No.

Jenis Tenaga Medis Nama

Tenaga Kefarmasian
1 Apoteker 1 Apt. SEPTIANA DWI PRAMITA, S.Farm
2 Apt. DEBY INDA LESTARI, S.Farm
3 Apt. JIHAN AZIZAH,S.Farm
4 Apt. HANIFAH NUR FADHILAH, S.Farm
5 Apt. NABILA,S.Farm
6 Apt.Dian oktafiani, S. Si

2 Sarjana Farmasi 1 HESTI MEGA PANGESTI, S.Farm

2 DIAN APIT FEBRIANI, S.Farm

3 Ahli Madya Farmasi 1 SOFIYATUN, A.Md.,Farm

2 SITI BARIYAH, A.Md., Farm

4 Analis Farmasi
Ten
1 Perawat 1 YUSUF ARIF HIDAYAT, S.Kep.,Ners
2 SAMSUL KHOZIN, S.Kep.,Ners
3 UMIYATUN
4 INDRI WIDI ASTUTI, Amd.Kep
5 PUSPITA SANDRA DEWI, AMK
6 NOVITA SARI,A.Md.,Kep
7 ANGGIT BAGUS SUDIBYO,S.Kep.,Ners
8 FAUZI ALAN KUSUMA, S.Kep., Ns
9 SAKINAH, AMK
10 NOVA IDA NURCAHYA, AMK
11 GIANA RIAN YUNITA, S.Kep.,Ns
12 WAHYU SARWONO AJI, S.Kep.,Ns
13 INA ULFATURROHMAH, A.Md., Kep
14 DIMAS RESTU NUHONO,A.Md.Kep
15 LULU INAFIAH,S.Kep.,Ns
16 ISWATUN MAWADAH,S.Kep.,Ns
17 DIAN TRI NURYANI,S.Kep.,Ns
18 FAIQAH RISCA ANGGITA, A.Md.,Kep
19 IKMALIA AMALI, A.Md., Kep
20 MOHAMAD DWI CAHYO, Amd.Kep
21 ARGA WERDHA RISMA, Amd. Kep
22 CAHYO ADE USMAN, AMK
23 LATIFATULANAM, A.Md.Kep
24 DESTA ABDI K.,S.Kep.Ns
25 LABIBAH RAMADHAN, A.Md.Kep
26 MARIA ANTONETTA VIRGINIA POTE, A.Md.Kep
27 RAFA AFIFAH, S.Kep., Ners
 28 LATIFAH NURUL KHASANAH
29 RUDIYONO
30 KHARISMA ANNISA FITRI, A.Md.Kep
31 KHOLIFATUN AMANAH, S.Kep., Ners
32 FITRIANINGSIH, Amd.Kep
AYU PURWASIH PUTRI JAYASENTIKA,
33
S.Kep.,Ns
34 JENI AMALIA SULASTRI, A.Md.Kep
35 SITI MAMDUDATUL KHASANAH, A.Md.Kep
36 Ns.Risang Sukma Wahyu N., S.Kep.
37 Desi Eka Nur Cahyani, S.Kep., Ners
38 ANGGI RAHMAN, Amd.Kep
39 RIFA FADILAH, S.Kep., Ners
40 BRILLIAN ANDRE PRADANA, S.Kep., Ners
41 HELIYANI NUR ISLAM, S.Kep., Ners
42 DWI NURKHASANAH, S.Kep., Ners
43 UMI FATONAH, S.Kep., Ners
44 FITRI FANJAYUSNU, A.Md.Kep
45 JANISAH PUSPARENI, A.Md.Kep
46 Rr. SRI LINTU NASTITI
47 REZA PUSPA ARUM, A.Md.Kep
48 NABILA RAMADHANTY, S.Kep., Ners

49 ERICK

50
RIFA KHOTIJAH
51
WAFIQOH
52
NABILLAH HANUN

Tenaga Kebidanan Nama

1 Bidan 1 NURUL HIDAYAH, A.Md.Keb

2 DIAN LESTARI,A.Md.Keb
3 TITIES MARTLISA, A.Md.Keb
4 RIA AMALIA RAHAYU,A.Md.Keb
5 YULI SETIYANINGSIH, A.Md.Keb
6 REVITA YULIANA, A.Md.Keb
7 FARIDATUN NIKMAH, A.Md.Keb
8 ESTI SULASTRI, A.Md.Keb
9 AFRA CITRA NIRMALA VIDYADARI, A.Md.Keb
 10 KRISNA DWI RARASARI,A.Md.Keb
11 IRMA YUNIATI AMANATULLOH, A.Md.Keb
12 NURMILA INTIHANA, A.Md.Keb
13 ULUMIYAH, A.Md.Keb
14 WINDY RAHAYU, A.Md.Keb
15 WINDARTI OKTAFIANI, A.Md.,Keb
16 WIDI ASTUTI,A.Md.,Keb
17 NANDA AULIA, A.MD.Keb
18 LILI MUJI WAHYU MULIANI, S.Tr.KeB.Bd
19 DEWI RETNO KURNIA SRILINUWIH, S.Tr.Keb
20 DINANTI ROKHMAH, A.Md.Keb
21 TRI JENI EMILDA NURROHMAH, A.Md.Keb
22 FANNY JULIA R.
23 MELISA ANGGRAENI
24 TIARA REVIANA S
25 ISMI HAJAR P
26 INDRIYATI RAHMADIYA, Amd.Keb
27 RETNO WULANDARI, A.Md.Keb
28 ARNIH
29 NANI

Tenaga Keterapian Fisik

1 Fisioterapis 1 YAUMI ZAKI INAYAH, A.Md., Kes
2 Terapis wicara
3 Okupasi terapis
Tenaga Teknik Biomedika
1 Radiografer 1 FADLIR RAHMAN, A.Md.Kes(Rad)
2 MAHATMA DAMAR KRISTI, A.Md.,Rad
3 SAHAL MAHFUDH, A.Md.Kes.,Rad
2 Elektromedis
3 Fisikawan medik
4 Ortotis prostetis
5 Radioterapis
Ahli teknologi laboratorium
6 1 RISTA LESTARI,Amd.Ak
medik (analis/biologi)
2 RILO PAMBUDI,Amd.Ak
3 WIDYA ARTA PRAYOGI, Amd.Ak
Tenaga keteknisian medik
1 Perekam medis dan informasi
Kesehatan 1 MELDA AYUSTININGRUM, A.Md.Kes
2 EMA RIZKI SETIYANI, A.Md.Kes
3 EFIT FEBRIYANTI, A.Md.RMIK
2 Penata anestesi 1 ANGGI RAHMAN, Amd.Kep
Tenaga Kesehatan Lain
1 Tenaga gizi 1 ANINDITA NUR ASILATIN, S.Gz
2 Tenaga psikologi klinis
3 Tenaga kesehatan lingkungan 1 AFIF SAPRILIANI, S.Tr.Kes

Mengetahui
Kepala SDM
Rumah Sakit Umum Aghisna Medika Sidareja

( Rohiwanto)
 Tanggal SIP
Tanggal SIP Mulai Berlaku
Nomor SIP Berakhir

19870929/SIPA.33.01/2019/02.066 8/30/2019 9/29/2024

19960906/SIPA.33.01/2020/02.212 8/13/2020 9/6/2024
19970324/SIPA.33.01/2022/02.413 12/12/2022 3/24/2027
19960712/SIPA.33.01/2022/02.398 12/12/2022 7/12/2026
19990929/SIPA.33.01/2023/02.498 3/24/2023 9/29/2027
19791028/SIPA.33.01/2023/02.186 3/24/2023 10/28/2024

19990608/SIPTTK.3301/02.088/2022 12/12/2022 6/8/2027

STR BELUM JADI

19940523/SIPTTK.3301/02.095/2022 12/22/2022 5/23/2026

19950111/SIPTTK.33.01/2021/241 8/9/2021 1/11/2025

Tenaga Keperawatan
1160/Din.Kes/SIPP.1/II/2020 2/7/2020 1/28/2023
664/Din.Kes/SIPP.1/VII/2020 7/21/2020 6/17/2025
449.1/01121/PER.I/XI/2022 11/25/2022 7/11/2027
449.1/01300/per.i/i/2023 1/10/2023 11/23/2027
719/Din.Kes/SIPP.1/V/2019 5/20/2019 12/10/2024
1168/Din.Kes/SIPP.1/III/2020 2/14/2020 11/24/2024
636/Din.Kes/SIPP.1/V/2019 5/20/2019 3/29/2023
449,1/01463/PER.I/III/2023 3/30/2023 2/17/2028
717/Din.Kes/SIPP.1/V/2019 5/20/2019 8/17/2023
1132/Din.Kes/SIPP.1/2020 1/15/2020 11/13/2024
665/Din.Kes/SIPP.1/VII/2020 7/21/2020 6/24/2025
449.1/00585/PER.I/VII/2022 6/20/2022 9/13/2027
2039/Din.Kes/SIPP.1/XII/2021 12/1/2021 3/19/2024
449.1/00706/PER.I/VIII/2022 8/8/2022 11/16/2026
666/Din.Kes/SIPP.1/III/2022 3/2/2022 8/15/2022
1713/Din.Kes/SIPP.1/III/2022 3/2/2022 6/15/2026
2134/Din.Kes/SIPP.1/III/2022 3/2/2022 9/17/2027
2132/Din.KeS/SIPP.1/III/2022 3/2/2022 9/5/2025
2133/Din.Kes/SIPP.1/III/2022 3/2/2022 7/30/2026
1669/Din.Kes/SIPP.1/III/2021 3/22/2021 3/2/2025

449.1/01123/PER.I/XI/2022 11/25/2022 3/12/2024

449.1/01082/PER.I/XI/2022 11/15/2022 12/17/2026

449.1/01118/PER.I/XI/2022 11/25/2022 1/31/2026
449.1/01010/PER.I/X/2022 10/14/2022 1/18/2027
449.1/00696/PER.I/XI/2022 11/15/2022 8/9/2025
 449.1/00952/PER.I/XI/2022 9/22/2022 10/28/2026
449.1/01083/PER.I/XI/2022 11/15/2022 5/6/2023
449.1/01011/PER.I/X/2022 10/14/2022 1/4/2026
449.1/01119/PER.I/XI/2022 11/25/2022 11/13/2025
449.1/01117/PER.I/XI/2022 11/25/2022 2/8/2026
449.1/01124/PER.I/XI/2022 11/25/2022 8/11/2026
449.1/01122/PER.I/XI/2022 11/25/2022 6/10/2026
449.1/01125/PER.I/XI/2022 11/25/2022 9/5/2026
449.1/01120/PER.I/XI/2022 11/20/2022 8/8/2026

449.1/01151/SIPPA.I/XI/2022 11/28/2022 11/13/2024

449.1/01171/PER.I/XI/2022 11/30/2022 2/25/2024

Tanggal SIP
Tanggal SIP Mulai Berlaku
Nomor SIP Berakhir

0414/Din.Kes/SIPB-1/V/2019 5/20/2019 10/29/2023

0417/Din.Kes/SIPB-1/V/2019 5/20/2019 4/12/2023
449.1/00553/SIPB.01/VIII/2022 8/29/2022 3/21/2027
449.1/00551/SIPB.01/VIII/2022 8/29/2022 5/20/2027
449.1/00550/SIPB.01/VIII/2022 8/29/2022 7/11/2026
0636/Din Kes/SIPB-1/VIII/2020 8/12/2020 1/29/2025
449.1/00554/SIPB.01/VIII/2022 8/29/2022 2/16/2027
449.1/00807/SIPB.01/X/2022 10/27/2022 7/3/2027
0366/Din Kes/SIPB-1/V/2019 5/20/2019 11/6/2023
449.1/01034/SIPB.01/I/2023 1/24/2023 9/28/2027
0769/Din Kes/SIPB-1/VI/2021 1/27/2022 6/23/2024
0915/Din Kes/SIPB-1/I/2022 1/27/2022 11/4/2026
0918/Din Kes/SIPB-1/I/2022 1/27/2022 5/16/2026
449.1/00555/SIPB.01/VIII/2022 8/29/2022 5/7/2024
449.1/00556/SIPB.01/VIII/2022 8/29/2022 10/23/2026
449.1/00557/SIPB.01/VIII/2022 8/29/2022 1/25/2027
0916/Din Kes/SIPB-1/I/2022 1/27/2022 7/9/2026
0917/Din Kes/SIPB-1/I/2022 1/27/2022 6/19/2025
0920/Din Kes/SIPB-1/I/2022 1/27/2022 1/18/2025
0872/Din Kes/SIPB-1/XII/2021 12/1/2021 8/25/2026
0789/Din Kes/SIPB-1/VII/2021 7/5/2021 6/21/2025
0864/Din Kes/SIPB-1/XI/2021 11/10/2021 7/5/2023
0873/Din Kes/SIPB-1/XII/2021 12/1/2021 1/26/2026
449.1/00820/SIPB.01/XI/2022 11/15/2022 4/7/2027
0863/Din Kes/SIPB-1/XI/2021 11/10/2021 4/21/2024
449.1/00821/SIPB.01/XI/2022 11/15/2022 12/16/2027

026/Dinkes/SIPF.2/V/2021 5/21/2021 1/28/2025

015/Din.Kes/SIKR.1/XII/2020 12/21/2020 9/16/2024

018/Din.Kes/SIKR.2/VI/2019 6/26/2019 12/31/2022
449.1/01056/Rad.I/X/2022 10/28/2022 4/18/2026

029/Din.Kes/SIP-ATLM.2/V/2021 5/24/2021 12/20/2025

009/Din.Kes/SIP-ATLM.1/II/2020 2/25/2020 3/16/2025
449.1/01339/ATLM.I/I/2023 1/26/2023 3/20/2027

012/Din.Kes/SIKREMIK.1/v/2021 5/24/2021 8/28/2025

449.1/00998/Per.Med.I/X/2022 10/14/2022 8/24/2027
449.1/00997/Per.Med.I/X/2022 10/14/2022 2/18/2027
449.1/01151/SIPPA.I/XI/2022 11/28/2022 11/13/2024

449.1/00709/T.Giz.I/I/2023 1/26/2023 11/18/2027

449.1/01062/TS.I/XI/2022 11/9/2022 5/30/2026

Cilacap, 14 Oktober 2022

Menyetujui
Direktur
Rumah Sakit Umum Aghisna Medika Sidareja

( dr. Hesti Hermawati )

Status Kepegawaian
No. SK/ PKS Tenaga Purna/
(Purna Waktu/ Paruh Keterangan
Paruh Waktu
Waktu)

Purna Waktu 080.A/RSU-AMS/III/2022 OFF 31 JAN 2023

Paruh Waktu 081.A/RSU-AMS/III/2022 OFF
Purna Waktu 549.A /RSU-AMS/IX/2022
Paruh Waktu 510.A/RSU-AMS/VIII/2022
Purna Waktu 552.A/RSU-AMS/IX/2022
Paruh Waktu

Purna Waktu 551.A/RSU-AMS/IX/2022

Purna Waktu 460.A/RSU-AMS/VII/2022

Purna Waktu 553.A/RSU-AMS/IX/2022

Purna Waktu 082.A/RSU-AMS/III/2021

Purna Waktu 144.A/RSU-AMS/IV/2022
Purna Waktu 145.A/RSU-AMS/IV/2022
Purna Waktu 146.A/RSU-AMS/IV/2022 DPMPTSP
Purna Waktu 083.A/RSU-AMS/III/2021 OFF DES 2022
Purna Waktu 084.A/RSU-AMS/III/2022
Purna Waktu 147.A/RSU-AMS/IV/2022 PERPANJANGAN SIP DALAM PROSES
Purna Waktu 148.A/RSU-AMS/IV/2022
Purna Waktu 149.A/RSU-AMS/IV/2022
Purna Waktu 105.A/RSU-AMS/V/2022
Purna Waktu 106.A/RSU-AMS/V/2022
Purna Waktu 150.A/RSU-AMS/IV/2022
Purna Waktu 038.A/RSU-AMS/II/2022
Purna Waktu 039.A/RSU-AMS/II/2022
Purna Waktu 085.A/RSU-AMS/III/2022 PROSES SIP
Purna Waktu 151.A/RSU-AMS/IV/2022
Purna Waktu 152.A/RSU-AMS/IV/2022
Purna Waktu 153.A/RSU-AMS/IV/2022
Purna Waktu 154.A/RSU-AMS/IV/2022
Purna Waktu 081.A/RSU-AMS/III/2022
Purna Waktu 086.A/RSU-AMS/VIII/2022 DPMPTSP
Purna Waktu 087.A/RSU-AMS/VIII/2022
Purna Waktu 089.A/RSU-AMS/VIII/2022 PROSES
Purna Waktu 554.A/RSU-AMS/IX/2022
Purna Waktu 555.A/RSU-AMS/IX/2022
Purna Waktu 557.A/RSU-AMS/IX/2022
Purna Waktu 563.A/RSU-AMS/IX/2022
 Purna Waktu 094.A/RSU-AMS/VIII/2022
Purna Waktu 095.A/RSU-AMS/VIII/2022
Purna Waktu 096.A/RSU-AMS/VIII/2022
Purna Waktu 559.A/RSU-AMS/IX/2022
Purna Waktu 097.A/RSU-AMS/VIII/2022
Purna Waktu 098.A/RSU-AMS/VIII/2022
Purna Waktu /RSU-AMS/VIII/2022
Purna Waktu /RSU-AMS/VIII/2022 off 25 juni 2023
Purna Waktu /RSU-AMS/VIII/2022

OFF PER 01/04/2023

Purna Waktu /RSU-AMS/VIII/2022

OFF PER 10/04/2023

OFF PER 20/04/2023

Status Kepegawaian
No. SK/ PKS Tenaga Purna/
(Purna Waktu/ Paruh Keterangan
Paruh Waktu
Waktu)
Purna Waktu 127.A/RSU-AMS/VI/2022
Purna Waktu 082.A/RSU-AMS/III/2022
Purna Waktu 107.A/RSU-AMS/V/2022
Purna Waktu 108.A/RSU-AMS/V/2022
Purna Waktu 128.A/RSU-AMS/VI/2022
Purna Waktu 463.A/RSU-AMS/VII/2022
Purna Waktu 129.A/RSU-AMS/IV/2022
Purna Waktu 130.A/RSU-AMS/IV/2022
Purna Waktu 131.A/RSU-AMS/IV/2022
Purna Waktu 109.A/RSU-AMS/V/2022
Purna Waktu 132.A/RSU-AMS/IV/2022
Purna Waktu 133.A/RSU-AMS/IV/2022
Purna Waktu 134.A/RSU-AMS/IV/2022
Purna Waktu 135.A/RSU-AMS/IV/2022
Purna Waktu 136.A/RSU-AMS/IV/2022
Purna Waktu 137.A/RSU-AMS/IV/2022
Purna Waktu 138.A/RSU-AMS/IV/2022
Purna Waktu 110.A/RSU-AMS/V/2022 OFF 28/12/2022
Purna Waktu 111.A/RSU-AMS/V/2022
Purna Waktu 035.A/RSU-AMS/II/2022
Purna Waktu 139.A/RSU-AMS/VI/2022
Purna Waktu 561.A/RSU-AMS/XI/2021
Purna Waktu 140.A/RSU-AMS/IV/2022
Purna Waktu 464.A/RSU-AMS/VII/2022
Purna Waktu 112.A/RSU-AMS/V/2022
Purna Waktu 141.A/RSU-AMS/IV/2022
BELUM PROSES

Purna Waktu 142.A/RSU-AMS/IV/2022

Purna Waktu 143.A/RSU-AMS/IV/2022

Paruh Waktu 036.A/RSU-AMS/II/2022
Paruh Waktu 100.A/RSU-AMS/VIII/2022

Purna Waktu 083.A/RSU-AMS/III/2022

Paruh Waktu 084.A/RSU-AMS/III/2022
Purna Waktu 037.A/RSU-AMS/II/2022

Purna Waktu 090.A/RSU-AMS/III/2022

Purna Waktu 101.A/RSU-AMS/VIII/2022
Purna Waktu 102.A/RSU-AMS/VIII/2022
Purna Waktu 562.A/RSU-AMS/IX/2022

Purna Waktu 091.A/RSU-AMS/III/2022

Purna Waktu 451/RSU-AMS/XI/2022
 Status Kepegawaian
Tanggal SIP Mulai Berlaku Tanggal SIP Berakhir
No. Jenis Tenaga Medis Nama Nomor SIP (Purna Waktu/ Paruh
Waktu)

Tenaga Kefarmasian
1 Apoteker 1 Apt. JIHAN AZIZAH,S.Farm 19970324/SIPA.33.01/2022/02.413 12/12/2022 3/24/2027 Purna Waktu
2 Apt. HANIFAH NUR FADHILAH, S.Farm 19960712/SIPA.33.01/2022/02.398 12/12/2022 7/12/2026 Paruh Waktu
3 Apt. NABILA,S.Farm 19990929/SIPA.33.01/2023/02.498 3/24/2023 9/29/2027 Purna Waktu
4 Apt.Dian oktafiani, S. Si 19791028/SIPA.33.01/2023/02.186 3/24/2023 10/28/2024 Paruh Waktu

2 Sarjana Farmasi 1 HESTI MEGA PANGESTI, S.Farm 19990608/SIPTTK.3301/02.088/2022 12/12/2022 6/8/2027 Purna Waktu
2 DIAN APIT FEBRIANI, S.Farm STR BELUM JADI

3 Ahli Madya Farmasi 1 SOFIYATUN, A.Md.,Farm 19940523/SIPTTK.3301/02.095/2022 12/22/2022 5/23/2026 Purna Waktu
2 SITI BARIYAH, A.Md., Farm 19950111/SIPTTK.33.01/2021/241 8/9/2021 1/11/2025 Purna Waktu
3 RETHA ASTRI NOVITASARI, A.Md.Farm. BELUM PROSES SIP MASUK 4 juli 2023

4 Analis Farmasi TIDAK ADA

Tenaga Keperawatan
1 Perawat 1 YUSUF ARIF HIDAYAT, S.Kep.,Ners 1160/Din.Kes/SIPP.1/II/2020 2/7/2020 1/28/2023 Purna Waktu
2 SAMSUL KHOZIN, S.Kep.,Ners 664/Din.Kes/SIPP.1/VII/2020 7/21/2020 6/17/2025 Purna Waktu
3 UMIYATUN 449.1/01121/PER.I/XI/2022 11/25/2022 7/11/2027 Purna Waktu
4 INDRI WIDI ASTUTI, Amd.Kep 449.1/01300/per.i/i/2023 1/10/2023 11/23/2027 Purna Waktu
5 NOVITA SARI,A.Md.,Kep 1168/Din.Kes/SIPP.1/III/2020 2/14/2020 11/24/2024 Purna Waktu
6 ANGGIT BAGUS SUDIBYO,S.Kep.,Ners 636/Din.Kes/SIPP.1/V/2019 5/20/2019 3/29/2023 Purna Waktu
7 FAUZI ALAN KUSUMA, S.Kep., Ns 449.1/01463/PER.I/III/2023 3/30/2023 2/17/2028 Purna Waktu
8 SAKINAH, Amd.Kep. 717/Din.Kes/SIPP.1/V/2019 5/20/2019 8/17/2023 Purna Waktu
9 NOVA IDA NURCAHYA, AMK 1132/Din.Kes/SIPP.1/2020 1/15/2020 11/13/2024 Purna Waktu
10 GIANA RIAN YUNITA, S.Kep.,Ns 665/Din.Kes/SIPP.1/VII/2020 7/21/2020 6/24/2025 Purna Waktu
11 WAHYU SARWONO AJI, S.Kep.,Ns 449.1/00585/PER.I/VII/2022 6/20/2022 9/13/2027 Purna Waktu
12 INA ULFATURROHMAH, A.Md., Kep 2039/Din.Kes/SIPP.1/XII/2021 12/1/2021 3/19/2024 Purna Waktu
13 DIMAS RESTU NUHONO,A.Md.Kep 449.1/00706/PER.I/VIII/2022 8/8/2022 11/16/2026 Purna Waktu
14 LULU INAFIAH,S.Kep.,Ns 666/Din.Kes/SIPP.1/III/2022 3/2/2022 8/15/2022 Purna Waktu
15 ISWATUN MAWADAH,S.Kep.,Ns 1713/Din.Kes/SIPP.1/III/2022 3/2/2022 6/15/2026 Purna Waktu
16 DIAN TRI NURYANI,S.Kep.,Ns 2134/Din.Kes/SIPP.1/III/2022 3/2/2022 9/17/2027 Purna Waktu
17 FAIQAH RISCA ANGGITA, A.Md.,Kep 2132/Din.KeS/SIPP.1/III/2022 3/2/2022 9/5/2025 Purna Waktu
18 IKMALIA AMALI, A.Md., Kep 2133/Din.Kes/SIPP.1/III/2022 3/2/2022 7/30/2026 Purna Waktu
19 MOHAMAD DWI CAHYO, Amd.Kep 1669/Din.Kes/SIPP.1/III/2021 3/22/2021 3/2/2025 Purna Waktu
20 ARGA WERDHA RISMA, Amd. Kep Purna Waktu
21 CAHYO ADE USMAN, AMK 449.1/01123/PER.I/XI/2022 11/25/2022 3/12/2024 Purna Waktu
22 LATIFULANAM, A.Md.Kep Purna Waktu
23 DESTA ABDI KURNIAWAN,S.Kep.Ns 449.1/01082/PER.I/XI/2022 11/15/2022 12/17/2026 Purna Waktu
24 LABIBAH NUR RAMADHANI KHAIDIR, S.Kep., Ners 449.1/01118/PER.I/XI/2022 11/25/2022 1/31/2026 Purna Waktu
25 MARIA ANTONETTA VIRGINIA POTE, A.Md.Kep 449.1/01010/PER.I/X/2022 10/14/2022 1/18/2027 Purna Waktu
26 RAFA AFIFAH, S.Kep., Ners 449.1/00696/PER.I/XI/2022 11/15/2022 8/9/2025 Purna Waktu
27 RUDIYONO, S.Kep., Ners 449.1/01083/PER.I/XI/2022 11/15/2022 5/6/2023 Purna Waktu
 28 KHARISMA ANNISA FITRI, A.Md.Kep 449.1/01011/PER.I/X/2022 10/14/2022 1/4/2026 Purna Waktu
29 KHOLIFATUN AMANAH, S.Kep., Ners 449.1/01119/PER.I/XI/2022 11/25/2022 11/13/2025 Purna Waktu
30 FITRIANINGSIH, Amd.Kep 449.1/01117/PER.I/XI/2022 11/25/2022 2/8/2026 Purna Waktu
31 AYU PURWASIH PUTRI JAYASENTIKA, S.Kep.,Ns 449.1/01124/PER.I/XI/2022 11/25/2022 8/11/2026 Purna Waktu
32 JENI AMALIA SULASTRI, A.Md.Kep 449.1/01122/PER.I/XI/2022 11/25/2022 6/10/2026 Purna Waktu
33 Ns.Risang Sukma Wahyu N., S.Kep. 449.1/01120/PER.I/XI/2022 11/20/2022 8/8/2026 Purna Waktu
34 Desi Eka Nur Cahyani, S.Kep., Ners
35 ANGGI RAHMAN, Amd.Kep 449.1/01151/SIPPA.I/XI/2022 11/28/2022 11/13/2024
36 BRILLIAN ANDRE PRADANA, S.Kep., Ners 449.1/01171/PER.I/XI/2022 11/30/2022 2/25/2024 Purna Waktu
37 HELIYANI NUR ISLAM, S.Kep., Ners
38 DWI NURKHASANAH, S.Kep., Ners
39 UMI FATONAH, S.Kep., Ners 449.1/Per/00774/80/CLP 8/11/2023 11/12/2026 Purna Waktu
40 JANISAH PUSPARENI, A.Md.Kep
41 Rr. SRI LINTU NASTITI,AMK
42 Ns. RIFA KHOTIJAH, S.Kep
43 WAFIQOH, Amd.Kep
44 NABIILAH HANUUN HANIIFAH, A.Md .Kep
45 Ns. WORO DYAH APRISKA,S.Kep.
46 MOHAMAD ASYIFAURROHMAN, A.Md.Kep

Status Kepegawaian
Tanggal SIP Mulai Berlaku Tanggal SIP Berakhir
Tenaga Kebidanan Nama Nomor SIP (Purna Waktu/ Paruh
Waktu)

1 Bidan 1 NURUL HIDAYAH, A.Md.Keb 0414/Din.Kes/SIPB-1/V/2019 5/20/2019 10/29/2023 Purna Waktu

2 TITIES MARTLISA, A.Md.Keb 449.1/00553/SIPB.01/VIII/2022 8/29/2022 3/21/2027 Purna Waktu
3 RIA AMALIA RAHAYU,A.Md.Keb 449.1/00551/SIPB.01/VIII/2022 8/29/2022 5/20/2027 Purna Waktu
4 YULI SETIYANINGSIH, A.Md.Keb 449.1/00550/SIPB.01/VIII/2022 8/29/2022 7/11/2026 Purna Waktu
5 REVITA YULIANA, A.Md.Keb 0636/Din Kes/SIPB-1/VIII/2020 8/12/2020 1/29/2025 Purna Waktu
6 FARIDATUN NIKMAH, A.Md.Keb 449.1/00554/SIPB.01/VIII/2022 8/29/2022 2/16/2027 Purna Waktu
7 ESTI SULASTRI, A.Md.Keb 449.1/00807/SIPB.01/X/2022 10/27/2022 7/3/2027 Purna Waktu
8 AFRA CITRA NIRMALA VIDYADARI, A.Md.Keb 0366/Din Kes/SIPB-1/V/2019 5/20/2019 11/6/2023 Purna Waktu
9 KRISNA DWI RARASARI,A.Md.Keb 449.1/01034/SIPB.01/I/2023 1/24/2023 9/28/2027 Purna Waktu
10 IRMA YUNIATI AMANATULLOH, A.Md.Keb 0769/Din Kes/SIPB-1/VI/2021 1/27/2022 6/23/2024 Purna Waktu
11 NURMILA INTIHANA, A.Md.Keb 0915/Din Kes/SIPB-1/I/2022 1/27/2022 11/4/2026 Purna Waktu
12 ULUMIYAH, A.Md.Keb 0918/Din Kes/SIPB-1/I/2022 1/27/2022 5/16/2026 Purna Waktu
13 WINDY RAHAYU, A.Md.Keb 449.1/00555/SIPB.01/VIII/2022 8/29/2022 5/7/2024 Purna Waktu
14 WINDARTI OKTAFIANI, A.Md.,Keb 449.1/00556/SIPB.01/VIII/2022 8/29/2022 10/23/2026 Purna Waktu
15 WIDI ASTUTI,A.Md.,Keb 449.1/00557/SIPB.01/VIII/2022 8/29/2022 1/25/2027 Purna Waktu
16 NANDA AULIA, A.MD.Keb 0916/Din Kes/SIPB-1/I/2022 1/27/2022 7/9/2026 Purna Waktu
17 DEWI RETNO KURNIA SRILINUWIH, S.Tr.Keb 0920/Din Kes/SIPB-1/I/2022 1/27/2022 1/18/2025 Purna Waktu
18 DINANTI ROKHMAH, A.Md.Keb 0872/Din Kes/SIPB-1/XII/2021 12/1/2021 8/25/2026 Purna Waktu
19 TRI JENI EMILDA NURROHMAH, A.Md.Keb 0789/Din Kes/SIPB-1/VII/2021 7/5/2021 6/21/2025 Purna Waktu
20 MELISA ANGGRAENI, A.Md.Keb 0873/Din Kes/SIPB-1/XII/2021 12/1/2021 1/26/2026 Purna Waktu
21 TIARA REVIANA SAPUTRI, A.Md.Keb 449.1/00820/SIPB.01/XI/2022 11/15/2022 4/7/2027 Purna Waktu
22 ISMI HAJAR PRAMUDYANI, A.Md.Keb 0863/Din Kes/SIPB-1/XI/2021 11/10/2021 4/21/2024 Purna Waktu
 23 INDRIYATI RAHMADIYA, Amd.Keb 449.1/00821/SIPB.01/XI/2022 11/15/2022 12/16/2027 Purna Waktu
24 RETNO WULANDARI, A.Md.Keb 449.1/01060/SIPB.01/II/2023 2/23/2023 8/10/2027 Purna Waktu
25 ARNIH, Amd.Keb
26 NANI RATNAWATI, Amd.Keb

Tenaga Keterapian Fisik

1 Fisioterapis 1 YAUMI ZAKI INAYAH, A.Md., Kes 026/Dinkes/SIPF.2/V/2021 5/21/2021 1/28/2025 Purna Waktu
2 Terapis wicara
3 Okupasi terapis
Tenaga Teknik Biomedika
1 Radiografer 1 FADLIR RAHMAN, A.Md.Kes(Rad) 015/Din.Kes/SIKR.1/XII/2020 12/21/2020 9/16/2024 Purna Waktu
2 MAHATMA DAMAR KRISTI, A.Md.,Rad 018/Din.Kes/SIKR.2/VI/2019 6/26/2019 12/31/2022 Paruh Waktu
3 SAHAL MAHFUDH, A.Md.Kes.,Rad 449.1/01056/Rad.I/X/2022 10/28/2022 4/18/2026 Paruh Waktu
2 Elektromedis
3 Fisikawan medik
4 Ortotis prostetis
5 Radioterapis

6 Ahli teknologi laboratorium medik (analis/biologi) 1 RISTA LESTARI,Amd.Ak 029/Din.Kes/SIP-ATLM.2/V/2021 5/24/2021 12/20/2025 Purna Waktu

2 RILO PAMBUDI,Amd.Ak 009/Din.Kes/SIP-ATLM.1/II/2020 2/25/2020 3/16/2025 Paruh Waktu

3 WIDYA ARTA PRAYOGI, Amd.Ak 449.1/01339/ATLM.I/I/2023 1/26/2023 3/20/2027 Purna Waktu
4 DILA RAHMAWATI DEWI, S.Tr.A.K.
Tenaga keteknisian medik

Perekam medis dan informasi Kesehatan 1 MELDA AYUSTININGRUM, A.Md.Kes 012/Din.Kes/SIKREMIK.1/v/2021 5/24/2021 8/28/2025 Purna Waktu
1
2 EMA RIZKI SETIYANI, A.Md.Kes 449.1/00998/Per.Med.I/X/2022 10/14/2022 8/24/2027 Purna Waktu
3 EFIT FEBRIYANTI, A.Md.RMIK 449.1/00997/Per.Med.I/X/2022 10/14/2022 2/18/2027 Purna Waktu

2 Penata anestesi 1 ANGGI RAHMAN, Amd.Kep 449.1/01151/SIPPA.I/XI/2022 11/28/2022 11/13/2024 Purna Waktu

Tenaga Kesehatan Lain

Tenaga gizi 1 ANINDITA NUR ASILATIN, S.Gz 449.1/00709/T.Giz.I/I/2023 1/26/2023 11/18/2027 Purna Waktu
1
2 NUR KHOFIFAH, S.Gz
2 Tenaga psikologi klinis
3 Tenaga kesehatan lingkungan 1 AFIF SAPRILIANI, S.Tr.Kes 449.1/01062/TS.I/XI/2022 11/9/2022 5/30/2026 Purna Waktu

Cilacap, 14 JULI 2023

Mengetahui Menyetujui
Kepala SDM Direktur
Rumah Sakit Umum Aghisna Medika Sidareja Rumah Sakit Umum Aghisna Medika Sidareja

( Rohiwanto) ( dr. Hesti Hermawati )

DATA DOKTER SPESIALIS PER 12 juli 2023

 No NAMA JK STATUS KARYAWAN NOMOR STR TGL ED NOMOR SIP DU/DS TGL DITETAPKAN
1 dr. Diana Anggraini, Sp.An P PT 3421501317098820 10/4/2027 33016/53212/DS/02/449.1/00413/IX/2022 9/9/2022
2 dr. Lia Amalia, Sp.N P PT 3421605419095200 04-11-2023 33016/53223/DS/02/449.1/0030/VII/2019 01-07-2019
3 dr. Nur Eko Hadi Sucipto, Sp.B L PT 3411101316003213 10/26/2026 33016/53223/DS/03/449.1/0011/X/2021 10/13/2021
4 dr. Irfan Alfarizi, Sp. PD L PT 3211401320087669 4/12/2025 33016/53223/DS/03/449.1/0254/XII/2021 12/21/2021
5 dr.Izrul Amin,Sp.OG L PT 7111301319006710 11/11/2024 33016/53223/DS/02/449.1/0344/X/2021 10/26/2021
6 dr. M. Sari'uddin Nuhriawangsa, Sp.N L PT 3411605220159290 2/23/2026 33016/53223/DS/03/449.1/0516/XI/2021 11/15/2021
7 dr. M. Fatikh Nanda Perdana, Sp.OT L PT 3211103320124641 7/3/2025 33016/53223/DS/02/449.1/0548/VI/2021 6/9/2021
8 dr. Tri Hartono, Sp.A L PT 33.1.1.201.4.21.071207 2/26/2027 33016/53212/DS/02/449.1/00613/XII/2022 12/29/2022
9 dr. Tiefha Farrah Martaningroem, Sp. K.F.R P PT 33.2.1.608.3.21.142324 3/31/2025 33016/53212/DS/03/499.1/00518/II/2023 2/23/2023
10 dr. Tisna Sendy Pratama, Sp. Rad L PT 3411503323127398 2/5/2028 330/53212/DS/3/449.1/00480/25/CLP 7/7/2023
11 dr. Herendra Medihirza Herman Prasetya, Sp.B. L PT 3311101219126855 1/11/2025 3301/53212/DS/2/44.1/00147/25/CLP 6/7/2023

TOTAL 11

UPDATE DATA DOKTER UMUM 4/4/2023

No NAMA JK STATUS KARYAWAN NOMOR STR TGL ED NOMOR SIP DU/DS TGL ED
1 dr. Muhammad Fahryzal L PT 3311100222202711 1/17/2028 33016/53212/DU/01/499.1/00326/I/2023 1/17/2028
2 dr. Hesti Hermawati P PT 3321100119202700 10-10-2023 33016/53223/DU/03/449.1/0116/I/2020 10-10-2023
3 dr. Atingul Ma'rifah P PT 3121100116166764 4/9/2028 33016/53212/DU/02/499.1/00387/XII/2022 4/9/2028
4 dr. Laela Nurrochmah P PT 3321100120216420 11-05-2024 33016/53223/DU/02/449.1/0279/XI/2020 11-05-2024
5 dr. Khairina Bayani Uyun P PT 3221100119200940 10/6/2025 33016/53223/DU/03/449.1/0570/XII/2021 10/6/2025
6 dr. Az-Zahra Mahrunnisa P PT 3221100121230306 4/3/2025 33016/53223/DU/01/449.1/0592/II/2022 4/3/2025
7 dr. Arsya Firdaus L PT 33111001222420701 2/8/2026 33016/53212/DU/02/499.1/00651/VIII/2022 2/8/2026
8 dr. MUHAMMAD FARHAN NAUFAL SIREGAR L PT 3411100222169105 3/20/2027 33016/53212/DU/02/499.1/00609/XI/2022 3/20/2027
9 dr. Arif Budiprasetyo L PT 3411100223180450 1/2/2028 3301/53212/DU/2/449.1/00512/25/CLP 6/2/2028
No. SK/ PKS Tenaga Purna/
Keterangan
Paruh Waktu

549.A /RSU-AMS/IX/2022
510.A/RSU-AMS/VIII/2022
552.A/RSU-AMS/IX/2022
044.A/RSU-AMS/I/2023

551.A/RSU-AMS/IX/2022

460.A/RSU-AMS/VII/2022
553.A/RSU-AMS/IX/2022

082.A/RSU-AMS/III/2021
144.A/RSU-AMS/IV/2022
145.A/RSU-AMS/IV/2022
146.A/RSU-AMS/IV/2022 DPMPTSP

084.A/RSU-AMS/III/2022
147.A/RSU-AMS/IV/2022 PROSES PERPANJANGAN SIP

148.A/RSU-AMS/IV/2022
149.A/RSU-AMS/IV/2022 STR MAU HABIS AGUSTUS

105.A/RSU-AMS/V/2022
106.A/RSU-AMS/V/2022
150.A/RSU-AMS/IV/2022
038.A/RSU-AMS/II/2022
039.A/RSU-AMS/II/2022
085.A/RSU-AMS/III/2022 PROSES PERPANJANGAN SIP

151.A/RSU-AMS/IV/2022
152.A/RSU-AMS/IV/2022
153.A/RSU-AMS/IV/2022
154.A/RSU-AMS/IV/2022
081.A/RSU-AMS/III/2022
086.A/RSU-AMS/VIII/2022 PROSES PEMBUATAN SIP

087.A/RSU-AMS/VIII/2022
089.A/RSU-AMS/VIII/2022 PROSES PEMBUATAN SIP
554.A/RSU-AMS/IX/2022
555.A/RSU-AMS/IX/2022
557.A/RSU-AMS/IX/2022
563.A/RSU-AMS/IX/2022
095.A/RSU-AMS/VIII/2022
096.A/RSU-AMS/VIII/2022
559.A/RSU-AMS/IX/2022
097.A/RSU-AMS/VIII/2022
098.A/RSU-AMS/VIII/2022

BELUM PROSES SIP

BELUM PROSES SIP
BELUM PROSES SIP
BELUM PROSES SIP
BELUM PROSES SIP

BELUM PROSES SIP

BELUM PROSES SIP
BELUM PROSES SIP
BELUM PROSES SIP
BELUM PROSES SIP
BELUM PROSES SIP
BELUM PROSES SIP

No. SK/ PKS Tenaga Purna/

Keterangan
Paruh Waktu

127.A/RSU-AMS/VI/2022
107.A/RSU-AMS/V/2022
108.A/RSU-AMS/V/2022
128.A/RSU-AMS/VI/2022
463.A/RSU-AMS/VII/2022
129.A/RSU-AMS/IV/2022
130.A/RSU-AMS/IV/2022
131.A/RSU-AMS/IV/2022
109.A/RSU-AMS/V/2022
132.A/RSU-AMS/IV/2022
133.A/RSU-AMS/IV/2022
134.A/RSU-AMS/IV/2022
135.A/RSU-AMS/IV/2022
136.A/RSU-AMS/IV/2022
137.A/RSU-AMS/IV/2022
138.A/RSU-AMS/IV/2022
111.A/RSU-AMS/V/2022
035.A/RSU-AMS/II/2022
139.A/RSU-AMS/VI/2022
140.A/RSU-AMS/IV/2022
464.A/RSU-AMS/VII/2022
112.A/RSU-AMS/V/2022
141.A/RSU-AMS/IV/2022
105/RSU-AMS/VII/2023
MASUK 23 Mei 2023 BELUM PROSES SIP
MASUK 23 Mei 2023 BELUM PROSES SIP

142.A/RSU-AMS/IV/2022

143.A/RSU-AMS/IV/2022
036.A/RSU-AMS/II/2022
100.A/RSU-AMS/VIII/2022

083.A/RSU-AMS/III/2022

084.A/RSU-AMS/III/2022
037.A/RSU-AMS/II/2022
MASUK 4 juli 2023 BELUM PROSES SIP

090.A/RSU-AMS/III/2022

101.A/RSU-AMS/VIII/2022
102.A/RSU-AMS/VIII/2022

562.A/RSU-AMS/IX/2022

091.A/RSU-AMS/III/2022

451/RSU-AMS/XI/2022
 TGL ED
10/4/2027
04-11-2023
10/26/2026
4/12/2025
11/11/2024
2/23/2026
7/3/2025
2/26/2027
3/31/2025
2/5/2028
1/11/2025

TGL DITETAPKAN
1/20/2023
02-01-2020
12/22/2022
04-11-2020
12/21/2021
2/24/2022
8/30/2022
11/9/2022
7/13/2023