Format Excel Puskesmas Wonosari

DATA TENAGA
KODE FASKES
NO (SESUAI SI SDMK) KODE PROVINSI PROVINSI KODE KAB/KOTA KAB/KOTA
1 P3511070102 35 Jawa Timur 3511 Bondowoso

54 P3511070102 35 Jawa Timur 3511
Bondowoso
DATA TENAGA NON ASN 2022
KEPEMILIKAN FASKES
TIPE FASKES (RS, PUSKESMAS,
NAMA FASKES DINKES, LABKES) (PEMKAB/PEMKOT/PEMP
ROV)
puskesmas Wonosari Puskesmas PEMKAB

TMT PENUGASAN
(TANGGAL/BULAN/TAHUN) NIK
MENGGUNAKAN FORMAT NAMA LENGKAP (16 ANGKA)
(01/09/1999)
3/1/2010 Siti Rahmi Lestari,S.Kep.Ns 3511104110820003
3/1/2010 Fieka Aulia,S.Kep.Ns 3511096009630001
3/1/2010 Nanik Istyowati,A.Md.Kep 3511094606830004
3/1/2010 Hermanto Adi Prayogo,A.Md.Kep 3511092803830001
3/1/2010 Ariza Febriyanti,S.Kep.Ns 3511075202850003
3/1/2010 Ning Ayu Hotijah,S.Kep.Ns 3511096511860002
3/1/2010 Nanik Handayani,S.Kep.Ns 3511096710800002
3/1/2010 Agustina Dwi Rahayu,S.Kep.Ns 3511094408860004
6/1/2011 Muzaeyanatul Azizah,A.Md.Kep 3511094108860001
01/09/2014 Nurriski Dwi Lestari,A.Md.Keb 3511086303900001
12/03/2019 Ayu Narulita Dwi Pepriasti,SST. 3511084504910001
2/4/2020 Yunita Sislindya Maya,SE 3528084706860002
14/05/2012 Chitra Wilda Husada,S.S.T. 3511114512890001
12/1/2021 Emi Sucianti, A.Md.Keb 1803065210890001
1/3/2022 Rini Jasrianti,S.Tr.Gz 3511084901960003
1/3/2022 Shafiyah Nur Laily, SKM 3511116003940001
01/03/2011 Beny Septriono,S.Kep.Ns 3511021409840007
01/03/2011 Romelia Aprilianti,A.Md.Kep 3511105204890001
01/01/2012 Adi Purwanto,A.Md.Kep 3511181805880001
01/01/2013 Mohammad Ades Romantika,A.Md.Kep 3511091012870004
01/09/2013 Sulistioning Wartika,S.Kep.Ns 3511086807870002
01/03/2014 Mochammad Alim Effendi,S.Kep.Ns 3511090805890001
03 /01/2017 Yoga Ari Pranata,S.Kep.Ns 3511220906920002
01/01/2011 Muhammad Jamik 3511091507750001
01/01/2012 Ifa Kusmiyati 3511095412920003
02/01/2016 Nanang Supriyadi 3511102203870001
02/01/2019 Octavianto Nuhadiyanzah 3511092710920003
01/03/2013 Halimatus Sakdiyah,A.Md.Keb 3511095603900001
01/02/2016 Irfiana Rahmasari,A.Md.Keb 3511086810910002
01/10/2012 Rishanty Dian Permata,A.Md.Keb 3509097110900001
01/01/2014 Tutik Nurzayyanah,A.Md.Keb 3511115612910001
01/03/2012 Khusnul Khotimah,A.Md.Keb 3511096112890001
3/1/2014 Nanin Dwi Novitasari,A.Md.Keb 3511137011880002
01/01/2014 Ayu Wulandari,A.Md.Keb 3509217510790002
01/03/2014 Wafi Azizatul KS,A.Md.Keb 3511145506930001
07/03/2016 Fendi Amzah 3511091806870001
01/04/2017 Hildatul Munawaroh 3511096502980001
01/06/2019 Susi Lowati,A.Md.Keb 3511185205930002
03/01/2017 Mulya Hartantina,A.Md.Keb 3511114510900003
03/01/2017 Lely Zamzam Firdausy,A.Md.Keb 3508104609940005
03/01/2017 Reliz Putri Cahyati,A.Md.Keb 3511094708940001
01/11/2017 Duwi Fajar Yanti,A.Md.Keb 3511108630494001
01/11/2016 Ika Permata Indah,A.Md.Kep 3511096609930001
01/01/2020 Shohibul Anas 3511091211000002
04/01/2021 Fitriyaningsih,A.Md.Keb 3511185505890001
04/01/2021 Sofiatul Munauwaroh 3511055407920002
04/01/2021 Rini Agustin 3511095108890002
01/02/2021 Indah Kurniatus Nofia,S.Kep.Ns 3511096011940001
04/01/2021 Widyo Indra Subakti 3511100601940001
05/01/2021 Dery Nurrahman Alfianto 3511111512970001
04/01/2021 Dicki Ardiansyah 3511100302030001
04/01/2021 Indra Kurniawan 3511100104020002
1/3/2022 Chandra Amar Imam Malik,S.Kep.Ns 3511111808970002
1/3/2022 3511094505980001
Sinta Kholifah Mar'ah Konitatillah,S.Kep.Ns
TANGGAL LAHIR
(TANGGAL/BULAN/TAHUN) JENIS KELAMIN
TEMPAT LAHIR MENGGUNAKAN FORMAT (L/P)
(01/09/1999)
Bondowoso 1/10/1982 P
Jember 9/20/1983 P
Sidoarjo 6/6/1983 P
Banyuwangi 3/28/1983 L
Jember 10/27/1980 P
Kediri 8/4/1986 P
Pamekasan 6/7/1986 P
Ogan Lima/Lampung 10/12/1989 P
Bondowoso 9/14/1984 L
Jember 4/14/1993 P
Jember 10/31/1990 P
Banyuwangi 12/21/1989 P
Jember 7/11/1990 P
Bima '06/9/1994 P
STATUS KEPEGAWAIAN (KONTRAK DAERAH, KONTRAK
BLUD, KONTRAK BLU, PTT DAERAH, SUKARELA, BOK)
KONTRAK DAERAH
KONTRAK DAERAH
KONTRAK DAERAH
KONTRAK DAERAH
KONTRAK DAERAH
KONTRAK DAERAH
KONTRAK DAERAH
KONTRAK DAERAH
KONTRAK DAERAH
KONTRAK DAERAH
KONTRAK DAERAH
BOK
KONTRAK DAERAH
NUSANTARA SEHAT
BOK
BOK
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
SUKARELA
PENDIDIKAN TERAKHIR BIDANG KELOMPOK TENAGA KESEHATAN (JENIS
KESEHATAN (D III, DIV, S1, S2) JAFUNG/JENIS SDMK)
S1 Ners
S1 Ners
D III Perawat (Non Ners)
S1 Ners
S1 Ners
S1 Ners
S1 Ners
D III Bidan Desa
D III Bidan Desa
S1
D IV Bidan Desa
D III Bidan Klinis
D III Nutrisionis
S1 Sanitasi Lingkungan
S1 Ners
S1 Ners
S1 Ners
S1 Ners
Tenaga Lainnya yg belum tercantum
Pengelola Data
D III Bidan Klinis
D III Bidan Desa
D III Bidan Desa
D III Bidan Klinis
D III Bidan Klinis
D IV Bidan Desa
Bidan Desa
D III Bidan Desa
Juru Mudi
Pengelola Data
D III Bidan Desa
D III Bidan Desa
D III Bidan Desa
D III Bidan Klinis
D III Bidan Klinis
D III Bidan Desa
Pengelola Data
S1 Ners
D III Perekam Medis
S1 Ners
S1 Ners
KONVERSI JABFUNG
RUMPUN SUB RUMPUN (AHLI PERTAMA / TERAMPIL)
Keparawatan Perawat Ahli Pertama

Keparawatan Perawat Terampil
Kebidanan Bidan Terampil
Dukungan Manajemen Keuangan
Gizi Nutrisionis Terampil
Kesehatan Lingkungan Sanitasi Lingkungan Ahli Pertama
Dukungan Manajemen Umum
Dukungan Manajemen Tekhnologi Informasi
Keperawatan Perawat Ahli Pertama
Ketekhnisian Medis Perekam Medis Terampil
NO STR KOMPETENSI
160172221-4048623 Ners
160172221-4021863 Ners
160152220-3260931 Ahli Madya Keperawatan
160172222-4150693 Ners
160172117-1350274 Ners
160152220-3295776 Ners
160172117-1440354 Ners
160252222-4217199 Ahli Madya Kebidanan

160962121-3531589 Ahli Madya Gizi
160171220-3346018 Ners
160152220 3186921 Ahli Madya Keperawatan
160172220-3291463 Ners
P2T/2347/03.02/02/V/2019 Ners
160171118-1560351 Ners

160252221- 3398678 Ahli Madya Kebidanan
P2T/5028/03.03/01/VIII/2017 Ahli Madya Kebidanan

160252218 2298320 Ahli Madya Kebidanan
160172119-3122513 Ners
161051121-3538907 Ahli Madya Perekam Medis
160171121-3447470 Ners
160172121-4041301
Ners
NO SIP NO IJAZAH
503.446/ 139 /SIK.Pr/ 430.9.13/ 2017 279/03/STIKES_NJ/2017

503.446/1370/SIPP/24/430.9.13/2022 0051/UNUJA-004/Fkes.3/Profesi/2020
503.446/677/SIPP/24/430.9.13/2020 039/2006
503.446/692/SIPP/24/430.9.13/2020 021/2006
503.446/1399/SIPP/24/430.9.13/2022 241/03/STIKES_NJ/2017
03.446/136/SIK.Pr/430.9.13/2017 270/03/STIKES_NJ/2017
503.446/816/SIPP/24/430.9.13 / 2020 005/UNUJA-004/FKes.3/Profesi/2020
503.446/ 817 /SIPP/24/ 430.9.13/ 2020 01/FIKES.Ns/1.IV/2016
503.446/823/SIPP/24/430.9.13/2020 00187/Dkep
503.446/897/SIPB/21/430.9.13/2022 102/KEB/WGH/VII/11
503.446/260/SIPB/21/430.09.13/2019 191/2013
00210/ AKT.1
503.446/685/SIPB/21/430.9.13/2021 2013/04.068/S.S.T./4
503.446/852/SIPB/21/430.9.13/2022 211,503,028,022,010
133112019001269
1743/KM/S1/2020
503.446/985/SIPP/24/430.9.13/2021 K.224/Kep/VIII/2008
503.446/580/SIPP/24/430.9.13/2020 031/073-141/1.5/A.Md.Kep/2010
503.446/877/SIPP/24/430.9.13/2020 27/FIKES.02/3.VIII/2011
503.446/1183/SIPP/24/430.9.13/2021 00307/D.Kep
503.446/814/SIPP/24/430.9.13/2020 026/144/04/Ns/2011
503.446/866/SIPP/24/430.9.13/2020 071.078/S1.Kep/11.0014.127
503.446/00116/SIK.Pr/446/5/430.9.13/2018 063/STIKES-BS/NS/IX/2016
DN-PC 0125531
MA 130028672
DN.05 Ma 0205711
DN.05 Ma 0058585
503.446/00110/SIPB/21/430.9.13/2018 0588/073146/01/A.Md.Keb/2012
503.446/679/SIPB/21/430.9.13/2021 447/074074/10/2014
503.446/001.28/SIPB/21/430.9.13/2018 2008 0740940044
503.446/711/SIPB/21/430.9.13/2021 710741150113
503.446/211/SIPB/21/430.9.13/2019 '2007 074094 0057
503.446/217/SIPB/21/430.9.13/2019 '071.078/d3.Keb/10.0033
503.446/00218/SIPB/21/430.9.13/2019 0579/073146/01/A,Md Keb/2012
503.446/730/SIPB/21/430.9.13/2021 071.078/D3.Keb/11.0104.261
MA 1410484
DN-05 Ma 0062977
503.446/SIPB/21/430.9.13/222 '2015/06061/6
503.446/00435/SIPB/21/430.9.13/2018 2009 074094 079
503.446/680/SIPB/21/430.9.13/2021 583/074074/7/2015
503.446/737/SIPB/21/430.9.13/2021 405017003606
503.446/215/SIPB/21/430.9.13/2019 154012016017
503.446/1257/SIPP/24/430.9.13/2021 00530
M-SMK/13-3/0550434
503.446/681/SIPB/21/430.9.13/2021 2008 074094 0009
DN-05Mk 0131782
DN-PC0125565
503.446/986/SIPP/24/430.9.13/2021 13/FIKES.Ns/2.XII/2008
DN-05 Ma 0053661
134622019001031
M-SMK/K13-3/0857343
M-SMK/K13-3/0857378
503.446/1432/SIPP/24/430.9.13/2022 IV.a/2020021/SK.KS.BAAK.Ners/VIII/2020
503.446/1433/SIPP/24/430.9.13/2022 799/IK/Ns/2021

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DATA TENAGA

1 P3511070102 35 Jawa Timur 3511 Bondowoso

puskesmas Wonosari Puskesmas PEMKAB

Keparawatan Perawat Ahli Pertama

160262119-1601894 Ahli Madya Kebidanan

160252217-2144447 Ahli Madya Kebidanan

160252121-3444874 Ahli Madya Kebidanan

160252119-3151881 Ahli Madya Kebidanan

161051121-3538907 Ahli Madya Perekam Medis

503.446/ 139 /SIK.Pr/ 430.9.13/ 2017 279/03/STIKES_NJ/2017

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