PENILAIAN KINERJA TENAGA KESEHATAN PADA PUSKESMAS PRINGGASELA

Bulan : JANUARI 2018

INDIKATOR KINERJA (Total skor indikator 100)

Bobot penilaian kinerja 40%
PELAKSANAAN TUGAS (25) PRODUKTIVITAS (75) NILAI
Sikap & Perilaku Kerja KINERJA
NO NAMA Kerjasama (10) kelengkapan JUMLAH
(15) data
(Jml x
Capaian 40/100)
Tangg Moti advokasi & Hub. kegiatan (60) pelaksanaan
Loya Kegiatan
jawab vasi koordinasi Harmonis
litas (5) (15)
(5) (5) (5) (5)
1 H.Ahmad Yani, S.Kep., MM 5 5 5 5 5 60 15 100 40
2 Effendi,S.Si 5 5 5 5 5 60 15 100 40
3 Masruni, AMd.Keb 5 5 3 3 5 50 10 81 32.4
4 Mutawakkil,SAP 5 5 5 3 5 50 10 83 33.2
5 Baik Mahnur 5 5 5 3 3 50 10 81 32.4
6 Algazali Hasan,S.Si 5 5 5 5 5 60 15 100 40
7 Muhammad Amrullah, A.MKep 5 5 3 3 5 40 10 71 28.4
8 drg.Vembriane Vaerus Rafani 0 0 0 0 0 0 0 0 0
9 dr. Baiq Nurlaili Hidayanti 5 5 5 5 5 50 10 85 34
10 Indah Arsyanti,S.Kep 5 5 5 3 5 40 10 73 29.2
11 Juhaini 5 3 3 3 3 40 10 67 26.8
12 Hamdi,S.Kep 5 3 5 3 3 50 10 79 31.6
13 Musdikin,S.Kep 5 3 5 3 5 50 10 81 32.4
14 Suhari All Abdi, S.Kep 3 5 3 3 5 50 10 79 31.6
15 Sucimah 5 5 3 3 5 40 10 71 28.4
16 Sri Kormawati 5 5 3 3 5 40 10 71 28.4
17 Laela Niswati,Amd.Kep 5 5 5 3 5 40 10 73 29.2
18 Ismayadi,S.Farm.Apt 3 3 5 5 3 40 10 69 27.6
19 dr. Baiq Intan Permata 5 5 5 5 5 50 15 90 36
20 Marlia Rosfiantini,A.Md.Keb 5 5 3 3 5 50 10 81 32.4
21 Hairani,SKM 5 5 5 3 3 50 15 86 34.4
22 Ilya Sobah, SST 5 5 5 3 3 50 10 81 32.4
23 Sri Uji Astuti,SST 3 5 5 3 3 40 10 69 27.6
24 Radiyah Wahidah 3 5 3 3 5 50 10 79 31.6
25 Edy Kusnadi, S.Kep 3 5 3 3 5 40 10 69 27.6
26 Sanusi Fadli, S.Kep 3 5 3 3 5 50 10 79 31.6
27 Yeni Prasasti, SKM 5 5 5 3 5 40 10 73 29.2
28 Wildan, , A.MKp 5 3 3 3 5 40 10 69 27.6
29 Hj. Rahmawati,S.ST 5 3 3 3 5 40 10 69 27.6
30 Sri Wahyuni, Amdg 5 5 5 3 5 50 10 83 33.2
31 Huzratul aini,A.Md,Keb 5 5 5 3 3 50 10 81 32.4
32 Bq. Lasmi Sariati 5 3 3 3 5 40 10 69 27.6
 INDIKATOR KINERJA (Total skor indikator 100)
Bobot penilaian kinerja 40%
PELAKSANAAN TUGAS (25) PRODUKTIVITAS (75) NILAI
Sikap & Perilaku Kerja KINERJA
NO NAMA Kerjasama (10) kelengkapan JUMLAH
(15) data
(Jml x
Capaian 40/100)
Tangg Moti advokasi & Hub. kegiatan (60) pelaksanaan
Loya Kegiatan
jawab vasi koordinasi Harmonis
litas (5) (15)
(5) (5) (5) (5)
33 Evi Susanti 5 5 5 3 5 50 10 83 33.2
 INDIKATOR KINERJA (Total skor indikator 100)
Bobot penilaian kinerja 40%
PELAKSANAAN TUGAS (25) PRODUKTIVITAS (75) NILAI
Sikap & Perilaku Kerja KINERJA
NO NAMA Kerjasama (10) kelengkapan JUMLAH
(15) data
(Jml x
Capaian 40/100)
Tangg Moti advokasi & Hub. kegiatan (60) pelaksanaan
Loya Kegiatan
jawab vasi koordinasi Harmonis
litas (5) (15)
(5) (5) (5) (5)
34 Nani Diana Zohrah, A.Md.Keb 5 5 3 3 5 50 10 81 32.4
35 Patmawati, Amd.Keb 5 3 3 5 5 40 10 71 28.4
36 Bq Eka Budiasih, Amd, Keb. 5 3 3 3 3 40 10 67 26.8
37 Mardin 5 5 3 5 5 40 10 73 29.2
38 Herman 5 5 5 3 3 40 10 71 28.4
39 Hamzan Wadi, Amd.Kep 5 5 3 3 5 40 10 71 28.4
40 Miskul Laelani, Amd.Kep 5 3 3 3 3 40 10 67 26.8
41 Jurianingsih, AMKG 5 5 3 3 5 35 10 66 26.4
42 Rosmanul Hakim 5 5 5 3 3 35 10 66 26.4
43 Sanimah,SKM 3 3 3 3 3 40 10 65 26
44 Murtini, AMG 5 5 5 3 5 40 10 73 29.2
45 Titin Suyani,SKM 5 3 3 3 5 40 10 69 27.6
46 Ulfa Rahmawati, AKL 5 3 3 3 5 30 5 54 21.6
47 Siti Haulani Wardiani, A.Md.Kep 5 5 5 5 5 50 15 90 36
48 Rusmayanti, A.Md.Kep 5 3 3 3 3 40 10 67 26.8
49 Muhibbin Ali, A.Md.Kep 3 3 3 1 3 30 10 53 21.2
50 Wita Apria Wardani,Amd.Keb 5 5 5 3 3 50 10 81 32.4
51 Indah Kusuma Wardani, Amd.Kep 3 3 3 3 3 40 10 65 26
52 Herman Hadi, S.Kom 5 3 5 3 5 40 10 71 28.4
53 Zohratul Farida, Amd.Farm 5 5 5 3 5 50 15 88 35.2
54 Lalu Abdurahim 3 3 3 3 3 40 10 65 26
55 Andi Sujudin,Amd.Kep 5 3 3 5 3 40 10 69 27.6
56 Rahadian Wahyudi,Amd.Kep 5 3 3 3 3 40 10 67 26.8
57 Liana Nurmalasari, Amd, Keb 5 5 5 3 5 50 10 83 33.2
58 Lalu ismail 3 3 3 3 3 40 10 65 26
59 Heri Agus Sidarta,Amd.Kep 5 3 3 5 3 40 10 69 27.6
60 Lalu Budyar Topan T.A,S.Kep, Ners. 5 5 3 3 5 40 5 66 26.4
61 Teguh Imam wahyudi,Amd.Kep 5 3 3 3 3 40 10 67 26.8
62 M. Azwar Hidayatullah,Amd.Kep 3 3 3 3 3 40 10 65 26
63 Jasman Wadi,Amd.AK 5 3 3 5 3 40 10 69 27.6
64 Upa Suparya Adimaja,A.MKL 5 3 3 3 5 30 5 54 21.6
65 Syarifa Zubaidah, A.Md.Keb 5 3 3 3 5 30 10 59 23.6
66 Nurmalia Anggraini, A.Md.Keb 5 5 5 3 5 60 10 93 37.2
67 Winda Kariantina, Amd.Keb 5 3 5 3 5 40 10 71 28.4
 INDIKATOR KINERJA (Total skor indikator 100)
Bobot penilaian kinerja 40%
PELAKSANAAN TUGAS (25) PRODUKTIVITAS (75) NILAI
Sikap & Perilaku Kerja KINERJA
NO NAMA Kerjasama (10) kelengkapan JUMLAH
(15) data
(Jml x
Capaian 40/100)
Tangg Moti advokasi & Hub. kegiatan (60) pelaksanaan
Loya Kegiatan
jawab vasi koordinasi Harmonis
litas (5) (15)
(5) (5) (5) (5)
68 Hevizatul Muftari,Amd,Keb 5 5 3 3 3 40 10 69 27.6
 INDIKATOR KINERJA (Total skor indikator 100)
Bobot penilaian kinerja 40%
PELAKSANAAN TUGAS (25) PRODUKTIVITAS (75) NILAI
Sikap & Perilaku Kerja KINERJA
NO NAMA Kerjasama (10) kelengkapan JUMLAH
(15) data
(Jml x
Capaian 40/100)
Tangg Moti advokasi & Hub. kegiatan (60) pelaksanaan
Loya Kegiatan
jawab vasi koordinasi Harmonis
litas (5) (15)
(5) (5) (5) (5)
69 Anita Wardiana M., Amd.Keb 5 5 3 3 3 40 10 69 27.6
70 Bq Astuti, Amd, Keb. 5 5 5 3 5 50 10 83 33.2
71 Yuliani Astuti,Amd.Keb 5 5 5 3 5 50 10 83 33.2
72 Irma Rahayu, AMd.Keb 5 3 3 3 5 40 15 74 29.6
73 Rahmawati, Amd, Keb 5 5 3 3 5 50 10 81 32.4
74 Bq Nani Sulistiyarini,Amd.Keb 5 3 3 3 5 50 10 79 31.6

Mengetahui
Kepala PKM Pringgasela

(H. AHMAD YANI, S.Kep.,MM)

NIP. 19741231 199503 1 003
 PENGHITUNGAN JASA PELAYANAN PROGRAM JAMINAN KESEHATAN NASIONAL
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR TAHUN 2018
PUSKESMAS : Pringgasela
BULAN : Januari 2018

PERHITUNGAN VARIABEL NON KINERJA (KETENAGAAN DAN HARI KERJA EFEKTIF) PERHITUNGAN POIN SELURUH VARIABEL

KINERJA
VARIABEL KETENAGAAN HARI KERJA PENGURANGAN POIN HARI KERJA KETENAGAAN & HARI EFEKTIF (BOBOT 60)
HARGA PER JUMLAH DITERIMA
No. NAMA GOL PENDIDIKAN (BOBOT 40) JUMLAH (Rp) PAJAK TANDA TANGAN
BEBAN PROSEN POIN
KERJA/ IJIN TIDAK TIDAK APEL IJIN TIDAK TIDAK APEL TASE TOTAL POIN
RANGKAP JML
PENDIDI TGNGJW MASA STATUS JML HR POIN APEL PAGI/TELAT APEL SIANG/PULANG JML HARI KEHADIRAN
TGS/JABA JML POIN TIDAK MASUK PEMOT. JML NILAI NILAI
KAN B KERJA KEPEG KERJA PERHARI PAGI/TELAT PIKET TANPA SIANG/PULAN DULUAN TANPA TDK MASUK
TAN POIN
PROGRA PIKET KET G DULUAN KET
M 20 =(11-19) /
1 2 3 4 5 6 7 8 9 10=5+ sd 9 11 12=10/11 13 14 15 16 17 18=13+14+15+16 19=18/12 21=20 x10 22=21x60% 23 24=22+23 23 24 25 26 = 24-25 27
11 x100
1 H.Ahmad Yani, S.Kep., MM III/d S-2 Managemen 80 100 40 20 50 290 26 11.15 1 2.79 0 0.00 0 0.00 0 0.00 0 0.00 2.79 0.25 99.04 287.21 172.33 40.0 212.3 15814.2 3,357,786 167,889 3,189,897 1

2 Effendi,S.Si III/c S-1 Analis 80 30 60 20 50 240 26 9.23 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 240.00 144.00 40.0 184.0 15814.2 2,909,818 145,491 2,764,327 2

3 Masruni, AMd.Keb III/d D-III Kebidanan 50 10 25 50 135 26 5.19 1 1.30 0 0.00 0 0.00 0 0.00 0 0.00 1.30 0.25 99.04 133.70 80.22 32.4 112.6 15814.2 1,781,016 89,051 1,691,966 3

4 Mutawakkil,SAP III/d S-1 Administrasi 50 25 50 125 26 4.81 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 125.00 75.00 33.2 108.2 15814.2 1,711,099 85,555 1,625,544 4

5 Baik Mahnur III/d SPK> 10 Th 50 20 50 120 26 4.62 2 2.31 0 0.00 1 1.15 0 0.00 0 0.00 3.46 0.75 97.12 116.54 69.92 32.4 102.3 15814.2 1,618,160 80,908 1,537,252 5

6 Algazali Hasan,S.Si III/d S-1 Biologi 80 30 20 50 180 26 6.92 0 0.00 0 0.00 1 1.73 0 0.00 0 0.00 1.73 0.25 99.04 178.27 106.96 40.0 147.0 15814.2 2,324,083 116,204 2,207,879 6

Muhammad Amrullah,
7 III/c D-III Keperawatan 60 10 25 50 145 26 5.58 8 11.15 0 0.00 0 0.00 13 36.25 0 0.00 47.40 8.50 67.31 97.60 58.56 28.4 87.0 15814.2 1,375,169 68,758 1,306,410 7
A.MKep

8 drg.Vembriane Vaerus Rafani III/c S-1 Kedoktern gigi 150 10 5 50 215 26 8.27 0 0.00 0 0.00 0 0.00 0 0.00 26 215.00 215.00 26.00 0.00 0.00 0.00 0.0 0.0 15814.2 - - - 8

9 dr. Baiq Nurlaili Hidayanti III/c S-1 Kedoktern 150 10 5 50 215 26 8.27 13 26.88 8 33.08 2 4.13 0 0.00 0 0.00 64.09 7.75 70.19 150.91 90.55 34.0 124.5 15814.2 1,969,631 98,482 1,871,150 9

10 Indah Arsyanti,S.Kep III/c S-1 Keperawatan 80 50 10 15 50 205 26 7.88 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 205.00 123.00 29.2 152.2 15814.2 2,406,925 120,346 2,286,579 10

11 Juhaini III/c SPK> 10 Th 50 25 50 125 26 4.81 1 1.20 1 2.40 2 2.40 5 12.02 1 4.81 22.84 4.75 81.73 102.16 61.30 26.8 88.1 15814.2 1,393,203 69,660 1,323,543 11

12 Hamdi,S.Kep III/c S-1 Keperawatan 80 20 15 50 165 26 6.35 0 0.00 0 0.00 2 3.17 0 0.00 1 6.35 9.52 1.50 94.23 155.48 93.29 31.6 124.9 15814.2 1,975,014 98,751 1,876,264 12

13 Musdikin,S.Kep III/c S-1 Keperawatan 80 10 15 50 155 26 5.96 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 155.00 93.00 32.4 125.4 15814.2 1,983,104 99,155 1,883,949 13

14 Suhari All Abdi, S.Kep III/c S-I Keperawatan 80 10 50 140 26 5.38 2 2.69 0 0.00 0 0.00 0 0.00 0 0.00 2.69 0.50 98.08 137.31 82.38 31.6 114.0 15814.2 1,802,579 90,129 1,712,450 14

15 Sucimah III/b SMA 25 25 50 100 26 3.85 3 2.88 3 5.77 0 0.00 0 0.00 1 3.85 12.50 3.25 87.50 87.50 52.50 28.4 80.9 15814.2 1,279,371 63,969 1,215,402 15

16 Sri Kormawati III/b SMA 25 25 50 100 26 3.85 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 100.00 60.00 28.4 88.4 15814.2 1,397,978 69,899 1,328,079 16

17 Laela Niswati,Amd.Kep III/b D-III Keperawatan 60 20 50 130 26 5.00 9 11.25 0 0.00 0 0.00 0 0.00 1 5.00 16.25 3.25 87.50 113.75 68.25 29.2 97.5 15814.2 1,541,096 77,055 1,464,042 17

18 Ismayadi,S.Farm.Apt III/b S-1 Apoteker 100 40 10 50 200 26 7.69 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 200.00 120.00 27.6 147.6 15814.2 2,334,180 116,709 2,217,471 18

19 dr. Baiq Intan Permata III/b S-1 Kedoktern 150 45 3 50 248 26 9.54 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 248.00 148.80 36.0 184.8 15814.2 2,922,469 146,123 2,776,346 19

20 Marlia Rosfiantini,A.Md.Keb III/b D-III Kebidanan 60 10 5 50 125 26 4.81 13 15.63 0 0.00 0 0.00 2 4.81 0 0.00 20.43 4.25 83.65 104.57 62.74 32.4 95.1 15814.2 1,504,572 75,229 1,429,343 20

21 Hairani,SKM III/b S-1 Kesmas 80 10 5 50 145 26 5.58 10 13.94 0 0.00 0 0.00 0 0.00 0 0.00 13.94 2.50 90.38 131.06 78.63 34.4 113.0 15814.2 1,787,555 89,378 1,698,177 21

22 Ilya Sobah, SST III/b D-4 Gizi 80 30 5 50 165 26 6.35 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 165.00 99.00 32.4 131.4 15814.2 2,077,989 103,899 1,974,090 22

23 Sri Uji Astuti,SST III/b D-4 Gizi 80 5 50 135 26 5.19 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 135.00 81.00 27.6 108.6 15814.2 1,717,425 85,871 1,631,554 23

24 Radiyah Wahidah III/b D-III Kebidanan 50 10 20 50 130 26 5.00 5 6.25 0 0.00 0 0.00 0 0.00 1 5.00 11.25 2.25 91.35 118.75 71.25 31.6 102.9 15814.2 1,626,493 81,325 1,545,169 24

25 Edy Kusnadi, S.Kep III/b S-I Keperawatan 80 15 50 145 26 5.58 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 145.00 87.00 27.6 114.6 15814.2 1,812,310 90,616 1,721,695 25

26 Sanusi Fadli, S.Kep III/b S-I Keperawatan 80 15 50 145 26 5.58 1 1.39 2 5.58 0 0.00 0 0.00 0 0.00 6.97 1.25 95.19 138.03 82.82 31.6 114.4 15814.2 1,809,421 90,471 1,718,950 26

27 Hj. Yeni Prasasti, SKM III/a S-1 Kesmas 80 15 10 50 155 26 5.96 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 155.00 93.00 29.2 122.2 15814.2 1,932,498 96,625 1,835,874 27
 PERHITUNGAN VARIABEL NON KINERJA (KETENAGAAN DAN HARI KERJA EFEKTIF) PERHITUNGAN POIN SELURUH VARIABEL

KINERJA
VARIABEL KETENAGAAN HARI KERJA PENGURANGAN POIN HARI KERJA KETENAGAAN & HARI EFEKTIF (BOBOT 60)
HARGA PER JUMLAH DITERIMA
No. NAMA GOL PENDIDIKAN (BOBOT 40) JUMLAH (Rp) PAJAK TANDA TANGAN
BEBAN PROSEN POIN
KERJA/ IJIN TIDAK TIDAK APEL IJIN TIDAK TIDAK APEL TASE TOTAL POIN
RANGKAP JML
PENDIDI TGNGJW MASA STATUS JML HR POIN APEL PAGI/TELAT APEL SIANG/PULANG JML HARI KEHADIRAN
TGS/JABA JML POIN TIDAK MASUK PEMOT. JML NILAI NILAI
KAN B KERJA KEPEG KERJA PERHARI PAGI/TELAT PIKET TANPA SIANG/PULAN DULUAN TANPA TDK MASUK
TAN POIN
PROGRA PIKET KET G DULUAN KET
M 20 =(11-19) /
1 2 3 4 5 6 7 8 9 10=5+ sd 9 11 12=10/11 13 14 15 16 17 18=13+14+15+16 19=18/12 21=20 x10 22=21x60% 23 24=22+23 23 24 25 26 = 24-25 27
11 x100
28 Wildan, , A.MKp III/a D-III Keperawatan 60 15 10 50 135 26 5.19 9 11.68 3 7.79 0 0.00 1 2.60 1 5.19 27.26 5.25 79.81 107.74 64.64 27.6 92.2 15814.2 1,458,771 72,939 1,385,833 28

29 Hj. Rahmawati,S.ST III/b D-4 Gizi 80 10 10 50 150 26 5.77 8 11.54 0 0.00 0 0.00 0 0.00 1 5.77 17.31 3.00 88.46 132.69 79.62 27.6 107.2 15814.2 1,695,528 84,776 1,610,752 29

30 Sri Wahyuni, AMKG II/d DIII Perwat gigi 60 10 10 50 130 26 5.00 5 6.25 0 0.00 2 2.50 0 0.00 1 5.00 13.75 2.75 89.42 116.25 69.75 33.2 103.0 15814.2 1,628,075 - 1,628,075 30

31 Huzratul aini,A.Md,Keb II/d D-III Kebidanan 60 35 10 50 155 26 5.96 10 14.90 0 0.00 1 1.49 0 0.00 0 0.00 16.39 2.75 89.42 138.61 83.16 32.4 115.6 15814.2 1,827,547 - 1,827,547 31

32 Bq. Lasmi Sariati II/a D-1 Sanitarian 50 10 3 50 113 26 4.35 8 8.69 0 0.00 0 0.00 0 0.00 1 4.35 13.04 3.00 88.46 99.96 59.98 27.6 87.6 15814.2 1,384,961 - 1,384,961 32

33 Evi Susanti II/a SPK 50 15 3 50 118 26 4.54 4 4.54 0 0.00 1 1.13 0 0.00 0 0.00 5.67 1.25 95.19 112.33 67.40 33.2 100.6 15814.2 1,590,850 - 1,590,850 33

Nani Diana Zohrah,

34 II/c D-III Kebidanan 60 3 30 93 26 3.58 2 1.79 0 0.00 0 0.00 0 0.00 0 0.00 1.79 0.50 98.08 91.21 54.73 32.4 87.1 15814.2 1,377,845 - 1,377,845 34
A.Md.Keb

35 Patmawati, Amd.Keb II/c D-III Kebidanan 60 3 30 93 26 3.58 1 0.89 0 0.00 0 0.00 0 0.00 0 0.00 0.89 0.25 99.04 92.11 55.26 28.4 83.7 15814.2 1,323,073 - 1,323,073 35

36 Bq Eka Budiasih, Amd, Keb. II/c D-III Kebidanan 60 3 30 93 26 3.58 1 0.89 1 1.79 0 0.00 0 0.00 0 0.00 2.68 0.75 97.12 90.32 54.19 26.8 81.0 15814.2 1,280,800 - 1,280,800 36

37 Mardin perjanj SMA 25 3 20 48 26 1.85 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 48.00 28.80 29.2 58.0 15814.2 917,225 45,861 871,364 37

38 Herman perjanj SMA 25 3 20 48 26 1.85 3 1.38 0 0.00 1 0.46 0 0.00 1 1.85 3.69 2.00 92.31 44.31 26.58 28.4 55.0 15814.2 869,539 43,477 826,062 38

39 Hamzan Wadi, Amd.Kep Job D-III Keperawatan 60 10 3 20 93 26 3.58 3 2.68 0 0.00 0 0.00 1 1.79 1 3.58 8.05 2.25 91.35 84.95 50.97 28.4 79.4 15814.2 1,255,193 - 1,255,193 39

40 Miskul Laelani, Amd.Kep Job D-III Keperawatan 60 3 20 83 26 3.19 9 7.18 0 0.00 0 0.00 1 1.60 0 0.00 8.78 2.75 89.42 74.22 44.53 26.8 71.3 15814.2 1,128,071 - 1,128,071 40

41 Jurianingsih, AMKG Job D-III Perwat gigi 60 3 20 83 26 3.19 4 3.19 0 0.00 0 0.00 0 0.00 1 3.19 6.38 2.00 92.31 76.62 45.97 26.4 72.4 15814.2 1,144,463 - 1,144,463 41

42 Rosmanul Hakim Job SMA 25 3 20 48 26 1.85 0 0.00 0 0.00 0 0.00 0 0.00 2 3.69 3.69 2.00 92.31 44.31 26.58 26.4 53.0 15814.2 837,911 - 837,911 42

43 Sanimah,SKM Job S-1 Kesmas 80 3 20 103 26 3.96 9 8.91 0 0.00 1 0.99 0 0.00 2 7.92 17.83 4.50 82.69 85.17 51.10 26.0 77.1 15814.2 1,219,338 - 1,219,338 43

44 Murtini, AMG Job D-III GIZI 60 3 20 83 26 3.19 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 83.00 49.80 29.2 79.0 15814.2 1,249,324 - 1,249,324 44

45 Titin Suyani,SKM Job S-1 Rekam Medik 80 20 3 20 123 26 4.73 1 1.18 0 0.00 0 0.00 0 0.00 0 0.00 1.18 0.25 99.04 121.82 73.09 27.6 100.7 15814.2 1,592,341 - 1,592,341 45

46 Ulfa Rahmawati, AKL Job D-III Kesling 60 10 3 20 93 26 3.58 5 4.47 0 0.00 0 0.00 0 0.00 0 0.00 4.47 1.25 95.19 88.53 53.12 21.6 74.7 15814.2 1,181,596 - 1,181,596 46

Siti Haulani Wardiani,

47 Job D-III Keperawatan 60 30 30 3 20 143 26 5.50 5 6.88 0 0.00 0 0.00 0 0.00 1 5.50 12.38 2.25 91.35 130.63 78.38 36.0 114.4 15814.2 1,808,752 - 1,808,752 47
A.Md.Kep

48 Rusmayanti, A.Md.Kep Job D-III Keperawatan 60 3 20 83 26 3.19 2 1.60 0 0.00 0 0.00 0 0.00 0 0.00 1.60 0.50 98.08 81.40 48.84 26.8 75.6 15814.2 1,196,225 - 1,196,225 48

49 Muhibbin Ali, A.Md.Kep perjanj D-III Keperawatan 60 3 20 83 26 3.19 4 3.19 0 0.00 0 0.00 0 0.00 0 0.00 3.19 1.00 96.15 79.81 47.88 21.2 69.1 15814.2 1,092,520 54,626 1,037,894 49

50 Wita Apria Wardani,Amd.Keb Job D-III Kebidanan 60 3 20 83 26 3.19 6 4.79 0 0.00 2 1.60 0 0.00 2 6.38 12.77 4.00 84.62 70.23 42.14 32.4 74.5 15814.2 1,178,768 - 1,178,768 50

Indah Kusuma Wardani,

51 Job D-III Keperawatan 60 3 20 83 26 3.19 0 0.00 1 1.60 0 0.00 0 0.00 0 0.00 1.60 0.50 98.08 81.40 48.84 26.0 74.8 15814.2 1,183,573 - 1,183,573 51
Amd.Kep

52 Herman Hadi, S.Kom Job S-1 Informatika 50 35 3 20 108 26 4.15 9 9.35 0 0.00 0 0.00 0 0.00 2 8.31 17.65 4.25 83.65 90.35 54.21 28.4 82.6 15814.2 1,306,377 - 1,306,377 52

53 Zohratul Farida, Amd.Farm Job D-III Farmasi 60 3 20 83 26 3.19 0 0.00 0 0.00 0 0.00 0 0.00 1 3.19 3.19 1.00 96.15 79.81 47.88 35.2 83.1 15814.2 1,313,919 - 1,313,919 53

54 Lalu Abdurahim Job SMA 25 3 20 48 26 1.85 0 0.00 0 0.00 0 0.00 0 0.00 1 1.85 1.85 1.00 96.15 46.15 27.69 26.0 53.7 15814.2 849,102 - 849,102 54

55 Andi Sujudin,Amd.Kep Job D-III Keperawatan 60 3 20 83 26 3.19 1 0.80 0 0.00 0 0.00 0 0.00 0 0.00 0.80 0.25 99.04 82.20 49.32 27.6 76.9 15814.2 1,216,449 - 1,216,449 55
 PERHITUNGAN VARIABEL NON KINERJA (KETENAGAAN DAN HARI KERJA EFEKTIF) PERHITUNGAN POIN SELURUH VARIABEL

KINERJA
VARIABEL KETENAGAAN HARI KERJA PENGURANGAN POIN HARI KERJA KETENAGAAN & HARI EFEKTIF (BOBOT 60)
HARGA PER JUMLAH DITERIMA
No. NAMA GOL PENDIDIKAN (BOBOT 40) JUMLAH (Rp) PAJAK TANDA TANGAN
BEBAN PROSEN POIN
KERJA/ IJIN TIDAK TIDAK APEL IJIN TIDAK TIDAK APEL TASE TOTAL POIN
RANGKAP JML
PENDIDI TGNGJW MASA STATUS JML HR POIN APEL PAGI/TELAT APEL SIANG/PULANG JML HARI KEHADIRAN
TGS/JABA JML POIN TIDAK MASUK PEMOT. JML NILAI NILAI
KAN B KERJA KEPEG KERJA PERHARI PAGI/TELAT PIKET TANPA SIANG/PULAN DULUAN TANPA TDK MASUK
TAN POIN
PROGRA PIKET KET G DULUAN KET
M 20 =(11-19) /
1 2 3 4 5 6 7 8 9 10=5+ sd 9 11 12=10/11 13 14 15 16 17 18=13+14+15+16 19=18/12 21=20 x10 22=21x60% 23 24=22+23 23 24 25 26 = 24-25 27
11 x100
56 Rahadian Wahyudi,Amd.Kep Job D-III Keperawatan 60 3 20 83 26 3.19 6 4.79 0 0.00 0 0.00 0 0.00 0 0.00 4.79 1.50 94.23 78.21 46.93 26.8 73.7 15814.2 1,165,934 - 1,165,934 56

57 Liana Nurmalasari, Amd, Keb perjanj D-III Kebidanan 60 3 20 83 26 3.19 2 1.60 0 0.00 0 0.00 0 0.00 0 0.00 1.60 0.50 98.08 81.40 48.84 33.2 82.0 15814.2 1,297,436 64,872 1,232,564 57

58 Lalu ismail perjanj SMA 25 3 20 48 26 1.85 0 0.00 0 0.00 0 0.00 0 0.00 1 1.85 1.85 1.00 96.15 46.15 27.69 26.0 53.7 15814.2 849,102 42,455 806,647 58

59 Heri Agus Sidarta,Amd.Kep perjanj D-III Keperawatan 60 3 20 83 26 3.19 3 2.39 0 0.00 0 0.00 2 3.19 11 35.12 40.70 12.75 50.96 42.30 25.38 27.6 53.0 15814.2 837,819 41,891 795,928 59

Lalu Budyar Topan

60 perjanj S-1 Keperawatan 100 10 3 20 133 26 5.12 3 3.84 0 0.00 0 0.00 0 0.00 2 10.23 14.07 2.75 89.42 118.93 71.36 26.4 97.8 15814.2 1,545,993 77,300 1,468,693 60
T.A,S.Kep, Ners.
Teguh Imam
61 Job D-III Keperawatan 60 3 20 83 26 3.19 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 83.00 49.80 26.8 76.6 15814.2 1,211,370 - 1,211,370 61
wahyudi,Amd.Kep
M. Azwar
62 Job D-III Keperawatan 60 3 20 83 26 3.19 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 83.00 49.80 26.0 75.8 15814.2 1,198,718 - 1,198,718 62
Hidayatullah,Amd.Kep

63 Jasman Wadi,Amd.AK Job D-III Analis 60 10 3 20 93 26 3.58 7 6.26 0 0.00 4 3.58 1 1.79 4 14.31 25.93 7.25 72.12 67.07 40.24 27.6 67.8 15814.2 1,072,843 - 1,072,843 63

64 Upa Suparya Adimaja,A.MKL Job D-III Sanitarian 60 10 3 20 93 26 3.58 6 5.37 0 0.00 0 0.00 0 0.00 5 17.88 23.25 6.50 75.00 69.75 41.85 21.6 63.5 15814.2 1,003,413 - 1,003,413 64

65 Syarifa Zubaidah, A.Md.Keb perjanj D-III Kebidanan 60 3 20 83 26 3.19 2 1.60 0 0.00 0 0.00 0 0.00 0 0.00 1.60 0.50 98.08 81.40 48.84 23.6 72.4 15814.2 1,145,619 57,281 1,088,338 65

Nurmalia Anggraini,
66 Job D-III Kebidanan 60 3 20 83 26 3.19 1 0.80 0 0.00 0 0.00 0 0.00 0 0.00 0.80 0.25 99.04 82.20 49.32 37.2 86.5 15814.2 1,368,265 - 1,368,265 66
A.Md.Keb

67 Winda Kariantina, Amd.Keb Orienta D-III Kebidanan 60 3 20 83 26 3.19 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 83.00 49.80 28.4 78.2 15814.2 1,236,673 - 1,236,673 67

68 Hevizatul Muftari,Amd,Keb Orienta D-III Kebidanan 60 3 20 83 26 3.19 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 83.00 49.80 27.6 77.4 15814.2 1,224,021 - 1,224,021 68

69 Anita Wardiana M., Amd.Keb Orienta D-III Kebidanan 60 3 20 83 26 3.19 3 2.39 0 0.00 0 0.00 0 0.00 0 0.00 2.39 0.75 97.12 80.61 48.36 27.6 76.0 15814.2 1,201,303 - 1,201,303 69

70 Bq Astuti, Amd, Keb. perjanj D-III Kebidanan 60 3 20 83 26 3.19 2 1.60 0 0.00 0 0.00 0 0.00 0 0.00 1.60 0.50 98.08 81.40 48.84 33.2 82.0 15814.2 1,297,436 64,872 1,232,564 70

71 Yuliani Astuti,Amd.Keb Job D-III Kebidanan 60 3 20 83 26 3.19 1 0.80 0 0.00 0 0.00 0 0.00 0 0.00 0.80 0.25 99.04 82.20 49.32 33.2 82.5 15814.2 1,305,008 - 1,305,008 71

72 Irma Rahayu, AMd.Keb Job D-III Kebidanan 60 3 20 83 26 3.19 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 83.00 49.80 29.6 79.4 15814.2 1,255,650 - 1,255,650 72

73 Rahmawati, Amd, Keb Job D-III Kebidanan 60 3 20 83 26 3.19 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 0.00 0.00 100.00 83.00 49.80 32.4 82.2 15814.2 1,299,929 - 1,299,929 73

74 Bq Nani Sulistiyarini,Amd.Keb Job D-III Kebidanan 60 3 20 83 26 3.19 1 0.80 0 0.00 0 0.00 0 0.00 0 0.00 0.80 0.25 99.04 82.20 49.32 31.6 80.9 15814.2 1,279,705 63,985 1,215,720 74

TOTAL 4,785 210 577 2,500 8,672 1,924 334 215 248.67 19 58.00 ### 24.35 26.00 64.04 72 385.15 153.25 6,810.58 7,891.79 4,735.07 2,173.60 6,908.67 109,255,320 3,231,882 106,023,438

Pringgasela, Februari 2018

MENGETAHUI, KEPALA PUSKESMAS
KEPALA DINAS KESEHATAN PRINGGASELA
KABUPATEN LOMBOK TIMUR

Drg H. Asrul Sani, M. Kes. (H. AHMAD YANI, S.Kep., MM )

NIP.19750823 200112 1 002 NIP. 19751231 199503 1 003
 PENGHITUNGAN JASA PELAYANAN PROGRAM JAMINAN KESEHATAN NASIONAL
DINAS KESEHATAN KABUPATEN LOMBOK TIMUR TAHUN 2018
PUSKESMAS : PRINGGASELA
BULAN : JANUARI 2018

JUMLAH DITERIMA SESUAI IURAN ZAKAT (2,5 TOTAL DANA DI

NO NAMA TOTAL POIN HARGA PER POIN JUMLAH (Rp) PAJAK REGULATOR LAIN-LAIN
SPJ %) TRANSFER

1 2 3 4 5 6 7 8 11 12

1 H.Ahmad Yani, S.Kep., MM 212.3 15814.2 3,357,786 167,889 3,189,897 79,747 - 2,000,000 1,110,149
2 Effendi,S.Si 184.0 15814.2 2,909,818 145,491 2,764,327 69,108 180,000 2,515,219
3 Masruni, AMd.Keb 112.6 15814.2 1,781,016 89,051 1,691,966 42,299 1,200,000 449,666
4 Mutawakkil,SAP 108.2 15814.2 1,711,099 85,555 1,625,544 40,639 180,000 1,404,906
5 Baik Mahnur 102.3 15814.2 1,618,160 80,908 1,537,252 38,431 1,000,000 498,821
6 Algazali Hasan,S.Si 147.0 15814.2 2,324,083 116,204 2,207,879 55,197 180,000 1,972,682
7 Muhammad Amrullah, A.MKep 87.0 15814.2 1,375,169 68,758 1,306,410 32,660 1,273,750
8 drg.Vembriane Vaerus Rafani 0.0 15814.2 - - - - -
9 dr. Baiq Nurlaili Hidayanti 124.5 15814.2 1,969,631 98,482 1,871,150 46,779 540,000 1,000,000 284,371
10 Indah Arsyanti,S.Kep 152.2 15814.2 2,406,925 120,346 2,286,579 57,164 2,229,415
11 Juhaini 88.1 15814.2 1,393,203 69,660 1,323,543 33,089 180,000 1,110,454
12 Hamdi,S.Kep 124.9 15814.2 1,975,014 98,751 1,876,264 46,907 1,829,357
13 Musdikin,S.Kep 125.4 15814.2 1,983,104 99,155 1,883,949 47,099 1,836,850
14 Suhari All Abdi, S.Kep 114.0 15814.2 1,802,579 90,129 1,712,450 42,811 1,669,638
15 Sucimah 80.9 15814.2 1,279,371 63,969 1,215,402 30,385 1,185,017
16 Sri Kormawati 88.4 15814.2 1,397,978 69,899 1,328,079 33,202 1,294,877
17 Laela Niswati,Amd.Kep 97.5 15814.2 1,541,096 77,055 1,464,042 36,601 1,000,000 427,441
18 Ismayadi,S.Farm.Apt 147.6 15814.2 2,334,180 116,709 2,217,471 55,437 2,162,034
19 dr. Baiq Intan Permata 184.8 15814.2 2,922,469 146,123 2,776,346 69,409 2,706,937
20 Marlia Rosfiantini,A.Md.Keb 95.1 15814.2 1,504,572 75,229 1,429,343 35,734 1,393,609
21 Hairani,SKM 113.0 15814.2 1,787,555 89,378 1,698,177 42,454 1,655,723
22 Ilya Sobah, SST 131.4 15814.2 2,077,989 103,899 1,974,090 49,352 1,924,738
23 Sri Uji Astuti,SST 108.6 15814.2 1,717,425 85,871 1,631,554 40,789 1,590,765
24 Radiyah Wahidah 102.9 15814.2 1,626,493 81,325 1,545,169 38,629 180,000 1,000,000 326,539
25 Edy Kusnadi, S.Kep 114.6 15814.2 1,812,310 90,616 1,721,695 43,042 1,678,652
26 Sanusi Fadli, S.Kep 114.4 15814.2 1,809,421 90,471 1,718,950 42,974 1,675,976
27 Hj. Yeni Prasasti, SKM 122.2 15814.2 1,932,498 96,625 1,835,874 45,897 1,789,977
 JUMLAH DITERIMA SESUAI IURAN ZAKAT (2,5 TOTAL DANA DI
NO NAMA TOTAL POIN HARGA PER POIN JUMLAH (Rp) PAJAK REGULATOR LAIN-LAIN
SPJ %) TRANSFER

1 2 3 4 5 6 7 8 11 12

28 Wildan, , A.MKp 92.2 15814.2 1,458,771 72,939 1,385,833 34,646 180,000 1,171,187
29 Hj. Rahmawati,S.ST 107.2 15814.2 1,695,528 84,776 1,610,752 40,269 430,000 1,000,000 140,483
30 Sri Wahyuni, AMKG 103.0 15814.2 1,628,075 - 1,628,075 40,702 1,000,000 587,373
31 Huzratul aini,A.Md,Keb 115.6 15814.2 1,827,547 - 1,827,547 45,689 180,000 1,601,858
32 Bq. Lasmi Sariati 87.6 15814.2 1,384,961 - 1,384,961 34,624 500,000 850,337
33 Evi Susanti 100.6 15814.2 1,590,850 - 1,590,850 39,771 1,551,079
34 Nani Diana Zohrah, A.Md.Keb 87.1 15814.2 1,377,845 1,377,845 34,446 1,343,399
35 Patmawati, Amd.Keb 83.7 15814.2 1,323,073 1,323,073 33,077 1,289,996
36 Bq Eka Budiasih, Amd, Keb. 81.0 15814.2 1,280,800 1,280,800 32,020 1,248,780
37 Mardin 58.0 15814.2 917,225 45,861 871,364 21,784 849,580
38 Herman 55.0 15814.2 869,539 43,477 826,062 20,652 805,411
39 Hamzan Wadi, Amd.Kep 79.4 15814.2 1,255,193 - 1,255,193 31,380 180,000 1,043,814
40 Miskul Laelani, Amd.Kep 71.3 15814.2 1,128,071 - 1,128,071 28,202 1,099,870
41 Jurianingsih, AMKG 72.4 15814.2 1,144,463 - 1,144,463 28,612 1,115,852
42 Rosmanul Hakim 53.0 15814.2 837,911 - 837,911 20,948 816,963
43 Sanimah,SKM 77.1 15814.2 1,219,338 - 1,219,338 30,483 1,188,854
44 Murtini, AMG 79.0 15814.2 1,249,324 - 1,249,324 31,233 1,218,091
45 Titin Suyani,SKM 100.7 15814.2 1,592,341 - 1,592,341 39,809 1,552,532
46 Ulfa Rahmawati, AKL 74.7 15814.2 1,181,596 - 1,181,596 29,540 1,152,057
47 Siti Haulani Wardiani, A.Md.Kep 114.4 15814.2 1,808,752 - 1,808,752 45,219 1,763,533
48 Rusmayanti, A.Md.Kep 75.6 15814.2 1,196,225 - 1,196,225 29,906 1,166,319
49 Muhibbin Ali, A.Md.Kep 69.1 15814.2 1,092,520 54,626 1,037,894 25,947 1,011,946
50 Wita Apria Wardani,Amd.Keb 74.5 15814.2 1,178,768 - 1,178,768 29,469 1,149,299
51 Indah Kusuma Wardani, Amd.Kep 74.8 15814.2 1,183,573 - 1,183,573 29,589 1,153,984
52 Herman Hadi, S.Kom 82.6 15814.2 1,306,377 - 1,306,377 32,659 1,273,717
53 Zohratul Farida, Amd.Farm 83.1 15814.2 1,313,919 - 1,313,919 32,848 1,281,071
54 Lalu Abdurahim 53.7 15814.2 849,102 - 849,102 21,228 827,875
55 Andi Sujudin,Amd.Kep 76.9 15814.2 1,216,449 - 1,216,449 30,411 1,186,037
 JUMLAH DITERIMA SESUAI IURAN ZAKAT (2,5 TOTAL DANA DI
NO NAMA TOTAL POIN HARGA PER POIN JUMLAH (Rp) PAJAK REGULATOR LAIN-LAIN
SPJ %) TRANSFER

1 2 3 4 5 6 7 8 11 12

56 Rahadian Wahyudi,Amd.Kep 73.7 15814.2 1,165,934 - 1,165,934 29,148 1,136,786

57 Liana Nurmalasari, Amd, Keb 82.0 15814.2 1,297,436 64,872 1,232,564 30,814 180,000 1,021,750
58 Lalu ismail 53.7 15814.2 849,102 42,455 806,647 20,166 786,481
59 Heri Agus Sidarta,Amd.Kep 53.0 15814.2 837,819 41,891 795,928 19,898 776,030
60 Lalu Budyar Topan T.A,S.Kep, Ners. 97.8 15814.2 1,545,993 77,300 1,468,693 36,717 180,000 1,251,976
61 Teguh Imam wahyudi,Amd.Kep 76.6 15814.2 1,211,370 - 1,211,370 30,284 1,181,085
62 M. Azwar Hidayatullah,Amd.Kep 75.8 15814.2 1,198,718 - 1,198,718 29,968 1,168,750
63 Jasman Wadi,Amd.AK 67.8 15814.2 1,072,843 - 1,072,843 26,821 1,046,022
64 Upa Suparya Adimaja,A.MKL 63.5 15814.2 1,003,413 - 1,003,413 25,085 978,327
65 Syarifa Zubaidah, A.Md.Keb 72.4 15814.2 1,145,619 57,281 1,088,338 27,208 1,061,130
66 Nurmalia Anggraini, A.Md.Keb 86.5 15814.2 1,368,265 - 1,368,265 34,207 1,334,058
67 Winda Kariantina, Amd.Keb 78.2 15814.2 1,236,673 - 1,236,673 30,917 1,205,756
68 Hevizatul Muftari,Amd,Keb 77.4 15814.2 1,224,021 - 1,224,021 30,601 1,193,421
69 Anita Wardiana M., Amd.Keb 76.0 15814.2 1,201,303 - 1,201,303 30,033 1,171,271
70 Bq Astuti, Amd, Keb. 82.0 15814.2 1,297,436 64,872 1,232,564 30,814 1,201,750
71 Yuliani Astuti,Amd.Keb 82.5 15814.2 1,305,008 - 1,305,008 32,625 1,272,383
72 Irma Rahayu, AMd.Keb 79.4 15814.2 1,255,650 - 1,255,650 31,391 1,224,258
73 Rahmawati, Amd, Keb 82.2 15814.2 1,299,929 - 1,299,929 32,498 1,267,431
74 Bq Nani Sulistiyarini,Amd.Keb 80.9 15814.2 1,279,705 63,985 1,215,720 30,393 1,185,327

TOTAL 6908.67 109,255,320 3,231,882 106,023,438 2,650,586 2,770,000 9,700,000 90,902,852

6,018,350
 TANDA TANGAN

14

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27
 TANDA TANGAN

14

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50

51

52

53

54

55
 TANDA TANGAN

14

56

57

58

59

60

61

62

63

64

65

66

67

68

69

70

71

72

73

74

18,352,468
 DATA STAF PKM PRINGGASELA 2018

NO NAMA NO REKENING JML YANG DITRANSFER CONTACT PERSON

1 H.Ahmad Yani, S.Kep., MM 473801003076-53.0 1,110,149 08175790186

2 Effendi,s.Si 2,429,700 085934580507
3 Masruni, AMd.Keb 0157-01-066929-50-8 449,666 081918255553
4 Mutawakkil,SAP 0157-01-067025-50-1 1,404,906 081997740401
5 Baik Mahnur 0157-01-066885-50-0 498,821 081917725733
6 Algazali Hasan,S.Si 0157-01-066890-50-5 1,972,682 081933160219
7 Muhammad Amrullah, A.MKep 0157-01-066892-50-7 1,273,750 087763147278
8 drg.Vembriane Vaerus Rafani 0157-01-066891-50-1 - 08175797446
9 dr. Baiq Nurlaili Hidayanti 0157-01-066978-50-7 284,371 081907260005
10 Indah Arsyanti,S.Kep 0157-01-066440-50-4 081915953661
11 Juhaini 0157-01-066894-50-9 1,110,454 087763085561
12 Hamdi,S.Kep 0157-01-066908-50-2 1,829,357 081915787270
13 Musdikin 0157-01-066895-50-5 1,836,850 087863309000
14 Suhari All Abdi, S.Kep 0157-01-066893-50-3 1,669,638 081933123872
15 Sucimah 0157-01-066909-50-8 1,185,017 087763244708
16 Sri Kormawati 0157-01-066910-50-9 1,294,877 081918355552
17 Laela Niswati,Amd.Kep 0157-01-066911-50-5 427,441 081997740303
18 Ismayadi,S.Farm.Apt 0157-01-066914-50-3 2,162,034 081906626887
19 dr. Baiq Intan Permata 0157-01-066913-50-7 2,706,937 081907880351
NO NAMA NO REKENING JML YANG DITRANSFER CONTACT PERSON

20 Marlia Rosfiantini,A.Md.Keb 0157-01-066782-50-8 1,393,609 081907852727

21 Hairani,SKM 0157-01-066912-50-1 1,655,723 081917704400
22 Ilya Sobah, SST 0157-01-066783-50-4 1,924,738 081805726166
23 Sri Uji Astuti,SST 0157-01-066785-50-6 1,590,765 081933156142
24 Radiyah Wahidah 0157-01-069097-50-4 326,539 081918457775
25 Edy Kusnadi, S.Kep 0157-0106-7151-50-6 1,678,652 081803662333
26 Sanusi Fadli, S.Kep 0157-01-066784-50-0 1,675,976 087877523861
27 Yeni Prasasti, SKM 0157-01-043023-50-1 1,789,977 081918109522
28 Wildan, , A.MKp 0157-01-066786-50-2 1,171,187 087763055565
29 Hj. Rahmawati 0157-01-054494-50-9 140,483 085253480855
30 Sri Wahyuni, Amkg 0157-01-066787-50-8 587,373 081918255565
31 Huzratul aini 0157-01-068497-50-7 1,601,858 087763109103
32 Bq. Lasmi Sariati 0157-01-066789-50-0 850,337 085934556255
33 Evi Susanti 0157-01-066790-50-1 1,551,079 081997622791
34 Nani Diana Zohrah, A.Md.Keb 0157-01-044507-50-8 1,343,399 081918476150
35 Patmawati, Amd.Keb 0157-01-0449628-50-3 1,289,996 085337090766
36 Bq Eka Budiasih, Amd, Keb. 0157-01-044479-50-1 1,248,780 087763085056
37 Mardin 0157-01-066823-50-8 849,580 085934545570
38 Herman 0157-01-066824-50-4 805,411 081918306777
39 Hamzan Wadi, Amd.Kep 0157-01-066825-50-0 1,043,814 087763177729
NO NAMA NO REKENING JML YANG DITRANSFER CONTACT PERSON

40 Miskul Laelani, Amd.Kep 0157-01-067150-50-0 1,099,870 085903102452

41 Jurianingsih, AMKG 0157-01-066826-50-6 1,115,852 081997877776
42 Rosmanul Hakim 0157-01-066831-50-1 816,963 082341830405
43 Sanimah,SKM 0157-01-067035-50-6 1,188,854 085934575559
44 Murtini, AMG 0157-01-066835-50-5 1,218,091 087864886141
45 Titin Suyani,SKM 0157-01-066833-50-3 1,552,532 081997770567
46 Ulfa Rahmawati, AKL 0157-01-066836-50-1 1,152,057 087763277644
47 Siti Haulani Wardiani, A.Md.Kep 0157-01-066838-50-3 1,763,533 081805741288
48 Rusmayanti, A.Md.Kep 0157-01-066839-50-9 1,166,319 085934831272
49 Muhibbin Ali, A.Md.Kep 0157-01-066841-50-6 1,011,946 081918300084
50 Wita Apria Wardani,Amd.Keb 0157-01-066840-50-0 1,149,299 081997888815
51 Indah Kusuma Wardani 0157-01-066844-50-4 1,153,984 087763481450
52 Herman Hadi 1,403,386
53 Zohratul Farida 0157-01-066889-50-4 1,281,071 087859369006
54 Lalu Abdurahim 0157-01-066845-50-0 827,875 081997701642
55 Andi Sujudin,Amd.Kep 0157-01-066842-50-2 1,186,037 081916265589
56 Rahadian Wahyudi,Amd.Kep 0157-01-066843-50-8 1,136,786 081907374736
57 Liana Nurmalasari, Amd, Keb 0157-01-066847-50-2 1,021,750 081915777703
58 Lalu ismail 0157-01-066853-50-3 786,481 081917932795
59 Heri Agus Sidarta,Amd.Kep 0157-01-066861-50-6 776,030 081997761440
NO NAMA NO REKENING JML YANG DITRANSFER CONTACT PERSON

60 Lalu Budyar Topan T.A,S.Kep, Ners. 0157-01-066875-50-5 1,251,976 081917742830

NO NAMA NO REKENING JML YANG DITRANSFER CONTACT PERSON

61 Teguh Imam wahyudi,Amd.Kep 0157-01-066876-50-1 1,181,085 087763345683

62 M. Azwar Hidayatullah,Amd.Kep 0157-01-066871-50-1 1,168,750 087763384777
63 Jasman Wadi,Amd.AK 0157-01-056301-50-8 1,046,022 081916022221
64 Upa Suparya Adimaja,A.MKL 0157-01-059615-50-8 978,327 081917366269
65 Syarifa Zubaidah, A.Md.Keb 0157-01-066880-50-0 1,061,130 081997995566
66 Nurmalia Anggraini, A.Md.Keb 0157-01-066866-50-6 1,334,058 087763177769
67 Winda Kariantina, Amd.Keb 0157-01-066863-50-8 1,205,756 081917366269
68 Hevizatul Muftari,Amd,Keb 0157-01-066864-50-4 1,193,421 087887637209
69 Anita Wardiana M., Amd.Keb 0157-01-066834-50-9 1,171,271 '081918236292
70 Bq Astuti, Amd, Keb. 0157-01-067152-50-2 1,201,750 081917996476
71 Yuliani Astuti,Amd.Keb 0157-01-066837-50-7 1,272,383 081917996476
72 Irma Rahayu, AMd.Keb 0157-01-066648-50-8 1,224,258 082341915589
73 Rahmawati, Amd, Keb 0157-01-066859-50-9 1,267,431 082341322463
74 Bq Nani Sulistiyarini,Amd.Keb 0157-01-066858-50-3 1,185,327 081915912444
TOTAL 88,717,588

Mengetahui
Kepala Puskesmas Pringgasela

H.AHMAD YANI,S.Kep.,MM
NIP.19741231 199503 1 003
NO NAMA NO REKENING JML YANG DITRANSFER CONTACT PERSON

JUMLAH POTONGAN
JUMLAH JASPEL JUMLAH TRANSFER (Pajak, Zakat, Regu, Lain*, KTU,
INDAH, HADI )

109,255,320 84,666,268 24,589,052 24,294,932