Makmin Pasien PKM 2020,1

REKAPITULASI MAKANAN DAN MINUMAN PASIEN RAWAT INAP
UPTD KESEHATAN PUSKESMAS …………………….

BAGIAN BULAN DESEMBER TAHUN 2013
Rekening : Belanja Makanan dan Minuman Pasien

Kode rekening :
Program : UPAYA KESEHATAN MASYARAKAT
Kegiatan :
Sumber Dana : DAU - APBD Kab. Pasuruan
Tahun Anggaran : 2013
PASIEN MASUK PASIEN KELUAR MAKAN MAKAN MAKAN

HARI PASIEN PASIEN PASIEN JUMLAH HARGA/
NO PASIEN UMUR ALAMAT JUMLAH
PERAWATAN HARI LAMA HARI PORSI PORSI
TANGGAL JAM TANGGAL JAM MASUK DIRAWAT KELUAR
1 2 3 4 5 6 7 8 9=7-5+1 10 11 12 13=10+11+12 14 15=13X14
1 TN. NANANG PUJO ASMORO 38 Th PASREPAN 30/03/2020 10.15 01/04/2020 09.15 3 Hari 2 3 1 6 15000 90000
2 NY. NASUTIN 48 Th PETUNG 30/03/2020 15.30 01/04/2020 09.30 3 Hari 1 3 1 5 15000 75000
3 TN. MUJIONO 63 Th JIMBARAN 03/04/2020 21.50 06/04/2020 09.00 4 Hari 0 6 1 7 15000 105000
4 NY. FARIDA 28 Th POHGADING 07/04/2020 12.00 09/04/2020 09.00 3 Hari 2 3 1 6 15000 90000
5 NY. SARI 64 Th KLAKAH 07/04/2020 13.00 10/04/2020 08.00 4 Hari 1 6 1 8 15000 120000
6 NY. HOIRIYAH 32 Th AMPELSARI 08/04/2020 09.00 10/04/2020 08.15 3 Hari 2 3 1 6 15000 90000
7 SDR. YUNUS ARIFANDI 15 Th PUSPO 10/04/2020 18.05 12/04/2020 09.30 3 Hari 0 3 1 4 15000 60000
8 AN. ALAN RIZQI 13 Th PASREPAN 11/04/2020 21.00 15/04/2020 09.15 5 Hari 0 9 1 10 15,000 150,000
9 NY. RIFIYATI 46 Th LEMAHBANG 13/04/2020 16.20 15/04/2020 09.00 3 Hari 1 3 1 5 15,000 75,000
10 NY. MARINTI 66 Th PETUNG 14/04/2020 14.00 17/04/2020 09.00 4 Hari 1 6 1 8 15,000 120,000
11 TN. UMAR 46 Th REJOSALAM 15/04/2020 08.08 18/04/2020 09.00 4 Hari 2 6 1 9 15,000 135,000
12 TN. HAFID 65 Th KEJAYAN 17/04/2020 07.30 18/04/2020 16.00 2 Hari 2 0 2 4 15,000 60,000
13 NY. AINUL MUFIDA 21 Th REJOSALAM 17/04/2020 13.00 19/04/2020 12.00 3 Hari 1 3 2 6 15,000 90,000
14 NY. ODIK 53 Th SIBON 17/04/2020 20.00 19/04/2020 09.00 3 Hari 0 3 1 4 15,000 60,000
15 TN. SELANI 50 Th NGANTUNGAN 19/04/2020 18.00 21/04/2020 10.00 3 Hari 0 3 1 4 15,000 60,000
16 NY. RASITI 55 Th POHGEDANG 23/04/2020 13.15 25/04/2020 09.00 3 Hari 1 3 1 5 15,000 75,000
17 NY. RUMIYANA 17 Th KEJAYAN 27/04/2020 21.15 29/04/2020 09.00 3 Hari 0 3 1 4 15,000 60,000
18 TN. SUHARIANTO 43 Th PUSPO 28/04/2020 17.00 29/04/2020 09.00 2 Hari 1 0 1 2 15,000 30,000
19 1 Hari 3 -3 0 0 15,000 -
20 1 Hari 3 -3 0 0 15,000 -
21 1 Hari 3 -3 0 0 15,000 -
22 AN. KODIRIN 13 Th SAPULANTE 29/03/2020 02.00 01/04/2020 09.00 4 Hari 3 6 1 10 15,000 150,000
1 dari 108_Makmin Pasien_2013

1 2 3 4 5 6 7 8 9=7-5+1 10 11 12 13=10+11+12 14 15=13X14
23 NN. RUAIDATUL ILMIYAH 17 Th TEMPURAN 31/03/2020 05.00 03/04/2020 09.00 4 Hari 3 6 1 10 15000 150000
24 AN. SISKA SECILIA 6 Th JIMBARAN 31/03/2020 08.45 03/04/2020 08.30 4 Hari 2 6 1 9 15000 135000
25 AN. MAULANA 7 Th SAPULANTE 31/03/2020 09.00 02/04/2020 09.00 3 Hari 2 3 1 6 15,000 90,000
26 NN. BELA APRILIA 19 Th PASREPAN 01/04/2020 10.00 03/04/2020 09.00 3 Hari 2 3 1 6 15,000 90,000
27 NN. MAULIDA 17 Th AMPELSARI 01/04/2020 10.30 03/04/2020 09.00 3 Hari 2 3 1 6 15,000 90,000
28 NY. HUMIMA 48 Th POHGEDANG 02/04/2020 03/04/2020 08.30 2 Hari 3 0 1 4 15,000 60,000
29 AN. SABRINA 9 Th LEMAHBANG 03/04/2020 03.10 05/04/2020 08.00 3 Hari 3 3 1 7 15,000 105,000
30 TN. NUR HASAN 50 Th POHGEDANG 04/04/2020 08.27 07/04/2020 09.00 4 Hari 2 6 1 9 15,000 135,000
31 TN. AJI KURNIAWANTO 30 Th MANGGUAN 05/04/2020 02.45 07/04/2020 09.00 3 Hari 3 3 1 7 15,000 105,000
32 TN. YAKOP 45 Th SAPULANTE 06/04/2020 03.00 08/04/2020 08.30 3 Hari 3 3 1 7 15,000 105,000
33 TN. ATIM 67 Th JOGOREPUH 06/04/2020 08.20 08/04/2020 09.15 3 Hari 2 3 1 6 15,000 90,000
34 TN. H. TOHIR 60 Th LEMAHBANG 07/04/2020 09.00 08/04/2020 09.00 2 Hari 2 0 1 3 15,000 45,000
35 NN. ANIK SULISTIYA 14 Th PASREPAN 11/04/2020 02.30 12/04/2020 09.00 2 Hari 3 0 1 4 15,000 60,000
36 TN. JUMAN 54 Th GALIH 12/04/2020 03.00 15/04/2020 09.20 4 Hari 3 6 1 10 15,000 150,000
37 AN. YASMIN AWALIYAH 2 Th SIBON 13/04/2020 10.00 15/04/2020 08.30 3 Hari 2 3 1 6 15,000 90,000
38 AN. WILDAN 5 Th PASREPAN 27/04/2020 09.45 29/04/2020 09.15 3 Hari 2 3 1 6 15,000 90,000
39 1 Hari 3 -3 0 0 15,000 -
40 1 Hari 3 -3 0 0 15,000 -
41 1 Hari 3 -3 0 0 15,000 -
42 1 Hari 3 -3 0 0 15,000 -
43 1 Hari 3 -3 0 0 15,000 -
44 1 Hari 3 -3 0 0 15,000 -
45 1 Hari 3 -3 0 0 15,000 -
46 1 Hari 3 -3 0 0 15,000 -
47 1 Hari 3 -3 0 0 15,000 -
48 1 Hari 3 -3 0 0 15,000 -
49 1 Hari 3 -3 0 0 15,000 -
50 1 Hari 3 -3 0 0 15,000 -
51 1 Hari 3 -3 0 0 15,000 -
52 1 Hari 3 -3 0 0 15,000 -
53 1 Hari 3 -3 0 0 15,000 -
54 1 Hari 3 -3 0 0 15,000 -
55 1 Hari 3 -3 0 0 15,000 -

1 2 3 4 5 6 7 8 9=7-5+1 10 11 12 13=10+11+12 14 15=13X14
56 1 Hari 3 -3 0 0 15,000 -
57 1 Hari 3 -3 0 0 15,000 -
58 1 Hari 3 -3 0 0 15,000 -
59 1 Hari 3 -3 0 0 15,000 -
60 1 Hari 3 -3 0 0 15,000 -
61 1 Hari 3 -3 0 0 15,000 -
62 1 Hari 3 -3 0 0 15,000 -
63 1 Hari 3 -3 0 0 15,000 -
64 1 Hari 3 -3 0 0 15,000 -
65 1 Hari 3 -3 0 0 15,000 -
66 1 Hari 3 -3 0 0 15,000 -
67 1 Hari 3 -3 0 0 15,000 -
68 1 Hari 3 -3 0 0 15,000 -
69 1 Hari 3 -3 0 0 15,000 -
70 1 Hari 3 -3 0 0 15,000 -
71 1 Hari 3 -3 0 0 15,000 -
72 1 Hari 3 -3 0 0 15,000 -
73 1 Hari 3 -3 0 0 15,000 -
74 1 Hari 3 -3 0 0 15,000 -
75 1 Hari 3 -3 0 0 15,000 -
76 1 Hari 3 -3 0 0 15,000 -
77 1 Hari 3 -3 0 0 15,000 -
78 1 Hari 3 -3 0 0 15,000 -
79 1 Hari 3 -3 0 0 15,000 -
80 1 Hari 3 -3 0 0 15,000 -
81 1 Hari 3 -3 0 0 15,000 -
39 Hari 219 7,500 3,285,000
Mengetahui Pasuruan, Desember 2013

NO JENIS MAKAN JAM PPTK UPTK Dinas Puskesmas... Kepala Perawatan
1 Makan pagi 07.00 UPTD Kesehatan Puskesmas ......
2 Makan siang 12.00

1 2 3 4 5 6 7 8 9=7-5+1 10 11 12 13=10+11+12 14 15=13X14
3 Makan sore 17.00

by: tw - abdullah xxx xxx
NIP. NIP.

UPTD KESEHATAN PUSKESMAS PASREPAN
BAGIAN BULAN JANUARI 2016
Rekening : Belanja Makanan dan Minuman Pasien ASKES

Kode rekening : 5.2.2.11.04
Kegiatan : PENINGKATAN KESEHATAN MASYARAKAT
Sumber Dana : PAD - APBD Kab. Pasuruan
PASIEN MASUK PASIEN KELUAR

NO PASIEN UMUR ALAMAT JUMLAH HARGA/ JUMLAH
PORSI PORSI
TANGGAL JAM TANGGAL JAM
1 2 3 4 5 6 7 8 9 10 11=9x10
1 SUYADI 52 Th POHGEDANG 06/01/2016 09.30 08/01/2016 17.30 8 14,900 119,200

2 M ALFIN 4 Th PASREPAN 13/01/2016 11.00 15/01/2016 10.00 6 14,900 89,400
AMANAH 54 Th PASREPAN 18/01/2016 20.00 23/01/2016 09.30 13 14,900 193,700
-
-
-
-
-
-
-
-
-
-
-
27 14,900 402,300
Mengetahui Pasuruan, 23 JanuarI 2016

PPTK UPTD Dinas Puskesmas Pasrepan Kepala Perawatan
UPTD Kesehatan Puskesmas Pasrepan
dr. H.R. GATOT TRISILA ALIMIN T, S.Kep.Ns

NIP.19650929 200701 1 008 NIP.19680103 198901 2 004
KETERANGAN MAKMIN PASIEN

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00
BAGIAN BULAN PEBRUARI 2016

PASIEN MASUK PASIEN KELUAR JUMLAH HARGA/

TANGGAL JAM TANGGAL JAM PORSI PORSI
1 2 3 4 5 6 7 8 9 10 11=9x10
1 JOYO 35 Th TEMPURAN 04/02/2016 15.00 08/02/2016 O8.45 13 14,900 193,700

2 LAILIYAH 12 Th POHGEDANG 07/02/2016 06.00 10/02/2016 09.15 10 14,900 149,000
-
-
-
-
-
-
-
-
-
-
-
-
23 14,900 342,700
Mengetahui Pasuruan, 10 Pebruari 2016


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00
BAGIAN BULAN MEI 2016


JUMLAH HARGA/
1 2 3 4 5 6 7 8 9 10 11=9x10
1 AMINAH 41 Th POHGEDANG 17/05/2016 03.15 18/05/2016 09.00 4 14,900 59,600

2 NASIR 56 Th PASREPAN 21/05/2016 09.45 23/05/2016 09.15 6 14,900 89,400
3 M RASIT 56 Th PASREPAN 28/05/2016 09.50 30/05/2016 09.00 6 14,900 89,400
-
-
-
-
-
-
-
-
-
-
-
16 14,900 238,400
Mengetahui Pasuruan, 30 Mei 2016


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00
BAGIAN BULAN JUNI 2016


1 2 3 4 5 6 7 8 9 10 11=9x10
1 HASMAWATI 34 Th NGANTUNGAN 01/06/2016 09.30 06/06/2016 09.00 15 14,900 223,500

2 -
-
-
-
-
-
-
-
-
-
-
-
-
15 14,900 223,500
Mengetahui Pasuruan, 6 Juni 2016


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00
BAGIAN BULAN SEPTEMBER 2015


1 2 3 4 5 6 7 8 9 10 11=9x10
1 MUNAWAROH 35 Th WONOSARI 9/11/2015 13.00 9/12/2015 12.00 3 15,000 45,000

2 -
-
-
-
-
-
-
-
-
-
-
-
-
3 9,950 45,000
Mengetahui Pasuruan, 12 September 2015


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00
3
5.2.2.11.04.PAD
3
6
12
5
4
2
3
3
8
6
Rekening : Belanja Makanan dan Minuman Pasien Jamkesmas


NO PASIEN UMUR ALAMAT JUMLAH HARGA/
PORSI PORSI
1 2 3 4 5 6 7 8 9 10
1 NY. PURWATI 65 Th POHGEDANG 27/02/2020 18.00 28/02/2020 15.00 2 15,000
2 15,000
Mengetahui Pasuruan, 28 Pebruari 2020

dr. H.R. GATOT TRISILA IDA SULISTIYOWATI, S.Kep.Ns

NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00

BAGIAN BULAN MARET 2020

Tahun Anggaran 2020

NO PASIEN UMUR ALAMAT
1 2 3 4 5 6 7 8 9 10
1 NN. SITI KHOTIJAH 18 Th AMPELSARI 28/02/2020 14.10 03/03/2020 10.30 11 15,000
2 NN. NAZILATUR ROHMA 15 Th KEJAYAN 28/02/2020 19.50 02/03/2020 10.05 7 15,000
3 AN. AFFANDI ROESDHIYANTO 6.5 TH NGANTUNGAN 29/02/2020 23.00 04/03/2020 09.45 10 15,000
4 NY. SUHAEMI 38 Th PUSPO 03/03/2020 11.40 05/03/2020 10.00 6 15,000
5 NN. ELA NURJANNAH 17 Th AMPELSARI 04/03/2020 08.00 06/03/2020 10.15 6 15,000
6 AN. MARVIN ANDIKA SAPUTRA 22 BLN KEJAYAN 04/03/2020 12.56 06/03/2020 10.10 5 15,000
7 NY. SUTIK 60 Th LEMAHBANG 05/03/2020 13.00 07/03/2020 09.45 5 15,000
8 TN. SAMSUNI 40 Th PUSPO 05/03/2020 22.15 07/03/2020 09.30 4 15,000
9 AN. KHIKMATUL K 3 Th KEJAYAN 06/03/2020 11.00 08/03/2020 09.30 6 15,000
10 AN. REVINDA CAHYA NOAVELI 10 Th REJOSALAM 06/03/2020 16.20 09/03/2020 09.00 8 15,000
11 TN. HASIM 40 Th NGANTUNGAN 06/03/2020 20.45 07/03/2020 11.00 1 15,000
12 AN. ABDULLOH 10 Th KEJAYAN 07/03/2020 08.00 09/03/2020 09.30 6 15,000
13 AN. AFFANDY ROESDHIYANTO 6,5 TH NGANTUNGAN 07/03/2020 08.00 11/03/2020 10.20 12 15,000
14 TN. SUCIYONO 47 Th PASREPAN 07/03/2020 07.45 10/03/2020 09.30 9 15,000
15 NY. HALIMAH 30 Th TOSARI 08/03/2020 08.15 11/03/2020 10.20 9 15,000
16 AN. SAFIRA MAZIYATUN N 14 Th PASREPAN 09/03/2020 11.30 11/03/2020 09.45 6 15,000
17 NY. SAYUNI 55 Th TEMPURAN 10/03/2020 12.40 12/03/2020 18.30 7 15,000
18 NY. SULIHATI 44 Th AMPELSARI 11/03/2020 18.25 14/03/2020 10.05 7 15,000
19 TN. FADOLI 49 Th POHGEDANG 13/03/2020 08.23 15/03/2020 10.00 6 15,000
20 NY. SITI FATIMAH 30 Th TEMPURAN 13/03/2020 18.15 15/03/2020 10.00 4 15,000
21 TN. ARSONO 44 Th SAPULANTE 14/03/2020 17.30 16/03/2020 10.00 4 15,000
22 AN. DEMI BASTIAN 6 Th KEJAYAN 15/03/2020 11.00 16/03/2020 09.30 3 15,000
23 AN. NUR AFQA RAMADANI 7 Th POHGADING 18/03/2020 11.50 20/03/2020 10.00 6 15,000
24 TN. MOHAMAT 64 Th NGANTUNGAN 18/03/2020 15.15 20/03/2020 10.00 5 15,000
25 NY. SOPIYAH 63 Th PASREPAN 20/03/2020 21.00 22/03/2020 10.00 4 15,000
26 TN. ABD. WAHID 54 Th KEJAYAN 21/03/2020 09.14 23/03/2020 09.00 6 15,000
27 AN. ABI AZI ELBY 7 Th REJOSALAM 21/03/2020 10.52 22/03/2020 10.00 3 15,000
28 NY. HOTIMA 48 Th TEMPURAN 23/03/2020 10.40 26/03/2020 09.30 9 15,000
29 AN. NAZILATUR ROHMA 15 Th KEJAYAN 23/03/2020 17.30 26/03/2020 10.00 7 15,000
30 TN. YAKIN 46 Th KLINTER 23/03/2020 22.15 26/03/2020 08.30 7 15,000
31 NY. ENEK 28 Th AMPELSARI 24/03/2020 12.00 26/03/2020 09.30 6 15,000
32 NY. LIHA 33 Th SAPULANTE 26/03/2020 20.20 29/03/2020 09.00 7 15,000
202 15,000
Mengetahui Pasuruan, 31 MARET 2020

PPTK UPTD Dinas Puskesmas Pasrepan Koordinator Rawat Inap
dr. H.R. GATOT TRISILA WAHYU TIN SUDIRMAN, Amd.Kep

NIP.19650929 200701 1 008 NIP.19830207 201406 2 002

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00
BAGIAN BULAN APRIL 2020


NO PASIEN UMUR ALAMAT PORSI PORSI
1 2 3 4 5 6 7 8 9 10
1 TN. NANANG PUJO ASMORO 38 Th PASREPAN 30/03/2020 10.15 01/04/2020 09.15 6 15,000
2 NY. NASUTIN 48 Th PETUNG 30/03/2020 15.30 01/04/2020 09.30 5 15,000
3 TN. MUJIONO 63 Th JIMBARAN 03/04/2020 21.50 06/04/2020 09.00 7 15,000
4 NY. FARIDA 28 Th POHGADING 07/04/2020 12.00 09/04/2020 09.00 6 15,000
5 NY. SARI 64 Th KLAKAH 07/04/2020 13.00 10/04/2020 08.00 8 15,000
6 NY. HOIRIYAH 32 Th AMPELSARI 08/04/2020 09.00 10/04/2020 08.15 6 15,000
7 SDR. YUNUS ARIFANDI 15 Th PUSPO 10/04/2020 18.05 12/04/2020 09.30 4 15,000
8 AN. ALAN RIZQI 13 Th PASREPAN 11/04/2020 21.00 15/04/2020 09.15 10 15,000
9 NY. RIFIYATI 46 Th LEMAHBANG 13/04/2020 16.20 15/04/2020 09.00 5 15,000
10 NY. MARINTI 66 Th PETUNG 14/04/2020 14.00 17/04/2020 09.00 8 15,000
11 TN. UMAR 46 Th REJOSALAM 15/04/2020 08.08 18/04/2020 09.00 9 15,000
12 TN. HAFID 65 Th KEJAYAN 17/04/2020 07.30 18/04/2020 16.00 4 15,000
13 NY. AINUL MUFIDA 21 Th REJOSALAM 17/04/2020 13.00 19/04/2020 12.00 6 15,000
14 NY. ODIK 53 Th SIBON 17/04/2020 20.00 19/04/2020 09.00 4 15,000
15 TN. SELANI 50 Th NGANTUNGAN 19/04/2020 18.00 21/04/2020 10.00 4 15,000
16 NY. RASITI 55 Th POHGEDANG 23/04/2020 13.15 25/04/2020 09.00 5 15,000
17 NY. RUMIYANA 17 Th KEJAYAN 27/04/2020 21.15 29/04/2020 09.00 4 15,000
TN. SUHARIANTO 43 Th PUSPO 28/04/2020 17.00 29/04/2020 09.00 2 15,000
103 15,000
Mengetahui Pasuruan, 30 APRIL 2020


NIP.19650929 200701 1 008 NIP.19830207 201406 2 002
NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00



1 2 3 4 5 6 7 8 9 10
1 15,000
2 15,000
3 15,000
4 15,000
5 15,000
6 15,000
7 15,000
8 15,000
9 15,000
10 15,000
11 15,000
12 15,000
13 15,000
14 15,000
15 15,000
16 15,000
17 15,000
18 15,000
19 15,000
20 15,000
21 15,000
22 15,000
23 15,000
24 15,000
25 15,000
26 15,000
27 15,000
28 15,000
29 15,000
- 15
Mengetahui Pasuruan,31 Maret 2019


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00



1 2 3 4 5 6 7 8 9 10
1 15,000
2 15,000
3 15,000
4 15,000
5 15,000
6 15,000
7 15,000
8 15,000
9 15,000
10 15,000
11 15,000
12 15,000
13 15,000
14 15,000
15 15,000
16 15,000
17 15,000
18 15,000
19 15,000
20 15,000
21 15,000
22 15,000
23 15,000
24 15,000
25 15,000
26 15,000
27 15,000
28 15,000
- 15,000
Mengetahui Pasuruan, 30 April 2019


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00



1 2 3 4 5 6 7 8 9 10
1 15,000
2 15,000
3 15,000
4 15,000
5 15,000
6 15,000
7 15,000
8 15,000
9 15,000
10 15,000
11 15,000
- 15,000
Mengetahui Pasuruan,31 Mei 2019


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00



1 2 3 4 5 6 7 8 9 10
1 15,000
2 15,000
3 15,000
4 15,000
5 15,000
6 15,000
7 15,000
8 15,000
9 15,000
10 15,000
11 15,000
12 15,000
13 15,000
14 15,000
15 15,000
16 15,000
17 15,000
18 15,000
19 15,000
20 15,000
- 15,000


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00

BAGIAN BULAN JULI 2019


1 2 3 4 5 6 7 8 9 10
1 15,000
2 15,000
3 15,000
4 15,000
5 15,000
6 15,000
7 15,000
8 15,000
9 15,000
10 15,000
11 15,000
12 15,000
13 15,000
14 15,000
15 15,000
16 15,000
17 15,000
18 15,000
19 15,000
20 15,000
21 15,000
- 15,000
Mengetahui Pasuruan,31 Juli 2019

NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00

BAGIAN BULAN AGUSTUS 2019


1 2 3 4 5 6 7 8 9 10
1 NY. SUKETI 45 Th PETUNG 29/07/2019 17.45 01/08/2019 09.30 7 15,000

2 SDR. KHOLILUR ROHMAN 14 Th NGANTUNGAN 30/07/2019 10.45 01/08/2019 09.30 6 15,000
3 NY.MUSLIMAH 37 Th POHGEDANG 31/07/2019 19.30 03/08/2019 09.30 7 15,000
4 AN. ACH. SULAIM 10 Th REJOSALAM 01/08/2019 09.45 03/08/2019 09.15 6 15,000
5 NY. SUMIATI 32 Th SIBON 01/08/2019 12.00 04/08/2019 10.00 9 15,000
6 TN. SANUSI 41 Th SAPULANTE 03/08/2019 08.45 05/08/2019 09.30 6 15,000
7 NY. KARYATI 45 Th PETUNG 03/08/2019 09.15 05/08/2019 09.30 6 15,000
8 TN. ABD.QODIR 19 Th KLAKAH 06/08/2019 08.41 08/08/2019 09.00 6 15,000
9 NY. HOLIFA 16 Th NGANTUNGAN 06/08/2019 10.15 08/08/2019 09.30 6 15,000
10 NY. NUR HAMIDA 27 Th KEJAYAN 06/08/2019 16.10 08/08/2019 09.00 5 15,000
11 NY. DEWI ASIA 45 Th PASREPAN 06/08/2019 19.10 09/08/2019 09.30 7 15,000
12 NY. MUSRI'AH 65 Th PASREPAN 07/08/2019 12.30 09/08/2019 19.15 7 15,000
13 TN. HASIM 55 Th POHGEDANG 11/08/2019 17.20 13/08/2019 09.00 4 15,000
14 AN. AMINATUS 5.5 TH PUSPO 12/08/2019 08.30 14/08/2019 09.10 6 15,000
15 NY. SATIMA 81 Th NGANTUNGAN 14/08/2019 08.00 16/08/2019 09.30 6 15,000
16 TN. MARSODIK 38 Th AMPELSARI 15/08/2019 16.00 19/08/2019 12.50 12 15,000
17 TN. HASIM 59 Th NGANTUNGAN 18/08/2019 09.40 21/08/2019 09.00 9 15,000
18 NY. SOLIHATI 33 Th KEJAYAN 19/08/2019 19.00 22/08/2019 09.00 7 15,000
19 NY. MUSRI'AH 71 Th PASREPAN 22/08/2019 03.00 24/08/2019 08.40 7 15,000
20 TN. ABD. KHOLIQ 55 Th TEMPURAN 22/08/2019 18.30 28/08/2019 09.00 16 15,000
21 NY. YULIANA 21 Th PASREPAN 23/08/2019 09.30 26/08/2019 09.00 9 15,000
22 TN. SUNALIM 58 Th AMPELSARI 25/08/2019 17.30 28/08/2019 09.30 7 15,000
23 TN. HAFID 60 Th TAMBAKREJO 27/08/2019 18.30 30/08/2019 09.30 7 15,000
24 TN. SAIFUL ANWAR 47 Th REJOSALAM 28/08/2019 10.15 29/08/2019 09.30 3 15,000
171 15,000
Mengetahui Pasuruan, 31 Agustus 2019


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00


Tahun Anggaran 2017

1 2 3 4 5 6 7 8 9 10
1
2
3
4
5
6
7
8
9
10
11
12
13
- 15,000


NIP.19650929 200701 1 008 NIP.19670908198801001

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00

BAGIAN BULAN OKTOBER 2017


1 2 3 4 5 6 7 8 9 10
1
2
3
4
5
6
7
8
9
- 15,000
Mengetahui Pasuruan,31 Oktober 2017


NIP.19650929 200701 1 008 NIP.19670908198801001

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00
BAGIAN BULAN NOVEMBER 2017


1 2 3 4 5 6 7 8 9 10
1
2
3
4
5
6
7
8
9
10
- 15,000
Mengetahui Pasuruan, 30 NOVEMBER 2017


NIP.19650929 200701 1 008 NIP.19670908198801001

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00
JUMLAH
11=9x10
30,000
30,000
JUMLAH
11=9x10
165,000
105,000
150,000
90,000
90,000
75,000
75,000
60,000
90,000
120,000
15,000
90,000
180,000
135,000
135,000
90,000
105,000
105,000
90,000
60,000
60,000
45,000
90,000
75,000
60,000
90,000
45,000
135,000
105,000
105,000
90,000
105,000
3,030,000
JUMLAH
11=9x10
90,000 3
75,000 3
105,000 4
90,000 3
120,000 4
90,000 3
60,000 3
150,000 5
75,000 3
120,000 4
135,000 4
60,000 2
90,000 3
60,000 3
60,000 3
75,000 3
60,000 3
30,000 2
1,545,000
JUMLAH
11=9x10
90,000 3
225,000 6
195,000 5
45,000 2
90,000 3
135,000 4
90,000 3
135,000 4
135,000 4
90,000 3
105,000 4
90,000 3
105,000 4
105,000 4
45,000 2
90,000 3
105,000 4
90,000 3
60,000 3
90,000 3
75,000 3
90,000 3
90,000 3
120,000 4
90,000 3
90,000 3
135,000 4
105,000 3
30,000 2
2,940,000 98
JUMLAH
11=9x10
90,000 3
90,000 3
45,000 2
90,000 3
135,000 4
60,000 3
210,000 6
180,000 5
120,000 4
60,000 3
165,000 5
150,000 4
75,000 3
90,000 3
45,000 2
45,000 2
45,000 2
30,000 2
90,000 3
225,000 6
105,000 4
135,000 4
90,000 3
90,000 3
45,000 2
135,000 4
105,000 4
90,000 2
2,835,000 94
JUMLAH
11=9x10
60,000 3
105,000 3
105,000 4
105,000 3
75,000 2
135,000 4
105,000 3
105,000 4
60,000 3
90,000 3
75,000 3
1,020,000
35
JUMLAH
11=9x10
60,000 3
45,000 2
60,000 3
120,000 4
90,000 3
75,000 3
135,000 4
135,000 4
90,000 3
75,000 3
30,000 2
150,000 5
105,000 4
210,000 6
90,000 3
- 2
90,000 3
75,000 3
60,000 3
60,000 3
1,755,000 66
JUMLAH
11=9x10
105,000 4
90,000 3
105,000 4
135,000 4
60,000 2
90,000 3
90,000 3
105,000 4
105,000 4
105,000 4
90,000 3
180,000 5
150,000 5
60,000 3
135,000 4
120,000 4
180,000 5
90,000 3
90,000 3
105,000 3
90,000 3
2,280,000 76
JUMLAH
11=9x10
105,000 4
90,000 3
105,000 4
90,000 3
135,000 4
90,000 3
90,000 3
90,000 3
90,000 3
75,000 3
105,000 4
105,000 3
60,000 3
90,000 3
90,000 3
180,000 5
135,000 4
105,000 4
105,000 3
240,000 7
135,000 4
105,000 4
105,000 4
45,000 2
2,565,000 86
JUMLAH
11=9x10
-
JUMLAH
11=9x10
4
4
3
4
3
3
3
3
5
0
JUMLAH
11=9x10
0
MAS - - - -
UMUM - 2.820.000 - #VALUE!
#VALUE!
10,485,000 #VALUE!
REKAPITULASI MAKMIN PASIEN PKM PASREPAN
PASIEN BULAN
JANUARI PEBRUARI MARET APRIL MEI JUNI JULI AGUSTUS SEP PORSI HRI PX HARGA JMLH OKT NOV
P HRI PX P HRI PX P HRI PX P HRI PX P HRI PX P HRI PX P HRI PX P HRI PX P HRI PX
ASKES 18 9 2 10 4 1 3 2 1 31 15 4 15,000 465,000
BPJS 12 6 2 8 4 1 42 19 4 5 2 1 5 4 1 72 35 9 15,000 1,080,000
JAMKESMAS 36 20 6 101 51 14 182 81 17 166 72 15 157 75 18 94 45 11 105 54 16 62 30 7 42 30 7 945 458 111 15,000 14,175,000
UMUM 227 111 35 289 154 46 200 108 38 313 167 55 184 101 37 158 74 28 111 59 25 111 60 26 95 47 16 1688 881 306 15,000 25,320,000
LAINNYA 18 9 2 18 9 2 15,000 270,000
GU 41,310,000
PAGU 41,940,000
SISA 630,000
PASIEN BULAN
ASKES 18 9 2 10 4 1 3 2 1 31 15 4 12,500 387,500
BPJS 12 6 2 8 4 1 42 19 4 5 2 1 5 4 1 72 35 9 12,500 900,000
JAMKESMAS 36 20 6 101 51 14 182 81 17 166 72 15 157 75 18 94 45 11 105 54 16 62 30 7 42 30 7 945 458 111 12,500 11,812,500
UMUM 227 111 35 289 154 46 200 108 38 313 167 55 184 101 37 158 74 28 111 59 25 111 60 26 95 47 16 1688 881 306 12,500 21,100,000
LAINNYA 18 9 2 18 9 2 12,500 225,000
GU 34,425,000
PAGU 41,940,000
SISA 7,515,000
RIIL PERAWATAN
PASIEN BULAN
ASKES 18 9 2 10 4 1 3 2 1 31 15 4 5,000 155,000
BPJS 12 6 2 8 4 1 42 19 4 5 2 1 5 4 1 72 35 9 5,000 360,000
JAMKESMAS 36 20 6 101 51 14 182 81 17 166 72 15 157 75 18 94 45 11 105 54 16 62 30 7 42 30 7 945 458 111 5,000 4,725,000
UMUM 227 111 35 289 154 46 200 108 38 313 167 55 184 101 37 158 74 28 111 59 25 111 60 26 95 47 16 1688 881 306 5,000 8,440,000
LAINNYA 18 9 2 18 9 2 5,000 90,000
GU 13,770,000
PAGU 41,940,000
SISA 28,170,000
PASIEN BULAN
OKT NOV PORSI HRI PX HARGA JMLH OKT NOV
P HRI PX P HRI PX
ASKES 0 0 0 15,000 -
BPJS 0 0 0 15,000 -
JAMKESMAS 91 40 11 74 34 9 165 74 20 15,000 2,475,000
UMUM 142 75 27 166 79 30 308 154 57 15,000 4,620,000
LAINNYA 0 0 0 15,000 -
GU 7,095,000
PAGU 41,940,000
SISA 34,845,000
REKAPITULASI MAKMIN PASIEN PKM PASREPAN TAHUN 2016
PASIEN BULAN
JANUARI PEB MARET APRIL MEI JUNI JULI AGST SEPT PORSI HRI PX HARGA JMLH OKT NOV
ASKES 27 12 3 23 9 2 16 8 3 15 6 1 81 35 9 14,900 1,206,900
BPJS 0 0 0 14,900 -
JAMKESMAS 74 37 11 73 37 9 77 54 11 150 73 21 60 1 86 42 12 520 243 65 14,900 7,748,000
UMUM 149 71 25 125 63 24 159 83 29 188 94 36 173 93 32 158 79 29 176 87 31 166 78 27 1294 648 233 14,900 19,280,600
LAINNYA 0 0 0 14,900 -
JAMDA
GU 28,235,500
PAGU 36,000,000
SISA 7,764,500
250 120 39 221 109 35 236 137 40 338 167 57 249 101 36 259 127 42 176 87 31 166 78 27 0 0 0
TRI BULAN I 707

TRI BULAN II 846
1553
revisi 6/8/16
PASIEN BULAN
JANUARI PEB MARET APRIL MEI JUNI JULI AGST SEPT PORSI HRI PX HARGA JMLH OKT NOV
ASKES 27 12 3 23 9 2 16 8 3 15 6 1 81 35 9 14,900 1,206,900
BPJS 0 0 0 14,900 -
JAMKESMAS 74 37 11 73 37 9 77 54 11 150 73 21 60 1 86 42 12 520 243 65 14,900 7,748,000
UMUM 140 71 23 125 63 24 153 83 27 158 94 30 148 93 26 158 79 29 882 483 159 14,900 13,141,800
LAINNYA 0 0 0 14,900 -
GU 22,096,700
PAGU 36,000,000
SISA 13,903,300
241 120 37 221 109 35 230 137 38 308 167 51 224 101 30 259 127 42 0 0 0 0 0 0 0 0 0 1483
TRI BULAN I 692

TRI BULAN II 791
1483
PASIEN BULAN
JULI AGUSTUS SEPT OKT NOV DES PORSI HRI PX HARGA JMLH
ASKES 0 0 0 14,900 -
BPJS 0 0 0 14,900 -
JAMKESMAS 93 46 12 93 46 12 83 43 11 55 28 9 324 163 44 14,900 4,827,600
UMUM 148 73 26 174 83 29 152 80 28 100 52 19 574 288 102 14,900 8,552,600
LAINNYA 0 0 0 14,900 -
GU 13,380,200
PAGU 36,000,000
SISA 22,619,800
241 119 38 267 129 41 235 123 39 155 80 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 898
TRI BULAN I 743

TRI BULAN II 155
898
REKAPITULASI MAKMIN PASIEN PKM PASREPAN TAHUN 2016 klaim makmin
PASIEN BULAN
JULI AGUSTUS SEPT OKT NOV DES PORSI HRI PX HARGA JMLH
ASKES 0 0 0 14,900 -
BPJS 0 0 0 14,900 -
JAMKESMAS 92 46 12 93 46 12 83 43 11 55 28 9 323 163 44 14,900 4,812,700
UMUM 142 70 25 164 78 28 136 74 27 96 47 18 538 269 98 14,900 8,016,200
LAINNYA 0 0 0 14,900 -
GU 12,828,900
PAGU 36,000,000
SISA 23,171,100
234 116 37 257 124 40 219 117 38 151 75 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 861
TRI BULAN I 710

TRI BULAN II 151
861
DES
DES
DES
DES
DES
DES
klaim makmin
Rekening : Belanja Makanan dan Minuman Pasien Umum

Tahun Anggaran 2020

JUMLAH HARGA/
PORSI PORSI
1 2 3 4 5 6 7 8 9 10 11=9x10
1 AN. ACHMAD ALI FIKRI 3 Th PUSPO 27/02/2020 10.30 29/02/2020 09.30 6 15,000 90,000
2 AN. FARICHATUL 27 BLN REJOSALAM 27/02/2020 12.39 28/02/2020 14.00 3 15,000 45,000
9 15,000 135,000
Mengetahui Pasuruan,28 PEBRUARI 2020


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00



1 2 3 4 5 6 7 8 9 10 11=9x10
1 NY. SUSIATI 48 Th KEJAYAN 28/02/2020 12.50 02/03/2020 10.00 8 15,000 120,000

2 AN. M. UMA HAMDAN 3 Th PASREPAN 29/02/2020 09.20 02/03/2020 15.00 7 15,000 105,000
3 AN. EFENDI MAULANA 6.5 TH PETUNG 29/02/2020 09.38 03/03/2020 09.30 9 15,000 135,000
4 TN. SU'UT 65 Th JOGOREPUH 02/03/2020 01.40 03/03/2020 09.45 4 15,000 60,000
5 NY. SUPIATI 17 Th KEJAYAN 03/03/2020 11.15 05/03/2020 09.30 6 15,000 90,000
6 AN. ACH. ZAINAL ABIDIN 3 Th NGANTUNGAN 03/03/2020 11.45 05/03/2020 11.00 6 15,000 90,000
7 TN. WAHID 50 Th GALIH 04/03/2020 11.40 06/03/2020 10.10 6 15,000 90,000
8 TN. SUJUD 33 Th PETUNG 04/03/2020 12.20 06/03/2020 10.20 5 15,000 75,000
9 TN. HALIMAN 50 Th PASREPAN 04/03/2020 15.00 06/03/2020 10.15 5 15,000 75,000
10 AN. AMZAR FAIRUS 5 Th PASREPAN 05/03/2020 05.40 06/03/2020 10.10 4 15,000 60,000
11 NY. SUMAIYAH 15 Th GALIH 06/03/2020 12.55 08/03/2020 09.30 5 15,000 75,000
12 NY. USWATUN H 27 Th REJOSALAM 09/03/2020 10.00 11/03/2020 10.00 6 15,000 90,000
13 NY. NABILA 22 Th POHGEDANG 09/03/2020 10.30 11/03/2020 10.00 6 15,000 90,000
14 NY. ASMUNAH 50 Th AMPELSARI 10/03/2020 10.30 11/03/2020 09.45 3 15,000 45,000
15 TN. YAKOP 42 Th SAPULANTE 10/03/2020 10.50 12/03/2020 09.30 6 15,000 90,000
16 AN. AGUS SAPUTRA 4,5 TH JOGOREPUH 11/03/2020 01.00 12/03/2020 09.30 4 15,000 60,000
17 AN. DINI SAFIRATUNISA 1 Th PUSPO 11/03/2020 10.30 14/03/2020 10.00 9 15,000 135,000
19 AN. WILDAN RIZALALLAH 2.6 TH REJOSALAM 12/03/2020 12.50 14/03/2020 10.15 5 15,000 75,000
20 NY. LAILATUL BADI'AH 20 Th MANGGUAN 13/03/2020 05.00 14/03/2020 09.45 4 15,000 60,000
21 AN. ARSILATUL ULYA 4 Th AMPELSARI 13/03/2020 08.45 15/03/2020 10.00 6 15,000 90,000
22 SDR. ACH. DANIER 12 Th KEJAYAN 13/03/2020 11.18 15/03/2020 10.00 6 15,000 90,000
23 NY. BAWON 55 Th PUSPO 14/03/2020 09.20 16/03/2020 10.00 6 15,000 90,000
24 TN. HANAPI 65 Th KEJAYAN 15/03/2020 03.00 16/03/2020 16.45 5 15,000 75,000
25 TN. BOIMIN 42 Th TEMPURAN 16/03/2020 10.10 18/03/2020 10.00 6 15,000 90,000
26 AN. FEBRIAN RAMADHAN 4 Th PETUNG 17/03/2020 02.00 19/03/2020 09.30 7 15,000 105,000
27 TN. HANAFI 45 Th PASREPAN 17/03/2020 04.00 18/03/2020 09.30 4 15,000 60,000
28 AN. GHILFANA FARAH 4 Th AMPELSARI 18/03/2020 02.00 19/03/2020 09.45 4 15,000 60,000
30 TN. MUHLISIN 20 Th MANGGUAN 20/03/2020 01.00 21/03/2020 09.30 4 15,000 60,000
31 AN. WIJAYANTI 2 Th GALIH 20/03/2020 07.00 21/03/2020 09.15 4 15,000 60,000
32 TN. KARTONO 41 Th AMPELSARI 20/03/2020 09.00 22/03/2020 10.20 6 15,000 90,000
33 AN. AFRIEL KURNIA MULAN 18 BLN PASREPAN 20/03/2020 12.00 21/03/2020 11.50 3 15,000 45,000
34 TN. SUBHAN EFENDI 30 Th SIBON 21/03/2020 03.30 22/03/2020 15.00 5 15,000 75,000
35 NN. NAILA 15 Th NGANTUNGAN 21/03/2020 10.20 22/03/2020 15.00 4 15,000 60,000
36 TN. NUKMAN 26 Th AMPELSARI 22/03/2020 04.30 23/03/2020 09.00 4 15,000 60,000
37 NY. ROBIATUL ADAWIYAH 24 Th MANGGUAN 22/03/2020 12.00 23/03/2020 18.00 5 15,000 75,000
38 TN. AHMAD NAWAWI 27 Th SIBON 27/03/2020 02.45 28/03/2020 10.00 4 15,000 60,000
39 AN. MAULANA 10 Th PUSPO 28/03/2020 01.15 29/03/2020 09.05 4 15,000 60,000
40 NY. INAMA 30 Th NGANTUNGAN 28/03/2020 01.45 29/03/2020 09.30 4 15,000 60,000
41 AN. ADITYA 2 Th POHGEDANG 29/03/2020 01.30 30/03/2020 09.00 4 15,000 60,000
42 AN. ANINDITA 18 BLN POHGEDANG 29/03/2020 02.00 31/03/2020 08.30 7 15,000 105,000
43 TN. ROFI'I 44 Th MANGGUAN 30/03/2020 03.40 31/03/2020 08.30 4 15,000 60,000
226 15,000 3,390,000
Mengetahui Pasuruan, 31 MARET 2020

PPTK UPTD Dinas Puskesmas Pasrepan Koordinator Rawat Inap

NIP.19650929 200701 1 008 NIP.19830207 201406 2 002

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00



1 2 3 4 5 6 7 8 9 10 11=9x10
1 AN. KODIRIN 13 Th SAPULANTE 29/03/2020 02.00 01/04/2020 09.00 10 15,000 150,000

2 NN. RUAIDATUL ILMIYAH 17 Th TEMPURAN 31/03/2020 05.00 03/04/2020 09.00 10 15,000 150,000
3 AN. SISKA SECILIA 6 Th JIMBARAN 31/03/2020 08.45 03/04/2020 08.30 9 15,000 135,000
4 AN. MAULANA 7 Th SAPULANTE 31/03/2020 09.00 02/04/2020 09.00 6 15,000 90,000
5 NN. BELA APRILIA 19 Th PASREPAN 01/04/2020 10.00 03/04/2020 09.00 6 15,000 90,000
6 NN. MAULIDA 17 Th AMPELSARI 01/04/2020 10.30 03/04/2020 09.00 6 15,000 90,000
7 NY. HUMIMA 48 Th POHGEDANG 02/04/2020 03/04/2020 08.30 4 15,000 60,000
8 AN. SABRINA 9 Th LEMAHBANG 03/04/2020 03.10 05/04/2020 08.00 7 15,000 105,000
9 TN. NUR HASAN 50 Th POHGEDANG 04/04/2020 08.27 07/04/2020 09.00 7 15,000 105,000
10 TN. AJI KURNIAWANTO 30 Th MANGGUAN 05/04/2020 02.45 07/04/2020 09.00 9 15,000 135,000
11 TN. YAKOP 45 Th SAPULANTE 06/04/2020 03.00 08/04/2020 08.30 7 15,000 105,000
12 TN. ATIM 67 Th JOGOREPUH 06/04/2020 08.20 08/04/2020 09.15 7 15,000 105,000
13 TN. H. TOHIR 60 Th LEMAHBANG 07/04/2020 09.00 08/04/2020 09.00 6 15,000 90,000
14 NN. ANIK SULISTIYA 14 Th PASREPAN 11/04/2020 02.30 12/04/2020 09.00 3 15,000 45,000
15 TN. JUMAN 54 Th GALIH 12/04/2020 03.00 15/04/2020 09.20 4 15,000 60,000
16 AN. YASMIN AWALIYAH 2 Th SIBON 13/04/2020 10.00 15/04/2020 08.30 10 15,000 150,000
17 AN. WILDAN 5 Th PASREPAN 27/04/2020 09.45 29/04/2020 09.15 6 15,000 90,000
117 15,000 1,755,000
Mengetahui Pasuruan, 30 APRIL 2020


NIP.19650929 200701 1 008 NIP.19830207 201406 2 002

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00



1 2 3 4 5 6 7 8 9 10 11=9x10
1 AN. BARIR 5 Th KEJAYAN 27/02/2019 11.00 01/03/2019 09.15 6 15,000 90,000

2 TN. SIFAK ZUBAIDI 25 Th POHGEDANG 27/02/2019 12.00 01/03/2019 09.40 6 15,000 90,000
3 NN. HUSNUL KHOTIMAH 21 Th KEJAYAN 28/02/2019 04.35 02/03/2019 09.30 7 15,000 105,000
4 NY. MUJIANA 26 Th KEJAYAN 28/02/2019 05.10 01/03/2019 09.30 4 15,000 60,000
5 AN. KAILA 11 Th KEJAYAN 28/02/2019 05.30 01/03/2019 09.30 4 15,000 60,000
6 AN. DEVI WULANDARI 2 Th AMPELSARI 01/03/2019 09.20 03/03/2019 09.00 6 15,000 90,000
7 AN. MALIHATUL JAMILAH 4.5 TH CENGKRONG 01/03/2019 10.00 03/03/2019 09.00 6 15,000 90,000
8 AN. ACH. FACHRILLAH 8 Th KEJAYAN 01/03/2019 11.00 03/03/2019 09.00 6 15,000 90,000
9 AN. ROHMATUL IBAD 9 Th LEMAHBANG 03/03/2019 20.00 05/03/2019 20.00 6 15,000 90,000
10 AN. HILMAN A 5,5 TH POHGEDANG 04/03/2019 05.00 05/03/2019 09.45 4 15,000 60,000
11 AN. ZAKARIYAH 3 Th KEJAYAN 04/03/2019 05.10 05/03/2019 09.30 4 15,000 60,000
12 AN. REZA SAPUTRA 8 BLN RANGGEH 04/03/2019 10.00 07/03/2019 10.45 9 15,000 135,000
13 AN. AISYAR FAIT 22 BLN REJOSALAM 04/03/2019 12.30 07/03/2019 10.30 8 15,000 120,000
14 SDR. M. AFANILLAH 14 Th POHGEDANG 04/03/2019 13.10 07/03/2019 10.00 8 15,000 120,000
15 AN. HASBI AMINUDIN 3.5 TH REJOSALAM 05/03/2019 09.30 08/03/2019 09.30 9 15,000 135,000
16 SDR. HARIS 18 Th PASREPAN 05/03/2019 11.00 07/03/2019 10.00 6 15,000 90,000
17 NN. MALICHATUS SUBHI 18 Th TEMPURAN 05/03/2019 11.30 07/03/2019 11.00 6 15,000 90,000
18 NN. SINTIA 13 Th PUSPO 05/03/2019 11.30 07/03/2019 11.00 6 15,000 90,000
19 NN. MERY ANDRIANI 22 Th PASREPAN 05/03/2019 12.00 08/03/2019 09.00 9 15,000 135,000
20 NY. AMA 41 Th SIBON 06/03/2019 11.00 08/03/2019 09.00 6 15,000 90,000
21 AN. FARUQ 10 Th PASREPAN 08/03/2019 11.30 09/03/2019 09.00 3 15,000 45,000
22 NN. INTAN 14 Th PASREPAN 09/03/2019 04.00 10/03/2019 09.00 4 15,000 60,000
23 AN. M. KHOSIIN SHOBIR 3 Th AMPELSARI 09/03/2019 09.30 13/03/2019 10.50 12 15,000 180,000
24 AN. OKI PRADITYA 2 Th AMPELSARI 11/03/2019 03.00 13/03/2019 10.45 7 15,000 105,000
25 AN. SELA 4 BLN SAPULANTE 11/03/2019 08.30 13/03/2019 11.00 6 15,000 90,000
26 AN. AHMAD NAZRIL ILHAM 3 BLN AMPELSARI 11/03/2019 12.00 13/03/2019 11.05 6 15,000 90,000
27 AN. M. ROMLI 14 Th PASREPAN 11/03/2019 14.25 13/03/2019 10.25 5 15,000 75,000
28 NY. ROHIMAH 60 Th CENGKRONG 12/03/2019 03.00 15/03/2019 09.45 10 15,000 150,000
29 NY. NUR FAIZAH 23 Th POHGEDANG 13/03/2019 09.00 15/03/2019 09.45 6 15,000 90,000
30 AN. AYU ANDIRA 8 Th AMPELSARI 13/03/2019 09.30 16/03/2019 12.30 10 15,000 150,000
31 AN. GIO SAVIN. A 4.5 TH JIMBARAN 13/03/2019 10.10 15/03/2019 09.15 6 15,000 90,000
32 AN. M. ZAKI KEVIN 5 Th REJOSALAM 13/03/2019 13.30 15/03/2019 09.30 5 15,000 75,000
33 NY. ANITA 29 Th SAPULANTE 13/03/2019 22.00 14/03/2019 13.30 2 15,000 30,000
34 AN. UMAR HAMDAN 2.5 TH PASREPAN 16/03/2019 10.00 18/03/2019 09.45 6 15,000 90,000
35 AN. JENITA 4 Th MANGGUAN 16/03/2019 11.55 17/03/2019 09.30 3 15,000 45,000
36 NN. RINI 18 Th TEMPURAN 17/03/2019 21.30 18/03/2019 15.00 2 15,000 30,000
37 NY. SLEPON 50 Th AMPELSARI 17/03/2019 20.40 18/03/2019 15.30 2 15,000 30,000
38 NN. DAHLIA 20 Th AMPELSARI 18/03/2019 04.00 19/03/2019 09.00 4 15,000 60,000
39 AN. AINUR ROHMAN 13 BLN PETUNG 18/03/2019 05.00 19/03/2019 09.05 4 15,000 60,000
40 AN. LAILA MUFIDA 12 Th KEJAYAN 18/03/2019 06.00 20/03/2019 09.40 7 15,000 105,000
41 NN. TSUAIBATUL ISLAMIAH 14 Th TUNDOSORO 19/03/2019 09.30 20/03/2019 09.45 3 15,000 45,000
42 AN. ARJUNA 4 Th GALIH 19/03/2019 12.15 22/03/2019 10.00 8 15,000 120,000
43 AN. MIZWAH MARETA 4 Th BAYEMAN 20/03/2019 01.00 22/03/2019 16.00 8 15,000 120,000
44 TN. HUSNI 36 Th POHGEDANG 20/03/2019 04.00 21/03/2019 09.10 4 15,000 60,000
45 NY. SUAIBA 22 Th REJOSALAM 20/03/2019 10.30 22/03/2019 09.30 6 15,000 90,000
46 TN. AHMAD IRWANTO 32 Th PASREPAN 20/03/2019 18.00 23/03/2019 09.40 7 15,000 105,000
47 TN. M. ARIFIN 24 Th PASREPAN 21/03/2019 09.00 23/03/2019 09.45 6 15,000 90,000
48 NN. IKA NUR AINI 18 Th GALIH 21/03/2019 13.30 23/03/2019 09.40 5 15,000 75,000
49 AN. REZA 7 Th KLAKAH 22/03/2019 03.00 24/03/2019 09.30 7 15,000 105,000
50 SDR. MIFTAHUL HUDA 18 Th MADURA 25/03/2019 10.15 30/03/2019 09.30 15 15,000 225,000
51 AN. HUSAINI 12 Th SAPULANTE 25/03/2019 12.30 27/03/2019 09.45 5 15,000 75,000
52 NY. ROMLAH 30 Th COBANJOYO 26/03/2019 14.00 28/03/2019 09.30 5 15,000 75,000
53 SDR. SOFYAN LUBIS 16 Th PETUNG 28/03/2019 03.00 30/03/2019 09.00 7 15,000 105,000
54 AN. M. HOIRUL 5 Th JIMBARAN 28/03/2019 11.15 30/03/2019 08.30 6 15,000 90,000
55 TN. SIONO 26 Th COBANJOYO 28/03/2019 16.30 31/03/2019 10.00 8 15,000 120,000
56 NY. RUPIAH 60 Th PUSPO 30/03/2019 10.30 31/03/2019 10.00 3 15,000 45,000
339 15,000 5,085,000
Mengetahui Pasuruan,31 Maret 2019


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00



1 2 3 4 5 6 7 8 9 10 11=9x10
1 TN. AS'ARI 65 Th PASREPAN 30/03/2019 03.00 01/04/2019 09.30 7 15,000 105,000

2 TN. SUBAWON SLAMET 21 Th PETUNG 30/03/2019 09.58 01/04/2019 09.30 6 15,000 90,000
3 NY. AISYAH 70 Th KLAKAH 30/03/2019 11.00 02/04/2019 09.30 9 15,000 135,000
4 AN. NUR MUHAMMAD 6 Th PASREPAN 30/03/2019 12.00 03/04/2019 10.00 12 15,000 180,000
5 AN. HALIMATUS SAKDIYAH 20 BLN COBANJOYO 01/04/2019 04.00 02/04/2019 09.30 4 15,000 60,000
6 AN. NAVISA 22 BLN BENERWOJO 01/04/2019 08.30 03/04/2019 10.00 6 15,000 90,000
7 NN. KHOIRUN NISA 19 Th PASREPAN 01/04/2019 12.30 03/04/2019 10.00 5 15,000 75,000
8 NN. NIKMATUL WIDAD 18 Th TAMBAK REJO 02/04/2019 11.30 04/04/2019 09.00 6 15,000 90,000
9 TN. KODIR 38 Th WONOREJO 04/04/2019 03.00 06/04/2019 09.30 7 15,000 105,000
10 TN. IKHWANUL MUSLIMIN 26 Th SIBON 05/04/2019 09.15 07/04/2019 09.00 6 15,000 90,000
11 AN. M. IQBAL 1.5 TH CENGKRONG 05/04/2019 09.45 06/04/2019 09.45 3 15,000 45,000
12 NN. YULIS NADIRO 18 Th POHGADING 06/04/2019 11.25 08/04/2019 09.00 6 15,000 90,000
13 AN. MUHIBUDIN 9 Th SAPULANTE 08/04/2019 03.00 12/04/2019 10.00 13 15,000 195,000
14 TN. SUHAEMI 63 Th CENGKRONG 09/04/2019 04.00 11/04/2019 09.15 7 15,000 105,000
15 TN. AINUL ROFIK 22 Th CENGKRONG 10/04/2019 09.20 12/04/2019 09.20 6 15,000 90,000
16 AN. NANDA 12 Th AMPELSARI 12/04/2019 08.30 14/04/2019 16.00 7 15,000 105,000
17 AN. ANGGRAENI 6.5 TH JIMBARAN 12/04/2019 09.15 15/04/2019 10.00 9 15,000 135,000
18 TN. M. KHASAN 25 Th PUSPO 13/04/2019 10.45 16/04/2019 09.00 9 15,000 135,000
19 TN. REPAT 42 Th PUSPO 14/04/2019 17.30 16/04/2019 09.30 4 15,000 60,000
20 TN. HUSNI 34 Th PASREPAN 15/04/2019 02.00 16/04/2019 09.30 4 15,000 60,000
21 AN. FARHAN 6 Th WONOREJO 18/04/2019 00.15 19/04/2019 18.00 6 15,000 90,000
22 SDR. MESWADI 19 Th KLAKAH 18/04/2019 10.30 19/04/2019 16.00 4 15,000 60,000
23 NN. IKA SUFROTUL Y 23 Th MANGGUAN 18/04/2019 12.30 20/04/2019 09.45 5 15,000 75,000
24 AN. SYAFITRI 8 Th SIBON 18/04/2019 13.00 19/04/2019 09.00 2 15,000 30,000
25 AN. HAYLAN 8 Th NGANTUNGAN 20/04/2019 03.00 21/04/2019 10.00 4 15,000 60,000
26 AN. NURIL 8 Th SAPULANTE 20/04/2019 09.30 22/04/2019 09.00 6 15,000 90,000
27 AN. DIMITRI WAHYU 6 Th PASREPAN 23/04/2019 02.00 24/04/2019 10.00 4 15,000 60,000
28 AN. ROBITUL ISLAM 7 Th PASREPAN 23/04/2019 10.30 25/04/2019 09.30 6 15,000 90,000
29 NN. CICI FITRIA 17 Th SAPULANTE 24/04/2019 10.45 25/04/2019 09.30 3 15,000 45,000
30 NY. HOTIMAH 36 Th CENGKRONG 25/04/2019 02.00 26/04/2019 09.30 4 15,000 60,000
31 TN. ROMLI 45 Th CENGKRONG 26/04/2019 18.15 28/04/2019 09.00 4 15,000 60,000
32 AN. M. UBAIDILLAH 9 Th BENERWOJO 27/04/2019 09.30 29/04/2019 09.00 6 15,000 90,000
33 AN. M. RIZKY 1 Th PASREPAN 27/04/2019 10.00 29/04/2019 09.00 6 15,000 90,000
196 15,000 2,940,000
Mengetahui Pasuruan, 30 April 2019


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00



NO PASIEN UMUR ALAMAT PORSI PORSI JUMLAH
1 2 3 4 5 6 7 8 9 10 11=9x10
1 SDR. HOIRUL YAQIN 23 Th REJOSALAM 02/05/2019 08.45 04/05/2019 09.00 6 15,000 90,000
2 AN. WULAN 6 Th NGANTUNGAN 05/05/2019 21.50 07/05/2019 08.50 4 15,000 60,000
3 AN. MUHIBUDDIN 9 Th SAPULANTE 06/05/2019 08.15 08/05/2019 09.30 6 15,000 90,000
4 TN. KHOIRIL 30 Th JOGOREPUH 07/05/2019 08.15 09/05/2019 10.00 6 15,000 90,000
5 AN. ARDI SAPUTRA 9 Th JOGOREPUH 07/05/2019 09.00 10/05/2019 09.30 9 15,000 135,000
6 AN. IN'AM 9 Th LEMAHBANG 07/05/2019 12.45 09/05/2019 09.50 5 15,000 75,000
7 AN. KAFI EL AZAM 4 Th PASREPAN 09/05/2019 10.00 10/05/2019 09.30 3 15,000 45,000
8 AN. KEYSA PUTRI A 4 Th PASREPAN 10/05/2019 09.30 12/05/2019 10.00 6 15,000 90,000
9 NY. AMELIA SAPUTRI 32 Th REJOSALAM 10/05/2019 18.50 11/05/2019 11.45 1 15,000 15,000
10 AN. FATHUR ROHMAN 6,5 TH CENGKRONG 13/05/2019 04.00 14/05/2019 09.00 4 15,000 60,000
11 AN. ELITA 4 Th REJOSALAM 13/05/2019 12.00 16/05/2019 09.00 9 15,000 135,000
12 SDR. NUR HAQIQI 15 Th JOGOREPUH 16/05/2019 10.15 18/05/2019 09.00 6 15,000 90,000
13 SDR. HIFNI 17 Th NGANTUNGAN 16/05/2019 10.45 18/05/2019 09.00 6 15,000 90,000
14 TN. SAMHUDI 100 Th COBANJOYO 18/05/2019 09.00 20/05/2019 08.45 6 15,000 90,000
15 NY. WAHYUNINGSIH 30 Th COBANJOYO 19/05/2019 18.00 22/05/2019 16.00 8 15,000 120,000
16 NN. SAFITRI 14 Th AMPELSARI 20/05/2019 19.40 21/05/2019 12.00 2 15,000 30,000
17 NY. YULIANA 30 Th AMPELSARI 21/05/2019 05.00 22/05/2019 09.30 4 15,000 60,000
18 TN. AZKIYAK 31 Th PASREPAN 22/05/2019 08.30 24/05/2019 09.30 6 15,000 90,000
19 AN. ZAINAL ARIFIN 7 Th PETUNG 23/05/2019 03.00 24/05/2019 09.40 4 15,000 60,000
20 TN. ARMO 72 Th AMPELSARI 27/05/2019 03.00 28/05/2019 09.30 4 15,000 60,000
21 SDR. TAUFIQI 17 Th PAGERWOJO 27/05/2019 05.00 28/05/2019 10.00 4 15,000 60,000
22 NY. ROBIATUL ADAWIYAH 24 Th PUSPO 27/05/2019 21.00 28/05/2019 10.50 1 15,000 15,000
110 15,000 1,650,000
Mengetahui Pasuruan,31 Mei 2019


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00



1 2 3 4 5 6 7 8 9 10 11=9x10
1 AN. SITI FAUZIAH 9 BLN GALIH 31/05/2019 10.30 01/06/2019 05.00 2 15,000 30,000
2 NY. FITRIANI 34 Th PASREPAN 31/05/2019 10.30 01/06/2019 09.00 3 15,000 45,000
3 AN. RANIA 10 BLN CENGKRONG 07/06/2019 18.00 09/06/2019 09.00 4 15,000 60,000
4 NY. HUROTI 60 Th PUSPO 08/06/2019 17.20 11/06/2019 06.30 6 15,000 90,000
5 AN. M. DAFFA 18 BLN SIBON 10/06/2019 03.00 11/06/2019 11.00 4 15,000 60,000
6 AN. SITI MARIA ULFA 27 BLN REJOSALAM 10/06/2019 10.15 11/06/2019 10.00 3 15,000 45,000
7 NY. SUNAMA 50 Th AMPELSARI 10/06/2019 21.30 12/06/2019 10.10 4 15,000 60,000
8 NY. HUSIANAH 35 Th AMPELSARI 11/06/2019 08.00 12/06/2019 10.15 3 15,000 45,000
9 TN. SAFIUDIN 60 Th COBANJOYO 11/06/2019 10.00 14/06/2019 09.10 9 15,000 135,000
10 NY. FARIDA 18 Th AMPELSARI 13/06/2019 12.00 14/06/2019 21.00 5 15,000 75,000
11 NY. DEWI PUSPITA RINI 33 Th MANGGUAN 14/06/2019 06.30 15/06/2019 09.20 4 15,000 60,000
12 NY. RUTI'IN 26 Th GALIH 14/06/2019 08.00 16/06/2019 09.00 6 15,000 90,000
13 AN. FATIMAH ZURROTUN A 2.5 TH SAPULANTE 17/06/2019 03.00 18/06/2019 09.30 4 15,000 60,000
14 TN. SUPRIYONO 38 Th PUSPO 17/06/2019 09.00 18/06/2019 09.30 3 15,000 45,000
15 AN. IRUL 1.5 TH COBANJOYO 17/06/2019 12.00 20/06/2019 10.10 9 15,000 135,000
16 AN. ZUHROTUL AULIAH 5.5 TH SAPULANTE 17/06/2019 12.30 19/06/2019 10.00 5 15,000 75,000
17 AN. M. ROJIKIN 8 Th COBANJOYO 21/06/2019 02.50 23/06/2019 09.00 7 15,000 105,000
18 SDR. LUKMAN 12 Th AMPELSARI 22/06/2019 03.00 23/06/2019 09.30 4 15,000 60,000
19 TN. MAT 70 Th CENGKRONG 24/06/2019 09.00 25/06/2019 10.00 3 15,000 45,000
20 AN. AMELIA PUTRI 7 Th TEMPURAN 25/06/2019 08.30 26/06/2019 10.30 3 15,000 45,000
21 NY. ALIYAH 44 Th MANGGUAN 25/06/2019 09.30 26/06/2019 09.45 3 15,000 45,000
22 NY. MARHAMA 60 Th COBANJOYO 27/06/2019 20.30 30/06/2019 10.00 7 15,000 105,000
23 AN. BINTANG 6 Th MANGGUAN 28/06/2019 10.00 30/06/2019 09.10 6 15,000 90,000
24 NY. NAYATI 28 Th TEMPURAN 28/06/2019 20.00 30/06/2019 09.00 4 15,000 60,000
111 15,000 1,665,000


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00

BAGIAN BULAN JULI 2019


1 2 3 4 5 6 7 8 9 10 11=9x10
1 NY. HENI 27 Th GALIH 01/07/2019 02.30 02/07/2019 09.30 4 15,000 60,000

2 AN. HALIMATUS 9 Th AMPELSARI 01/07/2019 06.30 02/07/2019 10.00 4 15,000 60,000
3 NY. STI AISYAH 35 Th PASREPAN 04/07/2019 08.30 05/07/2019 09.15 3 15,000 45,000
4 NY. MUASARO 29 Th POHGEDANG 04/07/2019 09.00 05/07/2019 09.30 3 15,000 45,000
5 NN. PUTRI 16 Th PASREPAN 04/07/2019 19.00 06/07/2019 09.30 4 15,000 60,000
6 NY. SRI WAHYUNI 21 Th GALIH 05/07/2019 10.15 06/07/2019 10.00 3 15,000 45,000
7 NY. SURYATI 80 Th KLINTER 06/07/2019 02.50 07/07/2019 09.30 4 15,000 60,000
8 NY. FEBRIANA RAHAYU 28 Th COBANJOYO 08/07/2019 10.30 10/07/2019 09.30 6 15,000 90,000
9 AN. SAILATUL RIZQIA 2 Th PETUNG 09/07/2019 04.00 11/07/2019 09.00 7 15,000 105,000
10 TN. ROHMAN 25 Th PUSPO 10/07/2019 10.10 13/07/2019 09.30 9 15,000 135,000
11 AN. MASYILATUL 13 BLN CENGKRONG 11/07/2019 02.30 12/07/2019 09.30 4 15,000 60,000
12 AN. REZA REVALIA A 2 Th PASREPAN 12/07/2019 04.00 13/07/2019 09.40 4 15,000 60,000
13 AN. NAZWA 2.3 BLN POHGEDANG 15/07/2019 02.45 16/07/2019 09.30 4 15,000 60,000
14 NN. YUSLIHA 16 Th SIBON 15/07/2019 20.15 17/07/2019 09.30 4 15,000 60,000
15 TN. HASIM 33 Th KEJAYAN 17/07/2019 08.00 19/07/2019 09.30 6 15,000 90,000
16 NN. NIKMATUS SOLIHA 20 Th MANGGUAN 18/07/2019 08.00 20/07/2019 09.30 6 15,000 90,000
17 TN. NUR HADI 35 Th GALIH 20/07/2019 10.30 22/07/2019 09.00 6 15,000 90,000
18 NY. HUSNIA 33 Th POHGEDANG 20/07/2019 10.30 22/07/2019 09.30 6 15,000 90,000
19 NY. SUTAMI 45 Th PETUNG 21/07/2019 06.45 23/07/2019 18.50 9 15,000 135,000
20 NY. JAMILAH 35 Th POHGADING 22/07/2019 03.15 23/07/2019 09.30 4 15,000 60,000
21 NY. LATIFATUS 21 Th MANGGUAN 24/07/2019 11.30 26/07/2019 10.00 6 15,000 90,000
22 TN. MUSTAKIM 40 Th POHGEDANG 25/07/2019 09.15 27/07/2019 10.00 6 15,000 90,000
23 TN. RINOTO 33 Th TEMPURAN 25/07/2019 10.00 29/07/2019 11.00 12 15,000 180,000
24 TN. RAHMAT 55 Th PETUNG 27/07/2019 10.00 29/07/2019 09.00 6 15,000 90,000
25 TN. SUPARJI 25 Th PUSPO 27/07/2019 10.30 30/07/2019 09.30 9 15,000 135,000
26 AN. AHMAD LUTFI 4 Th SIBON 27/07/2019 10.45 29/07/2019 09.30 6 15,000 90,000
27 AN. RINDI ARFIKA 2 Th PUSPO 29/07/2019 11.30 31/07/2019 09.00 6 15,000 90,000
151 15,000 2,265,000
Mengetahui Pasuruan, 31 Juli 2019


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00

BAGIAN BULAN AGUSTUS 2019


1 2 3 4 5 6 7 8 9 10 11=9x10
1 NY. AINUR FADILLAH 19 Th GALIH 29/07/2019 18.20 01/08/2019 08.30 7 15,000 105,000
2 AN. IRIL 16 BLN SIBON 01/08/2019 11.00 03/08/2019 09.35 6 15,000 90,000
3 TN. SUGENG 31 Th KLAKAH 01/08/2019 14.35 02/08/2019 15.30 3 15,000 45,000
4 AN. KHOIRIL ANAM 9 BLN NGANTUNGAN 02/08/2019 08.45 03/08/2019 16.00 4 15,000 60,000
5 AN. AZKA 17 BLN JIMBARAN 03/08/2019 02.45 04/08/2019 10.00 4 15,000 60,000
6 TN. ACHMAD SUDIONO 50 Th JOGOREPUH 03/08/2019 06.30 05/08/2019 09.30 7 15,000 105,000
7 AN. M. RAHMAT RAMADANI 3 Th POHGEDANG 03/08/2019 10.00 04/08/2019 10.00 3 15,000 45,000
8 NY. LAILATUL FITRIA 23 Th PASREPAN 03/08/2019 16.15 05/08/2019 13.30 6 15,000 90,000
9 NY. SIAMI 40 Th JOGOREPUH 04/08/2019 20.20 07/08/2019 09.30 7 15,000 105,000
10 SDR. MISBAHUL MUNIR 13 Th AMPELSARI 05/08/2019 09.30 07/08/2019 09.15 6 15,000 90,000
11 NY. RUTI'IN 30 Th GALIH 05/08/2019 10.00 06/08/2019 14.00 4 15,000 60,000
12 NY. HALIMA 35 Th POHGEDANG 06/08/2019 11.00 08/08/2019 09.30 6 15,000 90,000
13 AN. NAFISATUN NISA' 2 Th SAPULANTE 07/08/2019 12.00 08/08/2019 09.30 3 15,000 45,000
14 NY. MALIHA 50 Th JOGOREPUH 07/08/2019 20.10 09/08/2019 09.30 4 15,000 60,000
15 TN. SLAMET 27 Th TOSARI 10/08/2019 03.30 11/08/2019 09.30 4 15,000 60,000
16 NY. SUMANA 70 Th MANGGUAN 10/08/2019 06.50 13/08/2019 09.10 10 15,000 150,000
17 TN. SU'UD 40 Th PUSPO 12/08/2019 04.00 14/08/2019 15.00 8 15,000 120,000
18 NN. HALIMA 18 Th SIBON 13/08/2019 10.30 15/08/2019 09.30 6 15,000 90,000
19 TN. SUPARTO 60 Th POHGADING 14/08/2019 02.30 16/08/2019 09.00 7 15,000 105,000
20 AN. NAZWA 14 BLN SAPULANTE 15/08/2019 02.40 16/08/2019 09.30 4 15,000 60,000
21 AN. FATIMAH 6 Th PETUNG 15/08/2019 11.00 17/08/2019 09.30 6 15,000 90,000
22 TN. AJIRON 79 COBANJOYO 8/18/2019 14.00 8/20/2019 09.30 5 15,000 75,000
23 TN. M. NIJAR 40 Th KARANG PANAS 8/18/2019 19.00 8/20/2019 09.15 4 15,000 60,000
24 NY KARNISSINTIYA 19 Th GALIH 8/18/2019 19.15 8/20/2019 09.30 4 15,000 60,000
25 AN. M. AZRIL 3 Th SAPULANTE 8/19/2019 10.05 8/21/2019 09.00 6 15,000 90,000
26 TN. ABU AMAR 52 Th JIMBARAN 8/20/2019 03.00 8/21/2019 09.00 4 15,000 60,000
27 TN. MAHMUDI 40 Th SIBON 8/22/2019 07.15 8/24/2019 08.49 6 15,000 90,000
28 TN. URIP 65 Th KLAKAH 8/22/2019 18.30 8/23/2019 16.00 2 15,000 30,000
29 NY. NUR KHASILA 42 Th JOGOREPUH 8/22/2019 19.45 8/27/2019 09.30 13 15,000 195,000
30 TN. SIROJI 34 Th POHGEDANG 8/23/2019 02.30 8/25/2019 09.30 7 15,000 105,000
31 AN. ZAHRA 8 BLN SIBON 8/24/2019 10.30 8/25/2019 09.00 3 15,000 45,000
32 SDR. BONANG 15 Th PUSPO 8/27/2019 06.40 8/28/2019 10.00 4 15,000 60,000
33 AN. ACH. HABI 18 BLN TEMPURAN 8/27/2019 09.30 8/29/2019 10.00 6 15,000 90,000
34 AN. IRSYATUL IBAD 28 BLN TEMPURAN 8/28/2019 09.05 8/31/2019 09.00 9 15,000 135,000
35 AN. KENZIE MAHARDIKA 4 Th PASREPAN 8/28/2019 14.15 8/30/2019 09.00 5 15,000 75,000
36 NY. YANIK 27 Th JEMBER 8/29/2019 15.30 8/30/2019 10.00 2 15,000 30,000
37 NN. PUTRI MUSRIFAH 17 Th SURABAYA 8/29/2019 19.00 8/31/2019 09.30 4 15,000 60,000
199 15,000 2,985,000
Mengetahui Pasuruan,31 Agustus 2019


NIP.19650929 200701 1 008 NIP.19680103 198901 2 004

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00



1 2 3 4 5 6 7 8 9 10 11=9x10
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
- 15,000 -


NIP.19650929 200701 1 008 NIP.19670908198801001

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00

BAGIAN BULAN OKTOBER 2017


1 2 3 4 5 6 7 8 9 10 11=9x10
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
- 15,000 2.820.000
Mengetahui Pasuruan, 31 Oktober 2017


NIP.19650929 200701 1 008 NIP.19670908198801001

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00

BAGIAN BULAN NOVEMBER 2017


1 2 3 4 5 6 7 8 9 10 11=9x10
1
2
3
4
5
6
7
8
9
10
11
12
13
14
-
- 15,000 -
Mengetahui Pasuruan, 30 NOVEMBER 2017


NIP.19650929 200701 1 008 NIP.19670908198801001

NO JENIS MAKAN JAM
1 Makan pagi 07.00
2 Makan siang 12.00
3 Makan sore 17.00
3
5.2.2.11.04.PAD
2
5
4 Hari
3 Hari
4 Hari
2 Hari
3 Hari
3 Hari
3 Hari
3 Hari
3 Hari
2 Hari
3 Hari
3 Hari
3 Hari
2 Hari
3 Hari
2 Hari
4 Hari
4 Hari
3 Hari
2 Hari
3 Hari
3 Hari
3 Hari
2 Hari
3 Hari
3 Hari
2 Hari
2 Hari
2 Hari
2 Hari
2 Hari
3 Hari
2 Hari
2 Hari
2 Hari
2 Hari
2 Hari
2 Hari
2 Hari
2 Hari
2 Hari
3 Hari
2 Hari
112
4
4
4
3
3
3
2
3
4
3
3
3
2
2
4
3
3
3
56
3
3
3
2
2
3
3
3
3
2
2
4
4
4
4
3
3
3
4
3
2
2
5
3
3
3
3
4
3
4
3
3
2
3
2
2
2
2
2
3
2
4
3
2
3
4
3
3
3
6
3
3
3
3
4
2
168
3
3
4
5
2
3
3
3
3
3
2
3
5
3
3
3
4
4
3
2
2
2
3
2
2
3
2
3
2
2
3
3
3
96
3 AZAHRA
3
3
3
4
3
2
3
2
2
4
3
3
3
4
2
2
3
2
2
2
2
60
2
2
3
4
2
2
3
2
4
2
2
3
2
2
4 NUR HASAN
3
3
2
2
2
2
4
3
3
63
2
2
2
2
3
2
2
3
3
4
2
2
2
3
3
3
3
3
3
2
3
3
5
3 SABAR
4
3
3
75
4
3
2
2
2
3
2
3
4
3
2
3
2
3
2
4
3
3
3
2
3
3
3
3
3
2
3
2
6
3
2
2
3
4
3
2
3
105
3
2
2
2
2
3
2
3
2
5
2
3
2
2
2
3
4
5
2
3
2
3
2
2
3
4
2
3
2
2
79
3
2
3
3
2
4
3
3
3
2
2
2
3
3
2
5
2
2
3
2
2
4
2
3
2
5
6
2
3
REKAP TANGGAL MAKMIN REKAP TANGGAL MAKMIN
PASIEN : UMUM PASIEN : UMUM

BULAN : JANUARI BULAN : PEBRUARI
TAHUN : 2016 TAHUN : 2016
MENU MENU
JMLH JMLH
TGL PA SI SO TGL PA SI SO
6 1 1 30 1 2 2 5
7 1 2 2 5 31 2 2 2 6
8 3 3 3 9 1 2 4 3 9
9 3 3 3 9 2 4 2 2 8
10 3 2 1 6 3 2 1 3
11 1 2 3 6 4 0
12 4 4 3 11 5 2 1 1 4
13 4 2 2 8 6 2 3 3 8
14 2 2 1 5 7 3 4 3 10
15 1 1 8 3 1 1 5
16 1 1 2 9 3 2 2 7
17 1 1 1 3 10 2 2 2 6
18 3 2 1 6 11 2 1 1 4
19 2 3 3 8 12 1 1 1 3
20 3 3 1 7 13 2 2 2 6
21 1 3 4 8 14 2 1 1 4
22 5 5 4 14 15 2 1 1 4
23 3 4 4 11 16 1 1 1 3
24 4 1 5 17 2 1 1 4
25 0 18 1 1
26 1 2 2 5 19 1 1 2
27 2 1 1 4 20 1 2 2 5
28 2 2 1 5 21 2 1 1 4
29 1 1 22 1 1
50 48 41 140 23 1 1 1 3
24 1 1
25 2 1 1 4
26 1 1
27 1 1 1 3
28 1 1
29 0
30 0
31 0
JMLH 50 39 36 125

BULAN : MARET BULAN : APRIL
MENU MENU
JMLH JMLH
29 1 1 2 30 1 1 1 3
1 1 1 1 3 31 2 2 3 7
2 2 1 1 4 1 3 2 2 7
3 1 1 2 1 3 1 5
4 1 2 3 3 1 1 1 3
5 3 3 3 9 4 2 2 2 6
6 2 2 5 3 3 3 9
7 1 2 1 4 6 3 2 2 7
8 1 1 1 3 7 3 3 3 9
9 1 1 8 2 2 2 6
10 1 2 2 5 9 1 1 1 3
11 2 1 1 4 10 1 1
12 1 2 1 4 11 4 3 3 10
13 2 1 1 4 12 5 4 4 13
14 2 1 1 4 13 4 4 4 12
15 2 5 5 12 14 1 1 1 3
16 5 3 2 10 15 2 2 1 5
17 3 3 3 9 16 2 2 2 6
18 4 3 3 10 17 2 1 1 4
19 4 1 1 6 18 3 3 3 9
20 1 1 1 3 19 1 1 1 3
21 1 1 1 3 20 2 2 2 6
22 2 2 2 6 21 2 1 1 4
23 3 2 3 8 22 1 1 1 3
24 3 3 3 9 23 1 1 2
25 3 5 4 12 24 0
26 3 3 3 9 25 1 1 2
27 1 2 3 26 2 2 2 6
28 0 27 2 1 1 4
29 0 28 0
30 0 29 0
31 0 30 0
32 0 31 0
JMLH 55 51 47 153 JMLH 58 52 48 158

BULAN : MEI BULAN : JUNI
MENU MENU
JMLH JMLH
29 1 1 2 31 1 1 2 4
30 1 1 1 3 1 2 2 2 6
1 2 2 2 6 2 2 2 2 6
2 4 2 2 8 3 3 2 2 7
3 2 3 3 8 4 2 3 3 8
4 3 1 1 5 5 3 1 1 5
5 1 1 6 2 2 2 6
6 1 1 7 4 3 3 10
7 1 2 2 5 8 4 4 3 11
8 2 1 3 6 9 3 1 1 5
9 3 3 3 9 10 1 2 2 5
10 4 5 5 14 11 2 2
11 5 4 2 11 12 1 1 1 3
12 2 2 2 6 13 1 1 1 3
13 2 1 1 4 14 2 1 1 4
14 1 1 15 1 1 1 3
15 3 3 6 16 2 3 3 8
16 6 6 5 17 17 3 2 2 7
17 5 2 2 9 18 4 4 3 11
18 2 1 1 4 19 4 3 3 10
19 1 1 20 3 2 2 7
20 0 21 4 3 3 10
21 0 22 2 1 1 4
22 0 23 1 1
23 1 1 2 24 0
24 1 1 2 4 25 2 2 2 6
25 1 1 2 4 26 2 2 2 6
26 2 1 1 4 27 0
27 1 2 3 28 0
28 1 1 1 3 29 0
29 1 1 30 0
30 0 31 0
31 0 32 0
JMLH 54 47 47 148 JMLH 61 49 48 158
PASIEN : JAMKESMAS PASIEN : JAMKESMAS

BULAN : JANUARI BULAN : FEBRUARI
MENU MENU
JMLH JMLH
6 1 1 29 1 1 2
7 1 1 1 3 30 1 1 1 3
8 1 1 31 2 2 2 6
9 1 1 2 1 3 2 2 7
10 0 2 2 1 1 4
11 1 1 1 3 3 1 1 1 3
12 1 3 3 7 4 2 1 1 4
13 3 2 2 7 5 1 1 1 3
14 3 1 1 5 6 1 1 1 3
15 1 2 2 5 7 1 1 1 3
16 2 2 2 6 8 1 1
17 2 1 1 4 9 0
18 1 1 1 3 10 0
19 1 1 1 3 11 0
20 1 1 2 12 0
21 0 13 0
22 0 14 0
23 1 1 15 1 1 2
24 1 1 1 3 16 1 1 1 3
25 1 1 1 3 17 2 3 3 8
26 1 1 2 4 18 3 2 2 7
27 2 2 2 6 19 2 1 1 4
28 2 1 1 4 20 1 1
29 1 1 21 0
30 0 22 1 1 2
31 0 23 1 1 1 3
32 0 24 1 1
33 0 25 1 1 2
34 0 26 1 1
35 0 27 0
36 0 28 0
37 0 29 0
38 0 30 0
JMLH 27 23 24 74 JMLH 29 22 22 73

BULAN : MARET BULAN : APRIL
MENU MENU
JMLH JMLH
28 1 1 27 1 1 2
29 1 2 2 5 28 1 2 2 5
1 2 2 2 6 29 2 2 2 6
2 3 3 2 8 30 3 3 3 9
3 2 1 1 4 31 3 3 3 9
4 1 1 1 3 1 3 3
5 1 2 2 5 2 1 1 2
6 2 1 1 4 3 1 1 1 3
7 1 1 1 3 4 2 1 2 5
8 1 1 5 2 2 2 6
9 0 6 2 2 2 6
10 1 1 1 3 7 2 1 3
11 2 1 2 5 8 1 1 1 3
12 2 1 1 4 9 1 1 1 3
13 1 1 1 3 10 1 1 1 3
14 1 1 11 1 1
15 0 12 0
16 0 13 1 1 2
17 0 14 1 1 2
18 0 15 1 1
19 0 16 0
20 1 1 1 3 17 0
21 1 1 1 3 18 0
22 1 1 1 3 19 0
23 2 2 2 6 20 1 1
24 3 1 1 5 21 3 3 6
25 1 1 22 2 5 6 13
26 0 23 4 5 5 14
27 0 24 6 2 2 10
28 0 25 6 2 2 10
29 0 26 3 1 4
30 0 27 2 2 2 6
31 0 28 2 1 1 4
JMLH 30 23 24 77 29 4 2 1 7
30 1 1
31
32
33
34
JMLH 57 45 48 150

MENU MENU
JMLH JMLH
29 1 1 1 3 30 0
30 1 1 2 4 31 0
1 3 1 2 6 1 1 1 2
2 2 2 2 6 2 2 1 1 4
3 2 1 3 3 1 2 2 5
4 0 4 2 2 1 5
5 0 5 1 1 1 3
6 0 6 1 1
7 0 7 0
8 0 8 0
9 0 9 2 2 4
10 0 10 2 2 2 6
11 0 11 2 1 1 4
12 1 1 1 3 12 1 1 1 3
13 1 1 2 13 1 1
14 0 14 0
15 0 15 0
16 0 16 0
17 0 17 1 1
18 2 2 4 18 1 1
19 2 2 2 6 19 0
20 2 1 1 4 20 1 2 3
21 1 1 1 3 21 2 3 3 8
22 0 22 3 3 3 9
23 1 1 2 23 3 3 4 10
24 2 1 1 4 24 4 1 1 6
25 1 1 1 3 25 1 2 2 5
26 1 1 1 3 26 2 1 1 4
27 1 1 1 3 27 1 1
28 1 1 28 0
29 0 29 0
30 0 30 0
31 0 31 0
JMLH 22 19 19 60 JMLH 30 27 29 86
PASIEN : ASKES PASIEN : ASKES

BULAN : JANUARI BULAN : FEBRUARI
MENU MENU
JMLH JMLH
6 1 1 1 3 4 1 1
7 1 1 1 3 5 1 1 1 3
8 1 1 1 3 6 1 1 1 3
9 0 7 2 2 2 6
10 0 8 2 1 1 4
11 0 9 1 1 1 3
12 0 10 1 1
13 1 1 1 3 11 0
14 1 1 1 3 12 0
15 1 1 1 3 13 0
16 0 14 0
17 0 15 0
18 0 16 0
19 1 1 1 3 17 0
20 1 1 1 3 18 0
21 1 1 2 19 0
22 0 20 0
23 1 1 21 0
24 0 22 0
25 0 23 0
26 0 24 0
27 0 25 0
28 0 26 0
29 0 27 0
30 0 28 0
31 0 29 0
32 0 30 0
33 0 31 0
34 0 32 0
35 0 33 0
36 0 34 0
37 0 35 0
38 0 36 0
JMLH 10 9 8 27 JMLH 8 6 7 21
PASIEN : ASKES PASIEN : ASKES

MENU MENU
JMLH JMLH
17 1 1 1 3 1 1 1 2
18 1 1 2 1 1 1 3
19 0 3 1 1 1 3
20 0 4 1 1 1 3
21 1 1 2 5 1 1 1 3
22 1 1 1 3 6 1 1
23 1 1 7 0
24 0 8 0
25 0 9 0
26 0 10 0
27 0 11 0
28 1 1 2 12 0
29 1 1 1 3 13 0
30 1 1 14 0
31 0 15 0
32 0 16 0
33 0 17 0
34 0 18 0
35 0 19 0
36 0 20 0
37 0 21 0
38 0 22 0
39 0 23 0
40 0 24 0
41 0 25 0
42 0 26 0
43 0 27 0
44 0 28 0
45 0 29 0
46 0 30 0
47 0 31 0
48 0 32 0
49 0 33 0
JMLH 6 5 5 16 JMLH 5 5 5 15

MENU MENU
JMLH JMLH
6 0 30 0
7 0 31 0
8 0 1 0
9 0 2 0
10 0 3 0
11 0 4 0
12 0 5 0
13 0 6 0
14 0 7 0
15 0 8 0
16 0 9 0
17 0 10 0
18 0 11 0
19 0 12 0
20 0 13 0
21 0 14 0
22 0 15 0
23 0 16 0
24 0 17 0
25 0 18 0
26 0 19 0
27 0 20 0
28 0 21 0
29 0 22 0
30 0 23 0
31 0 24 0
32 0 25 0
33 0 26 0
34 0 27 0
35 0 28 0
36 0 29 0
37 0 30 0
38 0 31 0
JMLH 0 0 0 0 JMLH 0 0 0 0

BULAN : JULI BULAN : AGUSTUS
MENU MENU
JMLH JMLH
28 1 1 1 3 25 2 2 4
29 4 3 3 10 26 2 2 2 6
30 2 1 1 4 27 2 2 1 5
1 1 1 1 3 28 1 1 1 3
2 1 1 1 3 29 1 1 1 3
3 1 1 30 1 1 1 3
4 0 31 1 1
5 1 1 1 1 1 2
6 1 1 2 4 2 1 1
7 2 1 1 4 3 1 2 3
8 3 2 2 7 4 2 2 2 6
9 3 2 2 7 5 1 1 1 3
10 2 2 2 6 6 1 2 2 5
11 3 2 1 6 7 2 2 2 6
12 1 2 2 5 8 2 5 4 11
13 2 3 3 8 9 4 3 3 10
14 4 3 3 10 10 3 2 1 6
15 4 3 3 10 11 1 1 2 4
16 4 5 5 14 12 3 3 3 9
17 4 2 2 8 13 4 5 5 14
18 2 2 1 5 14 4 2 1 7
19 1 1 1 3 15 1 1
20 1 1 1 3 16 0
21 1 2 2 5 17 0
22 2 3 2 7 18 0
23 1 2 2 5 19 1 1 2
24 0 20 2 1 1 4
25 0 21 2 2 2 6
26 0 22 3 4 4 11
27 0 23 4 3 3 10
28 0 24 3 2 3 8
29 0 25 3 1 1 5
30 0 26 1 2 2 5
27 2 1 1 4
28 1 1
JMLH 51 46 45 142 JMLH 58 56 55 164
142 164
2,115,800 2,443,600

BULAN : SEPT BULAN : OKT
MENU MENU
JMLH JMLH
29 2 3 3 8 1 2 2
30 1 1 1 3 2 0
31 2 2 3 0
1 1 2 2 5 4 0
2 2 1 2 5 5 1 2 2 5
3 2 1 2 5 6 1 1 1 3
4 2 1 1 4 7 2 2 2 6
5 2 3 3 8 8 5 8 8 21
6 4 5 5 14 9 5 2 2 9
7 5 3 3 11 10 3 3 2 8
8 4 2 6 11 2 2 2 6
9 2 2 2 6 12 1 1 2
10 1 1 13 0
11 1 1 2 14 0
12 0 15 1 1 2
13 0 16 0
14 1 1 2 17 0
15 2 2 2 6 18 1 1 2
16 2 2 1 5 19 1 2 2 5
17 1 1 1 3 20 2 1 3
18 1 1 21 1 1
19 1 1 2 22 1 2 2 5
20 1 3 3 7 23 2 1 1 4
21 3 2 1 6 24 1 1
22 2 1 1 4 25 0
23 1 1 1 3 26 1 1
24 1 1 1 3 27 1 2 2 5
25 1 1 1 3 28 2 1 1 4
26 3 4 4 11 29 1 1
27 0 30 0
28 0 31 0
29 0 32 0
30 0 33 0
JMLH 49 45 42 136 JMLH 34 32 30 96
136 96
2,026,400 1,430,400

BULAN : JULI BULAN : AGUSTUS
MENU MENU
JMLH JMLH
29 2 1 3 29 0
30 1 1 1 3 30 0
1 1 1 2 31 0
2 1 1 1 3 1 2 1 2 5
3 1 1 2 1 1
4 0 3 0
5 0 4 1 1
6 0 5 1 1 1 3
7 0 6 1 1 1 3
8 1 1 2 7 1 1 1 3
9 1 2 2 5 8 1 3 3 7
10 2 2 2 6 9 3 2 2 7
11 2 1 3 10 2 1 1 4
12 0 11 1 1
13 0 12 0
14 0 13 1 1
15 2 2 2 6 14 1 1 1 3
16 2 3 3 8 15 1 1 1 3
17 3 2 2 7 16 1 1
18 2 2 17 0
19 1 1 1 3 18 0
20 1 1 1 3 19 1 1 1 3
21 1 1 1 3 20 1 1 1 3
22 1 1 1 3 21 2 2 2 6
23 1 1 22 2 1 1 4
24 0 23 2 3 3 8
25 1 1 1 3 24 4 4 4 12
26 2 3 3 8 25 3 2 2 7
27 3 1 1 5 26 2 2
28 2 1 1 4 27 0
29 1 1 1 3 28 0
30 1 1 29 1 1 2
31 1 2 1 4 30 1 1 1 3
JMLH 34 30 28 92 JMLH 34 28 31 93
ASLI 92 93 93

BULAN : SEPTEMBER BULAN : OKTOBER
MENU MENU
JMLH JMLH
1 3 3 3 9 29 0
2 3 3 3 9 30 0
3 2 1 1 4 31 0
4 2 1 1 4 1 0
5 1 1 1 3 2 0
6 1 1 1 3 3 0
7 1 1 1 3 4 1 1 1 3
8 1 1 5 1 1 1 3
9 0 6 1 1
10 0 7 0
11 0 8 1 1
12 0 9 1 1 1 3
13 0 10 1 1
14 0 11 1 1
15 0 12 1 2 2 5
16 0 13 3 3 3 9
17 1 1 1 3 14 3 3
18 2 1 1 4 15 0
19 1 1 1 3 16 1 1 1 3
20 1 1 17 1 1
21 1 1 18 0
22 2 2 2 6 19 0
23 5 4 4 13 20 0
24 3 2 2 7 21 0
25 3 2 2 7 22 0
26 2 2 23 0
27 0 24 1 1 2
28 0 25 1 1 1 3
29 0 26 1 1
30 0 27 1 1 1 3
31 0 28 4 3 3 10
32 0 29 2 2
33 0 30 0
JMLH 34 24 25 83 JMLH 23 15 17 55
83 55
REKAPITULASI MAKANAN PASIEN BULAN JANUARI S/D JUNI 2016
PERAWATAN UPTD KESEHATAN PUSKESMAS PASREPAN
BULAN JENIS PASIEN JUMLAH PASIEN JUMLAH MAKAN ( OH )
JANUARI ASKES 3 27
UMUM 23 140
JAMKESMAS 11 74
SUB TOTAL 37 241
PEBRUARI ASKES 2 23
UMUM 24 125
JAMKESMAS 9 73
SUB TOTAL 35 221
MARET ASKES 0 0
UMUM 27 153
JAMKESMAS 11 77
SUB TOTAL 38 230
APRIL ASKES 0 0
UMUM 30 158
JAMKESMAS 21 150
SUB TOTAL 51 308
MEI ASKES 3 16
UMUM 26 148
JAMKESMAS 10 60
SUB TOTAL 39 224
JUNI ASKES 1 15
UMUM 29 158
JAMKESMAS 12 86
SUB TOTAL 42 259
JUMLAH TOTAL 242 1483

REKAPITULASI MAKANAN PASIEN BULAN JULI S/D OKT 2016
BULAN JENIS PASIEN JUMLAH PASIEN OH BIAYA
JULI PERSALINAN
PERSALINAN 1. PAD 2 320,000
2. BPJS 1 160,000
UMUM 28 50 2,250,000
JAMKESMAS 12 31 1,395,000
SUB TOTAL 43 81 4,125,000
AGUSTUS PERSALINAN
PERSALINAN 1. PAD
2. BPJS 1 160,000
UMUM 30 55 2,475,000
JAMKESMAS 13 35 1,575,000
SUB TOTAL 44 90 4,210,000
SEPT PERSALINAN -
2. BPJS
UMUM 28 46 2,070,000
JAMKESMAS 11 32 1,440,000
SUB TOTAL 40 78 3,510,000
OKT PERSALINAN 0 0 -
PERSALINAN 1. PAD 3
2. BPJS
UMUM 19 32 4,950,000
JAMKESMAS 9 20 900,000
SUB TOTAL 31 52 5,850,000

JUMLAH TOTAL 114 211 13,485,000

JULI PERSALINAN
PERSALINAN 1. PAD 2 4 180,000
2. BPJS 1 2 90,000
UMUM 28 50 2,250,000
JAMKESMAS 12 31 1,395,000
SUB TOTAL 43 87 3,915,000
AGUSTUS PERSALINAN
PERSALINAN 1. PAD
2. BPJS 1 160,000
UMUM 30 55 2,475,000
JAMKESMAS 13 35 1,575,000
SUB TOTAL 44 90 4,210,000
SEPT PERSALINAN -
2. BPJS
UMUM 28 46 2,070,000
JAMKESMAS 11 32 1,440,000
SUB TOTAL 40 78 3,670,000
2. BPJS -
UMUM 19 32 1,440,000
SUB TOTAL 31 58 2,610,000
JUMLAH TOTAL 114 223 14,405,000

JULI PERSALINAN
2. BPJS 1 2 89,400
UMUM 28 50 2,235,000
JAMKESMAS 12 31 1,385,700
SUB TOTAL 43 87 3,888,900
AGUSTUS PERSALINAN
PERSALINAN 1. PAD
2. BPJS 1 2 89,400
UMUM 30 55 2,458,500
JAMKESMAS 13 35 1,564,500
SUB TOTAL 44 92 4,112,400
SEPT PERSALINAN -
2. BPJS -
UMUM 28 46 2,056,200
JAMKESMAS 11 32 1,430,400
SUB TOTAL 40 80 3,486,600
2. BPJS -
UMUM 19 32 1,430,400
SUB TOTAL 31 58 2,324,400
JUMLAH TOTAL 114 225 13,812,300

JUMLAH MAKAN ( OH )
HARGA SESUAI DPA
45000/HR
HARGA SESUAI HPS
44700/HR
REKAP KLAIM MAKMIN PASIEN RAWAT INAP PUSKESMAS PASREPAN
BULAN JENIS PASIEN JMLH PORSI SATUAN JUMLAH KLAIM
JULI UMUM 142 14,900 2,115,800

JKN 92 14,900 1,370,800
SUB TOTAL 3,486,600
AGUSTUS UMUM 164 14,900 2,443,600

JKN 93 14,900 1,385,700
SUB TOTAL 3,829,300
SEPT UMUM 136 14,900 2,026,400

JKN 83 14,900 1,236,700
SUB TOTAL 3,263,100
OKT UMUM 96 14,900 1,430,400

JKN 55 14,900 819,500
SUB TOTAL 2,249,900
TOTAL 861 12,828,900

REKAP SETORAN PUSKESMAS PASREPAN
BULAN KLAIM JKN UMUM TOTAL KLAIM MAKMIN SISA DANA
JULI 9,530,000 12,986,000 22,516,000 3,486,600 19,029,400
AGUSTUS 5,080,000 10,236,000 15,316,000 3,829,300 11,486,700
SEPT 4,243,000 8,436,000 12,679,000 3,263,100 9,415,900
OKTOBER 6,230,000 6,492,000 12,722,000 2,249,900 10,472,100
25,083,000 38,150,000 63,233,000 12,828,900 50,404,100

REKAP KLAIM MAKMIN PASIEN RAWAT INAP PUSKESMAS PASREPAN
BULAN JENIS PASIEN JMLH PORSI SATUAN JUMLAH KLAIM
JULI UMUM 150 15,000 2,250,000

JKN 93 15,000 1,395,000
SUB TOTAL 3,645,000
AGUSTUS UMUM 165 15,000 2,475,000

JKN 105 15,000 1,575,000
SUB TOTAL 4,050,000
SEPT UMUM 138 15,000 2,070,000

JKN 96 15,000 1,440,000
SUB TOTAL 3,510,000
OKT UMUM 96 15,000 1,440,000

JKN 60 15,000 900,000
SUB TOTAL 2,340,000
TOTAL 903 13,545,000

Makmin Pasien PKM 2020,1

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REKAPITULASI MAKANAN DAN MINUMAN PASIEN RAWAT INAP

UPTD KESEHATAN PUSKESMAS …………………….

Rekening : Belanja Makanan dan Minuman Pasien

PASIEN MASUK PASIEN KELUAR MAKAN MAKAN MAKAN

1 dari 108_Makmin Pasien_2013

2 dari 108_Makmin Pasien_2013

39 Hari 219 7,500 3,285,000

Mengetahui Pasuruan, Desember 2013

3 dari 108_Makmin Pasien_2013

3 Makan sore 17.00

4 dari 108_Makmin Pasien_2013

Rekening : Belanja Makanan dan Minuman Pasien ASKES

PASIEN MASUK PASIEN KELUAR

1 SUYADI 52 Th POHGEDANG 06/01/2016 09.30 08/01/2016 17.30 8 14,900 119,200

Mengetahui Pasuruan, 23 JanuarI 2016

dr. H.R. GATOT TRISILA ALIMIN T, S.Kep.Ns

KETERANGAN MAKMIN PASIEN

Rekening : Belanja Makanan dan Minuman Pasien ASKES

PASIEN MASUK PASIEN KELUAR JUMLAH HARGA/

1 JOYO 35 Th TEMPURAN 04/02/2016 15.00 08/02/2016 O8.45 13 14,900 193,700

Mengetahui Pasuruan, 10 Pebruari 2016

dr. H.R. GATOT TRISILA ALIMIN T, S.Kep.Ns

KETERANGAN MAKMIN PASIEN

Rekening : Belanja Makanan dan Minuman Pasien ASKES

PASIEN MASUK PASIEN KELUAR

1 AMINAH 41 Th POHGEDANG 17/05/2016 03.15 18/05/2016 09.00 4 14,900 59,600

Mengetahui Pasuruan, 30 Mei 2016

dr. H.R. GATOT TRISILA ALIMIN T, S.Kep.Ns

KETERANGAN MAKMIN PASIEN

Rekening : Belanja Makanan dan Minuman Pasien ASKES

PASIEN MASUK PASIEN KELUAR JUMLAH HARGA/

1 HASMAWATI 34 Th NGANTUNGAN 01/06/2016 09.30 06/06/2016 09.00 15 14,900 223,500

Mengetahui Pasuruan, 6 Juni 2016

dr. H.R. GATOT TRISILA ALIMIN T, S.Kep.Ns

KETERANGAN MAKMIN PASIEN

Rekening : Belanja Makanan dan Minuman Pasien ASKES

PASIEN MASUK PASIEN KELUAR JUMLAH HARGA/

1 MUNAWAROH 35 Th WONOSARI 9/11/2015 13.00 9/12/2015 12.00 3 15,000 45,000

Mengetahui Pasuruan, 12 September 2015

dr. H.R. GATOT TRISILA ALIMIN T, S.Kep.Ns

KETERANGAN MAKMIN PASIEN

Rekening : Belanja Makanan dan Minuman Pasien Jamkesmas

PASIEN MASUK PASIEN KELUAR

1 NY. PURWATI 65 Th POHGEDANG 27/02/2020 18.00 28/02/2020 15.00 2 15,000

Mengetahui Pasuruan, 28 Pebruari 2020

dr. H.R. GATOT TRISILA IDA SULISTIYOWATI, S.Kep.Ns

KETERANGAN MAKMIN PASIEN

REKAPITULASI MAKANAN DAN MINUMAN PASIEN RAWAT INAP

Rekening : Belanja Makanan dan Minuman Pasien Jamkesmas

PASIEN MASUK PASIEN KELUAR JUMLAH HARGA/

Mengetahui Pasuruan, 31 MARET 2020

dr. H.R. GATOT TRISILA WAHYU TIN SUDIRMAN, Amd.Kep

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Rekening : Belanja Makanan dan Minuman Pasien Jamkesmas

PASIEN MASUK PASIEN KELUAR JUMLAH HARGA/

Mengetahui Pasuruan, 30 APRIL 2020

dr. H.R. GATOT TRISILA WAHYU TIN SUDIRMAN, Amd.Kep

REKAPITULASI MAKANAN DAN MINUMAN PASIEN RAWAT INAP

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PASIEN MASUK PASIEN KELUAR JUMLAH HARGA/

Mengetahui Pasuruan,31 Maret 2019

dr. H.R. GATOT TRISILA IDA SULISTIYOWATI, S.Kep.Ns

KETERANGAN MAKMIN PASIEN

REKAPITULASI MAKANAN DAN MINUMAN PASIEN RAWAT INAP