5 Rapat validasi dan Pendataan ibu hamil semua bumil bisa Bumil
evaluasi data Gikia tertangani
semua sasaran Bidan Desa
Pembinaan E-Kohort masuk e kohort
17 Pengambilan sampel Pengawasan SKAMRT Memperoleh data dan Sarana Air Minum
untuk surveilans informasi tentang
kualitas air minum kualitas air minum
di tingkat rumah
tangga (SKAMRT)
Pengawasan Hilir Memperoleh data dan Sarana Air Minum
Kualitas Air informasi tentang
kualitas air minum
21 Rapat validasi dan Evaluasi data gizi Pemutakhiran data PJ KIA dan Dinas
evaluasi data Gikia gizi
33 IMUNISASI Pendataan Sasaran Semua bayi & baduta Bayi (umur 0-12 bln)
imunisasi mendapat IDL & Dan Baduta ( umur
Booster Lengkap 18-24 bln)
pendataan sasaran Semua bayi & baduta Bayi (umur 0-12 bln)
PCV, rotavirus mendapat Imunisasi
PCV dan Rotavirus
Jadwal Pelaksanaan
Target Sasaran Penanggung Jawab Volume Kegiatan
1 2 3 4 5 6 7 8 9
6 7 8 9
42 kader bikor 1x √
12 dukun bikor 4x √ √ √ √
25 bidan bikor 4x √ √ √ √
6 kegiatan
24 orang PJ Kespro 1X v
20 orang PJ Kespro 3X v v v
20 orang PJ Kespro 4X v v v v
20 orang PJ Kespro 2X v v
20 orang PJ Kespro 2X v v
Desa PJ SE 2 Bulan v v
Desa PJ SE 2 Bulan v v
Desa PJ SE 2 Bulan v v
Desa PJ SE 4 Bulan v v v v
Desa PJ SE
20 kali
Masyarakat PJ DBD 9 Bulan
√ √ √ √ √ √ √ √ √
⎷ ⎷
TOTAL
GIATAN TAHUNAN
BOK
M TAHUN 2023
ksanaan
Rincian Pelaksanaan
10 11 12
10
Transport kegiata
Petugas 3 petugas x 1 x ### =
n
Transport kegiata
Peserta 24 peserta x 1 x ### =
n
Snack kegiata
peserta x 1 x =
27 n ###
Transport 2 petugas x 3 kegiata x ### =
Petugas n
Transport 20 peserta x 3 kegiata x ### =
Peserta n
Snack 22 peserta x 3 kegiata x ### =
n
Transport 2 petugas x 4 kegiata x ### =
Petugas n
Transport 20 peserta x 4 kegiata x ### =
Peserta n
Snack 22 peserta x 4 kegiata x ### =
n
Transport 3 petugas x 2 kegiata x ### =
Petugas n
Transport 25 peserta x 2 kegiata x ### =
Peserta n
Snack 28 peserta x 2 kegiata x ### =
n
250 lembar x 2 kegiata x 300 =
Materi n
Transport 7 Sekolah x 2 petugas x 50,000
Petugas
⎷ ⎷ ⎷
snack 32 kotak x 1 kegiatan x 1 kali 17,500
√ √ √
22 kotak 17500
materi 492 lembar x 1 kegiatan x 1 kali x 300
⎷ ⎷ snack 67 kotak x 11 kegiatan x
17500
⎷ snack 35 kotak x 4 kegiatan x 17500
nasi 35
⎷ ⎷ ⎷
⎷ ⎷ ⎷
⎷ ⎷ ⎷
⎷ ⎷ ⎷
⎷
Lokasi Biaya
11 12
6,000,000 6,000,000
3,300,000 Sekolah 3,300,000
1,610,000
600,000 Puskesmas 6,210,000
Wonosalam
4,000,000
1,610,000
11,250,000 Balai Desa 17,010,000
Wonosalam,
1,350,000 Sambirejo, Jarak,
Wonomerto,
Galengdowo,
4,410,000 Carangwulung,
Panglungan,
6,000,000 Posbindu desa 6,000,000
Wonosalam,
Sambirejo, Jarak,
Galengdowo,
Wonomerto,
Carangwulung,
Panglungan,
Sumberjo, Wonokerto,
Ponpes BMW, SMK
Wonosalam, MA Faser
Panglungan
1750000
2400000
Balai Desa
3,327,500
Wonosalam
927500
1,250,000 1,250,000
Kecamatan
472500 472,500
Wonosalam
52500 52,500
1,250,000 1,250,000
472500 SMK 1 Wonosalam 472,500
52500 52,500
1,250,000 1,250,000
472500 PONPES Mangirejo 472,500
52500 52,500
1,250,000 1,250,000
Kecamatan
525000 525,000
Wonosalam
75000 75,000
450000
Posyandu Balita
450,000
Wonosalam
1,995,000
450,000 Desa Galengdowo 3,075,000
Desa Panglungan
2,625,000 Desa Carangwulung
2,550,000 Desa Galengdowo 3,547,500
Desa Panglungan
997,500 Desa Carangwulung
2,550,000 Desa Galengdowo 2,550,000
Desa Panglungan
Desa Carangwulung
560,000
3,500,000 Jasa Boga, Restoran, 16,600,000
Kantin sekolah /
Makanan jajanan,
PIRT
900,000 Puskesmas,
Klinik/Jejaring
3,000,000
600,000 Desa
600,000
Puskesmas 1,822,500 KB
150,000 Wonosalam
1,200,000
472,500
1,155,000
980,000
150,000
2,400,000
3,640,000
210,000
630,000
1,600,000
1,500,000 Desa Galengdowo, 1,500,000
Wonomerto, Jarak,
Sambirejo,
Wonosalam,
Carangwulung,
Panglungan,
Wonokerto, Sumberjo
1,050,000
2,700,000 Puskesmas 3,750,000
Wonosalam
1,050,000
2,700,000 Puskesmas 3,750,000
Wonosalam
1,050,000
7,200,000 Semua posyandu di 7,200,000
desa Galengdowo,
Wonomerto, Jarak,
Sambirejo,
Wonosalam,
Carangwulung,
Panglungan,
Wonokerto, Sumberjo
5,600,000 28 SD / MI 5,600,000
2,800,000 28 SD / MI 2,800,000
2,800,000 28 SD / MI 2,800,000
5,600,000 28 SD / MI 5,600,000
2,800,000 28 SD / MI 2,800,000
45,000
450,000 Puskesmas 1,439,500
Wonosalam
700,000
105,000
157,500
27,000
600,000
140,000
1,400,000 14 SD/ MI Kecamatan 1,400,000 KKO
Wonosalam
560,000
72,000
2,000,000 Desa 2,000,000
298,200
75,000
490,000 490,000
37,500 37,500
1,650,000 Desa 1,650,000
4,235,000
4235000
147600 147,500
12,897,500 Puskesmas 12,897,500
Wonosalam
4200000
Puskesmas 89,321,000
Wonosalam
Tanpa biaya
Tanpa biaya
537,942,000
NO KEGIATAN TUJUAN SASARAN
Stik Glukosa
Stik Kolesterol
Stik Asam Urat
STROMATOLYSER-WH, 500ML
(SWH-200A)
4 Belanja Bahan-Bahan Bakar dan Menjamin rekanan
Pelumas ketersediaan bahan
bakar operasional
puskesmas
BBM Kendaraan
Dinas/Operasional roda 4
(pertalite,pertamax)
BBM Kendaraan
Dinas/Operasional roda 4 (Solar)
Tabung O2 Kecil
Tabung O2 Besar
7 Belanja Bahan-Bahan Lainnya Menjamin rekanan
tersedianya bahan
lain
BMHP
Fotocopy/Penggandaan
jilid
11 Belanja Alat/Bahan Untuk Menjamin rekanan
Kegiatan Kantor-Bahan Cetak tersedianya alat
kegiatan kantor
berupa bahan cetak
materai 10000
13 Belanja Alat/Bahan Untuk Menjamin rekanan
Kegiatan Kantor-Bahan tersedianya bahan
Komputer komputer
Flashdisk
Mouse Wireless
15 Belanja Alat/Bahan Untuk Menjamin rekanan
Kegiatan Kantor-Alat Listrik tersedianya alat alat
listrik
Baterai 9V
Baterai AA
Baterai AAA
Led 20 Watt
Led 25 Watt
16 Belanja Obat-Obatan-Obat Menjamin rekanan
tersedianya obat-
obatan
Salbutamol
Metamizol inj
OBH
Profenid Sub
Ibu Profen tab
Ibu Profen sy
Ranitidin Inj
Ranitidin Tab
CTM
Combiven
Ringer Laktat
Omeprazole
Digoxin
HCT
Kaptopril
Dexametason
Klorampenicol sy
Nifedipine
ISDN
Amlodipine
17 Belanja Makanan dan Minuman Menjamin rekanan
Rapat tersedianya makanan
dan minuman
TOTAL
RENCANA PELAKSANAAN KEGIATAN TAHUNAN
PROGRAM : BLUD
PUSKESMAS WONOSALAM TAHUN 2023
Bendahara v v v v
BLUD, PP, Pj
Laborat
Bendahara 12 bulan v v v v v v
BLUD, PJ
Kendaraan
operasional
Bendahara 10 bulan v v v v v v
BLUD, PJ
Barang,
Nutrisionis
Bendahara 12 bulan v v v v v v
BLUD, PJ
Barang,
Nutrisionis
Bendahara 5 bulan v
BLUD, Ketua
Akreditasi,
Ketua Mutu
Bendahara 1 bulan
BLUD, PJ
Barang
Bendahara 12 bulan v v v v v v
BLUD,
Sanitarian
Bendahara 1 bulan
BLUD, PJ
Barang
Bendahara 12 bulan v v v v v v
BLUD, PJ
Barang
Bendahara 12 bulan v v v v v v
BLUD, PJ
Barang
Bendahara 12 bulan v v v v v v
BLUD, PJ
Barang
Bendahara 2 bulan v
BLUD, PJ
Barang
Bendahara 2 bulan v v
BLUD, PJ
Kepegawaian
Bendahara 1 bulan v
BLUD,
Sanitarian
Bendahara 5 bulan v v
BLUD, PJ
Barang
Bendahara 1 bulan
BLUD, PJ
Barang
Bendahara 1 bulan
BLUD, PJ
Barang
Bendahara 1 bulan v
BLUD, PJ
Barang, PJ Lab
Bendahara 4 bulan v v v
BLUD, PJ
Barang
Bendahara 3 bulan v v
BLUD, PJ
Barang
Bendahara 12 bulan v v v v v v
BLUD, PJ
Kepegawaian
2023
8 2,643,000
1 1,300,000
1 1,300,000
1 1,300,000
2 150,000
2 150,000
2 170,700
2 170,700
2 170,700
2 170,700
2 200,000
10 170,000
130 130,000
50 200,000
40 140,000
10 1,700,000
v v v v v v Pembayaran pembelian Puskesmas
bahan bakar Wonosalam
1,280 18,000
1,020 12,000
12 200,000
12 390,000
50 60,000.00
40 85,000.00
v v v v v v Pembayaran pembelian Puskesmas
bahan lainnya Wonosalam
1000 1,200.00
1000 1,200.00
1000 1,700.00
10 30,000.00
100 16,000.00
1 180,000.00
5 25,000.00
200 5,000.00
200 5,000.00
100 5,000.00
300 5,000.00
50 17,000.00
50 17,000.00
10 44,000.00
100 18,000.00
350 3,000.00
100 9,000.00
1000 2,200.00
10 20,000.00
100 8,000.00
1 100,000.00
10 120,000.00
2 80,000.00
40 32,000.00
12 100,000.00
30 32,000.00
30 60,000.00
24 70,000.00
25 37,000.00
20 14,800.00
20 14,800.00
20 28,000.00
20 38,000.00
3 19,000.00
2 5,000.00
2 20,000.00
5 21,000.00
5 19,000.00
20 17,000.00
30 16,000.00
40 19,000.00
110 38,000.00
30 25,000.00
39 20,000.00
2 500,000.00
5 37,000.00
30 34,000.00
12 10,000.00
120 19,000.00
120 11,000.00
6 19,000.00
10 18,000.00
7 28,000.00
6 48,000.00
40 15,000.00
560 15,000.00
20 20,000.00
4 100,000.00
v v v Pembayaran pembelian Puskesmas
suku cadang kendaraan Wonosalam
2 780,000
2 1,794,000
1 10,500,000
1 1,881,000
1 2,020,000
v v v v v v Pembayaran pembelian alat Puskesmas
tulis kantor Wonosalam
1 58,600
10 22,100
200 2,000
5 72,000
2 7,800
21 5,500
25 8,000
15 20,900
12 25,800
10 20,000
12 13,500
5 25,800
5 46,700
2 419,400
2 382,500
10 65,000
10 85,400
4 8,600
7 4,900
7 11,100
6 87,400
150 5,500
20 26,700
8 7,000
2 220,000
4 44,300
18 44,200
50 72,600
10 87,300
20 84,000
10 3,800
3 3,200
3 19,700
3 19,700
20 5,000
42 4,300
20 4,900
50 27,100
1 326,000
25 4,300
2 56,600
5 7,500
4 150,000
10 3,000
25 11,300
4 23,400
4 81,200
1 180,000
10 100,000
30 8,000
3 50,400
300 49,200
50 22,900
20 124,200
20 124,200
15 60,000
15 60,000
40 19,700
30 12,000
12 10,000
2 1,500,000
v v v v v v Pembayaran Alat/Bahan Puskesmas
Untuk Kegiatan Kantor- Wonosalam
Kertas dan cover
4,979 300
10 15,000
v v v v v v Pembayaran Alat/Bahan Puskesmas
Untuk Kegiatan Kantor- Wonosalam
bahan cetak
200 30,000
10,000 600
10,009 700
500 17,000
50 20,000
v v v v v v Pembayaran Alat/Bahan Puskesmas
Untuk Kegiatan Kantor- Wonosalam
Benda Pos
300 10,000
v v Pembayaran Alat/Bahan Puskesmas
Untuk Kegiatan Kantor- Wonosalam
Bahan Komputer
4 150,000
5 200,000
v v v v Pembayaran Alat/Bahan Puskesmas
Untuk Kegiatan Kantor-Alat Wonosalam
Listrik
10 27700
30 19700
30 19700
15 60000
15 92200
v v v Pembayaran obat-obatan Puskesmas
Wonosalam
10,000 100
1,000 3,500
200 6,000
200 2,500
3,000 300
200 5,000
1,000 1,100
5,000 200
10,000 200
100 5,000
1,283 10,000
2,000 300
3,000 200
3,500 200
5,000 200
5,000 250
300 4,000
5,000 600
1,000 400
5,000 200
v v v v v v Pembayaran Makanan dan Puskesmas
minuman Wonosalam
180 47,500
120 47,500
500 15,000
v v v v v v Pembayaran Makanan dan Puskesmas
minuman Wonosalam
4800 15,000.00
v v v v v v Pembayaran jasa tenaga Puskesmas
kesehatan Wonosalam
210 400,000
1 874,083,000
27 350,000
8 500,000
18 900,000
1 19,000,000
700 25,000
2 50,000
Pembayaran retribusi Bapelkes
diklat
1 3,000,000
2 350,000
4 300,000.00
v Pembayaran jasa servis Puskesmas
printer Wonosalam
10 600,000
8 730,000
4 485,000
150 50,000
2 1,000,000
9 100,000
4 750,000
3 1,000,000
1 44,000,000
v Pembayaran Alat Puskesmas
Laboratorium Hematologi Wonosalam
20,280,000
7,200,000
78,609,600
21,144,000
1,300,000
1,300,000
1,300,000
300,000
300,000
341,400
341,400
341,400
341,400
400,000
1,700,000
16,900,000
10,000,000
5,600,000
17,000,000
42,360,000
23,040,000
12,240,000
2,400,000
4,680,000
4,500,000
6,400,000
3,000,000
3,400,000
54,712,000
30,612,000
1,200,000
1,200,000
1,700,000
300,000
1,600,000
180,000
125,000
1,000,000
1,000,000
500,000
1,500,000
850,000
850,000
440,000
1,800,000
1,050,000
900,000
2,200,000
200,000
800,000
100,000
1,200,000
160,000
1,280,000
1,200,000
960,000
1,800,000
1,680,000
925,000
296,000
296,000
560,000
760,000
24,100,000
57,000
10,000
40,000
105,000
95,000
340,000
480,000
760,000
4,180,000
750,000
780,000
1,000,000
185,000
1,020,000
120,000
2,280,000
1,320,000
114,000
180,000
196,000
288,000
600,000
8,400,000
400,000
400,000
19,549,000
1,560,000
3,588,000
10,500,000
1,881,000
2,020,000
47,834,400
58,600
221,000
400,000
360,000
15,600
115,500
200,000
313,500
309,600
200,000
162,000
129,000
233,500
838,800
765,000
650,000
854,000
34,400
34,300
77,700
524,400
825,000
534,000
56,000
440,000
177,200
795,600
3,630,000
873,000
1,680,000
38,000
9,600
59,100
59,100
100,000
180,600
98,000
1,355,000
326,000
107,500
113,200
37,500
600,000
30,000
282,500
93,600
324,800
180,000
1,000,000
240,000
151,200
14,760,000
1,145,000
2,484,000
2,484,000
900,000
900,000
788,000
360,000
120,000
3,000,000
1,643,700
1,493,700
150,000
28,506,300
6,000,000
6,000,000
7,006,300
8,500,000
1,000,000
3,000,000
3,000,000
1,600,000
600,000
1,000,000
3,742,000
277,000
591,000
591,000
900,000
1,383,000
35,280,000
1,000,000
3,500,000
1,200,000
500,000
900,000
1,000,000
1,100,000
1,000,000
2,000,000
500,000
12,830,000
600,000
600,000
700,000
1,000,000
1,250,000
1,200,000
3,000,000
400,000
1,000,000
21,750,000
8,550,000
5,700,000
7,500,000
72,000,000
72,000,000
958,083,000
84,000,000
874,083,000
48,650,000
9,450,000
4,000,000
16,200,000
19,000,000
4,000,000
17,500,000
17,500,000
1,000,000
5,000,000
35,000,000
19,700,000
100,000
100,000
15,000,000
20,000,000
3,000,000
3,000,000
700,000
700,000
792,000
3,000,000
2,700,000
1,500,000
1,200,000
1,200,000
30,180,000
6,000,000
5,840,000
1,940,000
7,500,000
2,000,000
900,000
3,000,000
3,000,000
44,000,000
44,000,000
100,000,000
30,000,000
1,788,572,000
1,788,572,000
-
2,326,514,000