REKAPITULASI RETRIBUSI PELAYANAN KESEHATAN DI PUSKESMAS TIGANDERKET

Jenis Pelayanan : Umum

Bulan : Januari s/d Pebruari 2018
Tahun : 2018
A B C D E F G H I J K L M N O P Q
Jasa Perawat/ Jasa Jasa Jasa Jlh Setoran
No Unit Kerja Jenis Tindakan Jlh kunjungan BHP/Obat (Rp) Jasa Pusk (Rp) Jasa Dokter Para Medis
Oksigen Jasa Bidan Jasa Jurim
pet.Lab pet.Pendam
Jasa Supir
Kendaraan Jumlah (Rp)
(Rp) (Rp) (Rp) (Rp) (Rp)
(Rp) ping (Rp)
(Rp)
(Rp) (Rp)

1  Pusk.TIGANDERKET Rawat Jalan 239 1,195,000 597,500 1,195,000 597,500 0 0 0 0 0 0 0 3,585,000

Rawat inap 0 0 0 0 0 0 0 0 0 0 0 0 0
Im.Dasar 73 182,500 182,500 0 0 0 0 182,500 0 0 0 0 547,500
Buka Inplan 0 0 0 0 0 0 0 0 0 0 0 0 0
Sur.Kesehatn 26 0 65,000 130,000 0 0 0 0 0 65,000 0 0 260,000
Hacting 12 60,000 30,000 300,000 180,000 0 0 0 0 0 0 0 570,000 4,962,500
2 Desa Perbaji Rawat Jalan 30 150,000 75,000 0 0 0 75,000 0 0 0 0 0 300,000
Junita Im.Dasar 0 0 0 0 0 0 0 0 0 0 0 0 0 300,000
3 Desa Temburun Rawat Jalan 30 150,000 75,000 0 0 0 75,000 0 0 0 0 0 300,000
Im.Dasar 0 0 0 0 0 0 0 0 0 0 0 0 0 300,000
4 Desa Marding-ding Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Im.Dasar 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Desa Kt.Mbaru Rawat Jalan 66 330,000 165,000 0 0 0 165,000 0 0 0 0 0 660,000
Berta Br Ginting Im.Dasar 6 15,000 15,000 0 0 0 15,000 0 0 0 0 0 45,000 705,000
6 Desa Tj.Merawa Rawat Jalan 82 410,000 205,000 0 0 0 205,000 0 0 0 0 0 820,000
Anita Kristin Im.Dasar 16 40,000 40,000 0 0 0 40,000 0 0 0 0 0 120,000 940,000
7 Desa Sk Tendel Rawat Jalan 112 560,000 280,000 0 0 0 280,000 0 0 0 0 0 1,120,000
Elida Kacaribu Im.Dasar 20 50,000 50,000 0 0 0 50,000 0 0 0 0 0 150,000 1,270,000
8 Desa Penampen Rawat Jalan 20 100,000 50,000 0 0 0 50,000 0 0 0 0 0 200,000
Heny Novayanti Im.Dasar 0 0 0 0 0 0 0 0 0 0 0 0 0 200,000
9 Desa Gn.Merlawan Rawat Jalan 26 130,000 65,000 0 0 0 65,000 0 0 0 0 0 260,000
Nurhayati Im.Dasar 0 0 0 0 0 0 0 0 0 0 0 0 0 260,000
10 Desa Susuk Rawat Jalan 72 360,000 180,000 0 0 0 180,000 0 0 0 0 0 720,000
Devi Im.Dasar 21 52,500 52,500 0 0 0 52,500 0 0 0 0 0 157,500 877,500
11 Desa Jd.Meriah Rawat Jalan 101 505,000 252,500 0 0 0 252,500 0 0 0 0 0 1,010,000
Rinsoana Im.Dasar 24 60,000 60,000 0 0 0 60,000 0 0 0 0 0 180,000
Persalinan 1 20,000 5,000 0 0 0 200,000 0 0 0 0 0 225,000 1,415,000
12 Desa N.Gunung I Rawat Jalan 56 280,000 140,000 0 0 0 140,000 0 0 0 0 0 560,000
Liliant Im.Dasar 0 0 0 0 0 0 0 0 0 0 0 0 0 560,000
13 Desa N.Gunung II Rawat Jalan 43 215,000 107,500 0 0 0 107,500 0 0 0 0 0 430,000
Im.Dasar 0 0 0 0 0 0 0 0 0 0 0 0 0 430,000
14 Desa Tj.Mbelang Rawat Jalan 115 575,000 287,500 0 0 0 287,500 0 0 0 0 0 1,150,000
Im.Dasar 2 5,000 5,000 0 0 0 5,000 0 0 0 0 0 15,000 1,165,000
Jumlah 1,193 5,445,000 2,985,000 1,625,000 777,500 0 2,305,000 182,500 0 65,000 0 0 13,385,000 13,385,000
A B C D E F G H I J K L M N O P Q
Jasa Jasa Jasa Jasa
Jasa Dokter Perawat/ Oksigen Jasa Bidan Jasa Jurim Jasa Supir Jlh Setoran
No Unit Kerja Jenis Tindakan Jlh kunjungan BHP/Obat (Rp) Jasa Pusk (Rp) (Rp) Para Medis (Rp) (Rp) (Rp) pet.Lab pet.Pendam (Rp) Kendaraan Jumlah (Rp)
(Rp)
(Rp) (Rp) ping (Rp) (Rp)

Sam.Hal 1(Jlh) 1,193 5,445,000 2,985,000 1,625,000 777,500 0 2,305,000 182,500 0 65,000 0 0 13,385,000 13,385,000
15 Desa Kuta Galuh Rawat Jalan 25 125,000 62,500 0 0 0 62,500 0 0 0 0 0 250,000
Rupida Lestari Im.Dasar 6 15,000 15,000 0 0 0 15,000 0 0 0 0 0 45,000 295,000
16 Desa Tj.Pulo Rawat Jalan 46 230,000 115,000 0 0 0 115,000 0 0 0 0 0 460,000
Martina Br.Sebayang Im.Dasar 4 10,000 10,000 0 0 0 10,000 0 0 0 0 0 30,000 490,000
17 Desa Kuta Kepar Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Desiana Im.Dasar 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Jumlah 1,274 5,825,000 3,187,500 1,625,000 777,500 0 2,507,500 182,500 0 65,000 0 0 14,170,000 14,170,000

Mengetahui, Tiganderket, 07 Maret 2018

Ka.UPTD. Kesehatan Puskesmas Tiganderket Bendahara pembantu Puskesmas Tiganderket

dr. Deddy A Pinem Bertamasya Sembiring

Nip : 19761019200312 1004 Nip : 19620927198603 1001
 REKAPITULASI RETRIBUSI PELAYANAN KESEHATAN DI PUSKESMAS TIGANDERKET
Jenis Pelayanan : Jamkesmas Dan Jampersal
Bulan : Desember 2013
Tahun : 2013
A B C D E F G H I J K L M N O P Q
Jasa Jasa Jasa
Jlh BHP/Obat Jasa Dokter Oksigen Jasa Bidan Jasa Jurim Jasa pet.Lab Jasa Supir Jlh Setoran
No Unit Kerja Jenis Tindakan kunjungan (Rp) Jasa Pusk (Rp) (Rp)
Perawat/
Para Medis (Rp) (Rp) (Rp) (Rp) pet.Pendam (Rp) Kendaraan Jumlah (Rp)
(Rp)
(Rp) ping (Rp) (Rp)

1 Pusk.Tigandedrket Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0

Bertamasya Semb Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
ANC 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Desa Perbaji Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Junita Br Tarigan Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Desa Temburun Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Ervarida U Kalsum Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Desa Marding-ding Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Desa Kt.Mbaru Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Berta Br Ginting Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Desa Tj.Merawa Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Anita Kristin Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Desa Sk.Tendel Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Elida Br Kacaribu Persalinan 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Desa Penampen Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Desa Gn.Merlawan Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Nurhayati Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Desa Susuk Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Diana Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0
11 Desa Jandi Meriah Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Rinsoana Persalinan 2 40,000 10,000 0 0 0 400,000 0 0 0 0 0 450,000
 PNC 8 40,000 20,000 0 0 0 0 0 0 0 0 0 60,000 510,000
0
0
Jumlah 10 80,000 30,000 0 0 0 400,000 0 0 0 0 0 510,000 510,000

A B C D E F G H I J K L M N O P Q
Jasa Jasa Jasa
Jlh BHP/Obat Jasa Dokter Oksigen Jasa Bidan Jasa Jurim Jasa pet.Lab pet.Pendam Jasa Supir Jlh Setoran
No Unit Kerja Jenis Tindakan kunjungan (Rp) Jasa Pusk (Rp) (Rp)
Perawat/
Para Medis (Rp) (Rp) (Rp) (Rp) (Rp)
Kendaraan Jumlah (Rp)
(Rp)
(Rp) ping (Rp) (Rp)

Sam.Hal.1 (Jlh) 10 80,000 30,000 0 0 0 400,000 0 0 0 0 0 510,000 510,000

12 Desa N.Gunung I Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0
Lilianti Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Desa N.Gunung II Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Masri Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Desa Tj.Mbelang Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Rut Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Desa Tj.Pulo Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Martina Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Desa Kt.Galuh Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Persalinan 0 0 0 0 0 0 0 0 0 0 0 0 0
PNC 0 0 0 0 0 0 0 0 0 0 0 0 0
ANC 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Desa Kt.Kepar Rawat Jalan 0 0 0 0 0 0 0 0 0 0 0 0 0
Desiana PNC 0 0 0 0 0 0 0 0 0 0 0 0 0
ANC 0 0 0 0 0 0 0 0 0 0 0 0 0
0
0
0
0
0
0
0
0
0
0
0
 0
0
Jumlah 10 80,000 30,000 0 0 0 400,000 0 0 0 0 0 510,000 510,000

Mengetahui, Tiganderket, Desember 2013

Ka.UPTD. Kesehatan Puskesmas Tiganderket Bendahara pembantu Puskesmas Tiganderket

Dr. Deddy A Pinem Bertamasya Sembiring

Nip : 19761019200312 1004 Nip : 19620927198603 1001
 REKAPITULASI PENERIMAAN RETRIBUSI PELAYANAN PUSKESMAS TIGANDEKET

Jenis pelelayanan : Umum

Bulan : Pebruari 2014
T a h un : 2014

NO NAMA DESA NAMA PETUGAS / BIDAN JUMLAH SETORAN (Rp)

1 Puskesmas Tiganderket Bertamasya Sembiring 120,000
2 Desa Perbaji Junita Br Tarigan -
3 Desa Temburun Ervarida Umi Kalsum -
4 Desa Tanjung Merawa Anita Kristin -
5 Desa Marding-ding Patmawati Br Sembiring -
6 Desa Kuta Mbaru Berta Br Ginting -
7 Desa Suka Tendel Elida Br Kacaribu 600,000
8 Desa Penampen Yeni Yuslina Sari Sitepu -
9 Desa Gunung Merlawan Nurhayati Br Surbakti 100,000
10 Desa Susuk Devi 402,500
11 Desa Jandi Meriah Rinsoana Br Ginting 595,000
12 Desa Nari Gunung I Lilianti Br Surbakti 252,500
13 Desa Nari Gunung II Masri Br Ginting 320,000
14 Desa Tanjung Mbelang Rut Tarigan 562,500
15 Desa Kuta Galuh Rupida Lestari Br Bangun 460,000
16 Desa Tanjung Pulo Martina Br Sebayang -
17 Desa Kuta Kepar Desiana Br Karo 230,000

3,642,500

Tiganderket 10 Maret 2014

Mengetahui
Ka.UPTD. Kesehatan Puskesmas Tiganderket Bendahara pembantu Puskesmas Tiganderket

Dr. Deddy A Pinem Bertamasya Sembiring

Nip : 19761019200312 1004 Nip : 19620927198603 1001
 REKAPITULASI PENERIMAAN RETRIBUSI PELAYANAN PUSKESMAS TIGANDEKET

Jenis pelayanan : Jamkesmas / Jampersal

Bulan : Desember 2013
Tahun : 2013

NO NAMA DESA NAMA PETUGAS / BIDAN JUMLAH SETORAN (Rp)

1 Puskesmas Tiganderket Bertamasya Sembiring 0
2 Desa Perbaji Junita Br Tarigan 0
3 Desa Temburun Ervarida Ummi Kalsum 0
4 Dsa Tanjung Merawa Anita Kristin 0
5 Desa Marding-ding Patmawati Br Sembiring 0
6 Desa Kutambaru Berta br Ginting 0
7 Desa Suka Tendel Elida Br Kacaribu 0
8 Desa Penampen Yeni Yuslina Br Sitepu 0
9 Desa Gunung Merlawan Nurhayati Br Surbakti 0
10 Desa Susuk Diana Tarigan 0
11 Desa Jandi Meriah Rinsoana Br Ginting 510,000
12 Desa Nari Gunung I Lilianti Br Surbakti 0
13 Desa Nari Gunung II Masri Br Ginting 0
14 Desa Tanjung Mbelang Rut Tarigan 0
15 Desa Kuta Galuh Rupida L Br Bangun 0
16 Desa Tanjung Pulo Martina Br Sebayang 0
17 Desa Kuta Kepar Desiana Br Karo 0

J U M L A H 510,000

Mengetahui Tiganderket, Desember 2013

Ka.UPTD. Kesehatan Puskesmas Tiganderket Bendahara pembantu Puskesmas Tiganderket

Dr. Deddy A Pinem Bertamasy Sembiring

Nip : 19761019200312 1004 Nip : 19620927198603 1001