No.

Nama Karyawan Usia Unit

1 MULYANI, A.Md.Kep >40 thn Annisa

2 SWESTI EVA YANTI, A.Md.Keb >40 thn Annisa

3 Ns. SRI EMIL DARMIZA, S.Kep Annisa

4 GUSNELLY SULISNO, A.Md.Kep Annisa

5 IGA RAVANDA, A.Md.Keb Annisa

6 RIA OKTILOIS, A.Md.Keb Annisa

7 SELVINA PRIHANDAYANI, A.Md.Kep Annisa

8 ZULNIAH MIRZA, A. Md. Keb Annisa

9 YULIA SUSANTI, A. Md. Kep Annisa

10 Ns. RAHMIATI,S.Kep Annisa

11 Ns. HENNY PRASETYAWATI, S.Kep Annisa

12 Ns. DEWI ARZONA JUSMAN, S.Kep >40 thn Ash Shafa

13 FITRI YATI, A.Md.Kep >40 thn Ash Shafa

14 Ns. ANITA ANGGRAINI J, S.Kep Ash Shafa

15 Ns. GITA APRI LONIA, S.Kep Ash Shafa

16 Ns. MIZA SEPRINA, S.Kep Ash Shafa

17 EVY ERDINA RUMAPEA, A.Md.Kep Ash Shafa

18 LOLA DESVIRA, A.Md.Kep Ash Shafa

19 MIKYASUR RAFKI, A.Md.Kep Ash Shafa

20 RAHMA YULI, A.Md.Kep >40 thn CSSD

21 AFRIZONI >40 thn CSSD

22 AMELIA NOFRIYANI CSSD

23 DHARMA AULIA PUTRA CSSD

24 NANDA SUMARNO CSSD

25 DELI SURYANI >40 thn Gizi

26 DERVITA DARMA >40 thn Gizi

27 DESRY KURNIAWATI >40 thn Gizi

28 ZUWARNI >40 thn Gizi

29 AULIA RAMADHANI Gizi

30 NIRMALA Gizi
31 RAHMA YENI Gizi

32 RENI SAFITRI Gizi

33 SALWATI Gizi

34 FAIZAH AZZAHRA Gizi

35 HIDAYATUL HUSNA Gizi

36 NILDA FITRI YANTI, A.Md.Kep >40 thn ICU

37 RATIH MADONA, A.Md.Kep >40 thn ICU

38 YELITA GUSRIA, A.MK >40 thn ICU

39 AKMAL SHALEH, A.Md.Kep ICU

40 NELLYA SARI, A.Md.Kep ICU

41 NIA SASRIANTI, A.Md.Kep ICU

42 PURI NELLI HANDAYANI, A.Md.Kep ICU

43 RIKA MELIA, A. Md Kep ICU

44 YUSE ASMICEL, A.Md.Kep ICU

45 Ns. INDRA BUKHAIRI ,S.Kep >40 thn IGD

46 MEDYA, A.Md.Kep >40 thn IGD

47 ZULFADILLAH, A.MK >40 thn IGD

48 Ns. ORI FEBRIANTO, S.Kep IGD

49 ERWIN ARDI, A.Md.Kep IGD

50 FIRDAUS, A.Md.Kep IGD

51 FITRA YANELI, A.Md.Kep IGD

52 IRA SARTIKA SARI, A.Md.Kep IGD

53 IRSYAD AFFANDI, A.Md, S.Kep IGD

54 NENCY HELDILLA, A.Md.Kep IGD

55 RIMA GUSTIKAMELA IRAWAN, A.Md.Keb IGD

56 RIMMA NOVITA, A.Md. Kep IGD

57 SILFIA SYAFRIYANI, A.Md.Keb IGD

58 VIVI ANANDYA KURNIAWATI, A.Md.Keb IGD

59 WELLA AUGRIA, A.Md.Kep IGD

60 ZANNA DWI ANDHIKA PUTRI, A.Md.Keb IGD

61 dr. HUMAIRA ULFA HERMAN Medis IGD

62 dr. RAMZY BAYUNI Medis IGD

63 dr. SRI YULIANA BAKAR Medis IGD

64 dr. CUT MUTIA INDRA Medis IGD

65 dr. MUTHIA RAHMI Medis IGD

66 dr. RENGGA SEBASTIAN Medis IGD

67 drg. VISKA YOLANDA PUTRI Komite Mutu

68 dr. ISPHANDRA BAKMA, Sp.PK Laboratorium

69 HERMIDA, A.Md.AK >40 thn Laboratorium

70 FITRA HIDAYATI, A.Md. AK >40 thn Laboratorium

71 SUSI NOFRITA, A.Md.AK >40 thn Laboratorium

72 ELVIZAH >40 thn Laboratorium

73 ERLINDA >40 thn Laboratorium

74 dr. PUTRI ILHAMI Laboratorium

75 HARRY MIZUHRI, A.Md. AK Laboratorium

76 RAHADIAN BAGUSMAN. S.ST Laboratorium

77 SHARA WINANDA, A.Md. AK Laboratorium

78 SYUKRI, A.Md. AK Laboratorium

79 DESI FEBRIANI Laboratorium

80 RISMADISON >40 thn Laundry

81 SYAHRIANI >40 thn Laundry

82 ERLINDA DARWIS >40 thn Laundry

83 LINA >40 thn Laundry

84 IRMAYANTI Laundry

85 NELFIA YUSI, A.Md.Kep >40 thn Multazam

86 Ns. KHUSNUL KHATIMAH, S.Kep Multazam

87 Ns. REZA NIKA, S.Kep Multazam

88 Ns. SYAFRIDA YENNI, S.Kep Multazam

89 EKA KUMALA SARI, A.Md.Kep Multazam

90 INDAH AYU, A.Md.Kep Multazam

91 RIA ANGGRAINI, A.Md.Kep Multazam

92 ZAINAL ARIFIN, A.Md.Kep Multazam

93 Ns. DESI SUSANTI, S.Kep >40 thn OKRR

94 RAHMATU SJUKRIAH, A.Md.Kep >40 thn OKRR

95 SRI NOVRITA DEWI, A.Md.Kep >40 thn OKRR

96 SURIYANDI, A.Md. Kep >40 thn OKRR

97 Ns. DIAN AFRILIA SYAPUTRI, S.Kep OKRR

98 Ns. JOKO DWI NUGROHO, S.Kep OKRR

99 ASVA SAVIATI, A.Md.Kep OKRR

100 ELDI ANGGAMI, A.Md.Kep OKRR

101 ELSYA YOSITA UTAMI, A.Md.Kep OKRR

102 ISRA ELSA, A.Md.Kep OKRR

103 NOPRIZAL, A.Md.Kep OKRR

104 NOVA TRISNA AGUS, A.Md.Kep OKRR

105 NURBETTI, A.Md.Kep OKRR

106 PUTRI RAHMA ILLAHI, A.Md. Kep OKRR

107 RICHE NOVERA, A.Md.Kep OKRR

108 SURIYADI, A.Md.Kep OKRR

109 dr. RACHMAD TRY HENDRO, Sp.An ICU

110 dr. YOLA KHAIRANISYAH, Sp.OG Pelayanan Medis

111 dr. MEIDIANASER PUTRA, Sp.JP Pelayanan Medis

112 dr. ELFIZON AMIR, .SpPd >40 thn Pelayanan Medis

113 dr. ERWAN BARDAM, SpB >40 thn Pelayanan Medis

114 dr. M. HAFIZ NASRULOH, Sp.A Pelayanan Medis

115 dr. ATIKA NURUL ILMI Pelayanan Medis

116 dr. MIA PUSPITA Penunjang Medis

117 EMILDAWATI, A.MKG >40 thn Poliklinik

118 Ns. SRIHERTETI MAININGSIH, S.Kep >40 thn Poliklinik

119 DESI MARLINDA HARSA, A.Md.Kep >40 thn Poliklinik

120 ELVI YENTI, A.MK >40 thn Poliklinik

121 MAIZA OKTAWIDIA, A.Md.Kep >40 thn Poliklinik

122 MUTIA LINDA, A.Md, S.Keb >40 thn Poliklinik

123 NURLAILY, A.MK >40 thn Poliklinik

124 YUNITA, A.Md.Kep >40 thn Poliklinik

125 AYU MUSTIKA, A.Md. Kep Poliklinik

126 DESI SURYANI, A.Md. Kep Poliklinik

127 EKA SISKA, A.Md.Kep Poliklinik

128 FITRI VAMELA, A.Md.Kep Poliklinik

129 MORITA FITRIANINGSIH, A.Md.Kep Poliklinik

130 RINI KARTIKA KOMALASARI, A.Md.Kep Poliklinik

131 SRI WAHYUNI, A.Md. Keb Poliklinik

132 VIVI WULANDARI, A.Md.Kep Poliklinik

133 VIVI YARSI, A.Md. Kep Poliklinik

134 YESI ARDILA, A.Md. Kep Poliklinik

135 YOZZY INDRAWATY PUTRI, A.Md.Kep Poliklinik

136 YULIANA FITRI, A.Md.Kep Poliklinik

137 HARIVAN RAHMAD HARDIUS, A.Md. Rad Radiologi

138 NURHIDAYAH SAFUTRI, A.Md.Rad Radiologi

139 RECI WAHYUNI, A.Md. Rad Radiologi

140 YOVAN DWI ANTOS, A.Md. Rad Radiologi

141 AZMA TRY AULYA, A.Md.Kes.(Rad.) Radiologi

142 DEKI JONIANTO, S.Sos.I Ruhis

143 RIKI EKA PUTRA, S.Sos Ruhis

144 NELWATI, S.IQ Ruhis

145 dr. JEKI SAMUEL Dokter Ruangan

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Lampiran Surat Nomor : 18/SDM/IS-PD/IX-2022

ANGGARAN MEDICAL CHECK UP

KARYAWAN RSI IBNU SINA PADANG
Tahun 2022

JML TARIF
NO PEMERIKSAAN AWAL BIAYA
KARYAWAN @
1 Cek Fisik 143 orang 45,000 6,435,000
2 Laboratorium Dasar : -
Hematologi Rutin 143 orang 88,000 12,584,000
Urine 143 orang 50,000 7,150,000
Feses 143 orang 50,000 7,150,000
Sputum 143 orang 40,000 5,720,000
JML TARIF
NO PEMERIKSAAN LANJUTAN ATAS INDIKASI DOKTER MCU BIAYA
KARYAWAN @
1 RADIOLOGI 66 orang 50,000 3,300,000
2 EKG 66 orang 100,000 6,600,000
3 ANAL SWAB DAN SWAB KUKU 11 orang 80,000 880,000
4 LABOR : -
Anti Hbs orang -
HbsAg 66 orang 70,000 4,620,000
GDP, GDPP 66 orang 48,400 3,194,400
Kolesterol, HDL/LDL, & Trigereslida 66 orang 190,000 12,540,000
Ureum Kreatinin 66 orang 40,000 2,640,000
TOTAL ANGGARAN MCU 2022 72,813,400

Padang, 22 September 2022

Plt. Ka. Bag. Umum, SDM dan Perencanaan,

Orna Findra, S.E

 RINCIAN ANGGAR

CEK Pemeriksaan Laborato

NO NAMA KARYAWAN UMUR (thn) UNIT
FISIK Hema Rutin Urin

1 MULYANI, A.Md.Kep diatas 40 thn Annisa 45,000 88,000 50,000

2 SWESTI EVA YANTI, A.Md.Keb diatas 40 thn Annisa 45,000 88,000 50,000
3 Ns. DEWI ARZONA JUSMAN, S.Kep diatas 40 thn Ash Shafa 45,000 88,000 50,000
4 FITRI YATI, A.Md.Kep diatas 40 thn Ash Shafa 45,000 88,000 50,000
5 RAHMA YULI, A.Md.Kep diatas 40 thn CSSD 45,000 88,000 50,000
6 AFRIZONI diatas 40 thn CSSD 45,000 88,000 50,000
7 DELI SURYANI diatas 40 thn Gizi 45,000 88,000 50,000
8 DERVITA DARMA diatas 40 thn Gizi 45,000 88,000 50,000
9 DESRY KURNIAWATI diatas 40 thn Gizi 45,000 88,000 50,000
10 ZUWARNI diatas 40 thn Gizi 45,000 88,000 50,000
11 NILDA FITRI YANTI, A.Md.Kep diatas 40 thn ICU/HCU/NICU 45,000 88,000 50,000
12 RATIH MADONA, A.Md.Kep diatas 40 thn ICU/HCU/NICU 45,000 88,000 50,000
13 YELITA GUSRIA, A.MK diatas 40 thn ICU/HCU/NICU 45,000 88,000 50,000
14 Ns. INDRA BUKHAIRI ,S.Kep diatas 40 thn IGD 45,000 88,000 50,000
15 MEDYA, A.Md.Kep diatas 40 thn IGD 45,000 88,000 50,000
16 ZULFADILLAH, A.MK diatas 40 thn IGD 45,000 88,000 50,000
17 HERMIDA, A.Md.AK diatas 40 thn Laboratorium 45,000 88,000 50,000
18 FITRA HIDAYATI, A.Md. AK diatas 40 thn Laboratorium 45,000 88,000 50,000
19 SUSI NOFRITA, A.Md.AK diatas 40 thn Laboratorium 45,000 88,000 50,000
20 ELVIZAH diatas 40 thn Laboratorium 45,000 88,000 50,000
21 ERLINDA diatas 40 thn Laboratorium 45,000 88,000 50,000
22 RISMADISON diatas 40 thn Laundry 45,000 88,000 50,000
23 SYAHRIANI diatas 40 thn Laundry 45,000 88,000 50,000
24 ERLINDA DARWIS diatas 40 thn Laundry 45,000 88,000 50,000
25 LINA diatas 40 thn Laundry 45,000 88,000 50,000
26 NELFIA YUSI, A.Md.Kep diatas 40 thn Multazam 45,000 88,000 50,000
27 Ns. DESI SUSANTI, S.Kep diatas 40 thn OKRR 45,000 88,000 50,000
28 RAHMATU SJUKRIAH, A.Md.Kep diatas 40 thn OKRR 45,000 88,000 50,000
29 SRI NOVRITA DEWI, A.Md.Kep diatas 40 thn OKRR 45,000 88,000 50,000
30 SURIYANDI, A.Md. Kep diatas 40 thn OKRR 45,000 88,000 50,000
31 dr. ELFIZON AMIR, .SpPd diatas 40 thn Pelayanan Medis 45,000 88,000 50,000
32 dr. ERWAN BARDAM, SpB diatas 40 thn Pelayanan Medis 45,000 88,000 50,000
33 EMILDAWATI, A.MKG diatas 40 thn Poliklinik 45,000 88,000 50,000
34 Ns. SRIHERTETI MAININGSIH, S.Kep diatas 40 thn Poliklinik 45,000 88,000 50,000
35 DESI MARLINDA HARSA, A.Md.Kep diatas 40 thn Poliklinik 45,000 88,000 50,000
36 ELVI YENTI, A.MK diatas 40 thn Poliklinik 45,000 88,000 50,000
37 MAIZA OKTAWIDIA, A.Md.Kep diatas 40 thn Poliklinik 45,000 88,000 50,000
38 MUTIA LINDA, A.Md, S.Keb diatas 40 thn Poliklinik 45,000 88,000 50,000
39 NURLAILY, A.MK diatas 40 thn Poliklinik 45,000 88,000 50,000
40 YUNITA, A.Md.Kep diatas 40 thn Poliklinik 45,000 88,000 50,000
41 Ns. ANITA ANGGRAINI J, S.Kep Ash Shafa 45,000 88,000 50,000
42 Ns. GITA APRI LONIA, S.Kep Ash Shafa 45,000 88,000 50,000
43 Ns. MIZA SEPRINA, S.Kep Ash Shafa 45,000 88,000 50,000
44 EVY ERDINA RUMAPEA, A.Md.Kep Ash Shafa 45,000 88,000 50,000
45 LOLA DESVIRA, A.Md.Kep Ash Shafa 45,000 88,000 50,000
46 MIKYASUR RAFKI, A.Md.Kep Ash Shafa 45,000 88,000 50,000
47 HARIVAN RAHMAD HARDIUS, A.Md. Rad Radiologi 45,000 88,000 50,000
48 NURHIDAYAH SAFUTRI, A.Md.Rad Radiologi 45,000 88,000 50,000
49 RECI WAHYUNI, A.Md. Rad Radiologi 45,000 88,000 50,000
50 YOVAN DWI ANTOS, A.Md. Rad Radiologi 45,000 88,000 50,000
51 AZMA TRY AULYA, A.Md.Kes.(Rad.) Radiologi 45,000 88,000 50,000
52 dr. RACHMAD TRY HENDRO, Sp.An Inst Khusus 45,000 88,000 50,000
53 dr. YOLA KHAIRANISYAH, Sp.OG Inst Rajal 45,000 88,000 50,000
54 dr. MEIDIANASER PUTRA, Sp.JP Inst Ranap 45,000 88,000 50,000
55 dr. HUMAIRA ULFA HERMAN Medis IGD 45,000 88,000 50,000
56 dr. RAMZY BAYUNI Medis IGD 45,000 88,000 50,000
57 dr. SRI YULIANA BAKAR Medis IGD 45,000 88,000 50,000
58 dr. CUT MUTIA INDRA Medis IGD 45,000 88,000 50,000
59 dr. MUTHIA RAHMI Medis IGD 45,000 88,000 50,000
60 dr. RENGGA SEBASTIAN Medis IGD 45,000 88,000 50,000
NO NAMA KARYAWAN UMUR (thn) UNIT
FISIK Hema Rutin Urin

1 MULYANI, A.Md.Kep diatas 40 thn Annisa 45,000 88,000 50,000

61 drg. VISKA YOLANDA PUTRI Komite Mutu 45,000 88,000 50,000
62 dr. PUTRI ILHAMI Laboratorium 45,000 88,000 50,000
63 dr. M. HAFIZ NASRULOH, Sp.A Pelayanan Medis 45,000 88,000 50,000
64 dr. ATIKA NURUL ILMI Pelayanan Medis 45,000 88,000 50,000
65 dr. MIA PUSPITA Penunjang Medis 45,000 88,000 50,000
66 MORITA FITRIANINGSIH, A.Md.Kep Poliklinik 45,000 88,000 50,000
67 Ns. SRI EMIL DARMIZA, S.Kep Annisa 45,000 88,000 50,000
68 GUSNELLY SULISNO, A.Md.Kep Annisa 45,000 88,000 50,000
69 IGA RAVANDA, A.Md.Keb Annisa 45,000 88,000 50,000
70 RIA OKTILOIS, A.Md.Keb Annisa 45,000 88,000 50,000
71 SELVINA PRIHANDAYANI, A.Md.Kep Annisa 45,000 88,000 50,000
72 ZULNIAH MIRZA, A. Md. Keb Annisa 45,000 88,000 50,000
73 YULIA SUSANTI, A. Md. Kep Annisa 45,000 88,000 50,000
74 Ns. RAHMIATI,S.Kep Annisa 45,000 88,000 50,000
75 Ns. HENNY PRASETYAWATI, S.Kep Annisa 45,000 88,000 50,000
76 AMELIA NOFRIYANI CSSD 45,000 88,000 50,000
77 DHARMA AULIA PUTRA CSSD 45,000 88,000 50,000
78 NANDA SUMARNO CSSD 45,000 88,000 50,000
79 AULIA RAMADHANI Gizi 45,000 88,000 50,000
80 NIRMALA Gizi 45,000 88,000 50,000
81 RAHMA YENI Gizi 45,000 88,000 50,000
82 RENI SAFITRI Gizi 45,000 88,000 50,000
83 SALWATI Gizi 45,000 88,000 50,000
84 FAIZAH AZZAHRA Gizi 45,000 88,000 50,000
85 HIDAYATUL HUSNA Gizi 45,000 88,000 50,000
86 AKMAL SHALEH, A.Md.Kep ICU/HCU/NICU 45,000 88,000 50,000
87 NELLYA SARI, A.Md.Kep ICU/HCU/NICU 45,000 88,000 50,000
88 NIA SASRIANTI, A.Md.Kep ICU/HCU/NICU 45,000 88,000 50,000
89 PURI NELLI HANDAYANI, A.Md.Kep ICU/HCU/NICU 45,000 88,000 50,000
90 RIKA MELIA, A. Md Kep ICU/HCU/NICU 45,000 88,000 50,000
91 YUSE ASMICEL, A.Md.Kep ICU/HCU/NICU 45,000 88,000 50,000
92 Ns. ORI FEBRIANTO, S.Kep IGD 45,000 88,000 50,000
93 ERWIN ARDI, A.Md.Kep IGD 45,000 88,000 50,000
94 FIRDAUS, A.Md.Kep IGD 45,000 88,000 50,000
95 FITRA YANELI, A.Md.Kep IGD 45,000 88,000 50,000
96 IRA SARTIKA SARI, A.Md.Kep IGD 45,000 88,000 50,000
97 IRSYAD AFFANDI, A.Md, S.Kep IGD 45,000 88,000 50,000
98 NENCY HELDILLA, A.Md.Kep IGD 45,000 88,000 50,000
99 RIMA GUSTIKAMELA IRAWAN, A.Md.Keb IGD 45,000 88,000 50,000
100 RIMMA NOVITA, A.Md. Kep IGD 45,000 88,000 50,000
101 SILFIA SYAFRIYANI, A.Md.Keb IGD 45,000 88,000 50,000
102 VIVI ANANDYA KURNIAWATI, A.Md.Keb IGD 45,000 88,000 50,000
103 WELLA AUGRIA, A.Md.Kep IGD 45,000 88,000 50,000
104 ZANNA DWI ANDHIKA PUTRI, A.Md.Keb IGD 45,000 88,000 50,000
105 HARRY MIZUHRI, A.Md. AK Laboratorium 45,000 88,000 50,000
106 RAHADIAN BAGUSMAN. S.ST Laboratorium 45,000 88,000 50,000
107 SHARA WINANDA, A.Md. AK Laboratorium 45,000 88,000 50,000
108 SYUKRI, A.Md. AK Laboratorium 45,000 88,000 50,000
109 DESI FEBRIANI Laboratorium 45,000 88,000 50,000
110 IRMAYANTI Laundry 45,000 88,000 50,000
111 Ns. KHUSNUL KHATIMAH, S.Kep Multazam 45,000 88,000 50,000
112 Ns. REZA NIKA, S.Kep Multazam 45,000 88,000 50,000
113 Ns. SYAFRIDA YENNI, S.Kep Multazam 45,000 88,000 50,000
114 EKA KUMALA SARI, A.Md.Kep Multazam 45,000 88,000 50,000
115 INDAH AYU, A.Md.Kep Multazam 45,000 88,000 50,000
116 RIA ANGGRAINI, A.Md.Kep Multazam 45,000 88,000 50,000
117 ZAINAL ARIFIN, A.Md.Kep Multazam 45,000 88,000 50,000
118 Ns. DIAN AFRILIA SYAPUTRI, S.Kep OKRR 45,000 88,000 50,000
119 Ns. JOKO DWI NUGROHO, S.Kep OKRR 45,000 88,000 50,000
120 ASVA SAVIATI, A.Md.Kep OKRR 45,000 88,000 50,000
121 ELDI ANGGAMI, A.Md.Kep OKRR 45,000 88,000 50,000
122 ELSYA YOSITA UTAMI, A.Md.Kep OKRR 45,000 88,000 50,000
123 ISRA ELSA, A.Md.Kep OKRR 45,000 88,000 50,000
124 NOPRIZAL, A.Md.Kep OKRR 45,000 88,000 50,000
125 NOVA TRISNA AGUS, A.Md.Kep OKRR 45,000 88,000 50,000
NO NAMA KARYAWAN UMUR (thn) UNIT
FISIK Hema Rutin Urin

1 MULYANI, A.Md.Kep diatas 40 thn Annisa 45,000 88,000 50,000

126 NURBETTI, A.Md.Kep OKRR 45,000 88,000 50,000
127 PUTRI RAHMA ILLAHI, A.Md. Kep OKRR 45,000 88,000 50,000
128 RICHE NOVERA, A.Md.Kep OKRR 45,000 88,000 50,000
129 SURIYADI, A.Md.Kep OKRR 45,000 88,000 50,000
130 AYU MUSTIKA, A.Md. Kep Poliklinik 45,000 88,000 50,000
131 DERI GUSTIANI, A.Md. Fis Poliklinik 45,000 88,000 50,000
132 EKA SISKA, A.Md.Kep Poliklinik 45,000 88,000 50,000
133 FITRI VAMELA, A.Md.Kep Poliklinik 45,000 88,000 50,000
134 RINI KARTIKA KOMALASARI, A.Md.Kep Poliklinik 45,000 88,000 50,000
135 SRI WAHYUNI, A.Md. Keb Poliklinik 45,000 88,000 50,000
136 VIVI WULANDARI, A.Md.Kep Poliklinik 45,000 88,000 50,000
137 VIVI YARSI, A.Md. Kep Poliklinik 45,000 88,000 50,000
138 YESI ARDILA, A.Md. Kep Poliklinik 45,000 88,000 50,000
139 YOZZY INDRAWATY PUTRI, A.Md.Kep Poliklinik 45,000 88,000 50,000
140 YULIANA FITRI, A.Md.Kep Poliklinik 45,000 88,000 50,000
141 DEKI JONIANTO, S.Sos.I Ruhis 45,000 88,000 50,000
142 RIKI EKA PUTRA, S.Sos Ruhis 45,000 88,000 50,000
143 NELWATI, S.IQ Ruhis 45,000 88,000 50,000
N ANGGARAN MEDICAL CHECK UP KARYAWAN UNIT BERISIKO TINGGI
KARYAWAN RSI IBNU SINA PADANG
Tahun 2022

n Laboratorium Dasar Pemeriksaan Laboratorium Lanjutan

RADIOLOGI EKG ANAL SWAB dan
SWAB KUKU Kolesterol, HDL/LDL, &
Feses HbsAg GDP, GDPP
Trigereslida
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 80,000 70,000 48,400 190,000
50,000 100,000 50,000 80,000 70,000 48,400 190,000
50,000 100,000 50,000 80,000 70,000 48,400 190,000
50,000 100,000 50,000 80,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
 ANAL SWAB dan
RADIOLOGI EKG
SWAB KUKU Kolesterol, HDL/LDL, &
Feses HbsAg GDP, GDPP
Trigereslida
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000 100,000 50,000 70,000 48,400 190,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000 80,000
50,000 80,000
50,000 80,000
50,000 80,000
50,000 80,000
50,000 80,000
50,000 80,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
 ANAL SWAB dan
RADIOLOGI EKG
SWAB KUKU Kolesterol, HDL/LDL, &
Feses HbsAg GDP, GDPP
Trigereslida
50,000 100,000 50,000 70,000 48,400 190,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
50,000
Pemeriksaan Laboratorium Lanjutan
JUMLAH
Ureum Kreatinin Sputum

40,000 40,000 771,400

40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 851,400
40,000 40,000 851,400
40,000 40,000 851,400
40,000 40,000 851,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
 JUMLAH
Ureum Kreatinin Sputum

40,000 40,000 771,400

40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 40,000 771,400
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 353,000
40,000 353,000
40,000 353,000
40,000 353,000
40,000 353,000
40,000 353,000
40,000 353,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
 JUMLAH
Ureum Kreatinin Sputum

40,000 40,000 771,400

40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
40,000 273,000
Lampiran surat nomor : /A.4/IS-PD/IX-2022

JENIS PEMERIKSAAN MEDICAL CHECK UP KARYAWAN

RSI IBNU SINA PADANG
TAHUN 2022

PEMERIKSAAN TAHAP AWAL

① Pemeriksaan Fisik
② Laboratorium Dasar :
a. Hematologi Rutin (Hemoglobi, Leukosit, LED, Diffcount)
b. Urinalisis Rutin
c. Feses Rutin
PEMERIKSAAN TAHAP LANJUTAN
USIA > 40 thn / ATAS INDIKASI DOKTER USIA < 40 thn / ATAS INDIKASI DOKTER
▪ EKG
▪ Rontgen Thorax ▪ Rontgen Thorax
▪ Laboratorium : ▪ Laboratorium :
a. Pemeriksaan HBsAg a. Pemeriksaan HBsAg
b. Gula darah puasa, Gula darah 2 jam setelah makan b. Sputum
c. HDL/LDL
d. Trigliserida ▪ Audimetri (khusus unit UPRS, CSSD dan Laundry)
e. Kolesterol Total ▪ Swab Kuku dan Anal Swab (khusus Unit Gizi)
f. Ureum Kreatinin
g. Sputum

▪ Echocardiografi
▪ Spirometri
▪ Audimetri (khusus unit UPRS, CSSD dan Laundry)
▪ Swab Kuku dan Anal Swab (khusus Unit Gizi)
PEMERIKSAAN KHUSUS RADIOGRAFER
▪ EKG
▪ Rontgen Thorax
▪ Laboratorium :
a. Pemeriksaan HBsAg
b. Fungsi Ginjal : Ureum, Kreatinin
c. Lemak : HDL/LDL, Trigliserida, Kolesterol Total
d. Gula Darah
e. Fungsi Hati : SGOT, SGPT, Albumin dan Bilirubin direct
f. Ureum Kreatinin
g. Sputum

h. Darah : Hematoktrit, Eritrosit, Trombosit, Limfosit Absolut, Monosit

Absolut, Laju Endapan Darah, Segmen Absolut, MCHC, MCV, MCH

Padang, Oktober 2022

Direktur,

dr. H. Elfizon Amir, Sp.PD, Finasim

 REALISASI BIAYA MEDICAL CHECK UP KARYAWAN
RUMAH SAKIT ISLAM IBNU SINA PADANG
Tahun 2022

PEMERIKSAAN
CEK PEMERIKSAAN EKSERNAL
UMUR
NO TGL NAMA KARYAWAN UNIT JUMLAH
(thn) ADM LABOR RADIOLOGI EKG AUDIOMETRI SWAB KUKU
FISIK
ANAL SWAB

1 11-Oct MULYANI, A.Md.Kep >40 thn Annisa 50,000 50,000 487,700 587,700
2 SWESTI EVA YANTI, A.Md.Keb >40 thn Annisa -
3 21-Oct Ns. SRI EMIL DARMIZA, S.Kep Annisa 50,000 50,000 203,500 303,500
4 GUSNELLY SULISNO, A.Md.Kep Annisa -
5 18-Oct IGA RAVANDA, A.Md.Keb Annisa 50,000 50,000 203,500 303,500
6 15-Oct RIA OKTILOIS, A.Md.Keb Annisa 50,000 50,000 203,500 303,500
7 17-Oct SELVINA PRIHANDAYANI, A.Md.Kep Annisa 50,000 50,000 203,500 303,500
8 ZULNIAH MIRZA, A. Md. Keb Annisa -
9 YULIA SUSANTI, A. Md. Kep Annisa -
10 12-Oct Ns. RAHMIATI,S.Kep Annisa 50,000 50,000 248,300 348,300
11 14-Oct Ns. HENNY PRASETYAWATI, S.Kep Annisa 50,000 50,000 203,500 303,500
12 17-Oct Ns. DEWI ARZONA JUSMAN, S.Kep >40 thn Ash Shafa 50,000 50,000 537,700 100,000 737,700
13 FITRI YATI, A.Md.Kep >40 thn Ash Shafa -
14 21-Oct Ns. ANITA ANGGRAINI J, S.Kep Ash Shafa 50,000 50,000 203,500 303,500
15 19-Oct Ns. GITA APRI LONIA, S.Kep Ash Shafa 50,000 50,000 203,500 100,000 403,500
16 11-Oct Ns. MIZA SEPRINA, S.Kep Ash Shafa 50,000 50,000 203,500 303,500
17 10-Oct EVY ERDINA RUMAPEA, A.Md.Kep Ash Shafa 50,000 328,300 378,300
18 LOLA DESVIRA, A.Md.Kep Ash Shafa -
19 14-Oct MIKYASUR RAFKI, A.Md.Kep Ash Shafa 50,000 50,000 203,500 100,000 403,500
20 22-Oct RAHMA YULI, A.Md.Kep >40 thn CSSD 50,000 50,000 487,700 100,000 687,700
21 AFRIZONI >40 thn CSSD -
22 18-Oct AMELIA NOFRIYANI CSSD 50,000 50,000 203,500 303,500
23 20-Oct DHARMA AULIA PUTRA CSSD 50,000 50,000 203,500 303,500
24 19-Oct NANDA SUMARNO CSSD 50,000 50,000 203,500 303,500
25 DELI SURYANI >40 thn Gizi -
26 17-Oct DERVITA DARMA >40 thn Gizi 50,000 50,000 444,140 100,000 644,140
27 DESRY KURNIAWATI >40 thn Gizi -
28 ZUWARNI >40 thn Gizi -
29 AULIA RAMADHANI Gizi -
30 NIRMALA Gizi -
31 20-Oct RAHMA YENI Gizi 50,000 50,000 253,500 353,500
32 17-Oct RENI SAFITRI Gizi 50,000 50,000 253,500 353,500
33 22-Oct SALWATI Gizi 50,000 50,000 460,700 100,000 660,700
34 17-Oct FAIZAH AZZAHRA Gizi 50,000 50,000 253,500 353,500
35 14-Oct HIDAYATUL HUSNA Gizi 50,000 50,000 253,500 353,500
36 11-Oct NILDA FITRI YANTI, A.Md.Kep >40 thn ICU 50,000 50,000 487,700 587,700
37 18-Oct RATIH MADONA, A.Md.Kep >40 thn ICU 50,000 50,000 487,700 587,700
38 YELITA GUSRIA, A.MK >40 thn ICU -
39 AKMAL SHALEH, A.Md.Kep ICU -
40 17-Oct NELLYA SARI, A.Md.Kep ICU 50,000 50,000 203,500 303,500
41 NIA SASRIANTI, A.Md.Kep ICU -
 PEMERIKSAAN
CEK PEMERIKSAAN EKSERNAL
UMUR
NO TGL NAMA KARYAWAN UNIT JUMLAH
(thn) ADM LABOR RADIOLOGI EKG AUDIOMETRI SWAB KUKU
FISIK
ANAL SWAB
42 PURI NELLI HANDAYANI, A.Md.Kep ICU -
43 RIKA MELIA, A. Md Kep ICU -
44 15-Oct YUSE ASMICEL, A.Md.Kep ICU 50,000 50,000 203,500 303,500
45 Ns. INDRA BUKHAIRI ,S.Kep >40 thn IGD -
46 11-Oct MEDYA, A.Md.Kep >40 thn IGD 50,000 50,000 449,200 549,200
47 ZULFADILLAH, A.MK >40 thn IGD -
48 Ns. ORI FEBRIANTO, S.Kep IGD -
49 ERWIN ARDI, A.Md.Kep IGD -
50 FIRDAUS, A.Md.Kep IGD -
51 FITRA YANELI, A.Md.Kep IGD -
52 11-Oct IRA SARTIKA SARI, A.Md.Kep IGD 50,000 50,000 199,650 299,650
53 19-Oct IRSYAD AFFANDI, A.Md, S.Kep IGD 50,000 50,000 305,000 405,000
54 NENCY HELDILLA, A.Md.Kep IGD -
55 15-Oct RIMA GUSTIKAMELA IRAWAN, A.Md.Keb IGD 50,000 50,000 225,280 325,280
56 RIMMA NOVITA, A.Md. Kep IGD -
57 10-Oct SILFIA SYAFRIYANI, A.Md.Keb IGD 245,500 100,000 345,500
58 VIVI ANANDYA KURNIAWATI, A.Md.Keb IGD -
59 15-Oct WELLA AUGRIA, A.Md.Kep IGD 50,000 50,000 203,500 303,500
60 14-Oct ZANNA DWI ANDHIKA PUTRI, A.Md.Keb IGD 50,000 50,000 203,500 303,500
61 11-Oct dr. HUMAIRA ULFA HERMAN Medis IGD 50,000 50,000 203,500 303,500
62 19-Oct dr. RAMZY BAYUNI Medis IGD 50,000 50,000 203,500 303,500
63 21-Oct dr. SRI YULIANA BAKAR Medis IGD 50,000 50,000 203,500 303,500
64 20-Oct dr. CUT MUTIA INDRA Medis IGD 50,000 50,000 203,500 303,500
65 20-Oct dr. MUTHIA RAHMI Medis IGD 50,000 50,000 203,500 303,500
66 19-Oct dr. RENGGA SEBASTIAN Medis IGD 50,000 50,000 203,500 303,500
67 20-Oct drg. VISKA YOLANDA PUTRI Komite Mutu 50,000 50,000 343,500 443,500
68 dr. ISPHANDRA BAKMA, Sp.PK Laboratorium -
69 21-Oct HERMIDA, A.Md.AK >40 thn Laboratorium 50,000 50,000 487,700 100,000 687,700
70 22-Oct FITRA HIDAYATI, A.Md. AK >40 thn Laboratorium 50,000 50,000 487,700 100,000 687,700
71 19-Oct SUSI NOFRITA, A.Md.AK >40 thn Laboratorium 50,000 50,000 487,700 587,700
72 22-Oct ELVIZAH >40 thn Laboratorium 50,000 50,000 487,700 100,000 687,700
73 18-Oct ERLINDA >40 thn Laboratorium 50,000 50,000 487,700 100,000 687,700
74 22-Oct dr. PUTRI ILHAMI Laboratorium 50,000 50,000 203,500 303,500
75 HARRY MIZUHRI, A.Md. AK Laboratorium -
76 RAHADIAN BAGUSMAN. S.ST Laboratorium -
77 17-Oct SHARA WINANDA, A.Md. AK Laboratorium 50,000 50,000 203,500 303,500
78 SYUKRI, A.Md. AK Laboratorium -
79 11-Oct DESI FEBRIANI Laboratorium 50,000 50,000 203,500 303,500
80 10-Oct RISMADISON >40 thn Laundry 50,000 50,000 504,150 100,000 50,000 754,150
81 SYAHRIANI >40 thn Laundry -
82 ERLINDA DARWIS >40 thn Laundry -
83 21-Oct LINA >40 thn Laundry 50,000 50,000 444,140 100,000 644,140
84 18-Oct IRMAYANTI Laundry 50,000 50,000 203,500 303,500
85 19-Oct NELFIA YUSI, A.Md.Kep >40 thn Multazam 50,000 50,000 487,700 587,700
86 20-Oct Ns. KHUSNUL KHATIMAH, S.Kep Multazam 50,000 50,000 203,500 303,500
87 19-Oct Ns. REZA NIKA, S.Kep Multazam 50,000 50,000 203,500 303,500
88 Ns. SYAFRIDA YENNI, S.Kep Multazam -
 PEMERIKSAAN
CEK PEMERIKSAAN EKSERNAL
UMUR
NO TGL NAMA KARYAWAN UNIT JUMLAH
(thn) ADM LABOR RADIOLOGI EKG AUDIOMETRI SWAB KUKU
FISIK
ANAL SWAB
89 19-Oct EKA KUMALA SARI, A.Md.Kep Multazam 50,000 50,000 225,280 325,280
90 INDAH AYU, A.Md.Kep Multazam -
91 14-Oct RIA ANGGRAINI, A.Md.Kep Multazam 50,000 50,000 165,000 265,000
92 21-Oct ZAINAL ARIFIN, A.Md.Kep Multazam 50,000 50,000 203,500 303,500
93 Ns. DESI SUSANTI, S.Kep >40 thn OKRR -
94 17-Oct RAHMATU SJUKRIAH, A.Md.Kep >40 thn OKRR 50,000 50,000 487,700 100,000 687,700
95 21-Oct SRI NOVRITA DEWI, A.Md.Kep >40 thn OKRR 50,000 50,000 487,700 100,000 687,700
96 20-Oct SURIYANDI, A.Md. Kep >40 thn OKRR 50,000 50,000 444,140 100,000 644,140
97 21-Oct Ns. DIAN AFRILIA SYAPUTRI, S.Kep OKRR 50,000 50,000 203,500 303,500
98 14-Oct Ns. JOKO DWI NUGROHO, S.Kep OKRR 50,000 50,000 203,500 303,500
99 20-Oct ASVA SAVIATI, A.Md.Kep OKRR 50,000 50,000 203,500 303,500
100 19-Oct ELDI ANGGAMI, A.Md.Kep OKRR 50,000 50,000 203,500 303,500
101 19-Oct ELSYA YOSITA UTAMI, A.Md.Kep OKRR 50,000 50,000 203,500 303,500
102 21-Oct ISRA ELSA, A.Md.Kep OKRR 50,000 50,000 203,500 303,500
103 18-Oct NOPRIZAL, A.Md.Kep OKRR 50,000 50,000 203,500 303,500
104 19-Oct NOVA TRISNA AGUS, A.Md.Kep OKRR 50,000 50,000 203,500 303,500
105 NURBETTI, A.Md.Kep OKRR -
106 18-Oct PUTRI RAHMA ILLAHI, A.Md. Kep OKRR 50,000 50,000 203,500 303,500
107 RICHE NOVERA, A.Md.Kep OKRR -
108 18-Oct SURIYADI, A.Md.Kep OKRR 50,000 50,000 247,500 347,500
109 dr. RACHMAD TRY HENDRO, Sp.An ICU -
110 dr. YOLA KHAIRANISYAH, Sp.OG Pelayanan Medis -
111 21-Oct dr. MEIDIANASER PUTRA, Sp.JP Pelayanan Medis 50,000 50,000 206,500 306,500
112 21-Oct dr. ELFIZON AMIR, .SpPd >40 thn Pelayanan Medis 50,000 50,000 487,700 100,000 687,700
113 22-Oct dr. ERWAN BARDAM, SpB >40 thn Pelayanan Medis 50,000 50,000 487,700 100,000 687,700
114 dr. M. HAFIZ NASRULOH, Sp.A Pelayanan Medis -
115 22-Oct dr. ATIKA NURUL ILMI Pelayanan Medis 50,000 50,000 203,500 100,000 403,500
116 22-Oct dr. MIA PUSPITA Penunjang Medis 50,000 50,000 203,500 303,500
117 EMILDAWATI, A.MKG >40 thn Poliklinik -
118 14-Oct Ns. SRIHERTETI MAININGSIH, S.Kep >40 thn Poliklinik 50,000 50,000 522,350 622,350
119 22-Oct DESI MARLINDA HARSA, A.Md.Kep >40 thn Poliklinik 50,000 50,000 487,700 100,000 687,700
120 ELVI YENTI, A.MK >40 thn Poliklinik -
121 17-Oct MAIZA OKTAWIDIA, A.Md.Kep >40 thn Poliklinik 50,000 50,000 487,700 100,000 687,700
122 MUTIA LINDA, A.Md, S.Keb >40 thn Poliklinik -
123 NURLAILY, A.MK >40 thn Poliklinik -
124 YUNITA, A.Md.Kep >40 thn Poliklinik -
125 17-Oct AYU MUSTIKA, A.Md. Kep Poliklinik 50,000 50,000 253,500 353,500
126 15-Oct DESI SURYANI, A.Md. Kep Poliklinik 50,000 50,000 253,500 353,500
127 EKA SISKA, A.Md.Kep Poliklinik -
128 15-Oct FITRI VAMELA, A.Md.Kep Poliklinik 50,000 50,000 253,500 353,500
129 MORITA FITRIANINGSIH, A.Md.Kep Poliklinik -
130 RINI KARTIKA KOMALASARI, A.Md.Kep Poliklinik -
131 SRI WAHYUNI, A.Md. Keb Poliklinik -
132 18-Oct VIVI WULANDARI, A.Md.Kep Poliklinik 50,000 50,000 126,500 226,500
133 21-Oct VIVI YARSI, A.Md. Kep Poliklinik 50,000 50,000 203,500 303,500
134 17-Oct YESI ARDILA, A.Md. Kep Poliklinik 100,000 100,000
135 22-Oct YOZZY INDRAWATY PUTRI, A.Md.Kep Poliklinik 50,000 50,000 203,500 303,500
 PEMERIKSAAN
CEK PEMERIKSAAN EKSERNAL
UMUR
NO TGL NAMA KARYAWAN UNIT JUMLAH
(thn) ADM LABOR RADIOLOGI EKG AUDIOMETRI SWAB KUKU
FISIK
ANAL SWAB
136 22-Oct YULIANA FITRI, A.Md.Kep Poliklinik 50,000 50,000 203,500 303,500
137 11-Oct HARIVAN RAHMAD HARDIUS, A.Md. Rad Radiologi 50,000 50,000 664,420 100,000 50,000 914,420
138 NURHIDAYAH SAFUTRI, A.Md.Rad Radiologi -
139 RECI WAHYUNI, A.Md. Rad Radiologi -
140 11-Oct YOVAN DWI ANTOS, A.Md. Rad Radiologi 50,000 679,920 100,000 50,000 879,920
141 AZMA TRY AULYA, A.Md.Kes.(Rad.) Radiologi -
142 19-Oct DEKI JONIANTO, S.Sos.I Ruhis 50,000 50,000 203,500 303,500
143 19-Oct RIKI EKA PUTRA, S.Sos Ruhis 50,000 50,000 165,000 265,000
144 19-Oct NELWATI, S.IQ Ruhis 50,000 50,000 480,640 100,000 680,640
145 dr. JEKI SAMUEL Dokter Ruangan -
146 13-Oct NANDA RIANTIKA PUTRI Laboratorium 50,000 50,000 233,000 333,000
147 SELINA ORCHI JUEN Gizi -
148 21-Oct LYLY SUARNI Gizi 50,000 50,000 537,700 100,000 737,700
149 19-Oct MONICA SYAMILLA VANNY Gizi 50,000 50,000 126,500 226,500
150 18-Oct DELIMA ANASTASIA Poliklinik 50,000 50,000 126,500 226,500
151 15-Oct QUR'AINI Poliklinik 50,000 50,000 494,140 594,140
152 14-Oct DWI RENNY JUNNISA Poliklinik 50,000 50,000 126,500 226,500
153 -
154 -
155 -
156 -
#REF! -
TOTAL Rp 4,800,000 Rp 4,700,000 Rp 28,838,850 Rp 2,600,000 Rp 150,000 Rp 0 Rp 0 Rp 41,088,850

Mengetahui, Padang, 03 November 2022

Direktur, Plt. Kepala Bagian Umum, SDM dan Perencanaan,

dr. Zurrahmi, MARS Orna Findra, S.E

 DAFTAR NAMA KARYAWAN YANG TIDAK HADIR
PADA MEDICAL CHECK UP KARYAWAN
TAHUN 2021

NO TANGGAL NAMA KARYAWAN UMUR (thn) UNIT

1 Fiza Putrimadini Akuntansi dan Keuangan

2 Orna Findra > 40 thn Akuntansi dan Keuangan
3 Fitri Yati > 40 thn Al Marwah
4 Nilam Afriani Al Marwah
5 Renno Fitri Ariani Al Marwah
6 Reza Nika Al Marwah
7 Edo Suryana Fernando Ar Raudhah
8 Fatma Sari Ar Raudhah
9 Nurrasri Saputri Ar Raudhah
10 Yuliana Fitri Ar Raudhah
11 Anggi Septia Azhara Casemix
12 Afri Zoni > 40 thn CSSD
13 Feriani Farmasi
14 dr. Mursyidah Sholihati Fisioterapi/Medis
15 Hidayatul Husna Gizi
16 Laiza Faaghna Humas, Pemasaran & Perencanaan
17 dr. Rachmad Try Hendro, SpAn ICU / Dokter Spesialis
18 Medya IGD
19 Veri Hidayat IGD
20 dr. Yola Khairanisyah,SpOG Inst. IGD dan Rajal / Dokter Spesialis
21 Fitri Andria Sari Kesling
22 Rahmad Akbari Usman, SE > 40 thn Komkordik
23 Harry Mizuhri Laboratorium
24 Rahadian Bagusman Laboratorium
25 Reni Febriyanti > 40 thn Laboratorium
26 dr. Putri Ilhami Laboratorium/Medis
27 dr. Elia Maifa Medis
28 Asva Saviati OK RR
29 Khairul Ihsan OK RR
30 dr. Mia Puspita Penunjang Medis
31 Ayu Mustika Poliklinik
32 Fiki Yuliasni Poliklinik
33 dr. Dhania Pratiwi Radiologi
34 Muri Abdillah > 40 thn Radiologi
35 Anggia Febria Rekam Medis
36 Giska Yulia Rekam Medis
37 Ike Sutowo Rekam Medis
38 Ilham Purwandi Rekam Medis
39 Titik Syofianti Rekam Medis
40 Rosy Mutia Satrina > 40 thn SPI
41 Fredinal Pratama Transportasi
42 Zaidi Yuliandri > 40 thn Transportasi
43 Herzumalton Verifikasi dan Angaran
44 Yossy Dora Agusta Verifikasi dan Angaran
45 Puji Yastuti Rahmatia Zamzam
 1 Elsya Yosita Utami
2 Akmal Shaleh
3 Asri Mulyani
4 Desi Marlinda Harsa
5 Desi Susanti
6 Dian Afrilia Syaputri
KET 7 Eldi Anggami
8 Evitaria Widyani
9 Ferawati
Cuti Melahirkan 10 Iga Ravanda
11 Isra Elsa
12 Joko Dwi Nugroho
13 Khusnul Khatimah
14 Mutia Linda
15 Nellya Sari
16 Nilda Fitriyenti
17 Noprizal
18 Nurbetti
19 Nurlaily
Cuti Melahirkan 20 Puri Nelli Handayani
21 Ratih Madona
22 Riche Novera
23 Rika Melia
24 Rini Kartika Kumala Sari
& Perencanaan 25 Selvina Prihandayani
26 Sri Novita Dewi
27 Syafrida Yenni
28 Vivi Anandya Kurniawati
Dokter Spesialis 29 Vivi Wulandari
30 Wisa Febrina Lestari
31 Yelita Gusria
32 Yozzy Indrawati
33 Yuse Asmicel
34 Zanna Dwi Andikha Putri
Cuti Melahirkan
 Jenis Pemeriksaan Check Up Karyawan Resiko Tinggi
RSI Ibnu Sina Padang
Tahun 2020

No Jenis Pemeriksaan Tarif

1 Pemeriksaan Fisik 45,000
2 EKG 50,000
3 Echocardiografi
4 Rontgen Thorax 100,000
5 Laboratorium :
1. Hematologi Rutin 88,000
2. Labor Lanjutan 150,000
Eritrosit, Retikulosit, MCV, MCH & MCHC
3. Urinalisa Rutin 50,000
4. Analisis Feses Rutin 50,000
5. Profil Lipid
6. Kolesterol, HDL/LDL, & Trigereslida 190,000
7. Glukosa darah 25,000
8. SGOT/SGPT 80,000
9. Anti HBs 70,000
10. HBsAG 70,000
11. Sputum 40,000
12. LED
13. Anal Swab
14. Swab Kuku
Total 1,008,000