SKP Bulanan RSJ Maret 2022

PENGISIAN DATA
PERHITUNGAN TAMBAHAN PENGHASILAN ASN
1. DATA PEGAWAI
Catatan : Hanya Mengganti Nama Pegawai
NAMA PEGAWAI : MARTALINDA
NIP : 19790308 200701 2 004
PANGKAT / GOLONGAN : Pengatur Tk.I (II/d)
JABATAN : Pengadministrasi Kepegawaian
KELAS JABATAN : 5
UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan Pada Dinas Kesehatan
UNIT KERJA :
Provinsi Riau
ATASAN LANGSUNG : ALBER EKO SUYITNO, ST
NIP : 19821026 201001 1 019
PANGKAT / GOLONGAN : Penata (III/c)
JABATAN : Kepala Subbagian Umum dan Kepegawaian
UNIT KERJA :
Provinsi Riau
2. BULAN PENILAIAN
Catatan : Hanya Mengganti Bulan Penilaian saja
BULAN PENILAIAN : Maret
JENIS HARI KERJA : 5 Hari Kerja
MASA PENILAIAN : 01 Maret s.d 31 Maret 2022
JUMLAH HARI KALENDER : 31
JUMLAH HARI KERJA : 22
3. PEJABAT KEPEGAWAIAN PERANGKAT DAERAH

Catatan : Isi sesuai dengan Pejabat yang ada pada Perangkat Daerah ybs
NAMA : ALBER EKO SUYITNO, ST
NIP : 19821026 201001 1 019
PANGKAT/GOLONGAN : Penata (III/c)
JABATAN : Kepala Subbagian Kepegawaian dan Umum
* Langkah-langkah Pengisian :
- Memilih Nama Pegawai
- Memilih Bulan Penilaian
- Mengisi Data Pejabat Kepegawaian Perangkat Daerah
- Cetak dengan Kertas Folio (8.5x13)
OUTPUT SKP BULANAN KEPALA BKD TAHUN 2022
No Rencana Kinerja Uraian Tugas (Rencana Aksi) Indikator Target Satuan Januari Februari Maret April Mei Juni Juli Agustus Sept Okt
Terlaksananya pendistribusian surat masuk dan keluar di Menerima dan mengarsipkan Surat masuk dan keluar di Jumlah Pendistribusian Surat masuk dan keluar di bagian 12 Dokumen 12 12 12 12 12 12 12 12 12 12
1 bagian Humas bagian Humas Humas
Terlaksananya Pengarsipan surat masuk dan keluar di bagian Mengarsipkan surat masuk dan surat keluar bagian Humas 12 Dokumen 12 12 12 12 12 12 12 12 12 12
2 Humas
Jumlah Surat Masuk dan Keluar
Terlaksananya Pengetikan Surat Keluar Pimpinan di bagian 'Mambantuk mengetik draf (konsep) surat keluar pimpinan 12 Surat 1 1 1 1 1 1 1 1 1 1
3 Humas di bagian Humas
Jumlah Surat yang akan di ketik dibagian Humas
Terlaksananya Laporan tagihan listrik, telpon, internet, pajak, kir Merekap dan mengarsipkn tagihan listrik,Telpon, Internet, 12 Laporan 5 5 5 5 5 5 5 5 5 5
4 Pajak, Kir
Jumlah rekap tagihan
Terlaksanaya kegiatan makan dan minum Merekap dan mengarsipkan Tagihan Makan dan Minum 12 Laporan 6 6 6 6 6 6 6 6 6 6
5 Jumlah Kegiatan
Terlaksananya Laporan pelaksanaan Tugas di Bagian Humas Membantu membuat laporan hasil pelaksanaan tugas di 12 Laporan 6 6 6 6 6 6 6 6 6 6
6 bagian Humas
Jumlah Laporan
Jumlah Perbulan 42 42 42 42 42 42 42 42 42 42
Nov Des
12 6
12 8
1 1
5 5
6 6
6 6
42 32
SASARAN KINERJA PEGAWAI (SKP)
JABATAN PELAKSANA
PENDOKUMENTASIAN KINERJA
Periode Penilaian
UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan Pada Dinas Kesehatan Provinsi Riau 01 Maret s.d 31 Maret 2022
No PEGAWAI YANG DINILAI No PEJABAT PENILAI KINERJA
1 Nama MARTALINDA 1 Nama ALBER EKO SUYITNO, ST
2 NIP 19790308 200701 2 004 2 NIP 19821026 201001 1 019
3 Pangkat/ Gol Ruang Pengatur Tk.I (II/d) 3 Pangkat/ Gol Ruang Penata (III/c)
4 Jabatan Pengadministrasi Kepegawaian 4 Jabatan Kepala Subbagian Umum dan Kepegawaian
5 Unit Kerja UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan Pada Dinas Kesehatan Provinsi Riau 5 Unit Kerja UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan Pada Dinas Kesehatan Provinsi Riau
HASIL KERJA
UMPAN BALIK BERKELANJUTAN
NO RENCANA HASIL KERJA RENCANA AKSI INDIKATOR KINERJA INDIVIDU TARGET REALISASI DAN BUKTI DUKUNG
BERDASARKAN BUKTI DUKUNG
A. UTAMA
1 Terlaksananya pendistribusian surat masuk dan Menerima dan mengarsipkan Surat masuk Jumlah Pendistribusian Surat masuk dan Laporan Berdasarkan hasil analisis laporan Pimpinan : Laporan telah diterima,
keluar di bagian Humas dan keluar di bagian Humas keluar di bagian Humas 12 kinerja bulanan terimakasih
2 Terlaksananya Pengarsipan surat masuk dan Mengarsipkan surat masuk dan surat keluar Jumlah rekap tagihan Laporan Berdasarkan hasil analisis laporan Pimpinan : Laporan telah diterima,
keluar di bagian Humas bagian Humas 12 kinerja bulanan terimakasih
3 Terlaksananya Pengetikan Surat Keluar Pimpinan 'Mambantuk mengetik draf (konsep) surat Jumlah Surat yang akan di ketik dibagian Laporan Berdasarkan hasil analisis laporan Pimpinan : Laporan telah diterima,
di bagian Humas keluar pimpinan di bagian Humas Humas 1 kinerja bulanan terimakasih
4 Terlaksananya Laporan tagihan listrik, telpon, Merekap dan mengarsipkn tagihan Jumlah rekap tagihan Laporan Berdasarkan hasil analisis laporan Pimpinan : Laporan telah diterima,
internet, pajak, kir listrik,Telpon, Internet, Pajak, Kir 5 kinerja bulanan terimakasih
5 Terlaksanaya kegiatan makan dan minum Merekap dan mengarsipkan Tagihan Makan Jumlah Kegiatan Laporan Berdasarkan hasil analisis laporan Pimpinan : Laporan telah diterima,
dan Minum 6 kinerja bulanan terimakasih
6 Terlaksananya Laporan pelaksanaan Tugas di Membantu membuat laporan hasil Jumlah Laporan Laporan Berdasarkan hasil analisis laporan Pimpinan : Laporan telah diterima,
Bagian Humas pelaksanaan tugas di bagian Humas 6 kinerja bulanan terimakasih
B. TAMBAHAN
RATING HASIL KERJA*
SANGAT BAIK/ BAIK/ BUTUH PERBAIKAN/ KURANG(MISCONDUCT)/ SANGAT KURANG
PERILAKU KERJA UMPAN BALIK BERKELANJUTAN BERDASARKAN BUKTI DUKUNG
1 Berorientasi pelayanan
- Memahami dan memenuhi kebutuhan masyarakat Ekspektasi Khusus Pimpinan: baik
- Ramah, cekatan, solutif, dan dapat diandalkan Pelayanan yang bermutu untuk kedepannya
- Melakukan perbaikan tiada henti
2 Akuntabel
- Melaksanakan tugas dengan jujur bertanggung jawab cermat disiplin dan berintegritas tinggi Ekspektasi Khusus Pimpinan: baik
- Menggunakan kekayaan dan BMN secara bertanggung jawab efektif dan efisien Menjadi role model/ panutan dalam menjunjung komitmen dan integritas
pegawai di lingkungan kerjanya
- Tidak menyalahgunakan kewenangan jabatan
3 Kompeten
- Meningkatkan kompetensi diri untuk menjawab tantangan yang selalu berubah Ekspektasi Khusus Pimpinan: baik
- Membantu orang lain belajar dan efisien Menyelesaikan setiap pekerjaan sesuai dengan target dan standar kualitas
yang ditetapkan
- Melaksanakan tugas dengan kualitas terbaik
4 Harmonis
- Menghargai setiap orang apapun latar belakangnya Ekspektasi Khusus Pimpinan: baik
- Suka menolong orang lain Membangun komunikasi yang lebih terbuka dan menjaga hubungan baik
dengan stakeholder
- Membangun lingkungan kerja yang kondusif
5 Loyal
- Memegang teguh ideologi Pancasila, Undang-Undang Dasar Negara Republik Indonesia Ekspektasi Khusus Pimpinan: baik
Tahun 1945, setia pada NKRI serta pemerintahan yang sah Berani menyampaikan adanya indikasi/ hal-hal yang dapat merugikan dan
membahayakan negara
- Menjaga nama baik sesama ASN, Pimpinan, Instansi, dan Negara
- Menjaga rahasia jabatan dan negara
6 Adaptif
- Cepat menyesuaikan diri menghadapi perubahan Ekspektasi Khusus Pimpinan: baik
- Terus berinovasi dan mengembangkan kreativitas Mudah bergaul dengan kerabat kerja
- Bertindak proaktif
7 Kolaboratif
- Memberi kesempatan kepada berbagai pihak untuk berkontribusi Ekspektasi Khusus Pimpinan: baik
- Terbuka dalam bekerja sama untuk menghasilkan nilai tambah Mampu mengelola dan melibatkan seluruh pihak sesuai dengan peran dan
fungsinya untuk mencapai tujuan bersama
- Menggerakkan pemanfaatan berbagai sumberdaya untuk tujuan bersama
RATING PERILAKU KERJA*
DIATAS EKSPEKTASI/ SESUAI EKSPEKTASI/ DIBAWAH EKSPEKTASI**
PREDIKAT KINERJA PEGAWAI*
SANGAT BAIK/ BAIK/ BUTUH PERBAIKAN/ KURANG(MISCONDUCT)/ SANGAT KURANG
Pekanbaru, 31 Maret 2022

Pegawai Yang Dinilai,,
MARTALINDA
NIP. 19790308 200701 2 004
Keterangan :
* pilih salah satu
*** diisi dengan umpan balik sesuai dengan permasalahan atau apresiasi kepada pegawai atas realisasi hasil kerja atau perilaku kerja, umpan balik dapat berupa
narasi, simbol, atau keterangan lainnya dan disertai dengan bukti dukung yang relevan.
DOKUMEN EVALUASI KINERJA PEGAWAI
Periode Penilaian :
UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan Pada Dinas Kesehatan Provinsi 01 Maret s.d 31 Maret 2022
1 PEGAWAI YANG DINILAI
Nama : MARTALINDA
NIP : 19790308 200701 2 004
Pangkat/Gol Ruang : Pengatur Tk.I (II/d)
Jabatan : Pengadministrasi Kepegawaian

Unit Kerja :
Provinsi Riau
2 PEJABAT PENILAI KINERJA
Nama : ALBER EKO SUYITNO, ST
NIP : 19821026 201001 1 019
Pangkat/Gol Ruang : Penata (III/c)
Jabatan : Kepala Subbagian Umum dan Kepegawaian

Unit Kerja :
Provinsi Riau
3 ATASAN PEJABAT PENILAI KINERJA
Nama : IKHSAN ADITYA, ST.M.Si
NIP : 19830415 201001 1 012
Pangkat/Gol Ruang : Penata Tk.I
Jabatan : Kepala Bagian Tata Usaha

Unit Kerja :
Provinsi Riau
4 EVALUASI KINERJA
Predikat Kinerja Pegawai : Baik
5 CATATAN/REKOMENDASI

Pegawai Yang Dinilai, Pejabat Penilai Kinerja,
MARTALINDA ALBER EKO SUYITNO, ST
NIP. 19790308 200701 2 004 NIP. 19821026 201001 1 019
DAFTAR REKAPITULASI KEHADIRAN
PT. BERSIFAT KHUSUS RUMAH SAKIT JIWA TAMPAN PADA DINAS KESEHATAN PROVINSI RIAU PROVINSI RIAU
Nama : MARTALINDA Bulan : Maret 2022
NIP : 19790308 200701 2 004 Jenis Hari Kerja : 5 Hari Kerja
Pangkat / Gol : Pengatur Tk.I (II/d) Jumlah Hari Kalender : 31 Hari
Jabatan : Pengadministrasi Kepegawaian Jumlah Hari Kerja : 22 Hari
I. DAFTAR KEHADIRAN PEGAWAI

NO HARI / TANGGAL APEL MASUK KERJA PULANG KERJA KETERANGAN
1 2 3 4 5 6
1 Selasa / 01-03-2022
2 Rabu / 02-03-2022 H
3 Kamis / 03-03-2022 H SW SW Hari Suci Nyepi Tahun Baru Saka 1944
4 Jumat / 04-03-2022 H SW SW
5 Sabtu / 05-03-2022
6 Minggu / 06-03-2022
7 Senin / 07-03-2022 H SW SW
8 Selasa / 08-03-2022
9 Rabu / 09-03-2022
10 Kamis / 10-03-2022 H SW SW
11 Jumat / 11-03-2022 H SW SW
12 Sabtu / 12-03-2022 H SW SW
13 Minggu / 13-03-2022 H SW SW
14 Senin / 14-03-2022 H SW SW
15 Selasa / 15-03-2022
16 Rabu / 16-03-2022
17 Kamis / 17-03-2022 H SW SW
18 Jumat / 18-03-2022 H SW SW
19 Sabtu / 19-03-2022 H SW SW
20 Minggu / 20-03-2022 H SW SW
21 Senin / 21-03-2022 H SW SW
22 Selasa / 22-03-2022
23 Rabu / 23-03-2022
24 Kamis / 24-03-2022 H SW SW
25 Jumat / 25-03-2022 H SW SW
26 Sabtu / 26-03-2022 H SW SW
27 Minggu / 27-03-2022 H SW SW
28 Senin / 28-03-2022 H SW SW
29 Selasa / 29-03-2022 SW
30 Rabu / 30-03-2022
31 Kamis / 31-03-2022
H / SW 19 0 18 0 19 0
DL 0 0 0 0 0 0
DD 0 0 0 0 0 0
C 0 0 0 0 0 0
TH / TL1 1 / PSW 1 0 0 0 0 0 0
TL 2 / PSW 2 0 0 0 0
TL 3 / PSW 3 0 0 0 0
TL 4 / PSW 4 0 0 0 0
Jumlah Pengurangan 0 0 0
II. KETERANGAN BOBOT PENGURANGAN

Apel Masuk Kantor Pulang Kantor
H 0.00 Mengikuti Apel SW 0.00 Sesuai Waktu SW 0.00 Sesuai Waktu
DL 0.00 Dinas Luar DL 0.00 Dinas Luar DL 0.00 Dinas Luar
DD 0.00 Dinas Dalam DD 0.00 Dinas Dalam DD 0.00 Dinas Dalam
C 0.00 Cuti C 0.00 Cuti C 0.00 Cuti
TH 2.00 Tidak Mengikuti Apel TL 1 0.50 Terlambat 1 sd <31 Menit PSW 1 0.50 Kecepatan 1 sd < 31 Menit
TL 2 1.00 Terlambat 31 sd < 61 Menit PSW 2 1.00 Kecepatan 31 sd < 61 Menit
TL 3 1.25 Terlambat 61 sd < 91 Menit PSW 3 1.25 Kecepatan 61 sd < 91 Menit
TL 4 1.50 Terlambat > 91 Menit atau tidak PSW 4 1.50 Kecepatan > 31 Menit atau tidak
mengisi daftar hadir mengisi daftar hadir
Menyetujui Pekanbaru, 31 Maret 2022

Atasan Langsung, Kepala Subbagian Kepegawaian dan
Umum,
ALBER EKO SUYITNO, ST ALBER EKO SUYITNO, ST

Penata (III/c) Penata (III/c)
NIP. 19821026 201001 1 019 NIP. 19821026 201001 1 019
HASIL PERHITUNGAN
TAMBAHAN PENGHASILAN PEGAWAI
Bulan Penialain : Maret Kelas Jabatan : 5 CPNS
Jangka Waktu : 01 Maret s.d 31 Maret 2022 Status Pegawai : PNS CPNS ###
Jumlah Hari Kalender : 31 Hari
Jumlah Hari Kerja : 22 Hari
PEJABAT PENILAI PNS YANG DINILAI
Nama : ALBER EKO SUYITNO, ST Nama : MARTALINDA
NIP : 19821026 201001 1 019 NIP : 19790308 200701 2 004
Pangkat/Gol : Penata (III/c) Pangkat/Gol : Pengatur Tk.I (II/d)
Jabatan : Kepala Subbagian Umum dan Kepegawaian Jabatan : Pengadministrasi Kepegawaian
Unit Kerja : UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan Pada Dinas Unit Kerja : UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan Pada Dinas
Kesehatan Provinsi Riau Kesehatan Provinsi Riau
-
NO KRITERIA DAN INDIKATOR BOBOT PENGURANGAN % CAPAIAN BOBOT HASIL
I. CAPAIAN PENILAIAN TPP
1 Apel 40.00 0.00 100.00 40.00
2 Masuk Kantor 30.00 0.00 100.00 30.00
3 Pulang Kantor 30.00 0.00 100.00 30.00
TOTAL CAPAIAN PENILAIAN TPP 100.00
PERHITUNGAN TAMBAHAN PENGHASILAN ASN
Kategori TPP Bruto PPh Netto
Beban Kerja Rp1,340,192 Rp0 Rp1,340,192
Prestasi Kerja Rp0 Rp0 Rp0
Kondisi Kerja Rp2,680,383 Rp0 Rp2,680,383
Kelangkaan Profesi Rp0 Rp0 Rp0
Total Bruto Penerimaan Rp4,020,575 Rp0 Rp4,020,575

Pejabat Penilai/ Atasan Langsung
ALBER EKO SUYITNO, ST

Penata (III/c)
NIP. 19821026 201001 1 019
NO NAMA NIP GOL PANGKAT
1 dr. ELITA SARI 19721017 200801 2 010 IV/a Pembina
2 R. INDRA SUHEIRI, SE 19641026 199403 1 002 IV/a Pembina
3 Ns. SYAPARUDDIN DAUD,S.Kep,MM 19650605 198602 1 003 IV/a Pembina
4 FAHRIZAL, SE.M.Si 19720430 199403 1 002 IV/b Pembina Tk.I
5 IKHSAN ADITYA, ST.M.Si 19830415 201001 1 012 III/d Penata Tk.I
6 Ns. Z A I B A H, S.Kep. MM 19700401 199803 2 003 IV/a Pembina
7 drg. JENITA ARUMA, MM 19810103 201405 2 001 III/d Penata Tk.I
8 HAWARI DINAL S.Sos.M.si 19700211 199703 1 005 IV/a Pembina
9 ALBER EKO SUYITNO, ST 19821026 201001 1 019 III/c Penata
10 MAYA YOSANOVA, S.Si, APT 19761102 200604 2 016 IV/a Pembina
11 Drs. AKMAL 19640312 199503 1 002 III/d Penata Tk.I
12 Ns. LOLLY BILMONEVA, S.Kep.M.Kes 19710612 199703 2 005 IV/a Pembina
13 Dra. MERIANA 19640721 199503 2 002 III/d Penata Tk.I
14 drg. NOVA ANGGARAINI MARZUKI 19801122 201001 2 019 IV/a Pembina
15 dr. NUR ASYIDA 19800922 201102 2 001 III/d Penata Tk.I
16 HERI SUSANDI, SE.MM 19780606 200801 1 021 III/c Penata
17 SANGAP DANIEL, T.SKM.M.Kes 19740130 199803 1 004 IV/a Pembina
18 Dra. LISYA ELVIRA SALAMI, M.Pd 19661026 199703 2 002 IV/a Pembina
19 MUHAMMAD SALEH, LC.MA 19760115 200901 1 006 IV/a Pembina
20 S KADRIYANSYAH, S.Si 19860417 201102 1 002 III/c Penata
21 dr. WINDY ARIYANTI 19770525 200501 2 010 IV/c Pembina Utama Muda
22 drg. DWI RAHMAWATI WAHYU NINGSIH 19640918 198912 2 001 IV/c Pembina Utama Muda
23 dr. LINA FITRA 19810809 200604 2 008 IV/c Pembina Utama Muda
24 dr. INDRA YENNI 19760513 200604 2 007 IV/c Pembina Utama Muda
25 D E S N I, DCN 19641019 198803 2 003 IV/b Pembina Tk.I
26 Ns. ELFA HENDERI, S.Kep 19671111 198901 1 001 IV/b Pembina Tk.I
27 Ns. FATIMAH, S.Kep 19680916 198901 2 002 IV/a Pembina
28 BETTI KRISTINA, S.Farm,Apt 19790404 200604 2 007 IV/b Pembina Tk.I
29 dr. JHONSON 19750116 200604 1 006 IV/b Pembina Tk.I
30 Ns. ELFIZA, S.Kep 19681123 198901 2 001 IV/b Pembina Tk.I
31 dr. N I N A 19730929 200604 2 009 IV/b Pembina Tk.I
32 Ns. E N I T A, S.Kep 19700901 199503 2 002 IV/a Pembina
33 dr. ESI LESTARI 19811119 200902 2 005 IV/a Pembina
34 Ns. TIOMARLINA PURBA, S.Kep 19630712 199103 2 003 IV/a Pembina
35 RUSMANITA SITORUS, SKM 19651205 198903 2 006 IV/a Pembina
36 drg. DAHLIA SUSILAWATY DOLOKSARIBU 19770807 200701 2 006 IV/a Pembina
37 drg. NILA DEWI RATNAWATI PRASETIO 19770513 200701 2 004 IV/a Pembina
38 TARMIZI, SKM 19780411 199803 1 003 IV/a Pembina
39 Ns. TARULINA ROSARINA S, S.Kep 19781019 200903 2 001 IV/a Pembina
40 dr. NURYASMI 19831217 201001 2 020 IV/a Pembina
41 dr. RIA LESTARI RAHAYU 19820522 201001 2 020 IV/a Pembina
42 Ns. DESTRI INDRI BUDIARTI, S.Kep 199610132018082002 IV/a Pembina
43 Ns. ROSDIAR, S.Kep 19680928 198901 2 001 IV/b Pembina Tk.I
44 Ns. SUKMA DEWI, S.Kep.M.Kes 19771031 200501 2 004 IV/a Pembina
45 Ns. RAHMAWATI, S.Kep 19741001 199503 2 001 IV/a Pembina
46 Ns. TRISWAN SIMATUPANG, S.Kep 19730731 199603 1 001 IV/a Pembina
47 Ns.ULIA NELMA, S.Kep 19851228 201001 2 017 IV/a Pembina
48 Ns. ROSA PANJAITAN, S.Kep 19760217 199703 2 002 IV/a Pembina
49 drg. ARLINDA ROZA 19780210 201001 2 007 III/d Penata Tk.I
50 drg. WINDA HARSIANTY 19851031 201001 2 034 III/d Penata Tk.I

51 dr. MOHD.AIDIL SOLIHIN 19860813 201412 1 001 III/d Penata Tk.I
52 ZULMIATI, AMK 19650530 198703 2 004 III/d Penata Tk.I
53 SAHALIS, SKM. M.Kes 19680405 198903 1 004 III/d Penata Tk.I
54 SRI NURSANTI, Amd.Keb 19660324 198903 2 004 III/d Penata Tk.I
55 GUSPIDA MELWATI, AMK 19660807 198703 2 003 III/d Penata Tk.I
56 drg. ARIFAL WAHYUDI BACHTIAR 19830815 201102 1 005 III/d Penata Tk.I
57 PUJI ASTUTI, AMK 19661127 198803 2 003 III/d Penata Tk.I
58 Ns. EUIS DIAN HANDAYANI, S.Kep 19781010 199803 2 002 III/d Penata Tk.I
59 NURLAILA, AMK 19660104 198602 2 002 III/d Penata Tk.I
60 A R N E T I, A.Md.Farm 19671109 198803 2 005 III/d Penata Tk.I
61 dr. SUSANTI DWI ARIANI 19810325 200803 2 001 III/d Penata Tk.I
62 FAUZIAH SULFAH, SKM 19801119 200312 2 003 III/d Penata Tk.I
63 SYEFNI ZARMILA, Amd.Keb 19720928 199503 2 001 III/d Penata Tk.I
64 drg. DELVIA ROZA 19800423 201001 2 015 III/d Penata Tk.I
65 drg. RENY OZA 19750807 200903 2 003 III/d Penata Tk.I
66 A S R I L, S.Psi 19680525 198903 1 003 III/d Penata Tk.I
67 SALMI SUSANTI 19730724 199403 2 005 III/d Penata Tk.I
68 YULVIANA, SE 19790713 200502 2 002 III/d Penata Tk.I
69 Ns. KHAIRIYAH, S.Kep 19731230 199903 2 003 III/d Penata Tk.I
70 NOVA ISWANI SIHOTANG, SKM 19701120 199703 2 005 III/d Penata Tk.I
71 ROSNI PANGARIBUAN, AMK 19661009 199303 2 006 III/d Penata Tk.I
72 Ns. YURNIDES, S.Kep 19761224 199803 2 002 III/d Penata Tk.I
73 ELI YUSNANI, Amd.Keb.SKM 19690804 199012 2 001 III/d Penata Tk.I
74 YANCE TAMBA PARULIAN, SKM 19680112 199103 2 007 III/d Penata Tk.I
75 drg. RINA ANDRIANI 19791020 201001 2 020 III/d Penata Tk.I
76 SUMARTI, AMK 19751019 200003 2 002 III/d Penata Tk.I

77 ANDARMA MURYANTI, S.Psi.Psi 19761012 200902 2 001 III/d Penata Tk.I
78 Dra. WAN INDRAWATI W.H 19650817 199203 2 002 III/d Penata Tk.I
79 PAULINA NAPITUPULU, AMK 19640430 199303 2 001 III/d Penata Tk.I
80 HELDI NETTY NILAWATY PURBA, SKM 19671201 199203 2 006 III/d Penata Tk.I
81 Ns. TRI EXTIN RATFI, S.Kep 19860803 201001 2 029 III/d Penata Tk.I
82 dr. WELDAWIRA GUSNITA 19770424 201001 2 003 III/d Penata Tk.I
83 RAHMIWATI, Amd. AK, SKM 19721010 199303 2 005 III/d Penata Tk.I
84 Ns. DEVIKA HANDAYANI, S.Kep 19851227 201102 2 001 III/d Penata Tk.I
85 ERNAWATI Br TARIGAN, AMK 19660209 199803 2 001 III/d Penata Tk.I
86 RAHMAD SUKARMAN, AMK 19680816 198801 1 001 III/d Penata Tk.I
87 dr. DIAN PATRICA AMRI, SP.A.M.Ked(Ped) 19830615 200903 2 009 III/d Penata Tk.I
88 AMALIA PUTI MARETTA, S.Farm.Apt 19840324 200904 2 003 III/d Penata Tk.I
89 Hj. MASWARI, AM.Keb 19651027 198703 2 006 III/d Penata Tk.I
90 S O F Y A N. B, S.Psi 19711205 199203 1 004 III/d Penata Tk.I
91 SURYA MULYA F, S.Psi. M.Kes. M.Psi. Psi 19780925 199903 1 001 III/d Penata Tk.I
92 NURMANIS, AMK 19670313 198901 2 001 III/d Penata Tk.I
93 Ns. ADELINA, S.Kep 19740420 199703 2 001 III/d Penata Tk.I
94 RINDU HUTASOIT, AMK 19690901 199803 2 004 III/d Penata Tk.I
95 Ns. SLAMET DARMADI, S.Kep 19790513 200501 1 007 III/d Penata Tk.I
96 MESTIKA AGUSTINA S, A.Md. AK 19770805 200501 2 010 III/d Penata Tk.I
97 Ns. YUHELMA, S.Kep 19820414 200501 2 008 III/d Penata Tk.I
98 H E R L I N A, A.Md.Farm 19670623 199103 2 002 III/d Penata Tk.I
99 SRI DESNILA HIDAYATI, SKM.MM 19831224 200604 2 003 III/c Penata
100 SITI KHODIJAH, AMK 19780731 200502 2 001 III/c Penata
101 Ns. NONA AIDA, S.Kep 19781228 200604 2 019 III/c Penata
102 Ns. LAURA SIHITE, S.Kep 19780511 200801 2 023 III/c Penata
103 HARMENTO, SE 19730706 199402 1 002 III/c Penata
104 TRIANA AFRITA, SKM 19840401 201101 2 010 III/c Penata
105 MARTA IDA SIMANUNGKALIT 19660302 199003 2 002 III/c Penata
106 MUJIBUR RAHMAN, SKM 19721020 199803 1 006 III/c Penata
107 dr. RAHMANIA EKA SAGITA 19871213 201504 2 001 III/c Penata
108 dr. RICCA FITRIA, Sp.PK 19830712 200903 2 007 III/c Penata
109 Ns. ROMA YUDHI, S.Kep 19840812 201102 1 002 III/c Penata
110 ELSE TRIANA. Z.R, M.Psi 19810201 201001 2 011 III/c Penata
111 HERRY ELFIDA, A.Md.Farm 19701020 199803 2 004 III/c Penata
112 PEBRINA TIODORA, SKM 19790209 199803 2 001 III/c Penata
113 EKA RENOFA, AMK 19770306 200604 2 012 III/c Penata
114 ELVAIDA SIAHAAN, SKM 19780518 200604 2 002 III/c Penata
115 Ns. S U H U D, S.Kep 19770415 199903 1 005 III/c Penata
116 W A H Y U, AMK 19790330 199903 1 003 III/c Penata
117 dr. LIA SEPTINA PAKPAHAN, Sp.DV 19850920 201102 2 001 III/c Penata
118 PIDAJUNITA MUNTE, SKM.M.Kes 19730614 200012 2 001 III/c Penata
119 YAN BENNY AYUSLA, S.Kep 19870102 201102 1 001 III/c Penata
120 SUBUR LUBIS, AMG.GZ 19681110 199403 1 010 III/c Penata
121 dr. FITRI ARNITA 19860725 201503 2 001 III/c Penata
122 Ns. FAUMIRNA, S.Kep 19831210 201001 2 024 III/c Penata
123 MASLIANA, AMK 19790820 200003 2 001 III/c Penata
124 HENNI SAFITRI, AMK 19790823 200701 2 004 III/c Penata
125 HARITA SOVIANA, Amd. RM 19840102 200903 2 005 III/c Penata
126 Ns. AGUSTIEN HAYATI, S.Kep 19740818 200604 2 008 III/c Penata
127 NS. SASMAIDA SARAGIH, S.Kep 19750823 200604 2 011 III/c Penata
128 SANTI MARLINA, SKM 19780626 200501 2 014 III/c Penata

129 ALMULYANI, AMK 19651115 198703 1 005 III/c Penata
130 dr. DESMIATI 19801222 201408 2 001 III/c Penata
131 dr. MARESA LUSIANA 19860621 201408 2 001 III/c Penata
132 Ns. LENDRA HAYANI, S.Kep 19760125 200604 2 012 III/c Penata
133 Ns.AULYA AKBAR, M.Kep.Sp.Kep.J 19850328 201001 1 018 III/c Penata
134 Ns. RIKA HASTUTI,S.Kep 19800509 200903 2 004 III/c Penata
135 AULIA ARFAN, S.KOM 19830603 200901 1 011 III/c Penata
136 Ns. LELY REBECCA TOBING, S.Kep 19861018 200903 2 002 III/c Penata
137 DAHLAN PURBA, AMK 19780710 200801 1 013 III/c Penata
138 YANTINI MANIK, AMR 19750125 200902 2 001 III/c Penata
139 Ns. YUSMIDAR, S.Kep 19821127 201102 2 002 III/b Penata Muda Tk.I
140 IRI KRISTIYANDARI, SKM 19820507 200604 2 008 III/b Penata Muda Tk.I
141 NURHAYATI, S.Psi 19830218 200501 2 003 III/b Penata Muda Tk.I
142 SUPRIADI, SE 19801120 200902 1 002 III/b Penata Muda Tk.I
143 Ns. HERLAMBANG, S.Kep 19761016 199703 1 003 III/b Penata Muda Tk.I
144 INTAN JASMARLENA, A.Md 19890124 201101 2 010 III/b Penata Muda Tk.I
145 SAMSURIZAL 19670203 199803 1 007 III/b Penata Muda Tk.I
146 ANAS 19690206 199803 1 001 III/b Penata Muda Tk.I
147 R I K A, SKM 19860307 201001 2 013 III/b Penata Muda Tk.I
148 Ns. DWI SEPTIANI PUTRI, S.Kep 19890915 201102 2 002 III/b Penata Muda Tk.I
149 dr. NINING GILANG SARI, Sp.KJ 19840608 201903 2 001 III/b Penata Muda Tk.I
150 dr. MUHAMMAD AUZAN HINDAMI 19931018 201903 1 001 III/b Penata Muda Tk.I
151 dr. HANIFAL YUNIS 19881014 201903 2 001 III/b Penata Muda Tk.I
152 AMELIA OKTARINA, S.Farm.Apt 19941018 201903 2 002 III/b Penata Muda Tk.I
153 YULIA WARDANI, M.Psi 19900716 201903 2 002 III/b Penata Muda Tk.I
154 MAHA DECHA DWI PUTRI, M.Psi 19870319 201903 2 001 III/b Penata Muda Tk.I
155 A.R AMELIA S, M.Psi 19890611 201903 2 001 III/b Penata Muda Tk.I
156 SILVI AYU VAJRIKA, S.Farm.Apt 19920706 201903 2 001 III/b Penata Muda Tk.I
157 LIFA MUTIARA, S.Psi 19850605 200801 2 003 III/b Penata Muda Tk.I
158 dr. IRAWAN SUKMA KAMIL 19791214 201102 1 001 III/b Penata Muda Tk.I
159 K H O S N A N, S. Sos 19740410 199803 1 004 III/b Penata Muda Tk.I
160 R A H M I A T I, SKM 19800602 200501 2 010 III/b Penata Muda Tk.I
161 J U R I D, SKM 19750305 200701 1 007 III/b Penata Muda Tk.I
162 R U Y A T I, AMG 19770610 200604 2 015 III/b Penata Muda Tk.I
163 EDA SYAFNI, A.Md.PK 19800126 200604 2 015 III/b Penata Muda Tk.I
164 HADI SANJAYA, AMK 19800222 200903 1 001 III/b Penata Muda Tk.I
165 RASMI Br GINTING, AMG 19800222 200903 1 001 III/b Penata Muda Tk.I
166 RIZA TRIANA, S.KEP 19810710 200903 2 005 III/b Penata Muda Tk.I
167 Ns. MARMISA ,S.Kep 19750328 201001 2 004 III/b Penata Muda Tk.I
168 TIN ANDARINI, A.Md.AK 19840620 200903 2 005 III/b Penata Muda Tk.I
169 PUTRI YUNIARTI, AMK 19860626 200903 2 003 III/b Penata Muda Tk.I
170 Ns. DARMI NOVI YANTI, S.Kep 19850318 201001 2 018 III/b Penata Muda Tk.I
171 MORLAN LINTONG. HP, S.Kep 19770610 199703 1 002 III/b Penata Muda Tk.I
172 NELWATI, SKM 19780123 201102 2 001 III/b Penata Muda Tk.I
173 Ns. ELISABET Br TARIGAN, S.Kep 19780331 200801 2 015 III/b Penata Muda Tk.I
174 DIANA MARIA SIDABUTAR, S.Sos 19740407 200701 2 003 III/b Penata Muda Tk.I
175 dr. EVI CHRISTINA LINGGA, Sp. Rad 19810425 202012 2 001 III/b Penata Muda Tk.I
176 ALMUKMIN J, SE 19720721 200701 1 007 III/b Penata Muda Tk.I
177 NURELENA MARHALI 19640917 198403 2 002 III/b Penata Muda Tk.I
178 TENGKU RASUNA GUSTIANTI, AMK 19810815 200801 2 015 III/b Penata Muda Tk.I
179 Ns. DELNI ANGGRAINI, S.Kep 19791211 200801 2 014 III/b Penata Muda Tk.I
180 SYAWALUDDIN, SKM 19761008 201001 1 007 III/b Penata Muda Tk.I
181 Ns. GUSTINA RAMBE, S.Kep 19750827 201001 2 005 III/b Penata Muda Tk.I
182 HERI YULITA, S.Tr.Keb 19780707 200312 2 005 III/b Penata Muda Tk.I
183 Ns. PRAMANA, S.Kep 19860718 201102 1 001 III/b Penata Muda Tk.I
184 DELWI NOVITA. D, AMK 19761105 201102 2 002 III/b Penata Muda Tk.I
185 Ns. EVA MAYASARI, S.Kep 19800518 200801 2 018 III/b Penata Muda Tk.I
186 YUNITA SILAEN, SKM 19840626 201503 2 003 III/a Penata Muda
187 IRSYAD AGUS, Amd 19851215 200903 1 001 III/a Penata Muda
188 NURFITRI ASBEN, Amd 19790829 200902 2 005 III/a Penata Muda
189 FITRI SULASTRI, S.Gz 19911213 201903 2001 III/a Penata Muda
190 MEISARI PUJA DWI MARNI, S.Sos 19900526 202012 2 014 III/a Penata Muda
191 ELLYZABET SIHOL MARITO, S.I.Kom 19950908 2020122 020 III/a Penata Muda
192 LILIANA NINDARIATI, S.I.KOM 19971212 202012 2 009 III/a Penata Muda
193 ZARA ZETTIRA AMANY, S.Gz 19940708 201903 2 001 III/a Penata Muda
194 ADE KURNIAWAN 19860927 200604 1 005 III/a Penata Muda
195 HUTMAWATI, S.Gz 19800122 200604 2 014 III/a Penata Muda
196 IBRAR ZAITANTO, A.Md.AK 19811031 201001 1 020 III/a Penata Muda
197 TRIMULYANI INDRIATIE, Amd 19750206 200903 2 001 III/a Penata Muda
198 DOMEN FATHER. JP, AMK 19761012 200604 1 010 III/a Penata Muda
199 Ns. JUMRIADI SAPUTRA, S.Kep 19880311 201503 1 004 III/a Penata Muda
200 RAHAYU INDAH HANDAYANI, SE 19800303 201102 2 001 III/a Penata Muda
201 SERI NOVITA DEWI, , AMK 19781121 200604 2 010 III/a Penata Muda
202 ZAMRI 19640605 200701 1 009 II/d Pengatur Tk.I
203 PENI NAULI, AM.d.Kep 19870406 201503 2 005 II/d Pengatur Tk.I
204 ANGKI PRATAMA, A.Md.Rad 19860406 201903 1 001 II/d Pengatur Tk.I
205 PARDAMEAN, A.Md 19910103 201503 1 002 II/d Pengatur Tk.I
206 MARTALINDA 19790308 200701 2 004 II/d Pengatur Tk.I

207 REZA CAHYANI, AMK 19800914 200801 2 017 II/d Pengatur Tk.I
208 AMIN SHOLIHIN, A.Md 19880707 201503 1 008 II/d Pengatur Tk.I
209 RIO SAPUTRA 19771006 200312 1 002 II/d Pengatur Tk.I
210 HERIADI 19650917 200701 1 003 II/d Pengatur Tk.I
211 ISRA AYU PUTRI YOMA, A.Md.Kep 19900224 201503 2 003 II/d Pengatur Tk.I
212 M I S L A I L I, S.Tr.Keb 19730323 200604 2 033 II/d Pengatur Tk.I
213 ROSMANITA, AMK 19800203 200801 2 012 II/d Pengatur Tk.I
214 ANDI APRIADI 19770605 200701 1 010 II/d Pengatur Tk.I
215 MAITRI HARDIANTI, A.Md. Rad 19930502 202012 2 021 II/c Pengatur
216 ELFRI YUNNIE ARIEF, A.Md.Farm 19950621 201903 2 001 II/c Pengatur
217 FERA TAMALA SARI, A.Md.RMIK 19930228 201903 2 001 II/c Pengatur
218 NELMA PUTRI, AMKG 19970127 201903 2 001 II/c Pengatur
219 ARIFUL TASLIM,A.Md.Fis 19920721 201903 1 001 II/c Pengatur
220 ARIF NUR HIDAYAT, A.Md 19921014 201903 1 001 II/c Pengatur
221 FARISHA UTARA, A.Md 19940707 201903 2 001 II/c Pengatur
222 M. NUR SEHAN, A.Md.FT 19890131 201903 1 001 II/c Pengatur
223 PERDINANDUS SITUMORANG 19821016 200902 1 006 II/c Pengatur
224 AINUR NILA, A.Md.Ak 19921011 201903 2 002 II/c Pengatur
225 RESMI MARLIANA MANURUNG 19730408 199703 2 004 II/c Pengatur
226 FITRIA HELDAYATI, A.Md.AFM 19860412 201903 2 001 II/c Pengatur
227 HERNITA DWI JAYANTI, A.Md.Gz 19950628 201903 2 002 II/c Pengatur
228 ADAM YUSUF 19680805 200701 1 008 II/c Pengatur
229 DESI PERMATA SARI, A.Md.Ak 19941212 201903 2 001 II/c Pengatur
230 JUHRI HASIBUAN 19701117 200902 1 001 II/c Pengatur
231 MONALISA, A.Md.RM 19910727 201903 2 001 II/c Pengatur
232 BISMI AYU MULYANI, A.Md.Kes 19970810 202012 2 011 II/c Pengatur
233 ZULKIFLI 19820529 200801 1 009 II/c Pengatur
234 SRI PANGESTU 19640227 200701 2 001 II/c Pengatur
235 PENTIRA NURALIM, A.Md.Kes 19970217 202012 2 015 II/c Pengatur
236 BOY PARLINDUNGAN, A.Md.Rad 19960612 202012 1 017 II/c Pengatur
237 BELLA EKA WULANDARI, A.Md.RMIK 19950524 201903 2 001 II/c Pengatur
238 FADILA NISSA, A.Md 19960420 201903 2 002 II/c Pengatur
239 SUCI RAHMAWATI, A.Md.AFM 19890412 201903 2 001 II/c Pengatur
240 EKA GUSTRIA ELIZA, A.Md.Ft 19890617 202012 2 008 II/c Pengatur
241 HERMANTO 19691010 200902 1 001 II/b Pengatur Muda Tk.I
242 SUKMAWATY 19651019 200701 2 012 II/b Pengatur Muda Tk.I
243 ALYUDIANTO 19810817 200902 1 008 II/b Pengatur Muda Tk.I
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KELAS
JABATAN JENIS JABATAN
JABATAN
Plt. Direktur Wakil Direktur Medik dan Keperawatan STRUKTURAL 13
Wakil Direktur Umum dan Keuangan STRUKTURAL 13
Kepala Bidang Penunjang Medik dan Diklit STRUKTURAL 11
Kepala Bagian Keuangan STRUKTURAL 11
Kepala Bagian Tata Usaha STRUKTURAL 11
Kepala Bidang Keperawatan STRUKTURAL 11
Kepala Bidang Pelayanan Medik STRUKTURAL 11
Analis Perencanaan, Evaluasi dan Pelaporan STRUKTURAL 11
Kepala Subbagian Umum dan Kepegawaian STRUKTURAL 9
Kepala Subbagian Perencanaan dan Tindak Lanjut STRUKTURAL 9
Kepala Subbidang Pendidikan dan Penelitian STRUKTURAL 9
Administrator Kesehatan Muda FUNGSIONAL 9
ANALIS KEUANGAN PUSAT DAN DAERAH AHLI MUDA FUNGSIONAL 9
Dokter Gigi Muda FUNGSIONAL 10
ANALIS KEUANGAN PUSAT DAN DAERAH AHLI MUDA FUNGSIONAL 9
PRANATA HUBUNGAN MASYARAKAT MUDA FUNGSIONAL 9
Perencana Ahli Muda FUNGSIONAL 10
Dokter Madya FUNGSIONAL 12
Dokter Gigi Madya FUNGSIONAL 12

Nutrisionis Madya FUNGSIONAL 11
Perawat Madya FUNGSIONAL 11
Apoteker Madya FUNGSIONAL 11
Nutrisionis Madya FUNGSIONAL 11
Perekam Medis Madya FUNGSIONAL 11

Dokter Ahli Muda FUNGSIONAL 10
Perawat Penyelia FUNGSIONAL 8
Bidan Penyelia FUNGSIONAL 8
Perawat Muda FUNGSIONAL 9
Asisten Apoteker Penyelia FUNGSIONAL 8
Analis Data dan Informasi PELAKSANA 7
Pengawas Rehabilitasi Narkoba PELAKSANA 7
Pranata Labor Kesehatan Penyelia FUNGSIONAL 8
Arsiparis Muda FUNGSIONAL 9
Perawat Ahli Muda FUNGSIONAL 9
Pengawas Keselamatan dan Kesehatan Kerja dan Perlindungan Lingkungan PELAKSANA 7
Analis Kesehatan FUNGSIONAL 8
Pengawas Keselamatan dan Kesehatan Kerja dan Perlindungan Lingkungan PELAKSANA 7

Psikolog Klinis Muda FUNGSIONAL 9
Arsiparis Muda FUNGSIONAL 9
Penyusun Laporan Hasil Diklat PELAKSANA 7
Dokter Muda FUNGSIONAL 10
Pranata Laboratorium Penyelia FUNGSIONAL 8
Dokter Spesialis Anak Ahli Muda FUNGSIONAL 10
Apoteker Muda FUNGSIONAL 9
Pembina jasmani dan Mental PELAKSANA 7
Psikolog Klinis Muda FUNGSIONAL 9
Pranata Laboratorium Kesehatan Penyelia FUNGSIONAL 8
Analis Keuangan PELAKSANA 7

Dokter Spesialis Patologi Klinik Ahli Muda FUNGSIONAL 10
Psikologi Klinis Muda FUNGSIONAL 9
Nutrisionis Ahli Muda FUNGSIONAL 9
Dokter Spesialis Kulit Ahli Muda FUNGSIONAL 10
Pengelola Pelayanan kesehata PELAKSANA 6
Nutrisionis Penyelia FUNGSIONAL 8
Perawat Mahir FUNGSIONAL 7
Perekam Medis Penyelia FUNGSIONAL 8
Analis Perencanaan Penganggaran PELAKSANA 7

Radiografer Penyelia FUNGSIONAL 8
Perawat pertama FUNGSIONAL 8
Pengawas Keselamatan dan Kesehatan Kerja dan Perlindungan PELAKSANA 7
Pembina jasmani dan Mental PELAKSANA 7
Analis Penagihan PELAKSANA 7
Perawat Pertama FUNGSIONAL 8
Perawat Pelaksana Lanjutan FUNGSIONAL 7
Pemelihara Peralatan PELAKSANA 5
Pengadministrasi Keuangan PELAKSANA 5
Dokter Pertama Spesialis Jiwa FUNGSIONAL 9
Dokter Pertama FUNGSIONAL 9
Apoteker Pertama FUNGSIONAL 8
Psikolog Klisnis Pertama FUNGSIONAL 8

Apoteker Pertama FUNGSIONAL 8
Arsiparis Pertama FUNGSIONAL 8
Arsiparis Pertama FUNGSIONAL 8
Bendahara PELAKSANA 7
Kustodian Barang Milik Negara PELAKSANA 7
Nutrisionis Pelaksana Lanjutan FUNGSIONAL 7
Perekam Medis Pelaksana Lanjutan FUNGSIONAL 7
Nutrisionis Pelaksana Lanjutan FUNGSIONAL 7
Pranata Labkes Pelaksana Lanjutan FUNGSIONAL 7
Analis Kesehatan PELAKSANA 7
Dokter Spesialis Radiologi Ahli Pertama FUNGSIONAL 9
Penata Laporan Keuangan PELAKSANA 7
Pengadministrasi umum PELAKSANA 5

Pengelola Kepegawaian PELAKSANA 6
Pengelola kesehatan PELAKSANA 6
Pengelola Instalasi Air dan Listrik PELAKSANA 6
Pengelola Data Transaksi PELAKSANA 6
Nutrisionis Pertama FUNGSIONAL 8
Konselor PELAKSANA 7
Nutrisionis Pertama FUNGSIONAL 8
Pengadministrasi Umum PELAKSANA 5
Nutrisionis Ahli Pertama FUNGSIONAL 8
Verifikator Keuangan PELAKSANA 7
Analis Keuangan PELAKSANA 7
Perawat Terampil FUNGSIONAL 6
Radiografer Terampil FUNGSIONAL 6
Radiografer Pelaksana FUNGSIONAL 6
Pengadministrasi Kepegawaian PELAKSANA 5

Fisioterapis Terampil FUNGSIONAL 6
Pengemudi PELAKSANA 3
Perawat Terampil FUNGSIONAL 6
Pengadminitrasi Umum PELAKSANA 5
Asisten Apoteker Terampil FUNGSIONAL 6
Perekam Medis Terampil FUNGSIONAL 6
Perawat Gigi Terampil FUNGSIONAL 6
Terapis Wicara Terampil FUNGSIONAL 6
Okupasi Terapis Terampil FUNGSIONAL 6
Pranata Laboratorium Kesehatan Terampil FUNGSIONAL 6
Perawat Pelaksana FUNGSIONAL 6
Nutrisionis Terampil FUNGSIONAL 6
Pranata Laboratorium Kesehatan Terampil FUNGSIONAL 6
Pemelihara Peralatan PELAKSANA 5

Binatu Rumah sakit PELAKSANA 3
Terapis Wicara Terampil FUNGSIONAL 6
Binatu Rumah sakit PELAKSANA 3
Pengadministrasi Penerimaan PELAKSANA 5

MAX BESARAN TPP
T
KLASIFIKASI TPP O
PRESTASI KONDISI KELANGKAAN
BEBAN KERJA T
KERJA KERJA PROFESI
A
L
Wakil Direktur pada Rumah Sakit Jiwa Tampan Rp5,578,788 Rp0 Rp11,157,576 Rp0
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Wakil Direktur pada Rumah Sakit Jiwa Tampan Rp5,578,788 Rp0 Rp11,157,576 Rp0
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Kepala Bidang pada Badan/Dinas Rp5,518,010 Rp8,190,796 Rp1,724,378 Rp0

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Kepala Subbagian dan Subbidang pada Rumah Sakit Jiwa Tampan Rp2,609,568 Rp0 Rp5,219,136 Rp0
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Fungsional pada Rumah Sakit Jiwa Tampan Merangkap Sub Koordinator Rp3,261,960 Rp0 Rp5,219,136 Rp0
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Fungsional pada RSJ Tampan Rp4,460,800 Rp0 Rp8,921,600 Rp0

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Fungsional pada Perangkat Daerah Rp4,655,821 Rp6,983,731 Rp0 Rp0
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Administrator Kesehatan, Sanitarian, Perekam Medis pada Rumah Sakit Jiwa Tampan Rp3,448,756 Rp0 Rp6,897,512 Rp0
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Fungsional pada Rumah Sakit Jiwa Tampan Rp2,999,888 Rp0 Rp5,999,776 Rp0
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Pelaksana pada Perangkat Daerah #N/A #N/A #N/A #N/A

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Pelaksana pada Rumah Sakit Jiwa Tampan Rp1,849,280 Rp0 Rp3,698,561 Rp0
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Administrator Kesehatan, Sanitarian, Perekam Medis pada Rumah Sakit Jiwa Tampan Rp3,448,756 Rp0 Rp6,897,512 Rp0
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Pelaksana pada Rumah Sakit Jiwa Tampan #N/A #N/A #N/A #N/A
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Pelaksana pada Rumah Sakit Jiwa Tampan Rp656,295 Rp0 Rp1,312,590 Rp0
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Binatu pada RSJ Tampan Rp984,443 Rp0 Rp1,640,738 Rp0

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Binatu pada RSJ Tampan Rp984,443 Rp0 Rp1,640,738 Rp0

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J
A
B
JA
A
T
STATUS B
A
UNIT KERJA ATASAN LANGSUNG PAJAK JA
N
PEGAWAI
A
T
B
A
JA
N
UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan D
PNS 0.15 A
T
Pada Dinas Kesehatan Provinsi Riau M
B
A
IJ
UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan A
N
D
dr. ELITA SARI PNS 0.15 N
A
Pada Dinas Kesehatan Provinsi Riau T
M
IB
A
IJS
N
D
T
A
M
IR
B
A
IS
A
JA
N
N
T
R. INDRA SUHEIRI, SE PNS 0.15 S
A
T
IR
IA
B
IJS
A
N
D
R. INDRA SUHEIRI, SE PNS 0.05 N
T
S
A
M
IR
I
B
A
IS
A
JA
N
N
T
dr. ELITA SARI PNS 0.15 S
A
T
IR
IA
B
IJS
A
N
D
T
S
A
M
IR
I
B
A
IS
A
JA
N
N
T
R. INDRA SUHEIRI, SE PNS 0.15 S
A
T
IR
IB
A
IS
A
N
D
IKHSAN ADITYA, ST.M.Si PNS 0.05 N
T
S
JT
IA
R
IA
IS
A
UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan B
N
D
HAWARI DINAL S.Sos.M.si PNS 0.15 N
JT
S
Pada Dinas Kesehatan Provinsi Riau A
M
IR
IT
A
A
IS
A
B
A
N
T
Ns. SYAPARUDDIN DAUD,S.Kep,MM PNS 0.05 S
JA
N
IA
R
IT
IS
A
A
F
Ns. SYAPARUDDIN DAUD,S.Kep,MM PNS 0.15 N
T
S
JA
Pada Dinas Kesehatan Provinsi Riau N
U
IR
IT
A
N
S
A
A
F
FAHRIZAL, SE.M.Si PNS 0.05 G
T
S
JA
U
S
R
IT
A
N
IA
A
F
drg. JENITA ARUMA, MM PNS 0.15 G
O
S
JA
U
S
N
IA
T
N
IB
A
F
G
FAHRIZAL, SE.M.Si PNS 0.05 JO
LAN
Pada Dinas Kesehatan Provinsi Riau U
S
N
A
T
N
IA
A
F
IKHSAN ADITYA, ST.M.Si PNS 0.05 G
O
LN
JA
S
N
A
T
N
IB
A
F
G
drg. JENITA ARUMA, MM PNS 0.15 JO
LAN
S
N
A
T
N
IA
A
F
Ns. Z A I B A H, S.Kep. MM PNS 0.15 G
O
LN
JA
S
N
A
T
N
IA
A
F
HAWARI DINAL S.Sos.M.si PNS 0.15 OJG
LAN
S
N
A
T
N
IA
A
F
O
LN
JA
S
N
A
T
N
IA
A
F
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S
N
A
T
N
IB
A
F
G
drg. JENITA ARUMA, MM PNS 0.15 O
LA
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S
N
T
N
IA
F
G
LN
S
N
N
IA
UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan F
G
O
drg. JENITA ARUMA, MM PNS 0.15 L
S
N
N
IA
G
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L
S
N
IA
O
L
N
A
A
B
JA
A
T
B
A
JA
N
A
T
A
F
Ns. SYAPARUDDIN DAUD,S.Kep,MM PNS 0.15 JA
N
A
T
N
A
F
JA
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S
A
T
N
IB
F
G
Ns. Z A I B A H, S.Kep. MM PNS 0.15 JO
A
N
S
N
A
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N
IA
A
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Ns. SYAPARUDDIN DAUD,S.Kep,MM PNS 0.15 G
O
L
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N
A
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A
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drg. JENITA ARUMA, MM PNS 0.15 GJO
LA
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N
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N
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drg. JENITA ARUMA, MM PNS 0.15 OJG
LAN
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N
A
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N
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A
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LN
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N
A
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N
IA
A
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A
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N
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A
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G
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N
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Ns. Z A I B A H, S.Kep. MM PNS 0.15 GJO
LA
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Ns. Z A I B A H, S.Kep. MM PNS 0.15 O
LN
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drg. JENITA ARUMA, MM PNS 0.05 JA
N
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A
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S
N
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Ns. Z A I B A H, S.Kep. MM PNS 0.05 GJO
LA
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N
A
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N
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A
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LN
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N
A
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N
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Ns. Z A I B A H, S.Kep. MM PNS 0.05 OJG
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S
N
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Ns. SYAPARUDDIN DAUD,S.Kep,MM PNS 0.05 JO
LN
S
A
N
A
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ALBER EKO SUYITNO, ST PNS 0.05 O
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JP
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LF
B
LN
A
Pada Dinas Kesehatan Provinsi Riau JU
N
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N
A
A
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drg. JENITA ARUMA, MM PNS 0.05 JB
LNA
S
A
A
N
N
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T
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A
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N
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A
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A
A
IN
NT
B
F
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LN
P
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Pada Dinas Kesehatan Provinsi Riau S
N
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LA
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N
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A
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Ns. Z A I B A H, S.Kep. MM PNS 0.05 LN
JA
S
A
A
N
N
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N
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A
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P
A
N
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A
N
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S
N
N
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A
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N
A
B
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A
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A
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N
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Pada Dinas Kesehatan Provinsi Riau JN
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N
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A
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A
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N
N
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A
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N
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A
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A
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N
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LN
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drg. JENITA ARUMA, MM PNS 0.05 LN
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N
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LN
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S
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ALBER EKO SUYITNO, ST PNS 0.05 P
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N
Pada Dinas Kesehatan Provinsi Riau
E
A
T
UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan L
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A
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UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan G
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N
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Ns. Z A I B A H, S.Kep. MM PNS 0.05 OJB
LN
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A
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A
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B
S
A
FAHRIZAL, SE.M.Si PNS 0.05 LA
P
N
Pada Dinas Kesehatan Provinsi Riau J
E
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T
N
A
UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan LS
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A
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A
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N
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drg. JENITA ARUMA, MM PNS 0 J
S
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A
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drg. JENITA ARUMA, MM PNS 0 G
LN
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S
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T
N
N
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drg. JENITA ARUMA, MM PNS 0 O
JA
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N
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drg. JENITA ARUMA, MM PNS 0 JO
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N
IA
A
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O
LN
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S
N
A
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N
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A
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A
N
A
N
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A
Ns. SYAPARUDDIN DAUD,S.Kep,MM PNS 0 LA
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N
A
IA
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B
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LJP
S
A
N
E
A
T B
F
Ns. SYAPARUDDIN DAUD,S.Kep,MM PNS 0 OJA
LA
N
A
K
T
N
A
S
A
ALBER EKO SUYITNO, ST PNS 0 G
LN
P
S
E
T
N
IL
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A
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N
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N
A
F
G
drg. JENITA ARUMA, MM PNS 0 LA
S
N
N
I
A
G
O
S
N
IA
O
L
N
A
B
JA
A
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B
A
J
A
N
A
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Ns. SYAPARUDDIN DAUD,S.Kep,MM PNS 0 P
JA
E
A
T
B
A
Ns. SYAPARUDDIN DAUD,S.Kep,MM PNS 0 P
JA
N
E
A
K
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S
F
drg. JENITA ARUMA, MM PNS 0 JA
N
A
K
T
N
N
S
A
F
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S
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T
N
N
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F
G
drg. JENITA ARUMA, MM PNS 0 JO
A
N
S
N
A
T
N
IA
A
F
O
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S
N
T
N
A
IA
F
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S
N
N
A
IA
T
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B
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A
drg. JENITA ARUMA, MM PNS 0 L
S
A
N
N
A
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T
B
O
A
ALBER EKO SUYITNO, ST PNS 0 LP
A
N
E
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T
A
Ns. SYAPARUDDIN DAUD,S.Kep,MM PNS 0 L
P
A
E
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A
LS
UPT. Bersifat Khusus Rumah Sakit Jiwa Tampan
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P
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A
A
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A
A
N
A
KETERANGAN

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PENGISIAN DATA

PERHITUNGAN TAMBAHAN PENGHASILAN ASN

NAMA PEGAWAI : MARTALINDA

NIP : 19790308 200701 2 004

PANGKAT / GOLONGAN : Pengatur Tk.I (II/d)

JABATAN : Pengadministrasi Kepegawaian

ATASAN LANGSUNG : ALBER EKO SUYITNO, ST

NIP : 19821026 201001 1 019

PANGKAT / GOLONGAN : Penata (III/c)

JABATAN : Kepala Subbagian Umum dan Kepegawaian

BULAN PENILAIAN : Maret

JENIS HARI KERJA : 5 Hari Kerja

MASA PENILAIAN : 01 Maret s.d 31 Maret 2022

JUMLAH HARI KALENDER : 31

JUMLAH HARI KERJA : 22

3. PEJABAT KEPEGAWAIAN PERANGKAT DAERAH

NAMA : ALBER EKO SUYITNO, ST

NIP : 19821026 201001 1 019

PANGKAT/GOLONGAN : Penata (III/c)

JABATAN : Kepala Subbagian Kepegawaian dan Umum

1 Nama MARTALINDA 1 Nama ALBER EKO SUYITNO, ST

2 NIP 19790308 200701 2 004 2 NIP 19821026 201001 1 019

4 Jabatan Pengadministrasi Kepegawaian 4 Jabatan Kepala Subbagian Umum dan Kepegawaian

Pekanbaru, 31 Maret 2022

1 PEGAWAI YANG DINILAI

NIP : 19790308 200701 2 004

Pangkat/Gol Ruang : Pengatur Tk.I (II/d)

Jabatan : Pengadministrasi Kepegawaian

Nama : ALBER EKO SUYITNO, ST

NIP : 19821026 201001 1 019

Pangkat/Gol Ruang : Penata (III/c)

Jabatan : Kepala Subbagian Umum dan Kepegawaian

Nama : IKHSAN ADITYA, ST.M.Si

NIP : 19830415 201001 1 012

Pangkat/Gol Ruang : Penata Tk.I

Jabatan : Kepala Bagian Tata Usaha

Predikat Kinerja Pegawai : Baik

Pekanbaru, 31 Maret 2022

I. DAFTAR KEHADIRAN PEGAWAI

II. KETERANGAN BOBOT PENGURANGAN

Menyetujui Pekanbaru, 31 Maret 2022

ALBER EKO SUYITNO, ST ALBER EKO SUYITNO, ST

Bulan Penialain : Maret Kelas Jabatan : 5 CPNS

Jumlah Hari Kerja : 22 Hari

PEJABAT PENILAI PNS YANG DINILAI

Nama : ALBER EKO SUYITNO, ST Nama : MARTALINDA

NIP : 19821026 201001 1 019 NIP : 19790308 200701 2 004

Pangkat/Gol : Penata (III/c) Pangkat/Gol : Pengatur Tk.I (II/d)

Jabatan : Kepala Subbagian Umum dan Kepegawaian Jabatan : Pengadministrasi Kepegawaian

NO KRITERIA DAN INDIKATOR BOBOT PENGURANGAN % CAPAIAN BOBOT HASIL

I. CAPAIAN PENILAIAN TPP

1 Apel 40.00 0.00 100.00 40.00

2 Masuk Kantor 30.00 0.00 100.00 30.00

3 Pulang Kantor 30.00 0.00 100.00 30.00

TOTAL CAPAIAN PENILAIAN TPP 100.00

PERHITUNGAN TAMBAHAN PENGHASILAN ASN

Kategori TPP Bruto PPh Netto

Beban Kerja Rp1,340,192 Rp0 Rp1,340,192

Prestasi Kerja Rp0 Rp0 Rp0

Kondisi Kerja Rp2,680,383 Rp0 Rp2,680,383

Kelangkaan Profesi Rp0 Rp0 Rp0

Total Bruto Penerimaan Rp4,020,575 Rp0 Rp4,020,575

Pekanbaru, 31 Maret 2022