 210,000 Rp 276,000

4 Imunisasi Pendistribusian vaksin Petugas 1 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 105,000 Rp 105,000
dari induk ke Pustu Kesehatan Teluk Belengkong
1 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 105,000 Rp 105,000
Transport Teluk Belengkong
Petugas 1 org nakes UPT Puskesmas Ari Setyaningsih Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Sudiharsono,Amk Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Santi N,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Rekha De Sagita Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nurmala Dewi,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong Rp 1,290,000

Posyandu Balita Petugas 2 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 67,500 Rp 135,000
Kesehatan Teluk Belengkong
2 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 67,500 Rp 135,000
Transport Teluk Belengkong
Petugas 2 org nakes UPT Puskesmas Ari Setyaningsih Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 105,000 Rp 210,000
Teluk Belengkong
2 org nakes UPT Puskesmas Sudiharsono,Amk Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Rekha De Sagita Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong Rp 2,250,000

Pendataan sasaran MR Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000


SD Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

2 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 210,000

5 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 337,500

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Siswa/Siswi 4 orang SMP Sakarotan dr Riska Yuliana Sari Rp 67,500 Rp 270,000


SMP

2 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 135,000


Desa Tunggal Rahayu Jaya

2 0rang SMP Ari Setyaningsih Rp 67,500 Rp 135,000


Desa Indra Sarri Jaya

1 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


Desa Beringin Mulya

2 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


Desa Hibrida Jaya

1 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500


Desa Sumber Jaya

4 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 420,000

1 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


Desa Beringin Mulya
Siswa/siswi
MTs 2 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000
1 Desa Griya Mukti jaya Rp 105,000

1 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Makmur Jaya Rp 105,000

2 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 135,000


Desa Hibrida Mulya Rp 105,000

1 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


1 Desa Beringin Mulya Rp 105,000
Siswa/siswi
SMA 1 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Desa Sumber Jaya Rp 105,000

5 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 337,500


Rp 4,800,000

Pelaksanaam MR Siswa/siswi 2 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 135,000


SD Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


Rp 150,000
2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000
Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500
Rp 150,000

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

2 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 135,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Siswa/Siswi 4 orang SMP Sakarotan dr Riska Yuliana Sari Rp 67,500 Rp 270,000


SMP

2 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 135,000


Desa Tunggal Rahayu Jaya

2 0rang SMP Ari Setyaningsih Rp 67,500 Rp 135,000


Desa Indra Sarri Jaya

1 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


1 Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


Desa Hibrida Jaya
1 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500
1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 420,000

Siswa/siswi 1 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


MTs 1 Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000


Desa Griya Mukti jaya

1 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Makmur Jaya Rp 105,000 Rp 105,000

2 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 135,000


Desa Hibrida Mulya

Siswa/siswi 1 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


SMA 1 Desa Beringin Mulya Rp 105,000 Rp 105,000

1 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 270,000


Rp 5,010,000
Sweeping MR Siswa/siswi 2 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 135,000
SD Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000
2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

2 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 210,000

2 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 135,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Siswa/Siswi 2 orang SMP Sakarotan dr Riska Yuliana Sari Rp 67,500 Rp 135,000


SMP
2 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 135,000
Desa Tunggal Rahayu Jaya

2 0rang SMP Ari Setyaningsih Rp 67,500 Rp 135,000


Desa Indra Sarri Jaya

1 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


Desa Beringin Mulya

2 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


Desa Hibrida Jaya

1 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500


Desa Sumber Jaya

2 0rang SMP Cendana Dewi Sartika Rp 67,500 Rp 135,000

Siswa/siswi
MTs
1 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500
Desa Beringin Mulya

2 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000


Desa Griya Mukti jaya

1 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


Desa Sumber Makmur Jaya

2 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 135,000


Siswa/siswi Desa Hibrida Mulya
SMA
1 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500
Desa Beringin Mulya

1 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


Desa Sumber Jaya
2 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 135,000
Rp 3,315,000

Sweeping Imunisasi Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

6 Upaya Kesehatan Lanjut Usia Pemantuan Lansia Resti Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Posyandu Lansia Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

7 Upaya Promosi Kesehatan Honor Petugas Promkes Petugas 1 org Desa Sakarotan Rp 2,300,000 Rp 2,300,000
Kesehatan Rp 2,300,000

Saka Bakti Husada Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000
SMA 4 Desa Beringin Mulya Rp 105,000 Rp 420,000

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


4 Desa Sumber Jaya Rp 105,000 Rp 420,000

8 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 540,000


Rp 1,920,000

8 Upaya pencegahan dan Pemantauan Pasien Kusta Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
pengendalian penyakit Petugas Tunggal Rahayu Jaya 67,500.00 67,500.00
Menular langsuung 105,000.00 105,000.00
240,000.00

9 Upaya pencegahan dan Pelaksanaan Posbindu PTM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
pengendalian penyakit Kesehatan Tunggal Rahayu Jaya
Tidak menular 2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

Penyuluhan Kelompok Snack 650 Ktk 12,000.00 7,800,000.00


7,800,000.00
Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

10 Upaya Kesehatan jiwa Kunjungan rumah ODGJ Transport 2 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu jaya 67,500.00 67,500.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan 67,500.00 67,500.00
67,000.00 67,000.00

3 org nakes Desa Dewi Sartika 105,000.00 105,000.00


Gembaran 105,000.00 105,000.00
105,000.00 105,000.00

Rp 652,000

Upaya Kesehatan Lainnya Pembinaan Kes Olah Raga Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000
Transport petugas SD kls I Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb
1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

2 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 135,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Siswa/Siswi 4 orang SMP Sakarotan dr Riska Yuliana Sari Rp 67,500 Rp 270,000


SMP

2 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 135,000


Desa Tunggal Rahayu Jaya
2 0rang SMP Ari Setyaningsih Rp 67,500 Rp 135,000
Desa Indra Sarri Jaya

1 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


1 Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000


Desa Hibrida Jaya

1 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 0rang SMP Cendana Dewi Sartika Rp 67,500 Rp 270,000

Siswa/siswi 1 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


MTs 1 Desa Beringin Mulya Rp 105,000 Rp 105,000

2 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000


Desa Griya Mukti jaya

1 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Makmur Jaya Rp 105,000 Rp 105,000

2 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 135,000


Desa Hibrida Mulya

Siswa/siswi 1 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500


SMA 1 Desa Beringin Mulya Rp 105,000 Rp 105,000

1 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500


1 Desa Sumber Jaya Rp 105,000 Rp 105,000

4 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 270,000


Rp 4,695,000
JUMLAH Rp 75,933,000

DIKETAHUI/DISETUJUI TELUK BELENGKONG, AGUSTUS 2018


KEPALA DINAS KESEHATAN KABUPATEN INDRAGIRI HILIR KEPALA UPT PUSKESMAS TELUK BELENGKONG

H.ZAINAL ARIFIN, SKM.M.Kes AHMAD FAISAL,SST.MSi


NIP.19740226 199703 1 002
NIP.19700405 198912 1 001
1 67500 67500
1 105000 105000
PLAN OF ACTION (POA) PROGRAM BANTUAN OPERASIONAL KESEHATAN (BOK)
DI WILAYAH UPT. PUSKESMAS TELUK BELENGKONG
BULAN SEPTEMBER2018

BENTUK SASARAN JUMLAH BIAYA


NO KEGIATAN LOKASI JADWAL PENANGGUNG JAWAB KET
KEGIATAN KELOMPOK VOLUME SATUAN JUMLAH TOTAL
1 2 3 4 5 6 7 8 9 10 11 12
1 Manajemen Puskesmas Lokakarya Mini Bulanan Petugas Ahmad Faisal SST. Msi
Kesehatan
Staf Iinduk 19 orang UPT Puskesmas
Staf Pustu 18 orang Teluk Belengkong
Snack 38 ktk 12,000.00 456,000.00
Makan Siang 38 ktk 28,000.00 1,064,000.00
1,520,000.00
Transport 2 org nakes 67,500.00 135,000.00
Petugas 18 org nakes 105,000.00 1,890,000.00
2,025,000.00
3,545,000.00

Pengantaran SPJ dan Laporan BOK Petugas Ns.Afrianda Fajri,S.Kep


Kesehatan
Transport 1 org nakes DINKES 360,000.00 360,000.00
Penginapan 1 org nakes 200,000.00 200,000.00
Uang harian 1 org nakes 930,000.00 930,000.00
1,490,000.00

2 Pelayanan Kesehatan Ibu Kelas Ibu Hamil Snack 130 ktk 12,000.00 1,560,000.00
1,560,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
4,905,000.00

Kelas Ibu Balita Snack 195 ktk 12,000.00 2,340,000.00


2,340,000.00
Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00
Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
5,685,000.00

Pelaksanaan P4K Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Kunjungan Ibu Nifas Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

3 Upaya kesehatan anak sekolah Pemberian Tablet Fe Siswa/Siswi 16 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 1,080,000
dan usia remaja SMP
8 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 540,000
Desa Tunggal Rahayu Jaya

8 0rang SMP Ari Setyaningsih Rp 67,500 Rp 540,000


Desa Indra Sarri Jaya

4 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


Desa Beringin Mulya

8 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 540,000


Desa Hibrida Jaya

4 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 1,680,000

Siswa/siswi 4 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


MTs Desa Beringin Mulya

8 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 540,000


Desa Griya Mukti jaya

4 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Makmur Jaya

8 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 540,000


Desa Hibrida Mulya

Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


SMA Desa Beringin Mulya

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 1,080,000


Rp 8,160,000

Pendataan BIAS Siswa/siswi 2 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 135,000


Transport petugas SD kls I Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

2 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 210,000


2 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 135,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Rp 1,830,000

BIAS Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000


Transport petugas SD kls I Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

4 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 270,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Rp 2,310,000
4 Imunisasi Pendistribusian vaksin Petugas 1 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 105,000 Rp 105,000
dari induk ke Pustu Kesehatan Teluk Belengkong
1 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 105,000 Rp 105,000
Transport Teluk Belengkong
Petugas 1 org nakes UPT Puskesmas Ari Setyaningsih Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Sudiharsono,Amk Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Santi N,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Rekha De Sagita Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nurmala Dewi,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong Rp 1,290,000

Posyandu Balita Petugas 2 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 67,500 Rp 135,000
Kesehatan Teluk Belengkong
2 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 67,500 Rp 135,000
Transport Teluk Belengkong
Petugas 2 org nakes UPT Puskesmas Ari Setyaningsih Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 105,000 Rp 210,000
Teluk Belengkong
2 org nakes UPT Puskesmas Sudiharsono,Amk Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Rekha De Sagita Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong Rp 2,250,000

pelaksanaan MR Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
2 org nakes Desa Retno Wulandari,Amd.Keb 67,500 135,000
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
2 org nakes Desa Yelis Dametri,Amd.Keb 67,500 135,000
Sumber Jaya
2 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 135,000
Sumber Sari Jaya
2 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 135,000
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,755,000

Sweeping MR Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
2 org nakes Desa Retno Wulandari,Amd.Keb 67,500 135,000
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
2 org nakes Desa Yelis Dametri,Amd.Keb 67,500 135,000
Sumber Jaya
2 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 135,000
Sumber Sari Jaya
2 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 135,000
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,755,000

6 Upaya Kesehatan Lanjut Usia Pemantuan Lansia Resti Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Posyandu Lansia Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

7 Upaya Promosi Kesehatan Honor Petugas Promkes Petugas 1 org Desa Sakarotan Rp 2,300,000 Rp 2,300,000
Kesehatan Rp 2,300,000

Saka Bakti Husada Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000
SMA 4 Desa Beringin Mulya Rp 105,000 Rp 420,000

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


4 Desa Sumber Jaya Rp 105,000 Rp 420,000

8 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 540,000


Rp 1,920,000

8 Upaya pencegahan dan Pemantauan Pasien Kusta Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
pengendalian penyakit Petugas Tunggal Rahayu Jaya 67,500.00 67,500.00
Menular langsuung 105,000.00 105,000.00
240,000.00

9 Upaya pencegahan dan Pelaksanaan Posbindu PTM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
pengendalian penyakit Kesehatan Tunggal Rahayu Jaya
Tidak menular 2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

Pemeriksaan garam beryodium Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000
SD kls I Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

4 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 270,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Rp 2,310,000

Penyuluhan Di Sekolah dasar Snack 750 ktk Rp 12,000 Rp 9,000,000 Rp 9,000,000


Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000
SD kls I Desa Sakarotan
2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000

4 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 270,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000


Rp 2,310,000

10 Upaya Kesehatan jiwa Kunjungan rumah ODGJ Transport 2 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu jaya 67,500.00 67,500.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan 67,500.00 67,500.00
67,000.00 67,000.00

3 org nakes Desa Dewi Sartika 105,000.00 105,000.00


Gembaran 105,000.00 105,000.00
105,000.00 105,000.00

Rp 652,000

JUMLAH Rp 61,402,000

DIKETAHUI/DISETUJUI TELUK BELENGKONG, SEPTEMBER 2018


KEPALA DINAS KESEHATAN KABUPATEN INDRAGIRI HILIR KEPALA UPT PUSKESMAS TELUK BELENGKONG

H.ZAINAL ARIFIN, SKM.M.Kes AHMAD FAISAL,SST.MSi


NIP.19740226 199703 1 002
NIP.19700405 198912 1 001
PLAN OF ACTION (POA) PROGRAM BANTUAN OPERASIONAL KESEHATAN (BOK)
DI WILAYAH UPT. PUSKESMAS TELUK BELENGKONG
BULAN OKTOBER 2018

BENTUK SASARAN JUMLAH BIAYA


NO KEGIATAN LOKASI JADWAL PENANGGUNG JAWAB KET
KEGIATAN KELOMPOK VOLUME SATUAN JUMLAH TOTAL
1 2 3 4 5 6 7 8 9 10 11 12
1 Manajemen Puskesmas Lokakarya Mini Bulanan Petugas Ahmad Faisal SST. Msi
Kesehatan
Staf Iinduk 19 orang UPT Puskesmas
Staf Pustu 18 orang Teluk Belengkong
Snack 38 ktk 12,000.00 456,000.00
Makan Siang 38 ktk 28,000.00 1,064,000.00
1,520,000.00
Transport 2 org nakes 67,500.00 135,000.00
Petugas 18 org nakes 105,000.00 1,890,000.00
2,025,000.00
3,545,000.00

Pengantaran SPJ dan Laporan BOK Petugas Ns.Afrianda Fajri,S.Kep


Kesehatan
Transport 1 org nakes DINKES 360,000.00 360,000.00
Penginapan 1 org nakes 200,000.00 200,000.00
Uang harian 1 org nakes 930,000.00 930,000.00
1,490,000.00

2 Pelayanan Kesehatan Ibu Kelas Ibu Hamil Snack 130 ktk 12,000.00 1,560,000.00
1,560,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
4,905,000.00

Kelas Ibu Balita Snack 195 ktk 12,000.00 2,340,000.00


2,340,000.00
Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00
Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00
5,685,000.00

Pelaksanaan P4K Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Kunjungan Ibu Nifas Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

3 Upaya kesehatan anak sekolah Pemberian Tablet Fe Siswa/Siswi 16 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 1,080,000
dan usia remaja SMP
8 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 540,000
Desa Tunggal Rahayu Jaya

8 0rang SMP Ari Setyaningsih Rp 67,500 Rp 540,000


Desa Indra Sarri Jaya

4 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


Desa Beringin Mulya

8 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 540,000


Desa Hibrida Jaya

4 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 1,680,000

Siswa/siswi 4 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


MTs Desa Beringin Mulya

8 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 540,000


Desa Griya Mukti jaya

4 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Makmur Jaya

8 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 540,000


Desa Hibrida Mulya

Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


SMA Desa Beringin Mulya

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 1,080,000


Rp 8,160,000

BIAS Siswa/siswi 4 0rang SD 001 Herni Usmi.Amd.keb Rp 67,500 Rp 270,000


Transport petugas SD kls I Desa Sakarotan

2 0rang SD 002 Desa Tunggal Rahayu Jaya Rosmiati.Amd,Keb Rp 67,500 Rp 135,000

2 0rang SD 003 Desa Griya Mukti Jaya Rika Prima Santi.Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 004 Desa Indra Sari Jaya Ari Setyaningsih Rp 67,500 Rp 135,000
Hayatang.Amd,Keb

1 0rang SD 005 Desa Beringin Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 67,500

2 0rang SD 006 Desa Hibrida Mulya Sy.Reni WIdyanti.Amd.Keb Rp 67,500 Rp 135,000


Sudiharsono.Amk

2 0rang SD 007 Desa Hibrida Jaya Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000

1 0rang SD 008 Desa Sumber Jaya Yelis Dametri.Amd.keb Rp 67,500 Rp 67,500

1 0rang SD 009 Desa Sumber Makmur Jaya Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500

1 0rang SD 010 Desa Sumber Sari Jaya Rekha De Sagita.Amd.keb Rp 67,500 Rp 67,500

2 0rang SD 011 Desa Kelapa Patih Jaya Nella Sari,Amd.Keb Rp 67,500 Rp 135,000

2 0rang SD 012 Desa Sapta Mulya Jaya Bg Sumantri, S.Kep Ners Rp 67,500 Rp 135,000

4 0rang SD 013 Cendana Dewi Sartika Rp 105,000 Rp 420,000


4 0rang SD 017 Desa Sakarotan Herni Usmi.Amd.keb Rp 67,500 Rp 270,000

2 0rang MI Nurul Wathan Siti Aisyah.Amd.Keb Rp 67,500 Rp 135,000

Rp 2,310,000
4 Imunisasi Pendistribusian vaksin Petugas 1 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 105,000 Rp 105,000
dari induk ke Pustu Kesehatan Teluk Belengkong
1 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 105,000 Rp 105,000
Transport Teluk Belengkong
Petugas 1 org nakes UPT Puskesmas Ari Setyaningsih Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Sudiharsono,Amk Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Santi N,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Rekha De Sagita Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nurmala Dewi,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong Rp 1,290,000

Posyandu Balita Petugas 2 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 67,500 Rp 135,000
Kesehatan Teluk Belengkong
2 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 67,500 Rp 135,000
Transport Teluk Belengkong
Petugas 2 org nakes UPT Puskesmas Ari Setyaningsih Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 105,000 Rp 210,000
Teluk Belengkong
2 org nakes UPT Puskesmas Sudiharsono,Amk Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Rekha De Sagita Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong Rp 2,250,000

6 Upaya Kesehatan Lanjut Usia Pemantuan Lansia Resti Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Posyandu Lansia Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

7 Upaya Promosi Kesehatan Honor Petugas Promkes Petugas 1 org Desa Sakarotan Rp 2,300,000 Rp 2,300,000
Kesehatan Rp 2,300,000

Saka Bakti Husada Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000
SMA 4 Desa Beringin Mulya Rp 105,000 Rp 420,000

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


4 Desa Sumber Jaya Rp 105,000 Rp 420,000

8 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 540,000


Rp 1,920,000

8 Upaya pencegahan dan Pemantauan Pasien Kusta Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
pengendalian penyakit Petugas Tunggal Rahayu Jaya 67,500.00 67,500.00
Menular langsuung 105,000.00 105,000.00
240,000.00

9 Upaya pencegahan dan Pelaksanaan Posbindu PTM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
pengendalian penyakit Kesehatan Tunggal Rahayu Jaya
Tidak menular 2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

10 Upaya Kesehatan jiwa Kunjungan rumah ODGJ Transport 2 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu jaya 67,500.00 67,500.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan 67,500.00 67,500.00
67,000.00 67,000.00

3 org nakes Desa Dewi Sartika 105,000.00 105,000.00


Gembaran 105,000.00 105,000.00
105,000.00 105,000.00

Rp 652,000

JUMLAH Rp 42,442,000

DIKETAHUI/DISETUJUI TELUK BELENGKONG, OKTOBER 2018


KEPALA DINAS KESEHATAN KABUPATEN INDRAGIRI HILIR KEPALA UPT PUSKESMAS TELUK BELENGKONG

H.ZAINAL ARIFIN, SKM.M.Kes AHMAD FAISAL,SST.MSi


NIP.19740226 199703 1 002
NIP.19700405 198912 1 001
PLAN OF ACTION (POA) PROGRAM BANTUAN OPERASIONAL KESEHATAN (BOK)
DI WILAYAH UPT. PUSKESMAS TELUK BELENGKONG
BULAN NOPEMBER 2018

BENTUK SASARAN JUMLAH BIAYA


NO KEGIATAN LOKASI JADWAL PENANGGUNG JAWAB
KEGIATAN KELOMPOK VOLUME SATUAN JUMLAH TOTAL
1 2 3 4 5 6 7 8 9 10 11
1 Manajemen Puskesmas Lokakarya Mini Bulanan Petugas Ahmad Faisal SST. Msi
Kesehatan
Staf Iinduk 19 orang UPT Puskesmas
Staf Pustu 18 orang Teluk Belengkong
Snack 38 ktk 12,000.00 456,000.00
Makan Siang 38 ktk 28,000.00 1,064,000.00
1,520,000.00
Transport 2 org nakes 67,500.00 135,000.00
Petugas 18 org nakes 105,000.00 1,890,000.00
2,025,000.00

Pengantaran SPJ dan Laporan BOK Petugas Ns.Afrianda Fajri,S.Kep


Kesehatan
Transport 1 org nakes DINKES 360,000.00 360,000.00
Penginapan 1 org nakes 200,000.00 200,000.00
Uang harian 1 org nakes 930,000.00 930,000.00
1,490,000.00

2 Pelayanan Kesehatan Ibu Kelas Ibu Hamil Snack 130 ktk 12,000.00 1,560,000.00
1,560,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00
Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00

Kelas Ibu Balita Snack 195 ktk 12,000.00 2,340,000.00


2,340,000.00
Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00
Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00

Pelaksanaan P4K Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000
Kunjungan Ibu Nifas Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

3 Upaya kesehatan anak sekola Pemberian Tablet Fe Siswa/Siswi 16 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 1,080,000
dan usia remaja SMP

8 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 540,000


Desa Tunggal Rahayu Jaya
8 0rang SMP Ari Setyaningsih Rp 67,500 Rp 540,000
Desa Indra Sarri Jaya

4 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


Desa Beringin Mulya

8 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 540,000


Desa Hibrida Jaya

4 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 1,680,000

Siswa/siswi 4 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


MTs Desa Beringin Mulya

8 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 540,000


Desa Griya Mukti jaya

4 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Makmur Jaya

8 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 540,000


Desa Hibrida Mulya

Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


SMA Desa Beringin Mulya

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 1,080,000


Rp 8,160,000

4 Imunisasi Pendistribusian vaksin Petugas 1 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 105,000 Rp 105,000
dari induk ke Pustu Kesehatan Teluk Belengkong
1 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 105,000 Rp 105,000
Transport Teluk Belengkong
Petugas 1 org nakes UPT Puskesmas Ari Setyaningsih Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Sudiharsono,Amk Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Santi N,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Rekha De Sagita Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nurmala Dewi,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong Rp 1,290,000
Posyandu Balita Petugas 2 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 67,500 Rp 135,000
Kesehatan Teluk Belengkong
2 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 67,500 Rp 135,000
Transport Teluk Belengkong
Petugas 2 org nakes UPT Puskesmas Ari Setyaningsih Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 105,000 Rp 210,000
Teluk Belengkong
2 org nakes UPT Puskesmas Sudiharsono,Amk Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Rekha De Sagita Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong Rp 2,250,000

6 Upaya Kesehatan Lanjut Usia Pemantuan Lansia Resti Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Posyandu Lansia Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

7 Upaya Promosi Kesehatan Honor Petugas Promkes Petugas 1 org Desa Sakarotan Rp 2,300,000 Rp 2,300,000
Kesehatan Rp 2,300,000

Saka Bakti Husada Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000
SMA 4 Desa Beringin Mulya Rp 105,000 Rp 420,000

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


4 Desa Sumber Jaya Rp 105,000 Rp 420,000

8 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 540,000


Rp 1,920,000

Pembinaan Posyandu Snack 165 ktk 12,000.00 1,980,000.00


1,980,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Lusi,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nurbani Lailatul Qodriah,Amd 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Ignatia Putri Suraya,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Ns Siti Nurbaiti,S.Kep 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00
3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00
Sumber jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
4,072,500.00

Pembinaan Posbindu Snack 165 ktk 12,000.00 1,980,000.00


1,980,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Lusi,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya 105,000.00 105,000.00
105,000.00 105,000.00
3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00
Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nurbani Lailatul Qodriah,Amd 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Ignatia Putri Suraya,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Ns Siti Nurbaiti,S.Kep 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
4,072,500.00

Pembinaan Posbindu Lansia Snack 165 ktk 12,000.00 1,980,000.00


1,980,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Lusi,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00
3 org nakes Desa Nurbani Lailatul Qodriah,Amd 67,500.00 67,500.00
Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Ignatia Putri Suraya,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Ns Siti Nurbaiti,S.Kep 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya 105,000.00 105,000.00
105,000.00 105,000.00
3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00
Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
4,072,500.00

Pembinaan Desa PHBS Snack 347 ktk 12,000.00 4,164,000.00


4,164,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Lusi,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00
3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00
Gembaran Rita, Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nurbani Lailatul Qodriah,Amd 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Ignatia Putri Suraya,Amd.Keb 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Ns Siti Nurbaiti,S.Kep 67,500.00 67,500.00
105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya 105,000.00 105,000.00
105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
4,072,500.00

Penyuluhan Kelompok Snack 650 Ktk 12,000.00 7,800,000.00


7,800,000.00
Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

8 Upaya pencegahan dan Pemantauan Pasien Kusta Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
pengendalian penyakit Petugas Tunggal Rahayu Jaya 67,500.00 67,500.00
Menular langsuung 105,000.00 105,000.00
240,000.00

9 Upaya pencegahan dan Pelaksanaan Posbindu PTM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
pengendalian penyakit Kesehatan Tunggal Rahayu Jaya
Tidak menular 2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

10 Upaya Kesehatan jiwa Kunjungan rumah ODGJ Transport 2 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu jaya 67,500.00 67,500.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan 67,500.00 67,500.00
67,000.00 67,000.00

3 org nakes Desa Dewi Sartika 105,000.00 105,000.00


Gembaran 105,000.00 105,000.00
105,000.00 105,000.00

Rp 652,000

JUMLAH Rp 75,946,000
DIKETAHUI/DISETUJUI TELUK BELENGKONG, NOVEMBER 2018
KEPALA DINAS KESEHATAN KABUPATEN INDRAGIRI HILIR KEPALA UPT PUSKESMAS TELUK BELENGKONG

H.ZAINAL ARIFIN, SKM.M.Kes AHMAD FAISAL,SST.MSi


NIP.19740226 199703 1 002
NIP.19700405 198912 1 001
KET

12

3,545,000.00
4,905,000.00
5,685,000.00
MBER 2018
K BELENGKONG

ST.MSi
03 1 002
PLAN OF ACTION (POA) PROGRAM BANTUAN OPERASIONAL KESEHATAN (BOK)
DI WILAYAH UPT. PUSKESMAS TELUK BELENGKONG
BULAN DESEMBER 2018

BENTUK SASARAN JUMLAH BIAYA


NO KEGIATAN LOKASI JADWAL PENANGGUNG JAWAB
KEGIATAN KELOMPOK VOLUME SATUAN JUMLAH TOTAL
1 2 3 4 5 6 7 8 9 10 11
1 Manajemen Puskesmas Lokakarya Mini Bulanan Petugas Ahmad Faisal SST. Msi
Kesehatan
Staf Iinduk 19 orang UPT Puskesmas
Staf Pustu 18 orang Teluk Belengkong
Snack 38 ktk 12,000.00 456,000.00
Makan Siang 38 ktk 28,000.00 1,064,000.00
1,520,000.00
Transport 2 org nakes 67,500.00 135,000.00
Petugas 18 org nakes 105,000.00 1,890,000.00
2,025,000.00

Pengantaran SPJ dan Laporan BOK Petugas Ns.Afrianda Fajri,S.Kep


Kesehatan
Transport 1 org nakes DINKES 360,000.00 360,000.00
Penginapan 1 org nakes 200,000.00 200,000.00
Uang harian 1 org nakes 930,000.00 930,000.00
1,490,000.00

2 Pelayanan Kesehatan Ibu Kelas Ibu Hamil Snack 130 ktk 12,000.00 1,560,000.00
1,560,000.00

Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00


Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00
Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00

Kelas Ibu Balita Snack 195 ktk 12,000.00 2,340,000.00


2,340,000.00
Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Tunggal Rahayu Jaya Anitha EP, Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rika Prima Santi,Amd.Keb 67,500.00 67,500.00


Griya Mukti Jaya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Retno Wulandari,Amd.Keb 67,500.00 67,500.00


Beringin Mulya Rosmiati,Amd.Keb 105,000.00 105,000.00
Hayatang,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Ari Setyaningsih 67,500.00 67,500.00


Indra Sari Jaya Hayatang,Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Siti Aisyah,Amd.Keb 67,500.00 67,500.00


Gembaran Rita, Amd.Keb 67,500.00 67,500.00
Rosmiati,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Sy Widya,Amd.Keb 67,500.00 67,500.00


Hibrida Mulya Sudiharsono,Amk 67,500.00 67,500.00
Yelis Dametri,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Santi N,Amk 67,500.00 67,500.00


Hibrida jaya Nur Hidayah,Amd.Keb 67,500.00 67,500.00
Rika Prima Santi,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500.00 67,500.00


Sumber Sari Jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nurmala Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nurmala Dewi,Amd.Keb 67,500.00 67,500.00


Sumber Makmur jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Rekha De Sagita,Amd.Keb 67,500.00 67,500.00


Sapta Mulya jaya Nurmala Sari,Amd.Keb 105,000.00 105,000.00
Nella Sari,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Nella Sari,Amd.Keb 67,500.00 67,500.00


Kelapa Patih jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00

3 org nakes Desa Yelis Dametri,Amd.Keb 67,500.00 67,500.00


Sumber jaya Rekha De Sagita,Amd.Keb 105,000.00 105,000.00
Sy Widya,Amd.Keb 105,000.00 105,000.00
3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00
Sakarotan Luci indria sari,A.Md.Kep 67,500.00 67,500.00
Julianti,Amd.Keb 67,500.00 67,500.00
3,345,000.00

Pelaksanaan P4K Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000
Kunjungan Ibu Nifas Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

3 Upaya Kesehatan Anak Pemantuan Status Gizi 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
balita dan pra sekolah Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Griya Mukti jaya
2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

4 Upaya kesehatan anak sekolah Pemberian Tablet Fe Siswa/Siswi 16 orang SMP Sakarotan Herni Usmi,Amd.Keb Rp 67,500 Rp 1,080,000
dan usia remaja SMP

8 0rang SMP UPT I GHS I Rosmiati.Amd,Keb Rp 67,500 Rp 540,000


Desa Tunggal Rahayu Jaya

8 0rang SMP Ari Setyaningsih Rp 67,500 Rp 540,000


Desa Indra Sarri Jaya

4 0rang SMP Budi Mulya Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


Desa Beringin Mulya
8 0rang SMP N kls Jauh Teluk Belengkong Nurhidayah,Amd.Keb Rp 67,500 Rp 540,000
Desa Hibrida Jaya

4 0rang SMP N 2 Teluk Belengkong Yelis Dametri.Amd.keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 0rang SMP Cendana Dewi Sartika Rp 105,000 Rp 1,680,000

Siswa/siswi 4 0rang MTs Nurul Hidayah Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


MTs Desa Beringin Mulya

8 0rang MTs Baiturahman Rika Prima Santi.Amd.Keb Rp 67,500 Rp 540,000


Desa Griya Mukti jaya

4 0rang MTs Mamba'ul Ma'arif Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Makmur Jaya

8 0rang MTs Darul Tholibin Sudiharsono.Amk Rp 67,500 Rp 540,000


Desa Hibrida Mulya

Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000


SMA Desa Beringin Mulya

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


Desa Sumber Jaya

16 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 1,080,000


Rp 8,160,000

5 Imunisasi Pendistribusian vaksin Petugas 1 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 105,000 Rp 105,000
dari induk ke Pustu Kesehatan Teluk Belengkong
1 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 105,000 Rp 105,000
Transport Teluk Belengkong
Petugas 1 org nakes UPT Puskesmas Ari Setyaningsih Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 67,500
Teluk Belengkong
1 org nakes UPT Puskesmas Sudiharsono,Amk Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Santi N,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Rekha De Sagita Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nurmala Dewi,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 105,000 Rp 105,000
Teluk Belengkong
1 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 105,000 Rp 105,000
Teluk Belengkong Rp 1,290,000

Posyandu Balita Petugas 2 org nakes UPT Puskesmas Rosmiati,Amd.Keb Rp 67,500 Rp 135,000
Kesehatan Teluk Belengkong
2 org nakes UPT Puskesmas Rika Prima Santi,Amd.Keb Rp 67,500 Rp 135,000
Transport Teluk Belengkong
Petugas 2 org nakes UPT Puskesmas Ari Setyaningsih Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Herni Usmi,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Retno Wulandari,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Siti Aisyah,Amd.Keb Rp 105,000 Rp 210,000
Teluk Belengkong
2 org nakes UPT Puskesmas Sudiharsono,Amk Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nurhidayah,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong
1 org nakes UPT Puskesmas Yelis Dametri,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Rekha De Sagita Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
1 org nakes UPT Puskesmas Dahlia Lesmawati,Amd.Keb Rp 67,500 Rp 67,500
1 Teluk Belengkong Rp 105,000 Rp 105,000
2 org nakes UPT Puskesmas Bg Sumantri,S.Kep.Ns Rp 67,500 Rp 135,000
Teluk Belengkong
2 org nakes UPT Puskesmas Nella Sari,Amd.Keb Rp 67,500 Rp 135,000
Teluk Belengkong Rp 2,250,000

Sweeping Imunisasi Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

6 Upaya Kesehatan Lanjut Usia Pemantuan Lansia Resti Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
2 org nakes Desa Herni Usmi,Amd.Keb 67,500 135,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,485,000

Posyandu Lansia Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000


Kesehatan Tunggal Rahayu Jaya
2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

7 Upaya Promosi Kesehatan Honor Petugas Promkes Petugas 1 org Desa Sakarotan Rp 2,300,000 Rp 2,300,000
Kesehatan Rp 2,300,000

Saka Bakti Husada Siswa/siswi 4 0rang SMA Ash-Habul Mukmin Retno Wulandari.Amd.Keb Rp 67,500 Rp 270,000
SMA 4 Desa Beringin Mulya Rp 105,000 Rp 420,000

4 0rang SMA Ma'arif Nurul Hidayah Yelis Dametri,Amd.Keb Rp 67,500 Rp 270,000


4 Desa Sumber Jaya Rp 105,000 Rp 420,000

8 org SMA Teluk Belengkong dr Riska Yuliana Sari Rp 67,500 Rp 540,000


Rp 1,920,000

8 Upaya pencegahan dan Pemantauan Pasien Kusta Transport 3 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
pengendalian penyakit Petugas Tunggal Rahayu Jaya 67,500.00 67,500.00
Menular langsuung 105,000.00 105,000.00
60,000.00 60,000.00
300,000.00

9 Upaya pencegahan dan Pelaksanaan Posbindu PTM Petugas 2 org nakes Desa Rosmiati,Amd.Keb 67,500 135,000
pengendalian penyakit Kesehatan Tunggal Rahayu Jaya
Tidak menular 2 org nakes Desa Rika Prima Santi,Amd.Keb 67,500 135,000
Transport Griya Mukti jaya
Petugas 2 org nakes Desa Ari Setyaningsih 67,500 135,000
Indra Sari jaya
1 org nakes Desa Retno Wulandari,Amd.Keb 67,500 67,500
1 Beringin Mulya
2 org nakes Desa Siti Aisyah,Amd.Keb 67,500 135,000
Gembaran
2 org nakes Desa Sudiharsono,Amk 67,500 135,000
Hibrida Mulya
2 org nakes Desa Nurhidayah,Amd.Keb 67,500 135,000
Hibrida jaya
1 org nakes Desa Yelis Dametri,Amd.Keb 67,500 67,500
Sumber Jaya
1 org nakes Desa Rekha De Sagita,Amd.Keb 67,500 67,500
Sumber Sari Jaya
1 org nakes Desa Dahlia Lesmawati,Amd.Keb 67,500 67,500
Sumber Makmur jaya
2 org nakes Desa Bg Sumantri,S.Kep.Ns 67,500 135,000
Sapta Mulya Jaya
4 org nakes Desa Herni Usmi,Amd.Keb 67,500 270,000
Sakarotan
2 org nakes Desa Nella Sari,Amd.Keb 67,500 135,000
Kelapa Patih Jaya 1,620,000

10 Upaya Kesehatan jiwa Kunjungan rumah ODGJ Transport 2 org nakes Desa Rosmiati,Amd.Keb 67,500.00 67,500.00
Petugas Tunggal Rahayu jaya 67,500.00 67,500.00

3 org nakes Desa Herni Usmi,Amd.Keb 67,500.00 67,500.00


Sakarotan 67,500.00 67,500.00
67,000.00 67,000.00

3 org nakes Desa Dewi Sartika 105,000.00 105,000.00


Gembaran 105,000.00 105,000.00
105,000.00 105,000.00

Rp 652,000
JUMLAH Rp 43,162,000

DIKETAHUI/DISETUJUI TELUK BELENGKONG, DESEMBER 2018


KEPALA DINAS KESEHATAN KABUPATEN INDRAGIRI HILIR KEPALA UPT PUSKESMAS TELUK BELENGKONG

H.ZAINAL ARIFIN, SKM.M.Kes AHMAD FAISAL,SST.MSi


NIP.19740226 199703 1 002
NIP.19700405 198912 1 001
KET

12

3,545,000.00
4,905,000.00
5,685,000.00
EMBER 2018
UK BELENGKONG

SST.MSi
703 1 002

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