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PEMERINTAH KABUPATEN TANAH LAUT

DAFTAR PEMBAYARAN GAJI INDUK PNSD


[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 Hj. NINA SANDRA ,SKM, MM K -1 5,431,900 2,025,000 0 0 128,946 0 1 .............
0 543,190 0 0 0 0 0
0 0 144,840 0 80,001
10-07-1964 2 5,975,090 0 128,946 0
196407101985112002 MKG:32 0 478,007 0
Pembina Utama Muda-4C 0 2000217711
78 0
15.548.495.9-732.000 8,273,954 0 686,954 0
0 7,587,000
2 Dra, Hj. NURWATI ,Apt K -1 4,798,300 0 0 0 36,346 0 2 .............
2 479,830 0 0 0 0 0
191,932 1,200,000 289,680 0 66,701
31-12-1966 4 5,470,062 0 36,346 0
196612311998032019 MKG:24 0 437,605 0
Pembina Utama Muda-4C 0 2001368713
64 0
15.767.209.8-732.000 6,996,152 0 540,652 0
0 6,455,500
3 Hj. ANI HAIRIAH ,APT K -1 4,194,600 0 0 0 5,292 0 3 .............
2 419,460 0 0 0 0 0
167,784 1,200,000 289,680 0 59,818
15-11-1975 4 4,781,844 0 5,292 0
197511152006042020 MKG:18 0 382,548 0
Pembina Tk.I-4B 0 2001348402
42 0
25.055.824.4-732.000 6,276,858 0 447,658 0
0 5,829,200
4 H. ARLIANI ,SKM K -1 4,555,800 1,260,000 0 0 37,921 0 4 .............
1 455,580 0 0 0 0 0
91,116 0 217,260 0 63,625
22-02-1970 3 5,102,496 0 37,921 0
197002221993031006 MKG:26 0 408,200 0
Pembina-4A 0 2001336846
69 0
14.904.061.0.732.000 6,617,746 0 509,746 0
0 6,108,000
5 ANTONIUS JAKA ROYAN,M.KES ,S.KM K -1 4,699,300 980,000 0 0 42,942 0 5 .............
0 469,930 0 0 0 0 0
0 0 144,840 0 61,492
06-12-1966 2 5,169,230 0 42,942 0
196612061993021002 MKG:28 0 413,538 0
Pembina-4A 0 2001330899
60 0
15.478.859.0-732.000 6,337,072 0 517,972 0
0 5,819,100
6 A. DASUKI ,S.AP K -1 4,416,700 980,000 0 0 6,267 0 6 .............
2 441,670 0 0 0 0 0
176,668 0 289,680 0 60,150
11-12-1972 4 5,035,038 0 6,267 0
197212111992031003 MKG:25 0 402,803 0
Pembina-4A 0 2001361018
35 0
14.225.929.0-732.000 6,311,020 0 469,220 0
0 5,841,800
7 M. YULIANSYAH ,SKM K -1 3,901,500 980,000 0 0 0 0 7 .............
2 390,150 0 0 0 0 0
156,060 0 289,680 0 54,277
12-09-1976 4 4,447,710 0 0 0
197609122005011011 MKG:17 0 355,817 0
Pembina-4A 0 2001337745
4 0
78.354.166.7-732.000 5,717,394 0 410,094 0
0 5,307,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 ARI PURNAWAN K -1 4,024,400 0 0 0 0 0 8 .............
2 402,440 0 0 0 0 0
160,976 960,000 289,680 0 55,478
13-09-1976 4 4,587,816 0 0 0
197609132006041016 MKG:18 0 367,025 0
Pembina-4A 0 2001319828
7 0
15.993.229.2-732.000 5,837,503 0 422,503 0
0 5,415,000
9 Hj. RAUDATUL MARDHIAH ,S.ST TK-0 4,416,700 0 0 0 6,246 0 9 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 50,167
21-09-1973 1 4,416,700 0 6,246 0
197309211992022001 MKG:24 0 353,336 0
Pembina-4A 0 2001319887
83 0
78.345.692.4-732.000 5,095,449 0 409,749 0
0 4,685,700
10 Hj. YANTI MARIANI TK-0 4,555,800 0 0 0 0 0 10 .............
0 0 190,000 0 0 0 0
0 0 72,420 0 47,458
10-03-1970 1 4,555,800 0 0 0
197003101993032006 MKG:26 0 364,464 0
Pembina-4A 0 2001348337
2 0
15.047.552.3.731.000 4,818,222 0 411,922 0
0 4,406,300
11 ABU HANIFAH ,S.Kep,Ners K -1 4,416,700 0 0 0 0 0 11 .............
2 441,670 190,000 0 0 0 0
176,668 0 289,680 0 52,250
15-02-1973 4 5,035,038 0 0 0
197302151992021002 MKG:24 0 402,803 0
Pembina-4A 0 2001360348
35 0
14.166.170.2-731.000 5,514,753 0 455,053 0
0 5,059,700
12 dr, RA. VIVI MARIANA ,MM TK-0 4,281,800 0 0 0 0 0 12 .............
0 0 190,000 0 0 0 0
0 0 72,420 0 44,718
25-11-1970 1 4,281,800 0 0 0
197011252002122004 MKG:22 0 342,544 0
Pembina-4A 0 2001358882
42 0
25.073.280.7-732.000 4,544,262 0 387,262 0
0 4,157,000
SUB TOTAL PERGOLONGAN : IV 53,693,500 6,225,000 0 0 263,960 0
PEG: 12 4,043,920 570,000 0 0 0 0
IST: 9 JIWA= 34 1,121,204 3,960,000 2,462,280 0 696,135
58,858,624 0 263,960 0
ANK: 13 0 4,708,690 0
521 0 0
72,340,385 0 5,668,785
0 66,671,600
13 drg, BUDI RUKHIYAT K -1 3,410,600 980,000 0 0 0 0 13 .............
1 341,060 0 0 0 0 0
68,212 0 217,260 0 47,999
23-07-1987 3 3,819,872 0 0 0
198707232014111001 MKG:10 0 305,590 0
Penata Tk.I-3D 0 2001368934
57 0
66.436.678.8-723.000 5,017,189 0 353,589 0
0 4,663,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 HERU PURWANTO ,S.AP K -1 4,108,100 540,000 0 0 0 0 14 .............
2 410,810 0 0 0 0 0
164,324 0 289,680 0 52,232
27-04-1974 4 4,683,234 0 0 0
197404271995031003 MKG:22 0 374,659 0
Penata Tk.I-3D 0 2001331917
77 0
14.350.964.4.732.000 5,512,991 0 426,891 0
0 5,086,100
15 R. DODY ISKANDAR ,S.KM K -1 3,743,100 540,000 0 0 0 0 15 .............
2 374,310 0 0 0 0 0
149,724 0 289,680 0 48,071
19-09-1981 4 4,267,134 0 0 0
198109192006041017 MKG:16 0 341,371 0
Penata Tk.I-3D 0 2001320613
28 0
14.314.190.1-732.000 5,096,842 0 389,442 0
0 4,707,400
16 RETNA AFRYANI ,S.Gz K -1 3,628,900 540,000 0 0 0 0 16 .............
0 362,890 0 0 0 0 0
0 0 144,840 0 45,318
21-05-1983 2 3,991,790 0 0 0
198305212005012005 MKG:14 0 319,343 0
Penata Tk.I-3D 0 2001333968
31 0
15.993.201.1-732.000 4,676,661 0 364,661 0
0 4,312,000
17 MIERTA APRIANA ,SKM TK-0 3,410,600 540,000 0 0 0 0 17 .............
0 0 0 0 0 0 0
0 0 72,420 0 39,506
30-04-1985 1 3,410,600 0 0 0
198504302011012006 MKG:11 0 272,848 0
Penata Tk.I-3D 0 2001362561
34 0
15.993.500.6-732.000 4,023,054 0 312,354 0
0 3,710,700
18 ENDAH ASTUTI ,S.Sos TK-0 4,508,600 490,000 0 0 5,167 0 18 .............
0 0 0 0 0 0 0
0 0 72,420 0 49,986
09-03-1967 1 4,508,600 0 5,167 0
196703091989032007 MKG:28 0 360,688 0
Penata Tk.I-3D 0 2001350474
54 0
15.548.837.2-732.000 5,076,241 0 415,841 0
0 4,660,400
19 ARIYANI K -1 4,797,000 0 0 0 18,758 0 19 .............
1 479,700 0 0 0 0 0
95,940 600,000 217,260 0 59,726
26-04-1966 3 5,372,640 0 18,758 0
196604261988032009 MKG:32 0 429,811 0
Penata Tk.I-3D 0 2001337737
37 0
16.007.409.2.732.000 6,208,695 0 508,295 0
0 5,700,400
20 HAMDADI ,AMK K -1 4,508,600 0 0 0 0 0 20 .............
1 450,860 0 0 0 0 0
90,172 600,000 217,260 0 56,496
05-02-1968 3 5,049,632 0 0 0
196802051989031010 MKG:28 0 403,971 0
Penata Tk.I-3D 0 2001350423
75 0
16.061.645.4-732.000 5,866,967 0 460,467 0
0 5,406,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 M. HUSNI HADIANSYAH NOOR ,S.KM K -1 4,370,900 0 0 0 0 0 21 .............
1 437,090 0 0 0 0 0
87,418 600,000 217,260 0 54,954
30-04-1970 3 4,895,408 0 0 0
197004301991011001 MKG:26 0 391,633 0
Penata Tk.I-3D 0 2001324759
19 0
14.904.450.5-732.000 5,712,687 0 446,587 0
0 5,266,100
22 ADY TASADA KESUMA TAHJI ,S.Gz K -1 4,237,500 0 0 0 0 0 22 .............
2 423,750 0 0 0 0 0
169,500 600,000 289,680 0 54,308
15-09-1970 4 4,830,750 0 0 0
197009151992031009 MKG:24 0 386,460 0
Penata Tk.I-3D 0 2001347767
38 0
14.560.270.2-732.000 5,720,468 0 440,768 0
0 5,279,700
23 ILYASA KHALIK ,S.KM K -1 3,982,600 0 0 0 0 0 23 .............
0 398,260 0 0 0 0 0
0 600,000 144,840 0 49,809
05-06-1977 2 4,380,860 0 0 0
197706052000031003 MKG:20 0 350,469 0
Penata Tk.I-3D 0 2001324438
78 0
15.659.819.5-732-000 5,125,778 0 400,278 0
0 4,725,500
24 NUNUNG MARYANTI ,SKM K -1 3,861,000 0 0 0 0 0 24 .............
2 386,100 0 0 0 0 0
154,440 600,000 289,680 0 50,015
14-04-1978 4 4,401,540 0 0 0
197804141998032005 MKG:18 0 352,123 0
Penata Tk.I-3D 0 2001325593
18 0
15.478.846.7-732.000 5,291,238 0 402,138 0
0 4,889,100
25 LAILA NUZLA SAFITRI ,SST K -1 3,628,900 0 0 0 0 0 25 .............
1 362,890 0 0 0 0 0
72,578 600,000 217,260 0 46,644
26-06-1983 3 4,064,368 0 0 0
198306262006042023 MKG:14 0 325,149 0
Penata Tk.I-3D 0 2001336897
65 0
14.904.337.4-732.000 4,881,693 0 371,793 0
0 4,509,900
26 LISTIA ANGGRAINI ,S.Far, Apt TK-0 3,518,100 0 0 0 0 0 26 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 41,181
25-03-1984 1 3,518,100 0 0 0
198403252009042004 MKG:12 0 281,448 0
Penata Tk.I-3D 0 2001365568
9 0
88.921.224.7-733.000 4,190,529 0 322,629 0
0 3,867,900
27 MISTIJA SUKMA CAHAYA ,A.Md.Farm TK-0 4,508,600 0 0 0 5,642 0 27 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 50,086
13-05-1967 1 4,508,600 0 5,642 0
196705131988032007 MKG:28 0 360,688 0
Penata Tk.I-3D 0 2001330813
54 0
16.483.039.0-732.000 5,086,716 0 416,416 0
0 4,670,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
28 AGUSTA DWI REZEKI TK-0 4,237,500 0 0 0 0 0 28 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 47,375
16-08-1972 1 4,237,500 0 0 0
197208161992032010 MKG:24 0 339,000 0
Penata Tk.I-3D 0 2001335165
55 0
15.064.110.8-732.000 4,809,975 0 386,375 0
0 4,423,600
29 LINDA ANGGRAENI TK-0 3,982,600 0 0 0 0 0 29 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 44,826
04-09-1977 1 3,982,600 0 0 0
197709041996032001 MKG:20 0 318,608 0
Penata Tk.I-3D 0 2001347872
14 0
15.767.219.7.732.000 4,555,034 0 363,434 0
0 4,191,600
30 SUPRAPTI ,SST K -1 3,743,100 0 0 0 0 0 30 .............
2 374,310 0 0 0 0 0
149,724 185,000 289,680 0 44,521
09-04-1981 4 4,267,134 0 0 0
198104092006042022 MKG:16 0 341,371 0
Penata Tk.I-3D 0 2001323779
78 0
16.332.347.0-732.000 4,741,892 0 385,892 0
0 4,356,000
31 SUPRIHATIN ,AM.Keb TK-0 4,370,900 0 0 0 0 0 31 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 45,559
12-04-1970 1 4,370,900 0 0 0
197004121991022003 MKG:26 0 349,672 0
Penata Tk.I-3D 0 2001338048
11 0
15.475.494.9-732.000 4,628,331 0 395,231 0
0 4,233,100
32 MIRA SUSANTI ,SKM K -1 3,591,200 540,000 0 0 0 0 32 .............
2 359,120 0 0 0 0 0
143,648 0 289,680 0 46,340
07-05-1982 4 4,093,968 0 0 0
198205072003122003 MKG:16 0 327,517 0
Penata-3C 0 2001347856
9 0
87.669.139.5-732.000 4,923,657 0 373,857 0
0 4,549,800
33 LAILA ALFISAH ,AMD K -1 3,481,600 490,000 0 0 0 0 33 .............
2 348,160 0 0 0 0 0
139,264 0 289,680 0 44,590
27-12-1981 4 3,969,024 0 0 0
198112272005012009 MKG:14 0 317,522 0
Penata-3C 0 2001314017
8 0
15.969.403.3-732.000 4,748,712 0 362,112 0
0 4,386,600
34 MAULIDA PRAMITASARI ,Apt TK-0 2,890,500 0 0 0 0 0 34 .............
0 0 0 0 0 0 0
0 750,000 72,420 0 36,405
21-09-1991 1 2,890,500 0 0 0
199109212019032009 MKG: 3 0 231,240 0
Penata-3C 0 2001370707
25 0
71.980.710.9-732.000 3,712,945 0 267,645 0
0 3,445,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 6

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
35 IRWAN SETIAWAN SYAH K -0 3,272,200 0 0 0 0 0 35 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 38,722
19-09-1984 1 3,272,200 0 0 0
198409192014111001 MKG:10 0 261,776 0
Penata-3C 0 2001369493
78 0
66.578.185.2-732.000 3,944,698 0 300,498 0
0 3,644,200
36 WIJI RAHAYU ,A.Md.Farm K -1 3,591,200 0 0 0 0 0 36 .............
1 359,120 0 0 0 0 0
71,824 500,000 217,260 0 45,221
18-02-1969 3 4,022,144 0 0 0
196902182000122004 MKG:16 0 321,772 0
Penata-3C 0 2001335203
89 0
16.482.890.7-732.000 4,739,493 0 366,993 0
0 4,372,500
37 ABDUL LATIF K -1 4,325,600 0 0 0 0 0 37 .............
1 432,560 185,000 0 0 0 0
86,512 0 217,260 0 50,297
26-10-1968 3 4,844,672 0 0 0
196810261989031006 MKG:28 0 387,574 0
Penata-3C 0 2001350447
39 0
55.145.800.3-732.000 5,246,971 0 437,871 0
0 4,809,100
38 YULAIKAH ,AMG K -1 3,941,400 0 0 0 0 0 38 .............
2 394,140 185,000 0 0 0 0
157,656 0 289,680 0 46,782
02-06-1969 4 4,493,196 0 0 0
196906021994032006 MKG:22 0 359,456 0
Penata-3C 0 2001322993
62 0
15.548.662.4-732.000 4,967,938 0 406,238 0
0 4,561,700
39 RAHMAWATI ,A.M.KL K -1 3,591,200 0 0 0 0 0 39 .............
1 359,120 185,000 0 0 0 0
71,824 0 217,260 0 42,071
04-08-1977 3 4,022,144 0 0 0
197708042007012006 MKG:16 0 321,772 0
Penata-3C 0 2001321032
39 0
15.084.335.7-732.000 4,424,443 0 363,843 0
0 4,060,600
40 HJ. EVI WULANSARI, AM.KL TK-0 3,591,200 0 0 0 0 0 40 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 37,762
22-09-1977 1 3,591,200 0 0 0
197709222006042022 MKG:16 0 287,296 0
Penata-3C 0 2001348372
38 0
25.079.310.6-732.000 3,848,658 0 325,058 0
0 3,523,600
41 SYAHRUL HASANI ,AMK TK-0 3,591,200 0 0 0 0 0 41 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 37,762
14-07-1981 1 3,591,200 0 0 0
198107142003121008 MKG:16 0 287,296 0
Penata-3C 0 2001321188
38 0
57.822.651.6-732.000 3,848,658 0 325,058 0
0 3,523,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 7

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
42 SHANTY MAULIDA ,AMK TK-0 3,481,600 0 0 0 0 0 42 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 36,666
19-01-1981 1 3,481,600 0 0 0
198101192006042015 MKG:15 0 278,528 0
Penata-3C 0 2001350148
74 0
57.822.640.9-732.000 3,739,094 0 315,194 0
0 3,423,900
43 H. ONEST SAPUTRA ,AM,KEP K -1 3,481,600 0 0 0 0 0 43 .............
2 348,160 185,000 0 0 0 0
139,264 0 289,680 0 41,540
28-04-1982 4 3,969,024 0 0 0
198204282006041011 MKG:14 0 317,522 0
Penata-3C 0 2001321277
58 0
15.548.229.2-732.000 4,443,762 0 359,062 0
0 4,084,700
44 MUTI ANDAYANI ,AM.KEB K -1 3,481,600 0 0 0 0 0 44 .............
2 348,160 185,000 0 0 0 0
139,264 0 289,680 0 41,540
05-08-1983 4 3,969,024 0 0 0
198308052006042024 MKG:14 0 317,522 0
Penata-3C 0 2001322918
58 0
15.478.850.9-732.000 4,443,762 0 359,062 0
0 4,084,700
45 SITI CHOTIMAH ,S.Kep TK-0 3,481,600 0 0 0 0 0 45 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 36,666
18-03-1984 1 3,481,600 0 0 0
198403182006042008 MKG:14 0 278,528 0
Penata-3C 0 2001350245
74 0
14.350.865.3-732.000 3,739,094 0 315,194 0
0 3,423,900
46 AIDI RAHMAN ,AMK K -0 3,272,200 0 0 0 0 0 46 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 34,572
08-08-1985 1 3,272,200 0 0 0
198508082010011010 MKG:10 0 261,776 0
Penata-3C 0 2001336994
28 0
15.548.642.6-732.000 3,529,648 0 296,348 0
0 3,233,300
47 Hj. KHAIRUNNISA ,AM.KEB K -1 3,272,200 0 0 0 0 0 47 .............
2 327,220 185,000 0 0 0 0
130,888 0 289,680 0 39,153
01-02-1988 4 3,730,308 0 0 0
198802012010012006 MKG:10 0 298,425 0
Penata-3C 0 2001348003
90 0
18.767.334.4-732.000 4,205,078 0 337,578 0
0 3,867,500
48 VERAWATI FEBRUARITA TK-0 3,445,500 0 0 0 0 0 48 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 37,105
05-02-1980 1 3,445,500 0 0 0
198002052000122001 MKG:16 0 275,640 0
Penata Muda Tk.I-3B 0 2001319925
25 0
09.983.340.2.732.000 3,782,945 0 312,745 0
0 3,470,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 8

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
49 SANTI SEPRIANI TK-0 3,238,300 0 0 0 0 0 49 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 35,033
20-09-1985 1 3,238,300 0 0 0 0
198509202005012004 MKG:12 0 259,064 0
Penata Muda Tk.I-3B 0 007.03.28.02440.3
77 0
16.232.493.3.732.000 3,575,797 0 294,097 0
0 3,281,700
50 ADESTY WULANSARI ,A.Md.Far K -1 3,043,600 0 0 0 0 0 50 .............
1 304,360 0 0 0 0 0
60,872 265,000 217,260 0 36,738
05-02-1989 3 3,408,832 0 0 0
198902052011012001 MKG: 9 0 272,707 0
Penata Muda Tk.I-3B 0 2001369655
53 0
57.822.798.5-732.000 3,891,145 0 309,445 0
0 3,581,700
51 NINA ASTUTI ,AMD.AK K -1 3,043,600 0 0 0 0 0 51 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
29-06-1988 4 3,469,704 0 0 0
198806292011012006 MKG: 8 0 277,576 0
Penata Muda Tk.I-3B 0 2001360844
39 0
16.657.123.2.732.000 4,024,423 0 314,923 0
0 3,709,500
52 DINA WIDYA NINGSIH ,AM.Keb TK-0 3,043,600 0 0 0 0 0 52 .............
0 0 0 0 0 0 0
0 185,000 72,420 0 32,286
23-06-1989 1 3,043,600 0 0 0
198906232011012006 MKG: 8 0 243,488 0
Penata Muda Tk.I-3B 0 2001369318
54 0
16.407.614.3-732.000 3,301,074 0 275,774 0
0 3,025,300
53 ACHMAD SOEGIARTO K -1 3,781,400 0 0 0 0 0 53 .............
2 378,140 185,000 0 0 0 0
151,256 0 289,680 0 44,958
10-10-1968 4 4,310,796 0 0 0
196810101992031011 MKG:22 0 344,864 0
Penata Muda Tk.I-3B 0 2001348507
46 0
15.767.464.9-732.000 4,785,522 0 389,822 0
0 4,395,700
54 TAUFIK RAHMAN K -1 3,139,400 0 0 0 0 0 54 .............
2 313,940 185,000 0 0 0 0
125,576 0 289,680 0 37,639
12-02-1985 4 3,578,916 0 0 0 0
198502122006041004 MKG:11 0 286,313 0
Penata Muda Tk.I-3B 0 2001335033
56 0
16.257.861.1-732.000 4,053,652 0 323,952 0
0 3,729,700
55 YENNI RONEKA SARI ,AMK K -1 3,139,400 0 0 0 0 0 55 .............
2 313,940 185,000 0 0 0 0
125,576 0 289,680 0 37,639
27-05-1983 4 3,578,916 0 0 0
198305272010012012 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001337621
56 0
16.115.075.0-732.000 4,053,652 0 323,952 0
0 3,729,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 9

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
56 YUYUN ANGGRAENI ,S.Kep.Ners TK-0 3,139,400 0 0 0 0 0 56 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 33,244
03-04-1986 1 3,139,400 0 0 0
198604032010012017 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001348607
76 0
16.007.426.6-732.000 3,396,896 0 284,396 0
0 3,112,500
57 ANDANG SETIAWAN ,AMK K -1 3,139,400 0 0 0 0 0 57 .............
2 313,940 185,000 0 0 0 0
125,576 0 289,680 0 37,639
10-05-1988 4 3,578,916 0 0 0
198805102010011001 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001345586
56 0
57.822.796.9-732.000 4,053,652 0 323,952 0
0 3,729,700
58 NOVITA ROSIANA ,A.Md.Kep TK-0 3,139,400 0 0 0 0 0 58 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 33,244
05-01-1989 1 3,139,400 0 0 0
198901052010012009 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001368764
76 0
74.423.955.9-733.000 3,396,896 0 284,396 0
0 3,112,500
59 Hj. ADYA FARIANI ,A.Md.Kep TK-0 3,043,600 0 0 0 0 0 59 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 32,286
20-10-1980 1 3,043,600 0 0 0
198010202011012003 MKG: 8 0 243,488 0
Penata Muda Tk.I-3B 0 2001369329
54 0
49.492.129.9-732.000 3,301,074 0 275,774 0
0 3,025,300
60 LAILI RAHMAHADINI ,AMD K -0 3,043,600 0 0 0 0 0 60 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 32,286
05-08-1990 1 3,043,600 0 0 0
199008052011012001 MKG: 8 0 243,488 0
Penata Muda Tk.I-3B 0 2001369663
54 0
57.822.799.3-732.000 3,301,074 0 275,774 0
0 3,025,300
61 FAJAR SETYO WARDOYO ,SKM K -1 2,773,200 0 0 0 0 0 61 .............
2 277,320 185,000 0 0 0 0
110,928 0 289,680 0 33,464
30-06-1988 4 3,161,448 0 0 0
198806302019031003 MKG: 3 0 252,916 0
Penata Muda Tk.I-3B 0 2001370548
52 0
16.571.152.4-732.000 3,636,180 0 286,380 0
0 3,349,800
62 M. ADITYA SHOLIHIN ,Apt K -1 2,773,200 0 0 0 0 0 62 .............
1 277,320 185,000 0 0 0 0
55,464 0 217,260 0 32,910
03-07-1992 3 3,105,984 0 0 0
199207032019031006 MKG: 2 0 248,479 0
Penata Muda Tk.I-3B 0 2001370696
45 0
85.269.349.8-732.000 3,508,289 0 281,389 0
0 3,226,900
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 10

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
63 FURY HESTI KUSUMA ASTUTI K -1 2,920,100 0 0 0 0 0 63 .............
,A.Md.FARM 2 292,010 0 0 0 0 0
116,804 265,000 289,680 0 35,939
12-02-1989 4 3,328,914 0 0 0 0
198902122009032001 MKG: 8 0 266,313 0
Penata Muda-3A 0 2001322969
58 0
15.478.643.8-782.000 3,883,652 0 302,252 0
0 3,581,400
64 ANITA WAHYUNINGSIH ,A.Md. Farm TK-0 2,830,900 0 0 0 0 0 64 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 30,959
15-06-1980 1 2,830,900 0 0 0
198006152010012017 MKG: 7 0 226,472 0
Penata Muda-3A 0 2001348089
11 0
16.407.651.5-732.000 3,168,331 0 257,431 0
0 2,910,900
65 LAILI MUNADA TK-0 3,627,900 0 0 0 0 0 65 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 38,129
27-12-1975 1 3,627,900 0 0 0
197512272005012013 MKG:22 0 290,232 0
Penata Muda-3A 0 2001353783
41 0
16.134.977.4-732.000 3,885,361 0 328,361 0
0 3,557,000
66 ENDAH SULISTIYANINGSIH ,A.Md K -1 3,106,900 0 0 0 0 0 66 .............
2 310,690 185,000 0 0 0 0
124,276 0 289,680 0 37,269
01-04-1977 4 3,541,866 0 0 0
197704012007012023 MKG:13 0 283,349 0
Penata Muda-3A 0 2001362545
72 0
16.407.521.0-732.000 4,016,618 0 320,618 0
0 3,696,000
67 DAHLIANA ,AMD TK-0 3,106,900 0 0 0 0 0 67 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 32,919
25-12-1983 1 3,106,900 0 0 0
198312252008012014 MKG:12 0 248,552 0
Penata Muda-3A 0 2001335025
51 0
15.504.076.9-732.000 3,364,371 0 281,471 0
0 3,082,900
68 RINI WIJAYANTI ,AMD K -1 2,920,100 0 0 0 0 0 68 .............
0 292,010 185,000 0 0 0 0
0 0 144,840 0 33,971
02-08-1988 2 3,212,110 0 0 0
198808022011012004 MKG: 8 0 256,969 0
Penata Muda-3A 0 2001362537
90 0
16.114.932.3-732.000 3,542,040 0 290,940 0
0 3,251,100
69 YUNITA ANDRELIA ,AMK K -1 2,920,100 0 0 0 0 0 69 .............
1 292,010 185,000 0 0 0 0
58,402 0 217,260 0 34,555
29-01-1989 3 3,270,512 0 0 0
198901292011012005 MKG: 8 0 261,641 0
Penata Muda-3A 0 2001368788
24 0
57.822.637.5-732.000 3,672,796 0 296,196 0
0 3,376,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 11

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
70 ARIYANTO ,A.Md.Kep K -1 2,920,100 0 0 0 0 0 70 .............
1 292,010 185,000 0 0 0 0
58,402 0 217,260 0 34,555
13-03-1989 3 3,270,512 0 0 0
198903132011011003 MKG: 8 0 261,641 0
Penata Muda-3A 0 2001359487
24 0
16.571.189.6-732.000 3,672,796 0 296,196 0
0 3,376,600
71 AZARIA NAFISAH PAHLAVIE ,S.Gz TK-0 2,660,700 0 0 0 0 0 71 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 28,457
10-11-1997 1 2,660,700 0 0 0
199711102020122014 MKG: 2 0 212,856 0
Penata Muda-3A 0 2001373636
93 0
96.929.588.0-513.000 2,918,213 0 241,313 0
0 2,676,900
72 AHMAD HIDAYATULLAH ,SKM K -1 2,063,520 0 0 0 0 0 72 .............
2 206,352 185,000 0 0 0 0
82,541 0 289,680 0 25,374
28-06-1991 4 2,352,413 0 0 0
199106282022031001 MKG: 0 0 188,193 0
Penata Muda-3A 0 3200405683
74 0
716565957731000 2,827,167 0 213,567 0
0 2,613,600
SUB TOTAL PERGOLONGAN : III 208,899,120 4,660,000 0 0 29,567 0
PEG: 60 12,246,192 5,550,000 0 0 0 0
IST: 35 JIWA= 147 3,599,593 10,110,000 10,645,740 0 2,450,646
224,744,905 0 29,567 0
ANK: 52 0 17,979,595 0
2,996 0 0
255,743,208 0 20,459,808
0 235,283,400
73 AGUSTINAWATI ,A.Md.Keb TK-0 3,271,400 0 0 0 0 0 73 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 34,514
17-08-1979 1 3,271,400 0 0 0
197908172007012016 MKG:23 0 261,712 0
Pengatur Tk.I-2D 0 2001362553
6 0
14.560.262.9-732.000 3,523,826 0 296,226 0
0 3,227,600
74 FARIDA MULYANI TK-0 3,074,700 0 0 0 0 0 74 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 32,547
04-01-1982 1 3,074,700 0 0 0
198201042007012012 MKG:19 0 245,976 0
Pengatur Tk.I-2D 0 2001314745
3 0
15.504.306.0-732.000 3,327,123 0 278,523 0
0 3,048,600
75 EKO WAHYUDIANTO K -1 2,980,800 0 0 0 0 0 75 .............
2 298,080 180,000 0 0 0 0
119,232 0 289,680 0 35,781
07-07-1977 4 3,398,112 0 0 0
197707072010011001 MKG:17 0 271,849 0
Pengatur Tk.I-2D 0 2001332018
38 0
45.884.780.3-732.000 3,867,830 0 307,630 0
0 3,560,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 12

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
76 KHADAVI MUTTAQEIN K -1 2,980,800 0 0 0 0 0 76 .............
2 298,080 180,000 0 0 0 0
119,232 0 289,680 0 35,781
23-05-1983 4 3,398,112 0 0 0
198305232010011026 MKG:17 0 271,849 0
Pengatur Tk.I-2D 0 2001362348
38 0
16.115.076.8-732.000 3,867,830 0 307,630 0
0 3,560,200
77 GT INDRA NOORRAHMAN ,A.Md.Kom K -1 2,980,800 0 0 0 0 0 77 .............
2 298,080 180,000 0 0 0 0
119,232 0 289,680 0 35,781
02-02-1985 4 3,398,112 0 0 0
198502022010011002 MKG:17 0 271,849 0
Pengatur Tk.I-2D 0 2001323027
38 0
46.024.425.4-732.000 3,867,830 0 307,630 0
0 3,560,200
78 ROHANI K -1 2,980,800 0 0 0 0 0 78 .............
2 298,080 180,000 0 0 0 0
119,232 0 289,680 0 35,781
07-06-1985 4 3,398,112 0 0 0
198506072010012002 MKG:17 0 271,849 0
Pengatur Tk.I-2D 0 2001329548
38 0
66.874.529.2-732.000 3,867,830 0 307,630 0
0 3,560,200
79 IIS TRIANA K -0 2,716,000 0 0 0 0 0 79 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 28,960
18-10-1988 1 2,716,000 0 0 0
198810182010012003 MKG:11 0 217,280 0
Pengatur Tk.I-2D 0 2001320028
20 0
57.822.818.1-732.000 2,968,440 0 246,240 0
0 2,722,200
80 AGUNG PRASETYO, AMD K -1 2,633,100 0 0 0 0 0 80 .............
1 263,310 180,000 0 0 0 0
52,662 0 217,260 0 31,291
09-04-1985 3 2,949,072 0 0 0
198504092015021001 MKG: 9 0 235,926 0
Pengatur Tk.I-2D 0 2001369124
85 0
16.325.915.3-731.000 3,346,417 0 267,217 0
0 3,079,200
81 INDRA KESUMA WIJAYA K -0 2,687,800 0 0 0 0 0 81 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 29,278
17-11-1974 1 2,687,800 0 0 0
197411172009031003 MKG:13 0 215,024 0
Pengatur-2C 0 2001322691
82 0
16.514.123.5-732.000 3,000,302 0 244,302 0
0 2,756,000
82 YAHYA K -1 3,237,500 0 0 0 0 0 82 .............
2 323,750 180,000 0 0 0 0
129,500 0 289,680 0 38,708
28-11-1975 4 3,690,750 0 0 0
197511281997031006 MKG:25 0 295,260 0
Pengatur-2C 0 2003294458
38 0
15.997.609.1-734.000 4,160,468 0 333,968 0
0 3,826,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 13

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
83 MOCHAMAD SALMI DD-0 2,949,900 0 0 0 0 0 83 .............
2 0 180,000 0 0 0 0
117,996 0 217,260 0 32,479
11-09-1982 3 3,067,896 0 0 0
198209112008011014 MKG:19 0 245,432 0
Pengatur-2C 0 2001362073
55 0
79.112.059.5-732.000 3,465,211 0 277,911 0
0 3,187,300
84 PADLI RAHMAN K -1 2,687,800 0 0 0 0 0 84 .............
2 268,780 180,000 0 0 0 0
107,512 0 289,680 0 32,441
27-01-1978 4 3,064,092 0 0 0 0
197801272010011001 MKG:14 0 245,127 0
Pengatur-2C 0 3200899163
96 0
16.257.696.1-732.000 3,533,868 0 277,568 0
0 3,256,300
85 FITRIA UTAMI ,A.Md K -1 1,841,440 0 0 0 0 0 85 .............
2 184,144 180,000 0 0 0 0
73,658 0 289,680 0 22,792
18-06-1988 4 2,099,242 0 0 0
198806182022032001 MKG: 3 0 167,939 0
Pengatur-2C 0 3200406531
9 0
70994278732000 2,568,931 0 190,731 0
0 2,378,200
86 NAFA SEPTIANDA YATRI ,A.Md TK-0 1,841,440 0 0 0 0 0 86 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
09-09-1997 1 1,841,440 0 0 0
199709092022032005 MKG: 3 0 147,315 0
Pengatur-2C 0 3200406558
69 0
637353343625000 2,093,929 0 167,529 0
0 1,926,400
SUB TOTAL PERGOLONGAN : 38,864,280 0 0 0 0 0
PEG: 14 2,232,304 2,340,000 0 0 0 0
IST: 8 JIWA= 39 958,256 240,000 2,824,380 0 446,348
42,054,840 0 0 0
ANK: 17 0 3,364,387 0
615 0 0
47,459,835 0 3,810,735
0 43,649,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] DINAS KESEHATAN
(002) D50500100200001 BULAN : DESEMBER 2022 HALAMAN : 14

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 301,456,900 10,885,000 0 0 293,527 0
PEG: 86 18,522,416 8,460,000 0 0 0 0
IST: 52 JIWA= 220 5,679,053 14,310,000 15,932,400 0 3,593,129
ANK: 82 325,658,369 0 293,527 0
0 26,052,672 0
0 0
4,132 0 29,939,328
375,543,428
0 345,604,100

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TIRTAJAYA
(002) D50500100200002 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 dr, Hj. SURAYYA TK-0 3,782,400 0 0 0 6,121 0 1 .............
0 0 0 0 0 0 0
0 1,200,000 72,420 0 49,824
20-09-1976 1 3,782,400 0 6,121 0
197609202009042001 MKG:14 0 302,592 0
Pembina-4A 0 2001350164
96 0
54.804.699.4-732.000 5,061,037 0 358,537 0
0 4,702,500
SUB TOTAL PERGOLONGAN : IV 3,782,400 0 0 0 6,121 0
PEG: 1 0 0 0 0 0 0
IST: 0 JIWA= 1 0 1,200,000 72,420 0 49,824
3,782,400 0 6,121 0
ANK: 0 0 302,592 0
96 0 0
5,061,037 0 358,537
0 4,702,500
2 dr, FERLINA DIAH AYU YOSIPA K -1 3,306,500 0 0 0 0 0 2 .............
2 330,650 0 0 0 0 0
132,260 750,000 289,680 0 45,194
23-01-1989 4 3,769,410 0 0 0
198901232014022002 MKG: 8 0 301,553 0
Penata Tk.I-3D 0 2001369485
57 0
71.452.589.6-732.000 4,809,147 0 346,747 0
0 4,462,400
3 RITA HIDAYATI ,SST TK-0 4,108,100 0 0 0 0 0 3 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 47,081
16-05-1974 1 4,108,100 0 0 0
197405162005012011 MKG:22 0 328,648 0
Penata Tk.I-3D 0 2001320702
9 0
16.657.199.2-732.000 4,780,529 0 375,729 0
0 4,404,800
4 KUNTARI RAHAYU ,S.Kep.NS K -1 3,982,600 0 0 0 0 0 4 .............
2 398,260 0 0 0 0 0
159,304 600,000 289,680 0 51,402
06-08-1972 4 4,540,164 0 0 0
197208062000032001 MKG:20 0 363,213 0
Penata Tk.I-3D 0 2001348208
71 0
15.767.426.8-732.000 5,429,915 0 414,615 0
0 5,015,300
5 NOORHAYATI ,S.ST K -1 3,982,600 0 0 0 0 0 5 .............
2 398,260 0 0 0 0 0
159,304 600,000 289,680 0 51,402
07-03-1978 4 4,540,164 0 0 0
197803072006042014 MKG:20 0 363,213 0
Penata Tk.I-3D 0 2001350369
71 0
46.024.653.1-732.000 5,429,915 0 414,615 0
0 5,015,300
6 SRI REJEKI HANDAYANI ,S.ST TK-0 3,861,000 0 0 0 0 0 6 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 44,610
26-09-1979 1 3,861,000 0 0 0
197909262007012010 MKG:18 0 308,880 0
Penata Tk.I-3D 0 2001350048
70 0
15.767.418.5-732.000 4,533,490 0 353,490 0
0 4,180,000
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TIRTAJAYA
(002) D50500100200002 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
7 HARIS PRASETYO ,SKM K -1 3,518,100 0 0 0 0 0 7 .............
2 351,810 0 0 0 0 0
140,724 600,000 289,680 0 46,106
28-02-1987 4 4,010,634 0 0 0
198702282009031001 MKG:13 0 320,851 0
Penata Tk.I-3D 0 2001325208
43 0
15.993.347.2-732.000 4,900,357 0 366,957 0
0 4,533,400
8 NANI SAFITRI ,AMK K -1 4,508,600 0 0 0 10,675 0 8 .............
0 450,860 0 0 0 0 0
0 500,000 144,840 0 54,595
28-10-1969 2 4,959,460 0 10,675 0
196910281989022001 MKG:28 0 396,757 0
Penata Tk.I-3D 0 2001323493
52 0
14.904.454.7-732.000 5,615,027 0 462,027 0
0 5,153,000
9 SRI SUHARTANTI ,AM.KEB K -1 4,370,900 0 0 0 0 0 9 .............
2 437,090 0 0 0 0 0
174,836 500,000 289,680 0 54,828
09-09-1968 4 4,982,826 0 0 0
196809091991032008 MKG:26 0 398,626 0
Penata Tk.I-3D 0 2001337443
48 0
16.407.511.1-732.000 5,772,554 0 453,454 0
0 5,319,100
10 RUSDIANOR ,A.Md.Kep K -1 4,370,900 0 0 0 0 0 10 .............
2 437,090 0 0 0 0 0
174,836 500,000 289,680 0 54,828
09-06-1969 4 4,982,826 0 0 0
196906091990021001 MKG:26 0 398,626 0
Penata Tk.I-3D 0 2001319844
48 0
78.345.697.3-732.000 5,772,554 0 453,454 0
0 5,319,100
11 NOORLAILA FITRIANY ,A.Md.Gz TK-0 4,108,100 0 0 0 0 0 11 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 46,081
19-11-1971 1 4,108,100 0 0 0
197111191994032002 MKG:22 0 328,648 0
Penata Tk.I-3D 0 2001350091
9 0
15.626.848.4-732.000 4,680,529 0 374,729 0
0 4,305,800
12 DWI BASUKI ,A.Md.Kep K -1 4,108,100 0 0 0 0 0 12 .............
1 410,810 0 0 0 0 0
82,162 500,000 217,260 0 51,011
27-07-1973 3 4,601,072 0 0 0
197307271994021003 MKG:22 0 368,086 0
Penata Tk.I-3D 0 2001337397
65 0
15.993.345.6-732.000 5,318,397 0 419,097 0
0 4,899,300
13 dr, RETNA PUTRI TK-0 3,306,500 0 0 0 0 0 13 .............
0 0 0 0 0 0 0
0 0 72,420 0 33,065
30-01-1992 1 3,306,500 0 0 0
199201302014112001 MKG: 8 0 264,520 0
Penata Tk.I-3D 0 2001369345
65 0
71.176.020.7-732.000 3,378,985 0 297,585 0
0 3,081,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TIRTAJAYA
(002) D50500100200002 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 dr, ARIAN RIZKI AMALIA K -1 2,890,500 0 0 0 0 0 14 .............
2 289,050 0 0 0 0 0
115,620 750,000 289,680 0 40,452
18-01-1993 4 3,295,170 0 0 0
199301182019032007 MKG: 3 0 263,614 0
Penata-3C 0 2001370505
16 0
80.127.901.9-732.000 4,334,866 0 304,066 0
0 4,030,800
15 TUTI HARIYATMI ,AM.KG K -1 3,821,000 0 0 0 0 0 15 .............
1 382,100 0 0 0 0 0
76,420 500,000 217,260 0 47,795
03-07-1975 3 4,279,520 0 0 0
197507031997032003 MKG:20 0 342,362 0
Penata-3C 0 2001324988
77 0
16.000.929.6-732.000 4,996,857 0 390,157 0
0 4,606,700
16 SRI NURHAYATI ,A.Md.Keb TK-0 3,821,000 0 0 0 0 0 16 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 43,210
06-04-1978 1 3,821,000 0 0 0
197804062002122005 MKG:20 0 305,680 0
Penata-3C 0 2001341343
70 0
46.022.849.7-732.000 4,393,490 0 348,890 0
0 4,044,600
17 Hj. SYANTI LAINA DEWI ,A.Md.Keb TK-0 3,821,000 0 0 0 0 0 17 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 43,210
19-09-1978 1 3,821,000 0 0 0
197809192002122002 MKG:20 0 305,680 0
Penata-3C 0 2001325135
70 0
46.023.102.0-732.000 4,393,490 0 348,890 0
0 4,044,600
18 SRI PURNA NINGSIH ,AM.KEB K -1 3,481,600 0 0 0 0 0 18 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
25-10-1981 4 3,969,024 0 0 0 0
198110252006042012 MKG:14 0 317,522 0
Penata-3C 0 2001323612
8 0
75.406.907.8-732.000 4,758,712 0 362,212 0
0 4,396,500
19 CITRA FARLINA ,AM.KEB TK-0 3,481,600 0 0 0 0 0 19 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 39,816
16-04-1983 1 3,481,600 0 0 0
198304162006042011 MKG:14 0 278,528 0
Penata-3C 0 2001322888
24 0
16.115.116.2-732.000 4,054,044 0 318,344 0
0 3,735,700
20 RAHMI AGISNI ,AM.KG K -1 3,375,300 0 0 0 0 0 20 .............
1 337,530 0 0 0 0 0
67,506 500,000 217,260 0 42,803
26-08-1981 3 3,780,336 0 0 0
198108262005012013 MKG:12 0 302,427 0
Penata-3C 0 2001329327
34 0
78.345.694.0-732.000 4,497,630 0 345,230 0
0 4,152,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TIRTAJAYA
(002) D50500100200002 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 RIZKY FAZAR REZALINOOR ,A.MA.K K -1 3,272,200 0 0 0 0 0 21 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
20-10-1987 4 3,730,308 0 0 0
198710202010011002 MKG:10 0 298,425 0
Penata-3C 0 2001348027
40 0
15.504.058.7-732.000 4,520,028 0 340,728 0
0 4,179,300
22 NORLIA ,AM.Keb K -1 3,272,200 0 0 0 0 0 22 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
06-12-1988 4 3,730,308 0 0 0
198812062010012003 MKG:10 0 298,425 0
Penata-3C 0 2001322942
40 0
15.582.991.4-732.000 4,520,028 0 340,728 0
0 4,179,300
23 BUDI AMARULLAH K -1 3,941,400 0 0 0 0 0 23 .............
2 394,140 185,000 0 0 0 0
157,656 0 289,680 0 46,782
19-09-1974 4 4,493,196 0 0 0
197409191995021001 MKG:22 0 359,456 0
Penata-3C 0 2001349999
62 0
15.993.340.4-732.000 4,967,938 0 406,238 0
0 4,561,700
24 RAMADHANI ,S.KM K -1 3,704,300 0 0 0 0 0 24 .............
2 370,430 185,000 0 0 0 0
148,172 0 289,680 0 44,079
18-08-1978 4 4,222,902 0 0 0
197808181999031003 MKG:18 0 337,832 0
Penata-3C 0 2001350407
29 0
15.250.635.8-732.000 4,697,611 0 381,911 0
0 4,315,700
25 ENDANG WIDORINI ,AM.Keb TK-0 3,781,400 0 0 0 0 0 25 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 40,464
19-02-1976 1 3,781,400 0 0 0
197602192006042020 MKG:22 0 302,512 0
Penata Muda Tk.I-3B 0 2001350024
56 0
15.767.641.7-732.000 4,118,876 0 342,976 0
0 3,775,900
26 YULI ASTUTI K -1 3,665,900 0 0 0 0 0 26 .............
1 366,590 0 0 0 0 0
73,318 265,000 217,260 0 43,708
12-06-1977 3 4,105,808 0 0 0
197706122002122007 MKG:20 0 328,465 0
Penata Muda Tk.I-3B 0 2001325313
5 0
15.871.961.7-732.000 4,588,073 0 372,173 0
0 4,215,900
27 KAMIL ,AMK K -1 3,340,300 0 0 0 0 0 27 .............
2 334,030 0 0 0 0 0
133,612 265,000 289,680 0 40,729
12-05-1979 4 3,807,942 0 0 0
197905122006041019 MKG:14 0 304,635 0
Penata Muda Tk.I-3B 0 2001369159
42 0
16.115.112.1-732.000 4,362,664 0 345,364 0
0 4,017,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TIRTAJAYA
(002) D50500100200002 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
28 PRISKA YUNIARTI ,AMK TK-0 3,238,300 0 0 0 0 0 28 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 35,033
30-06-1979 1 3,238,300 0 0 0
197906302006042018 MKG:12 0 259,064 0
Penata Muda Tk.I-3B 0 2001350059
77 0
16.571.011.2-732.000 3,575,797 0 294,097 0
0 3,281,700
29 HAYATUS SIVA ,AM.Far K -1 3,139,400 0 0 0 0 0 29 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
29-08-1986 4 3,578,916 0 0 0
198608292006042004 MKG:11 0 286,313 0
Penata Muda Tk.I-3B 0 2001350083
56 0
46.023.374.5-732.000 4,133,652 0 324,752 0
0 3,808,900
30 SASKIA NOVITA ,AMD TK-0 3,139,400 0 0 0 0 0 30 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
22-11-1986 1 3,139,400 0 0 0
198611222009032006 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001323469
76 0
79.771.575.2-732.000 3,476,896 0 285,196 0
0 3,191,700
31 apt, A. HADI AZHARI ,S.Farm K -1 2,150,800 0 0 0 0 0 31 .............
0 215,080 185,000 0 0 0 0
0 0 144,840 0 25,509
23-11-1994 2 2,365,880 0 0 0
199411232022031005 MKG: 0 0 189,270 0
Penata Muda Tk.I-3B 0 3200404687
59 0
850532854733000 2,695,779 0 214,779 0
0 2,481,000
SUB TOTAL PERGOLONGAN : III 108,869,600 0 0 0 10,675 0
PEG: 30 7,220,320 555,000 0 0 0 0
IST: 20 JIWA= 82 2,322,346 12,590,000 5,938,440 0 1,315,572
118,412,266 0 10,675 0
ANK: 32 0 9,472,983 0
1,449 0 0
137,507,830 0 10,799,230
0 126,708,600
32 HAFIZHAH HASANAH ,A.Md.Keb K -1 2,474,700 0 0 0 0 0 32 .............
1 247,470 0 0 0 0 0
49,494 240,000 217,260 0 30,117
01-12-1994 3 2,771,664 0 0 0
199412012019032011 MKG: 6 0 221,733 0
Pengatur Tk.I-2D 0 2001371048
26 0
76.921.271.3-732.000 3,228,950 0 251,850 0
0 2,977,100
33 AULIA FITRI RAMADHANI ,A.Md.Kes TK-0 2,374,300 0 0 0 0 0 33 .............
0 0 0 0 0 0 0
0 360,000 72,420 0 27,343
30-12-1997 1 2,374,300 0 0 0
199712302020122012 MKG: 5 0 189,944 0
Pengatur-2C 0 2001372516
67 0
41.028.123.2-732.000 2,806,787 0 217,287 0
0 2,589,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TIRTAJAYA
(002) D50500100200002 BULAN : DESEMBER 2022 HALAMAN : 6

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
SUB TOTAL PERGOLONGAN : 4,849,000 0 0 0 0 0
PEG: 2 247,470 0 0 0 0 0
IST: 1 JIWA= 4 49,494 600,000 289,680 0 57,460
5,145,964 0 0 0
ANK: 1 0 411,677 0
93 0 0
6,035,737 0 469,137
0 5,566,600
TOTAL PER SATKER 117,501,000 0 0 0 16,796 0
PEG: 33 7,467,790 555,000 0 0 0 0
IST: 21 JIWA= 87 2,371,840 14,390,000 6,300,540 0 1,422,856
ANK: 33 127,340,630 0 16,796 0
0 10,187,252 0
0 0
1,638 0 11,626,904
148,604,604
0 136,977,700

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PELAIHARI
(002) D50500100200003 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 dr, SAMSUL BAHRI ,MPH K -1 4,326,700 0 0 0 23,492 0 1 .............
1 432,670 0 0 0 0 0
86,534 1,200,000 217,260 0 60,459
27-06-1972 3 4,845,904 0 23,492 0
197206272005011004 MKG:20 0 387,672 0
Pembina Tk.I-4B 0 2001348078
67 0
14.560.047.4-732.000 6,286,723 0 471,623 0
0 5,815,100
2 dr, GUSTI NOVRIANA ADHAYATI K -0 3,901,500 0 0 0 11,496 0 2 .............
0 0 0 0 0 0 0
0 1,200,000 72,420 0 51,015
15-11-1977 1 3,901,500 0 11,496 0
197711152009042001 MKG:16 0 312,120 0
Pembina-4A 0 2001325011
15 0
57.822.635.9-732.000 5,185,431 0 374,631 0
0 4,810,800
3 drg, TITIS AYU TUNGGAL WARDHANI TK-0 3,782,400 0 0 0 6,121 0 3 .............
0 0 0 0 0 0 0
0 1,200,000 72,420 0 49,824
30-11-1981 1 3,782,400 0 6,121 0
198111302008032001 MKG:14 0 302,592 0
Pembina-4A 0 2001362731
96 0
08.708.887.8-622.000 5,061,037 0 358,537 0
0 4,702,500
4 ISWATI ,S.ST TK-0 4,555,800 0 0 0 24,396 0 4 .............
0 0 0 0 0 0 0
0 850,000 72,420 0 54,058
09-10-1969 1 4,555,800 0 24,396 0
196910091990112001 MKG:26 0 364,464 0
Pembina-4A 0 2001350358
2 0
15.504.001.7-732.000 5,502,618 0 442,918 0
0 5,059,700
5 dr, LESMANA DHANU UMBARA K -1 3,901,500 0 0 0 0 0 5 .............
2 390,150 0 0 0 0 0
156,060 750,000 289,680 0 51,977
07-04-1979 4 4,447,710 0 0 0
197904072006041020 MKG:16 0 355,817 0
Pembina-4A 0 2001345397
4 0
15.180.655.1-732.000 5,487,394 0 407,794 0
0 5,079,600
SUB TOTAL PERGOLONGAN : IV 20,467,900 0 0 0 65,505 0
PEG: 5 822,820 0 0 0 0 0
IST: 2 JIWA= 10 242,594 5,200,000 724,200 0 267,333
21,533,314 0 65,505 0
ANK: 3 0 1,722,665 0
184 0 0
27,523,203 0 2,055,503
0 25,467,700
6 drg, MIA SUBO ASMORO TK-0 3,410,600 0 0 0 0 0 6 .............
0 0 0 0 0 0 0
0 750,000 72,420 0 41,606
23-07-1977 1 3,410,600 0 0 0
197707232011012002 MKG:10 0 272,848 0
Penata Tk.I-3D 0 2001369213
34 0
57.822.809.0-732.000 4,233,054 0 314,454 0
0 3,918,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PELAIHARI
(002) D50500100200003 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
7 INDRA WAHYUDI ,SKM K -1 3,518,100 0 0 0 0 0 7 .............
2 351,810 0 0 0 0 0
140,724 600,000 289,680 0 46,106
12-06-1984 4 4,010,634 0 0 0
198406122010011013 MKG:12 0 320,851 0
Penata Tk.I-3D 0 2001329707
43 0
15.582.991.4-732.000 4,900,357 0 366,957 0
0 4,533,400
8 Hj. MAHPUJAH TK-0 4,650,600 0 0 0 12,050 0 8 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 51,506
11-01-1966 1 4,650,600 0 12,050 0
196611011987032006 MKG:30 0 372,048 0
Penata Tk.I-3D 0 2001350296
34 0
15.504.006.6-732.000 5,235,104 0 435,604 0
0 4,799,500
9 TAUFIK RAHMAN K -1 4,508,600 0 0 0 0 0 9 .............
2 450,860 0 0 0 0 0
180,344 500,000 289,680 0 56,398
26-02-1967 4 5,139,804 0 0 0
196702261991031004 MKG:28 0 411,184 0
Penata Tk.I-3D 0 2001337362
98 0
15.993.266.4-732.000 5,929,582 0 467,582 0
0 5,462,000
10 SITI ALIKAH ,AM.KEB TK-0 4,508,600 0 0 0 5,642 0 10 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 50,086
20-07-1969 1 4,508,600 0 5,642 0
196907201989032006 MKG:28 0 360,688 0
Penata Tk.I-3D 0 2001369132
54 0
15.358.228.3-732.000 5,086,716 0 416,416 0
0 4,670,300
11 MESRAWATI SIMANJUNTAK ,AMK K -1 4,370,900 0 0 0 0 0 11 .............
2 437,090 0 0 0 0 0
174,836 500,000 289,680 0 54,828
08-04-1967 4 4,982,826 0 0 0
196704081990032007 MKG:26 0 398,626 0
Penata Tk.I-3D 0 2001320974
48 0
15.475.499.8-732.000 5,772,554 0 453,454 0
0 5,319,100
12 JAINI K -1 4,370,900 0 0 0 0 0 12 .............
0 437,090 0 0 0 0 0
0 500,000 144,840 0 53,080
13-07-1967 2 4,807,990 0 0 0
196707131991012001 MKG:26 0 384,639 0
Penata Tk.I-3D 0 2001325108
89 0
15.504.002.5-732.000 5,452,919 0 437,719 0
0 5,015,200
13 Hj. SRI LESTARI ,AMK K -1 4,370,900 0 0 0 3,842 0 13 .............
0 437,090 0 0 0 0 0
0 500,000 144,840 0 53,080
06-10-1968 2 4,807,990 0 3,842 0
196810061990022001 MKG:26 0 384,639 0
Penata Tk.I-3D 0 2001337516
89 0
78.347.285.5-732.000 5,456,761 0 441,561 0
0 5,015,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PELAIHARI
(002) D50500100200003 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 KAMARIAH ,AM.KG TK-0 4,370,900 0 0 0 0 0 14 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 48,709
01-01-1970 1 4,370,900 0 0 0
197001011990032006 MKG:26 0 349,672 0
Penata Tk.I-3D 0 2001323167
61 0
15.504.005.8-732.000 4,943,381 0 398,381 0
0 4,545,000
15 SUKAESIH ,AM.Keb K -1 4,370,900 0 0 0 0 0 15 .............
0 437,090 0 0 0 0 0
0 500,000 144,840 0 53,080
22-05-1971 2 4,807,990 0 0 0
197105221991012002 MKG:26 0 384,639 0
Penata Tk.I-3D 0 2001320427
89 0
14.314.112.5-732.000 5,452,919 0 437,719 0
0 5,015,200
16 NORHIDAYAT ,AMK K -1 4,370,900 0 0 0 0 0 16 .............
2 437,090 0 0 0 0 0
174,836 500,000 289,680 0 54,828
04-07-1971 4 4,982,826 0 0 0
197107041991031007 MKG:26 0 398,626 0
Penata Tk.I-3D 0 2001335556
48 0
16.657.197.6-732.000 5,772,554 0 453,454 0
0 5,319,100
17 SRI LESTARI ,AMK K -1 4,370,900 0 0 0 0 0 17 .............
1 437,090 0 0 0 0 0
87,418 500,000 217,260 0 53,954
23-02-1972 3 4,895,408 0 0 0
197202231991012002 MKG:26 0 391,633 0
Penata Tk.I-3D 0 2001320389
19 0
15.548.958.6-732.000 5,612,687 0 445,587 0
0 5,167,100
18 WINDARYANTI ,AMK K -1 3,982,600 0 0 0 0 0 18 .............
1 398,260 0 0 0 0 0
79,652 500,000 217,260 0 49,605
12-01-1976 3 4,460,512 0 0 0
197601121996032002 MKG:20 0 356,841 0
Penata Tk.I-3D 0 2001320467
74 0
15.250.631.7-732.000 5,177,846 0 406,446 0
0 4,771,400
19 CHRISTINA UMIATY ,SST K -1 3,481,600 0 0 0 0 0 19 .............
2 348,160 0 0 0 0 0
139,264 600,000 289,680 0 45,690
18-08-1978 4 3,969,024 0 0 0
197808182006042007 MKG:14 0 317,522 0
Penata-3C 0 2001321008
8 0
15.308.300.1-732.000 4,858,712 0 363,212 0
0 4,495,500
20 MARLINA ,S.ST K -1 3,375,300 0 0 0 0 0 20 .............
2 337,530 0 0 0 0 0
135,012 600,000 289,680 0 44,478
05-04-1984 4 3,847,842 0 0 0
198404052008032002 MKG:12 0 307,827 0
Penata-3C 0 2001337451
83 0
15.154.191.9-732.000 4,737,605 0 352,305 0
0 4,385,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PELAIHARI
(002) D50500100200003 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 ZULYANI AGUSTINA ,SST TK-0 3,272,200 0 0 0 0 0 21 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 38,722
03-08-1986 1 3,272,200 0 0 0
198608032009032006 MKG:10 0 261,776 0
Penata-3C 0 2001325275
78 0
16.570.928.8-732.000 3,944,698 0 300,498 0
0 3,644,200
22 VERAWATI ,S.ST TK-0 3,272,200 0 0 0 0 0 22 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 38,722
07-05-1987 1 3,272,200 0 0 0
198705072009032007 MKG:10 0 261,776 0
Penata-3C 0 2001325259
78 0
16.657.194.3-732.000 3,944,698 0 300,498 0
0 3,644,200
23 ARSIAH TK-0 3,821,000 0 0 0 0 0 23 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 43,210
19-09-1973 1 3,821,000 0 0 0 0
197309191997022001 MKG:20 0 305,680 0
Penata-3C 0 2001324716
70 0
16.257.694.6-732.000 4,393,490 0 348,890 0
0 4,044,600
24 YULIA RUSIDA TK-0 3,591,200 0 0 0 0 0 24 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 40,912
01-10-1975 1 3,591,200 0 0 0 0
197510012000032004 MKG:16 0 287,296 0
Penata-3C 0 2001359099
88 0
57.822.805.8-732.000 4,163,708 0 328,208 0
0 3,835,500
25 SUCIATI SRI WAHYUNI ,AMK JD-0 3,591,200 0 0 0 0 0 25 .............
1 0 0 0 0 0 0
71,824 500,000 144,840 0 41,630
07-07-1982 2 3,663,024 0 0 0
198207072006042037 MKG:16 0 293,042 0
Penata-3C 0 2001369086
8 0
15.789.410.6-734.000 4,307,872 0 334,672 0
0 3,973,200
26 Hj. HASLIDA YANTI K -1 3,375,300 0 0 0 0 0 26 .............
2 337,530 0 0 0 0 0
135,012 500,000 289,680 0 43,478
18-01-1981 4 3,847,842 0 0 0
198101182005012014 MKG:12 0 307,827 0
Penata-3C 0 2001338423
83 0
16.483.037.4-732.000 4,637,605 0 351,305 0
0 4,286,300
27 HENNY SUGIHARYAWATI ,AMK TK-0 3,375,300 0 0 0 0 0 27 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 38,753
13-09-1982 1 3,375,300 0 0 0
198209132005012010 MKG:12 0 270,024 0
Penata-3C 0 2001320982
57 0
14.904.263.2-732.000 3,947,777 0 308,777 0
0 3,639,000
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PELAIHARI
(002) D50500100200003 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
28 FRANCISCA ROMANA ANITA ,AMK K -1 3,272,200 0 0 0 0 0 28 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
18-04-1984 4 3,730,308 0 0 0
198404182009032010 MKG:11 0 298,425 0
Penata-3C 0 2001325038
40 0
16.407.525.1-732.000 4,520,028 0 340,728 0
0 4,179,300
29 WELDA MUSDALIYANTI ,AMK TK-0 3,272,200 0 0 0 0 0 29 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
24-09-1980 1 3,272,200 0 0 0
198009242010012015 MKG:10 0 261,776 0
Penata-3C 0 2001348321
78 0
15.478.520.8-732.000 3,844,698 0 299,498 0
0 3,545,200
30 IKSAN GUNAWAN ,A.Md.Far K -1 3,272,200 0 0 0 0 0 30 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
11-02-1985 4 3,730,308 0 0 0
198502112009031004 MKG:10 0 298,425 0
Penata-3C 0 2001323663
40 0
15.993.312.6-732.000 4,520,028 0 340,728 0
0 4,179,300
31 JAYANTI OKTRIANA ,AM.KEB K -0 3,272,200 0 0 0 0 0 31 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
21-10-1985 1 3,272,200 0 0 0
198510212010012010 MKG:10 0 261,776 0
Penata-3C 0 2001360402
78 0
16.482.804.8-732.000 3,844,698 0 299,498 0
0 3,545,200
32 IRMAWATI ,AM.KEB K -1 3,272,200 0 0 0 0 0 32 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
27-08-1987 4 3,730,308 0 0 0
198708272010012021 MKG:10 0 298,425 0
Penata-3C 0 2001362189
40 0
47.613.973.8-735.000 4,520,028 0 340,728 0
0 4,179,300
33 ARINI MUSLIHAH ,AM.KEB K -1 3,272,200 0 0 0 0 0 33 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
13-01-1988 4 3,730,308 0 0 0
198801132010012003 MKG:10 0 298,425 0
Penata-3C 0 2001359013
40 0
16.257.868.6-732.000 4,520,028 0 340,728 0
0 4,179,300
34 DEVI VEMMY RATNANINGTYAS ,AM.Keb K -0 3,272,200 0 0 0 0 0 34 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
02-02-1989 1 3,272,200 0 0 0
198902022010012003 MKG:10 0 261,776 0
Penata-3C 0 2001337257
78 0
16.407.645.7-732.000 3,844,698 0 299,498 0
0 3,545,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PELAIHARI
(002) D50500100200003 BULAN : DESEMBER 2022 HALAMAN : 6

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
35 dr., AINUN MARTONI TK-0 2,773,200 0 0 0 0 0 35 .............
0 0 0 0 0 0 0
0 325,000 72,420 0 30,982
07-06-1992 1 2,773,200 0 0 0
199206072020122028 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 2001373474
18 0
74.125.724.0-801.000 3,170,638 0 252,838 0
0 2,917,800
36 NURI HANDAYANI ,A.Md. Keb TK-0 3,554,000 0 0 0 0 0 36 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 38,190
29-06-1979 1 3,554,000 0 0 0
197906292005012015 MKG:18 0 284,320 0
Penata Muda Tk.I-3B 0 2001319787
90 0
14.314.079.6-732.000 3,891,510 0 322,510 0
0 3,569,000
37 ULIS LESTARI ,AM.Keb K -1 3,445,500 0 0 0 0 0 37 .............
1 344,550 0 0 0 0 0
68,910 265,000 217,260 0 41,240
08-11-1978 3 3,858,960 0 0 0
197811082000032001 MKG:16 0 308,717 0
Penata Muda Tk.I-3B 0 2001323604
37 0
16.514.121.9-732.000 4,341,257 0 349,957 0
0 3,991,300
38 NANA RAHMIYANI AGUS ,AM.Keb K -0 3,139,400 0 0 0 0 0 38 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
17-08-1984 1 3,139,400 0 0 0
198408172010012027 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001337648
76 0
15.767.289.0-732.000 3,476,896 0 285,196 0
0 3,191,700
39 HALIMAH ,AMG K -1 3,139,400 0 0 0 0 0 39 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
02-01-1985 4 3,578,916 0 0 0
198501022009032009 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001321237
56 0
16.257.692.0-732.000 4,133,652 0 324,752 0
0 3,808,900
40 PURNA YULIATI ,S.Kep TK-0 3,139,400 0 0 0 0 0 40 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
12-07-1985 1 3,139,400 0 0 0
198507122009032011 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001339748
76 0
16.482.876.6-732.000 3,476,896 0 285,196 0
0 3,191,700
41 NOOR ISRINA HIDAYAH ,AM.Keb TK-0 3,043,600 0 0 0 0 0 41 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,086
23-02-1990 1 3,043,600 0 0 0
199002232011012003 MKG: 9 0 243,488 0
Penata Muda Tk.I-3B 0 2001359242
54 0
16.257.699.5-732.000 3,381,074 0 276,574 0
0 3,104,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PELAIHARI
(002) D50500100200003 BULAN : DESEMBER 2022 HALAMAN : 7

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
42 YULIA HILMAH ,AMK K -0 3,043,600 0 0 0 0 0 42 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,086
02-07-1986 1 3,043,600 0 0 0
198607022011012004 MKG: 8 0 243,488 0
Penata Muda Tk.I-3B 0 2001359005
54 0
16.257.870.2-732.000 3,381,074 0 276,574 0
0 3,104,500
43 SUPRIH TK-0 4,280,800 0 0 0 0 0 43 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 44,658
01-10-1965 1 4,280,800 0 0 0
196510011987032020 MKG:30 0 342,464 0
Penata Muda Tk.I-3B 0 2001331887
2 0
15.475.494.9-732.000 4,538,222 0 387,122 0
0 4,151,100
44 apt, WILU DWI SEPTINA ,S.Farm TK-0 2,150,800 0 0 0 0 0 44 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
08-09-1988 1 2,150,800 0 0 0
198809082022032004 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200400975
2 0
633447222732000 2,408,222 0 195,422 0
0 2,212,800
45 ARRIFAH NOER EMMA ,SST TK-0 2,660,700 0 0 0 0 0 45 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 29,607
30-04-1992 1 2,660,700 0 0 0
199204302020122023 MKG: 2 0 212,856 0
Penata Muda-3A 0 2001373423
43 0
74.951.263.8-731.000 3,033,163 0 242,463 0
0 2,790,700
46 FEBBY ZURIANI FITRIA ,S.K.M. TK-0 2,660,700 0 0 0 0 0 46 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 29,607
12-02-1997 1 2,660,700 0 0 0
199702122020122032 MKG: 2 0 212,856 0
Penata Muda-3A 0 2001373498
43 0
96.852.104.7-731.000 3,033,163 0 242,463 0
0 2,790,700
47 SAIPUDDIN.RO ,AMD K -1 3,860,100 0 0 0 0 0 47 .............
2 386,010 0 0 0 0 0
154,404 265,000 289,680 0 46,655
03-11-1969 4 4,400,514 0 0 0 0
196911032006041013 MKG:26 0 352,041 0
Penata Muda-3A 0 2001369407
2 0
15.042.267.3-732.000 4,955,196 0 398,696 0
0 4,556,500
48 YULIANA TK-0 3,627,900 0 0 0 0 0 48 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 38,929
10-05-1976 1 3,627,900 0 0 0 0
197605102006042022 MKG:22 0 290,232 0
Penata Muda-3A 0 2001320966
41 0
16.115.106.3-732.000 3,965,361 0 329,161 0
0 3,636,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PELAIHARI
(002) D50500100200003 BULAN : DESEMBER 2022 HALAMAN : 8

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
49 MAIMUNAH YUNIARTI TK-0 3,517,200 0 0 0 0 0 49 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 37,822
13-06-1978 1 3,517,200 0 0 0
197806132006042017 MKG:20 0 281,376 0
Penata Muda-3A 0 2001337532
78 0
16.407.657.2-732.000 3,854,698 0 319,198 0
0 3,535,500
50 MARLINA K -1 3,204,700 0 0 0 0 0 50 .............
1 320,470 0 0 0 0 0
64,094 265,000 217,260 0 38,543
14-04-1977 3 3,589,264 0 0 0 0
197704142006042022 MKG:14 0 287,141 0
Penata Muda-3A 0 2001369388
60 0
16.462.363.9-732.000 4,071,584 0 325,684 0
0 3,745,900
51 ANTIKA NUR ISMAWATI ,A.Md. Farm TK-0 2,920,100 0 0 0 0 0 51 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 31,851
30-09-1990 1 2,920,100 0 0 0
199009302009032001 MKG: 8 0 233,608 0
Penata Muda-3A 0 2001350466
39 0
16.257.700.1-732.000 3,257,559 0 265,459 0
0 2,992,100
52 SELVI IZZATIYAH ,AMD.Far TK-0 2,744,500 0 0 0 0 0 52 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 30,095
10-02-1993 1 2,744,500 0 0 0
199302102015022001 MKG: 4 0 219,560 0
Penata Muda-3A 0 2001369008
35 0
72.459.591.3-732.000 3,081,955 0 249,655 0
0 2,832,300
53 AYU KARLINA ,S.Tr.KL K -1 2,063,520 0 0 0 0 0 53 .............
1 206,352 185,000 0 0 0 0
41,270 0 217,260 0 24,961
07-04-1994 3 2,311,142 0 0 0
199404072022032008 MKG: 0 0 184,891 0
Penata Muda-3A 0 3200406418
50 0
050596063732000 2,713,452 0 209,852 0
0 2,503,600
SUB TOTAL PERGOLONGAN : III 168,205,220 0 0 0 21,534 0
PEG: 48 7,726,892 555,000 0 0 0 0
IST: 21 JIWA= 101 2,296,728 19,620,000 7,314,420 0 1,984,036
178,228,840 0 21,534 0
ANK: 32 0 14,258,307 0
2,583 0 0
205,742,377 0 16,263,877
0 189,478,500
54 MARDIANA ,AM.Keb TK-0 2,801,500 0 0 0 0 0 54 .............
1 0 0 0 0 0 0
56,030 240,000 144,840 0 30,975
24-01-1990 2 2,857,530 0 0 0
199001242017042002 MKG:13 0 228,602 0
Pengatur Tk.I-2D 0 2001369116
7 0
16.781.658.6-732.000 3,242,377 0 259,577 0
0 2,982,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PELAIHARI
(002) D50500100200003 BULAN : DESEMBER 2022 HALAMAN : 9

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
55 LYNDA TRIASRARY ,AM.Keb K -1 2,801,500 0 0 0 0 0 55 .............
2 280,150 0 0 0 0 0
112,060 240,000 289,680 0 34,337
26-01-1990 4 3,193,710 0 0 0
199001262017042002 MKG:13 0 255,497 0
Pengatur Tk.I-2D 0 2001369237
44 0
66.507.356.5-732.000 3,723,434 0 289,834 0
0 3,433,600
56 MUHAMMAD IQBAL RAZIFUDDIN ,AMK K -1 2,474,700 0 0 0 0 0 56 .............
1 247,470 0 0 0 0 0
49,494 240,000 217,260 0 30,117
11-01-1989 3 2,771,664 0 0 0
198901112019031007 MKG: 6 0 221,733 0
Pengatur Tk.I-2D 0 2001371633
26 0
90.815.300.0-736.000 3,228,950 0 251,850 0
0 2,977,100
57 SYAHPUR RIZALI K -1 2,980,800 0 0 0 0 0 57 .............
2 298,080 180,000 0 0 0 0
119,232 0 289,680 0 35,781
27-07-1979 4 3,398,112 0 0 0
197907272010011002 MKG:17 0 271,849 0
Pengatur Tk.I-2D 0 2001320761
38 0
16.257.697.9-732.000 3,867,830 0 307,630 0
0 3,560,200
58 ROIDA WINIJAYANTI ,A.Md.KL TK-0 2,374,300 0 0 0 0 0 58 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
09-02-1996 1 2,374,300 0 0 0
199602092019032006 MKG: 5 0 189,944 0
Pengatur-2C 0 2001370807
67 0
90.781.302.6-732.000 2,686,787 0 216,087 0
0 2,470,700
59 YUSNITA ,A.Md.RMIK K -1 1,841,440 0 0 0 0 0 59 .............
0 184,144 180,000 0 0 0 0
0 0 144,840 0 22,056
09-08-1992 2 2,025,584 0 0 0
199208092022032002 MKG: 3 0 162,047 0
Pengatur-2C 0 3200401491
79 0
813958899732000 2,350,503 0 184,103 0
0 2,166,400
60 DEWI YULIANI ,A.Md.Kes K -1 1,841,440 0 0 0 0 0 60 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
02-07-1998 3 2,062,413 0 0 0
199807022022032009 MKG: 3 0 164,993 0
Pengatur-2C 0 3200406132
44 0
930226881732000 2,459,717 0 187,417 0
0 2,272,300
SUB TOTAL PERGOLONGAN : 17,115,680 0 0 0 0 0
PEG: 7 1,193,988 540,000 0 0 0 0
IST: 5 JIWA= 19 373,645 960,000 1,375,980 0 201,833
18,683,313 0 0 0
ANK: 7 0 1,494,665 0
305 0 0
21,559,598 0 1,696,498
0 19,863,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PELAIHARI
(002) D50500100200003 BULAN : DESEMBER 2022 HALAMAN : 10

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 205,788,800 0 0 0 87,039 0
PEG: 60 9,743,700 1,095,000 0 0 0 0
IST: 28 JIWA= 130 2,912,967 25,780,000 9,414,600 0 2,453,202
ANK: 42 218,445,467 0 87,039 0
0 17,475,637 0
0 0
3,072 0 20,015,878
254,825,178
0 234,809,300

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAKISUNG
(002) D50500100200004 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 dr, AGUSTINA MARIA K -1 3,554,900 0 0 0 0 0 1 .............
2 355,490 0 0 0 0 0
142,196 1,200,000 289,680 0 52,526
04-03-1982 4 4,052,586 0 0 0
198203042011012002 MKG:11 0 324,207 0
Pembina-4A 0 2001359501
67 0
16.482.833.7-732.000 5,542,333 0 376,733 0
0 5,165,600
SUB TOTAL PERGOLONGAN : IV 3,554,900 0 0 0 0 0
PEG: 1 355,490 0 0 0 0 0
IST: 1 JIWA= 4 142,196 1,200,000 289,680 0 52,526
4,052,586 0 0 0
ANK: 2 0 324,207 0
67 0 0
5,542,333 0 376,733
0 5,165,600
2 drg, KARINA IKA PUTRI SUKARNO K -1 3,410,600 0 0 0 0 0 2 .............
2 341,060 0 0 0 0 0
136,424 750,000 289,680 0 46,381
27-06-1985 4 3,888,084 0 0 0
198506272014112001 MKG:10 0 311,047 0
Penata Tk.I-3D 0 2001362917
64 0
66.491.218.5-732.000 4,927,828 0 357,428 0
0 4,570,400
3 SUPARDI ,SKM TK-0 4,508,600 0 0 0 10,392 0 3 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 51,086
04-10-1969 1 4,508,600 0 10,392 0
196910041989031006 MKG:28 0 360,688 0
Penata Tk.I-3D 0 2001350636
54 0
57.822.652.4-732.000 5,191,466 0 422,166 0
0 4,769,300
4 SUTANTI ,SST K -1 3,743,100 0 0 0 0 0 4 .............
2 374,310 0 0 0 0 0
149,724 600,000 289,680 0 48,671
28-10-1982 4 4,267,134 0 0 0
198210282006042019 MKG:16 0 341,371 0
Penata Tk.I-3D 0 2001350571
28 0
88.508.919.3-732.000 5,156,842 0 390,042 0
0 4,766,800
5 AHMAD GAFURI ,S.Gz K -1 3,628,900 0 0 0 0 0 5 .............
2 362,890 0 0 0 0 0
145,156 600,000 289,680 0 47,369
16-11-1982 4 4,136,946 0 0 0
198211162005011005 MKG:14 0 330,956 0
Penata Tk.I-3D 0 2001368691
99 0
68.287.307.0-735.000 5,026,725 0 378,325 0
0 4,648,400
6 RENASARI JD-0 4,650,600 0 0 0 0 0 6 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 51,506
20-01-1965 1 4,650,600 0 0 0
196501201986032012 MKG:30 0 372,048 0
Penata Tk.I-3D 0 2001319682
34 0
15.250.781.0-732.000 5,223,054 0 423,554 0
0 4,799,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAKISUNG
(002) D50500100200004 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
7 BURHANUDDIN,AMK K -1 4,508,600 0 0 0 0 0 7 .............
1 450,860 0 0 0 0 0
90,172 500,000 217,260 0 55,496
11-10-1966 3 5,049,632 0 0 0
196610111989031008 MKG:28 0 403,971 0
Penata Tk.I-3D 0 2001323687
75 0
75.836.426.9-732.000 5,766,967 0 459,467 0
0 5,307,500
8 TRI WAHYUNI ,AM.KEB K -1 4,370,900 0 0 0 0 0 8 .............
1 437,090 0 0 0 0 0
87,418 500,000 217,260 0 53,954
20-04-1971 3 4,895,408 0 0 0
197104201991022003 MKG:26 0 391,633 0
Penata Tk.I-3D 0 2001325291
19 0
15.250.539.2-732.000 5,612,687 0 445,587 0
0 5,167,100
9 SITI NGATMINAH ,AM.KEB K -1 4,370,900 0 0 0 0 0 9 .............
1 437,090 0 0 0 0 0
87,418 500,000 217,260 0 53,954
14-12-1971 3 4,895,408 0 0 0
197112141991032004 MKG:26 0 391,633 0
Penata Tk.I-3D 0 2001350601
19 0
16.153.758.4-732.000 5,612,687 0 445,587 0
0 5,167,100
10 MUHAMMAD RAHMAT ,A.Md.Kes TK-0 4,237,500 0 0 0 0 0 10 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 47,375
20-05-1969 1 4,237,500 0 0 0
196905201993031010 MKG:24 0 339,000 0
Penata Tk.I-3D 0 2001323388
55 0
57.822.642.5-732.000 4,809,975 0 386,375 0
0 4,423,600
11 FX. BUDIONO ,AMK K -1 4,108,100 0 0 0 0 0 11 .............
1 410,810 0 0 0 0 0
82,162 500,000 217,260 0 51,011
05-11-1974 3 4,601,072 0 0 0
197411051994031007 MKG:22 0 368,086 0
Penata Tk.I-3D 0 2001350431
65 0
15.548.729.1-732.000 5,318,397 0 419,097 0
0 4,899,300
12 PAHLIYANI ,S.ST.Ners K -1 3,272,200 0 0 0 0 0 12 .............
2 327,220 0 0 0 0 0
130,888 600,000 289,680 0 43,303
27-11-1987 4 3,730,308 0 0 0
198711272010012004 MKG:10 0 298,425 0
Penata-3C 0 2001359463
40 0
57.822.648.2-732.000 4,620,028 0 341,728 0
0 4,278,300
13 ONNY ANGGRAINI ,AM.KEB K -1 3,272,200 0 0 0 0 0 13 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
16-08-1987 4 3,730,308 0 0 0
198708162010012008 MKG:10 0 298,425 0
Penata-3C 0 2001322683
40 0
16.232.467.7-732.000 4,520,028 0 340,728 0
0 4,179,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAKISUNG
(002) D50500100200004 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 RAY SANJAYA ,AMK K -1 3,272,200 0 0 0 0 0 14 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
01-06-1988 4 3,730,308 0 0 0
198806012010011002 MKG:10 0 298,425 0
Penata-3C 0 2001323086
40 0
87.669.136.1-732.000 4,520,028 0 340,728 0
0 4,179,300
15 NURHIDAYANI ,AMK JD-0 3,272,200 0 0 0 0 0 15 .............
2 0 0 0 0 0 0
130,888 500,000 217,260 0 39,031
03-12-1988 3 3,403,088 0 0 0
198812032010012003 MKG:10 0 272,247 0
Penata-3C 0 2001349808
30 0
57.822.627.6-732.000 4,120,378 0 311,278 0
0 3,809,100
16 dr., FEBA PALGUNA WARDHANI TK-0 2,773,200 0 0 0 0 0 16 .............
0 0 0 0 0 0 0
0 325,000 72,420 0 30,982
24-02-1989 1 2,773,200 0 0 0
198902242020122013 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 2001373776
18 0
64.378.877.1-505.000 3,170,638 0 252,838 0
0 2,917,800
17 apt, LUVITA ,S.Farm TK-0 2,773,200 0 0 0 0 0 17 .............
0 0 0 0 0 0 0
0 325,000 72,420 0 30,982
16-12-1993 1 2,773,200 0 0 0
199312162020122023 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 2001372443
18 0
93.014.822.6-732.000 3,170,638 0 252,838 0
0 2,917,800
18 RUPI TJAHJANI ,A.Md.Keb TK-0 3,781,400 0 0 0 0 0 18 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 40,464
05-01-1974 1 3,781,400 0 0 0
197401052005012010 MKG:22 0 302,512 0
Penata Muda Tk.I-3B 0 2001350617
56 0
57.822.656.5-732.000 4,118,876 0 342,976 0
0 3,775,900
19 BAHRIANI ,A.Md.Keb K -0 3,665,900 0 0 0 0 0 19 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 39,309
05-12-1974 1 3,665,900 0 0 0
197412052005012010 MKG:21 0 293,272 0
Penata Muda Tk.I-3B 0 2001350555
61 0
15.308.314.2-732.000 4,003,381 0 332,581 0
0 3,670,800
20 AHDIYATNA PARIYANTI ,A.Md.Keb K -1 3,665,900 0 0 0 0 0 20 .............
1 366,590 0 0 0 0 0
73,318 265,000 217,260 0 43,708
15-07-1975 3 4,105,808 0 0 0
197507152007012025 MKG:20 0 328,465 0
Penata Muda Tk.I-3B 0 2001323701
5 0
15.696.556.8-732.000 4,588,073 0 372,173 0
0 4,215,900
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAKISUNG
(002) D50500100200004 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 ENI PURWANTI ,S.ST K -0 3,665,900 0 0 0 0 0 21 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 39,309
01-07-1977 1 3,665,900 0 0 0
197707012007012012 MKG:20 0 293,272 0
Penata Muda Tk.I-3B 0 2001323736
61 0
15.767.333.6-732.000 4,003,381 0 332,581 0
0 3,670,800
22 UMI AMIATI ,A.Md K -1 3,043,600 0 0 0 0 0 22 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
25-03-1983 4 3,469,704 0 0 0
198303252011012008 MKG: 9 0 277,576 0
Penata Muda Tk.I-3B 0 2001373989
39 0
16.213.355.7-732.000 4,024,423 0 314,923 0
0 3,709,500
23 ISTIYANA MIRANDARI ,AMK JD-0 3,106,900 0 0 0 0 0 23 .............
2 0 0 0 0 0 0
124,276 265,000 217,260 0 34,962
17-10-1981 3 3,231,176 0 0 0
198110172005012009 MKG:12 0 258,494 0
Penata Muda-3A 0 2001322322
20 0
16.232.498.2-732.000 3,713,456 0 293,456 0
0 3,420,000
SUB TOTAL PERGOLONGAN : III 81,102,600 0 0 0 10,392 0
PEG: 22 4,466,720 0 0 0 0 0
IST: 12 JIWA= 57 1,621,364 9,890,000 4,127,940 0 970,806
87,190,684 0 10,392 0
ANK: 23 0 6,975,258 0
940 0 0
101,219,956 0 7,956,456
0 93,263,500
24 ARI YULIANA ,AM.Keb K -1 2,889,800 0 0 0 0 0 24 .............
2 288,980 0 0 0 0 0
115,592 240,000 289,680 0 35,344
02-10-1987 4 3,294,372 0 0 0
198710022017042006 MKG:15 0 263,550 0
Pengatur Tk.I-2D 0 2001369205
42 0
87.655.535.0-732.000 3,824,094 0 298,894 0
0 3,525,200
25 EMELIA ,AM.Keb TK-0 2,801,500 0 0 0 0 0 25 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 30,415
16-02-1988 1 2,801,500 0 0 0
198802162017042004 MKG:13 0 224,120 0
Pengatur Tk.I-2D 0 2001369248
15 0
66.484.707.6-732.000 3,113,935 0 254,535 0
0 2,859,400
26 RUSMAYANTI ,A.Md.Farm K -0 2,859,800 0 0 0 0 0 26 .............
1 0 0 0 0 0 0
57,196 240,000 144,840 0 31,570
18-03-1985 2 2,916,996 0 0 0
198503182014062003 MKG:17 0 233,360 0
Pengatur-2C 0 2001362871
94 0
16.000.940.3-732.000 3,301,930 0 264,930 0
0 3,037,000
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAKISUNG
(002) D50500100200004 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
27 NURHAYATI ASLAMI ALMA ,A.Md.AK TK-0 1,841,440 0 0 0 0 0 27 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
03-08-1995 1 1,841,440 0 0 0
199508032022032004 MKG: 3 0 147,315 0
Pengatur-2C 0 3200403427
69 0
838328904732000 2,093,929 0 167,529 0
0 1,926,400
SUB TOTAL PERGOLONGAN : 10,392,540 0 0 0 0 0
PEG: 4 288,980 180,000 0 0 0 0
IST: 1 JIWA= 8 172,788 720,000 579,360 0 117,543
10,854,308 0 0 0
ANK: 3 0 868,345 0
220 0 0
12,333,888 0 985,888
0 11,348,000
TOTAL PER SATKER 95,050,040 0 0 0 10,392 0
PEG: 27 5,111,190 180,000 0 0 0 0
IST: 14 JIWA= 69 1,936,348 11,810,000 4,996,980 0 1,140,875
ANK: 28 102,097,578 0 10,392 0
0 8,167,810 0
0 0
1,227 0 9,319,077
119,096,177
0 109,777,100

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BATI-BATI
(002) D50500100200005 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 dr, ENDAH BUDIATI K -1 3,666,900 0 0 0 0 0 1 .............
1 366,690 0 0 0 0 0
73,338 1,200,000 217,260 0 53,069
25-11-1973 3 4,106,928 0 0 0
197311252010012001 MKG:12 0 328,554 0
Pembina-4A 0 2001325577
35 0
15.478.641.2-732.000 5,524,223 0 381,623 0
0 5,142,600
2 Hj. MASNAWIAH ,S.Kep K -1 4,847,300 0 0 0 33,179 0 2 .............
1 484,730 0 0 0 0 0
96,946 850,000 217,260 0 62,790
27-12-1964 3 5,428,976 0 33,179 0
196412271986032010 MKG:30 0 434,318 0
Pembina-4A 0 2001353007
72 0
16.061.796.5-732.000 6,529,487 0 530,287 0
0 5,999,200
SUB TOTAL PERGOLONGAN : IV 8,514,200 0 0 0 33,179 0
PEG: 2 851,420 0 0 0 0 0
IST: 2 JIWA= 6 170,284 2,050,000 434,520 0 115,859
9,535,904 0 33,179 0
ANK: 2 0 762,872 0
107 0 0
12,053,710 0 911,910
0 11,141,800
3 WIDURI RATNA WULAN ,S.KEP K -0 3,743,100 0 0 0 0 0 3 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 43,431
08-04-1972 1 3,743,100 0 0 0
197204082006042001 MKG:16 0 299,448 0
Penata Tk.I-3D 0 2001355174
59 0
16.077.653.0-732.000 4,415,579 0 342,879 0
0 4,072,700
4 RINA INDRIANI ,S.Kep K -1 3,628,900 0 0 0 0 0 4 .............
2 362,890 0 0 0 0 0
145,156 600,000 289,680 0 47,369
06-06-1976 4 4,136,946 0 0 0
197606062006042008 MKG:14 0 330,956 0
Penata Tk.I-3D 0 2001353198
99 0
16.090.451.2-732.000 5,026,725 0 378,325 0
0 4,648,400
5 RINA INDRIANI ,SKM TK-0 3,518,100 0 0 0 0 0 5 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 41,181
27-10-1983 1 3,518,100 0 0 0
198310272009032007 MKG:12 0 281,448 0
Penata Tk.I-3D 0 2001368772
9 0
16.061.689.2-732.000 4,190,529 0 322,629 0
0 3,867,900
6 Hj. RINA MUTIAH TK-0 4,650,600 0 0 0 12,050 0 6 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 51,506
14-09-1967 1 4,650,600 0 12,050 0
196709141987032002 MKG:30 0 372,048 0
Penata Tk.I-3D 0 2001351535
34 0
08.375.955.5-732.000 5,235,104 0 435,604 0
0 4,799,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BATI-BATI
(002) D50500100200005 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
7 HJ. BASITAH TK-0 4,508,600 0 0 0 0 0 7 .............
1 0 0 0 0 0 0
90,172 500,000 144,840 0 50,988
09-09-1965 2 4,598,772 0 0 0 0
196509091988122001 MKG:28 0 367,902 0
Penata Tk.I-3D 0 2001353864
78 0
15.478.849.1-732.000 5,243,690 0 418,890 0
0 4,824,800
8 Hj. MURNIAH ,AM.Keb.Keb TK-0 4,237,500 0 0 0 0 0 8 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 47,375
24-12-1972 1 4,237,500 0 0 0
197212241992022002 MKG:24 0 339,000 0
Penata Tk.I-3D 0 2001353872
55 0
15.358.047.7-732.000 4,809,975 0 386,375 0
0 4,423,600
9 H. SUPIANI ,S.KM K -1 4,237,500 0 0 0 0 0 9 .............
2 423,750 0 0 0 0 0
169,500 500,000 289,680 0 53,308
20-09-1973 4 4,830,750 0 0 0
197309201993031005 MKG:24 0 386,460 0
Penata Tk.I-3D 0 2001353899
38 0
15.419.080.5-732.000 5,620,468 0 439,768 0
0 5,180,700
10 SRI HARTATI ,A.Md.Farm TK-0 3,982,600 0 0 0 0 0 10 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 44,826
19-08-1975 1 3,982,600 0 0 0
197508191996032001 MKG:20 0 318,608 0
Penata Tk.I-3D 0 2001355123
14 0
16.061.685.0-732.000 4,555,034 0 363,434 0
0 4,191,600
11 WARSINI ,AMK TK-0 3,628,900 0 0 0 0 0 11 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 41,289
24-06-1979 1 3,628,900 0 0 0
197906242006042008 MKG:14 0 290,312 0
Penata Tk.I-3D 0 2001350188
81 0
16.288.552.9-731.000 4,201,401 0 331,601 0
0 3,869,800
12 ENDAH RESSIA DEWI K -0 2,890,500 0 0 0 0 0 12 .............
0 0 0 0 0 0 0
0 750,000 72,420 0 36,405
13-12-1989 1 2,890,500 0 0 0
198912132019032004 MKG: 3 0 231,240 0
Penata-3C 0 2001370227
25 0
71.711.335.1-732.000 3,712,945 0 267,645 0
0 3,445,300
13 NURUL QAMARIAH ,S.ST JD-0 3,941,400 0 0 0 0 0 13 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 45,414
08-10-1974 1 3,941,400 0 0 0
197410082006042024 MKG:22 0 315,312 0
Penata-3C 0 2001355166
6 0
15.042.269.9-732.000 4,613,826 0 360,726 0
0 4,253,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BATI-BATI
(002) D50500100200005 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 HALIMAH ,S.Kep TK-0 3,481,600 0 0 0 0 0 14 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 40,816
10-06-1981 1 3,481,600 0 0 0
198106102006042027 MKG:14 0 278,528 0
Penata-3C 0 2001334231
24 0
16.232.495.8-732.000 4,154,044 0 319,344 0
0 3,834,700
15 SITI AWWALIAH K -1 3,591,200 0 0 0 0 0 15 .............
0 359,120 0 0 0 0 0
0 500,000 144,840 0 44,503
23-03-1979 2 3,950,320 0 0 0
197903232003122008 MKG:16 0 316,026 0
Penata-3C 0 2001351567
69 0
89.487.447.8-732.000 4,595,229 0 360,529 0
0 4,234,700
16 ASNI FAJRIA FITHRIANUR ,AM.KG TK-0 3,272,200 0 0 0 0 0 16 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
18-06-1986 1 3,272,200 0 0 0
198606182009032012 MKG:11 0 261,776 0
Penata-3C 0 2001319836
78 0
15.871.903.9-732.000 3,844,698 0 299,498 0
0 3,545,200
17 RAUDAH ,AM.KEB K -0 3,272,200 0 0 0 0 0 17 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
26-01-1985 1 3,272,200 0 0 0
198501262010012010 MKG:10 0 261,776 0
Penata-3C 0 2001355077
78 0
16.717.705.4-732.000 3,844,698 0 299,498 0
0 3,545,200
18 SRI WAHYUNI ,AM.KEB K -1 3,781,400 0 0 0 0 0 18 .............
1 378,140 0 0 0 0 0
75,628 265,000 217,260 0 45,002
10-04-1974 3 4,235,168 0 0 0 0
197404102002122009 MKG:22 0 338,813 0
Penata Muda Tk.I-3B 0 2001352361
87 0
16.061.688.4-732.000 4,717,515 0 383,815 0
0 4,333,700
19 SITI YUNITA ANDHINI K -1 3,665,900 0 0 0 0 0 19 .............
2 366,590 0 0 0 0 0
146,636 265,000 289,680 0 44,441
28-06-1975 4 4,179,126 0 0 0
197506282006042010 MKG:20 0 334,330 0
Penata Muda Tk.I-3B 0 2001351478
65 0
16.620.035.2-732.000 4,733,871 0 378,771 0
0 4,355,100
20 ASLAMIAH TK-0 3,665,900 0 0 0 0 0 20 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 39,309
07-03-1976 1 3,665,900 0 0 0 0
197603072005012004 MKG:20 0 293,272 0
Penata Muda Tk.I-3B 0 2001353805
61 0
16.682.528.1-732.000 4,003,381 0 332,581 0
0 3,670,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BATI-BATI
(002) D50500100200005 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 LINA ,A.Md.Keb K -1 3,554,000 0 0 0 0 0 21 .............
2 355,400 0 0 0 0 0
142,160 265,000 289,680 0 43,166
20-02-1978 4 4,051,560 0 0 0
197802202007012010 MKG:18 0 324,125 0
Penata Muda Tk.I-3B 0 2001334107
51 0
16.570.965.0-732.000 4,606,291 0 367,291 0
0 4,239,000
22 NINA RAFI'AH ,AMK K -1 3,139,400 0 0 0 0 0 22 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
05-06-1987 4 3,578,916 0 0 0
198706052010012008 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001322958
56 0
16.114.913.3-732.000 4,133,652 0 324,752 0
0 3,808,900
23 SISNAWATI ,A.Md K -1 3,139,400 0 0 0 0 0 23 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
18-08-1987 4 3,578,916 0 0 0
198708182009032006 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001368748
56 0
88.905.245.2-726.000 4,133,652 0 324,752 0
0 3,808,900
24 MARIATUL HADIAH ,A.Md.Kep K -1 3,043,600 0 0 0 0 0 24 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
25-11-1988 4 3,469,704 0 0 0
198811252011012006 MKG: 9 0 277,576 0
Penata Muda Tk.I-3B 0 2001359037
39 0
16.257.687.0-732.000 4,024,423 0 314,923 0
0 3,709,500
25 YUNIARTI K -1 3,043,600 0 0 0 0 0 25 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
27-06-1989 4 3,469,704 0 0 0
198906272011012006 MKG: 8 0 277,576 0
Penata Muda Tk.I-3B 0 2001745444
39 0
754242097732000 4,024,423 0 314,923 0
0 3,709,500
26 CITRA IRAWAN ,S.Kep.,Ns K -1 2,660,700 0 0 0 0 0 26 .............
1 266,070 0 0 0 0 0
53,214 300,000 217,260 0 32,800
05-03-1992 3 2,979,984 0 0 0
199203052020121015 MKG: 2 0 238,399 0
Penata Muda-3A 0 2001373792
55 0
81.633.356.1-731.000 3,497,299 0 271,199 0
0 3,226,100
SUB TOTAL PERGOLONGAN : III 86,278,800 0 0 0 12,050 0
PEG: 24 3,748,560 0 0 0 0 0
IST: 11 JIWA= 54 1,317,106 10,670,000 3,910,680 0 1,020,145
91,344,466 0 12,050 0
ANK: 19 0 7,307,557 0
1,256 0 0
105,938,452 0 8,339,752
0 97,598,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BATI-BATI
(002) D50500100200005 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
27 SRI RAHAYU ,A.Md.Keb TK-0 2,716,000 0 0 0 0 0 27 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 29,560
10-03-1976 1 2,716,000 0 0 0
197603102010012004 MKG:11 0 217,280 0
Pengatur Tk.I-2D 0 2001346396
20 0
16.309.069.9-732.000 3,028,440 0 246,840 0
0 2,781,600
28 NURAINA PUTRI LESTARI ,A.Md.Farm TK-0 2,474,700 0 0 0 0 0 28 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 27,147
26-08-1996 1 2,474,700 0 0 0
199608262019032010 MKG: 6 0 197,976 0
Pengatur Tk.I-2D 0 2001370661
3 0
85.450.977.5-732.000 2,787,123 0 225,123 0
0 2,562,000
29 SALAMIAH ,A.Md.Keb K -1 2,374,300 0 0 0 0 0 29 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
08-08-1993 3 2,659,216 0 0 0
199308082020122030 MKG: 5 0 212,737 0
Pengatur-2C 0 2001372796
53 0
86.269.082.3-732.000 3,116,529 0 241,729 0
0 2,874,800
30 ASBIANI K -1 2,687,800 0 0 0 0 0 30 .............
2 268,780 180,000 0 0 0 0
107,512 0 289,680 0 32,441
16-12-1975 4 3,064,092 0 0 0
197512162010011002 MKG:13 0 245,127 0
Pengatur-2C 0 2001352353
96 0
16.134.976.6-732.000 3,533,868 0 277,568 0
0 3,256,300
31 FITRIA HAYATI K -1 2,605,800 0 0 0 0 0 31 .............
2 260,580 180,000 0 0 0 0
104,232 0 289,680 0 31,506
05-07-1980 4 2,970,612 0 0 0 0
198007052011012001 MKG:11 0 237,649 0
Pengatur-2C 0 2001359633
63 0
16.098.787.1-731.000 3,440,355 0 269,155 0
0 3,171,200
SUB TOTAL PERGOLONGAN : 12,858,600 0 0 0 0 0
PEG: 5 766,790 360,000 0 0 0 0
IST: 3 JIWA= 13 259,230 720,000 941,460 0 149,646
13,884,620 0 0 0
ANK: 5 0 1,110,769 0
235 0 0
15,906,315 0 1,260,415
0 14,645,900
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BATI-BATI
(002) D50500100200005 BULAN : DESEMBER 2022 HALAMAN : 6

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 107,651,600 0 0 0 45,229 0
PEG: 31 5,366,770 360,000 0 0 0 0
IST: 16 JIWA= 73 1,746,620 13,440,000 5,286,660 0 1,285,650
ANK: 26 114,764,990 0 45,229 0
0 9,181,198 0
0 0
1,598 0 10,512,077
133,898,477
0 123,386,400

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TANJUNG HABULU
(002) D50500100200006 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 NOORHAYATI ,A.Md. Keb JD-0 4,370,900 0 0 0 6,813 0 1 .............
1 0 0 0 0 0 0
87,418 500,000 144,840 0 49,583
19-02-1970 2 4,458,318 0 6,813 0
197002191991012002 MKG:26 0 356,665 0
Penata Tk.I-3D 0 2001323598
90 0
15.478.845.9-732.000 5,110,061 0 413,061 0
0 4,697,000
2 dr, E. ELECTA INGRID ROSELINA K -1 2,890,500 0 0 0 0 0 2 .............
TINAMBUNAN 2 289,050 0 0 0 0 0
115,620 750,000 289,680 0 40,452
06-08-1987 4 3,295,170 0 0 0
198708062019032003 MKG: 2 0 263,614 0
Penata-3C 0 2001370238
16 0
16.483.049.9-732.000 4,334,866 0 304,066 0
0 4,030,800
3 SARBAINI ,A.Md.Kep K -1 3,704,300 0 0 0 0 0 3 .............
2 370,430 0 0 0 0 0
148,172 500,000 289,680 0 47,229
16-07-1976 4 4,222,902 0 0 0
197607101998031004 MKG:18 0 337,832 0
Penata-3C 0 2001319957
79 0
16.514.122.7-732.000 5,012,661 0 385,061 0
0 4,627,600
4 PURNAMAWATI GULTOM ,AMK K -1 3,481,600 0 0 0 0 0 4 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
10-05-1979 4 3,969,024 0 0 0
197905102006042031 MKG:14 0 317,522 0
Penata-3C 0 2001322985
8 0
15.478.640.4-732.000 4,758,712 0 362,212 0
0 4,396,500
5 SITI MAIMUNAH ,AM.Keb K -1 3,375,300 0 0 0 0 0 5 .............
2 337,530 0 0 0 0 0
135,012 500,000 289,680 0 43,478
12-07-1984 4 3,847,842 0 0 0
198407122006042009 MKG:12 0 307,827 0
Penata-3C 0 2001346353
83 0
46.024.102.9-732.000 4,637,605 0 351,305 0
0 4,286,300
6 SISCA HETIUTAMI K -0 2,773,200 0 0 0 0 0 6 .............
0 0 0 0 0 0 0
0 325,000 72,420 0 30,982
21-09-1989 1 2,773,200 0 0 0
198909212019032007 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 2001370203
18 0
66.038.815.8-732.000 3,170,638 0 252,838 0
0 2,917,800
7 MASLIANI ,A.Md.Keb K -1 3,517,200 0 0 0 0 0 7 .............
2 351,720 0 0 0 0 0
140,688 265,000 289,680 0 42,746
21-10-1975 4 4,009,608 0 0 0
197510212006042014 MKG:20 0 320,769 0
Penata Muda-3A 0 2001350385
27 0
16.022.395.4-734.000 4,564,315 0 363,515 0
0 4,200,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TANJUNG HABULU
(002) D50500100200006 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 MARDIANTO ,AMK K -1 2,920,100 0 0 0 0 0 8 .............
2 292,010 0 0 0 0 0
116,804 265,000 289,680 0 35,939
19-08-1984 4 3,328,914 0 0 0
198408192011011004 MKG: 8 0 266,313 0
Penata Muda-3A 0 2001359471
58 0
16.514.120.1-732.000 3,883,652 0 302,252 0
0 3,581,400
9 NADYA MUSTIYANI ,S.Tr.Gz K -1 2,063,520 0 0 0 0 0 9 .............
0 206,352 185,000 0 0 0 0
0 0 144,840 0 24,549
11-12-1996 2 2,269,872 0 0 0
199612112022032004 MKG: 0 0 181,590 0
Penata Muda-3A 0 3200406825
27 0
635825474732000 2,599,739 0 206,139 0
0 2,393,600
SUB TOTAL PERGOLONGAN : III 29,096,620 0 0 0 6,813 0
PEG: 9 2,195,252 185,000 0 0 0 0
IST: 7 JIWA= 29 882,978 3,605,000 2,100,180 0 359,648
32,174,850 0 6,813 0
ANK: 13 0 2,573,988 0
406 0 0
38,072,249 0 2,940,449
0 35,131,800
10 NORHIKMAH IHSANIA ,A.Md.Kep K -1 2,474,700 0 0 0 0 0 10 .............
1 247,470 0 0 0 0 0
49,494 240,000 217,260 0 30,117
07-11-1994 3 2,771,664 0 0 0
199411072019032009 MKG: 6 0 221,733 0
Pengatur Tk.I-2D 0 2001371013
26 0
90.799.663.1-732.000 3,228,950 0 251,850 0
0 2,977,100
11 ANDI IRAWAN MUSTIKA AJI K -1 2,474,700 0 0 0 0 0 11 .............
,A.Md.Far 1 247,470 0 0 0 0 0
49,494 240,000 217,260 0 30,117
18-09-1995 3 2,771,664 0 0 0
199509182019031002 MKG: 6 0 221,733 0
Pengatur Tk.I-2D 0 2001370537
26 0
15.582.991.4-732.000 3,228,950 0 251,850 0
0 2,977,100
12 ABAITI K -1 3,820,000 0 0 0 0 0 12 .............
2 382,000 180,000 0 0 0 0
152,800 0 289,680 0 45,348
04-05-1969 4 4,354,800 0 0 0
196905041989031006 MKG:33 0 348,384 0
Pengatur Tk.I-2D 0 2001350261
52 0
72.502.553.0-732.000 4,824,532 0 393,732 0
0 4,430,800
13 LIA IRAWATI ,AMK K -1 2,374,300 0 0 0 0 0 13 .............
2 237,430 0 0 0 0 0
94,972 240,000 289,680 0 29,467
25-06-1991 4 2,706,702 0 0 0
199106252020122019 MKG: 5 0 216,536 0
Pengatur-2C 0 2001372451
21 0
76.409.356.3-732.000 3,236,403 0 246,003 0
0 2,990,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TANJUNG HABULU
(002) D50500100200006 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 QURROTU A'YUN SUPARDI ,A.Md.AK K -1 2,374,300 0 0 0 0 0 14 .............
2 237,430 0 0 0 0 0
94,972 240,000 289,680 0 29,467
05-01-1992 4 2,706,702 0 0 0
199201052019032009 MKG: 5 0 216,536 0
Pengatur-2C 0 2001370149
21 0
90.833.314.9-732.000 3,236,403 0 246,003 0
0 2,990,400
15 AFRIDA NORLATIPAH ,A.Md.AK K -1 2,374,300 0 0 0 0 0 15 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
28-12-1992 3 2,659,216 0 0 0
199212282020122030 MKG: 5 0 212,737 0
Pengatur-2C 0 2001373768
53 0
85.981.006.1-732.000 3,116,529 0 241,729 0
0 2,874,800
16 AULIA NOOR HAFIZAH ,A.Md.Kg K -1 2,374,300 0 0 0 0 0 16 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
18-02-1995 3 2,659,216 0 0 0
199502182020122026 MKG: 5 0 212,737 0
Pengatur-2C 0 2001372893
53 0
41.120.284.9-732.000 3,116,529 0 241,729 0
0 2,874,800
17 NI WAYAN DESSY SETIARINI TK-0 1,841,440 0 0 0 0 0 17 .............
,A.Md.Keb 0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
19-12-1994 1 1,841,440 0 0 0
199412192022032008 MKG: 3 0 147,315 0
Pengatur-2C 0 3200400614
69 0
538922352732000 2,093,929 0 167,529 0
0 1,926,400
18 LUTHFI FIRMANSYAH ,A.Md.Kes TK-0 1,841,440 0 0 0 0 0 18 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
22-11-1997 1 1,841,440 0 0 0
199711222022031004 MKG: 3 0 147,315 0
Pengatur-2C 0 3200406086
69 0
637273954732000 2,093,929 0 167,529 0
0 1,926,400
SUB TOTAL PERGOLONGAN : 21,949,480 0 0 0 0 0
PEG: 9 1,826,660 540,000 0 0 0 0
IST: 7 JIWA= 26 536,704 1,440,000 1,882,920 0 262,928
24,312,844 0 0 0
ANK: 10 0 1,945,026 0
390 0 0
28,176,154 0 2,207,954
0 25,968,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TANJUNG HABULU
(002) D50500100200006 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 51,046,100 0 0 0 6,813 0
PEG: 18 4,021,912 725,000 0 0 0 0
IST: 14 JIWA= 55 1,419,682 5,045,000 3,983,100 0 622,576
ANK: 23 56,487,694 0 6,813 0
0 4,519,014 0
0 0
796 0 5,148,403
66,248,403
0 61,100,000

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAJAU PECAH
(002) D50500100200007 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 YATRIPINA ,S.Farm, Apt K -1 3,205,500 0 0 0 0 0 1 .............
2 320,550 0 0 0 0 0
128,220 750,000 289,680 0 44,043
25-01-1988 4 3,654,270 0 0 0
198801252015022003 MKG: 6 0 292,342 0
Penata Tk.I-3D 0 2001369361
35 0
16.407.596.2-732.000 4,693,985 0 336,385 0
0 4,357,600
2 MUSLIM ,AM.KEP K -1 4,508,600 0 0 0 0 0 2 .............
2 450,860 0 0 0 0 0
180,344 500,000 289,680 0 56,398
27-02-1969 4 5,139,804 0 0 0
196902271989031013 MKG:28 0 411,184 0
Penata Tk.I-3D 0 2001346337
98 0
78.345.721.1-732.000 5,929,582 0 467,582 0
0 5,462,000
3 NUR IZZATUSSA'ADAH TK-0 4,108,100 0 0 0 0 0 3 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 46,081
12-02-1972 1 4,108,100 0 0 0
197202121994032007 MKG:22 0 328,648 0
Penata Tk.I-3D 0 2001369687
9 0
15.758.655.3-732.000 4,680,529 0 374,729 0
0 4,305,800
4 EDY SISKOWANTO K -1 4,108,100 0 0 0 0 0 4 .............
1 410,810 0 0 0 0 0
82,162 500,000 217,260 0 51,011
05-09-1974 3 4,601,072 0 0 0
197409051994031008 MKG:22 0 368,086 0
Penata Tk.I-3D 0 2001335254
65 0
16.000.867.8-732.000 5,318,397 0 419,097 0
0 4,899,300
5 BODRO WIYONO ,AMK K -1 3,861,000 0 0 0 0 0 5 .............
2 386,100 0 0 0 0 0
154,440 500,000 289,680 0 49,015
20-07-1978 4 4,401,540 0 0 0
197807201998031003 MKG:18 0 352,123 0
Penata Tk.I-3D 0 2001345594
18 0
16.482.804.8-732.000 5,191,238 0 401,138 0
0 4,790,100
6 BERTA LIANAWATI ,AMK K -1 3,628,900 0 0 0 0 0 6 .............
2 362,890 0 0 0 0 0
145,156 500,000 289,680 0 46,369
17-09-1981 4 4,136,946 0 0 0
198109172005012010 MKG:14 0 330,956 0
Penata Tk.I-3D 0 2001344946
99 0
15.582.991.4-732.000 4,926,725 0 377,325 0
0 4,549,400
7 drg, AUGUST ROMDHONY TK-0 3,172,300 0 0 0 0 0 7 .............
0 0 0 0 0 0 0
0 750,000 72,420 0 39,223
10-08-1978 1 3,172,300 0 0 0
197808102014111001 MKG: 8 0 253,784 0
Penata-3C 0 2001369469
87 0
15.711.283.0-942.000 3,994,807 0 293,007 0
0 3,701,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAJAU PECAH
(002) D50500100200007 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 FARIDAH IRIANI ,SKM TK-0 3,375,300 0 0 0 0 0 8 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 39,753
11-02-1981 1 3,375,300 0 0 0
198102112009032007 MKG:12 0 270,024 0
Penata-3C 0 2001344539
57 0
15.121.501.9-732.000 4,047,777 0 309,777 0
0 3,738,000
9 SLAMET SUTOPO K -1 4,325,600 0 0 0 0 0 9 .............
2 432,560 0 0 0 0 0
173,024 500,000 289,680 0 54,312
25-04-1967 4 4,931,184 0 0 0
196704251989031010 MKG:28 0 394,495 0
Penata-3C 0 2001344504
43 0
15.250.902.2-732.000 5,720,907 0 448,807 0
0 5,272,100
10 SUMARTINI ,A.Md.Keb K -1 4,065,500 0 0 0 0 0 10 .............
1 406,550 0 0 0 0 0
81,310 500,000 217,260 0 50,534
04-09-1971 3 4,553,360 0 0 0
197109041993022001 MKG:24 0 364,269 0
Penata-3C 0 2001345144
83 0
15.548.926.3-732.000 5,270,703 0 414,803 0
0 4,855,900
11 ROHMIATUN ,AMK K -1 3,481,600 0 0 0 0 0 11 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
06-08-1979 4 3,969,024 0 0 0
197908062007012014 MKG:14 0 317,522 0
Penata-3C 0 2001344393
8 0
57.822.795.1-732.000 4,758,712 0 362,212 0
0 4,396,500
12 SRI ASTUTI ,AM,KEP K -0 3,481,600 0 0 0 0 0 12 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 39,816
13-03-1985 1 3,481,600 0 0 0
198503132006042007 MKG:14 0 278,528 0
Penata-3C 0 2001322101
24 0
16.282.251.4-732.000 4,054,044 0 318,344 0
0 3,735,700
13 RIRY PAMUJU NORMANTI ,A.MA.K TK-0 3,375,300 0 0 0 0 0 13 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 38,753
24-04-1985 1 3,375,300 0 0 0 0
198504242005012002 MKG:12 0 270,024 0
Penata-3C 0 2001349708
57 0
57.822.823.1-732.000 3,947,777 0 308,777 0
0 3,639,000
14 BENI MAULANA ,S.Kep,N.s K -1 3,375,300 0 0 0 0 0 14 .............
2 337,530 185,000 0 0 0 0
135,012 0 289,680 0 40,328
11-05-1985 4 3,847,842 0 0 0
198505112010011012 MKG:12 0 307,827 0
Penata-3C 0 2001345608
33 0
16.232.392.7-732.000 4,322,555 0 348,155 0
0 3,974,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAJAU PECAH
(002) D50500100200007 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
15 AMIN NUR ROHMAN ,AMK TK-0 3,139,400 0 0 0 0 0 15 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 34,394
18-11-1978 1 3,139,400 0 0 0
197811182010011008 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001345004
26 0
15.478.523.2-732.000 3,511,846 0 285,546 0
0 3,226,300
16 ENDANG SUSILAWATI K -1 3,665,900 0 0 0 0 0 16 .............
1 366,590 0 0 0 0 0
73,318 265,000 217,260 0 43,708
07-03-1976 3 4,105,808 0 0 0
197603072007012013 MKG:20 0 328,465 0
Penata Muda Tk.I-3B 0 2001345748
5 0
57.822.792.8-732.000 4,588,073 0 372,173 0
0 4,215,900
17 IKHA ROSSELAWATI TK-0 3,665,900 0 0 0 0 0 17 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 39,309
14-12-1976 1 3,665,900 0 0 0 0
197612142006042014 MKG:20 0 293,272 0
Penata Muda Tk.I-3B 0 2001345462
61 0
57.822.808.2-732.000 4,003,381 0 332,581 0
0 3,670,800
18 NURSIAH K -1 3,665,900 0 0 0 0 0 18 .............
1 366,590 0 0 0 0 0
73,318 265,000 217,260 0 43,708
22-03-1978 3 4,105,808 0 0 0 0
197803222007012009 MKG:20 0 328,465 0
Penata Muda Tk.I-3B 0 2001345241
5 0
57.822.801.7-732.000 4,588,073 0 372,173 0
0 4,215,900
19 SUHERNI ,A.Md.Keb K -1 3,554,000 0 0 0 0 0 19 .............
0 355,400 0 0 0 0 0
0 265,000 144,840 0 41,744
26-09-1978 2 3,909,400 0 0 0
197809262005012008 MKG:18 0 312,752 0
Penata Muda Tk.I-3B 0 2001345233
56 0
57.822.804.1-732.000 4,319,296 0 354,496 0
0 3,964,800
20 EKA PUTRI YUNANDA ,AMK TK-0 3,043,600 0 0 0 0 0 20 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,086
18-08-1989 1 3,043,600 0 0 0
198908182011012002 MKG: 8 0 243,488 0
Penata Muda Tk.I-3B 0 2001359552
54 0
15.767.254.4-732.000 3,381,074 0 276,574 0
0 3,104,500
21 WIDARYO DD-0 4,280,800 0 0 0 0 0 21 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 44,658
24-11-1965 1 4,280,800 0 0 0
196511241986031010 MKG:30 0 342,464 0
Penata Muda Tk.I-3B 0 2001345322
2 0
14.089.411.4-732.000 4,538,222 0 387,122 0
0 4,151,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAJAU PECAH
(002) D50500100200007 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
22 dr, AULIA CHAYA KUSUMA K -0 2,773,200 0 0 0 0 0 22 .............
0 0 0 0 0 0 0
0 0 72,420 0 27,732
29-09-1992 1 2,773,200 0 0 0
199209292019032006 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 007.03.28.06730.0
68 0
76.485.054.1-657.000 2,845,688 0 249,588 0
0 2,596,100
23 dr, DWI SRIHANDAYANI TK-0 2,150,800 0 0 0 0 0 23 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
08-07-1988 1 2,150,800 0 0 0
198807082022032001 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200405411
2 0
759778483731000 2,408,222 0 195,422 0
0 2,212,800
24 LUTHFI RIJALI NOOR D ,S.Kep.Ners K -1 2,660,700 0 0 0 0 0 24 .............
1 266,070 0 0 0 0 0
53,214 300,000 217,260 0 32,800
04-08-1992 3 2,979,984 0 0 0
199208042020121015 MKG: 2 0 238,399 0
Penata Muda-3A 0 2001372397
55 0
81.284.849.7-732.000 3,497,299 0 271,199 0
0 3,226,100
25 NIDYA RAHMAH ,S.Si.T K -1 2,660,700 0 0 0 0 0 25 .............
0 266,070 0 0 0 0 0
0 300,000 144,840 0 32,268
16-09-1994 2 2,926,770 0 0 0
199409162020122018 MKG: 2 0 234,142 0
Penata Muda-3A 0 2001372915
0 0
95.945.455.4-735.000 3,371,610 0 266,410 0
0 3,105,200
26 MITA DWI LESTINA ,S.Gz TK-0 2,063,520 0 0 0 0 0 26 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 22,485
23-07-1997 1 2,063,520 0 0 0
199707232022032010 MKG: 0 0 165,082 0
Penata Muda-3A 0 3200407872
27 0
539192021734000 2,320,967 0 187,567 0
0 2,133,400
27 AULIA MULYA ,S.Tr.Kes K -1 2,063,520 0 0 0 0 0 27 .............
0 206,352 185,000 0 0 0 0
0 0 144,840 0 24,549
13-10-1997 2 2,269,872 0 0 0
199710132022032007 MKG: 0 0 181,590 0
Penata Muda-3A 0 3200406981
27 0
637282898732000 2,599,739 0 206,139 0
0 2,393,600
SUB TOTAL PERGOLONGAN : III 91,460,640 0 0 0 0 0
PEG: 27 5,283,082 925,000 0 0 0 0
IST: 15 JIWA= 61 1,418,782 9,325,000 4,417,620 0 1,084,125
98,162,504 0 0 0
ANK: 19 0 7,853,003 0
1,104 0 0
112,831,228 0 8,937,128
0 103,894,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAJAU PECAH
(002) D50500100200007 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
28 NENENG SUHARNI TK-0 2,980,800 0 0 0 0 0 28 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 32,208
08-05-1979 1 2,980,800 0 0 0 0
197905082008012024 MKG:17 0 238,464 0
Pengatur Tk.I-2D 0 2001345478
52 0
57.822.814.0-732.000 3,293,272 0 270,672 0
0 3,022,600
29 RINI SAPTARI MUFIDAH ,AM.Keb K -1 2,980,800 0 0 0 0 0 29 .............
2 298,080 0 0 0 0 0
119,232 240,000 289,680 0 36,381
30-01-1988 4 3,398,112 0 0 0
198801302017042003 MKG:17 0 271,849 0
Pengatur Tk.I-2D 0 2001369768
38 0
16.001.078.1-732.000 3,927,830 0 308,230 0
0 3,619,600
30 HILDA PUTRI AWALIA ,AM.Keb TK-0 2,889,800 0 0 0 0 0 30 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 31,298
02-11-1988 1 2,889,800 0 0 0
198811022017042001 MKG:15 0 231,184 0
Pengatur Tk.I-2D 0 2001369698
62 0
66.491.453.8-732.000 3,202,282 0 262,482 0
0 2,939,800
31 FATHUL JANNAH FITRIANI ,Am.Keb K -1 2,801,500 0 0 0 0 0 31 .............
1 280,150 0 0 0 0 0
56,030 240,000 217,260 0 33,777
28-03-1988 3 3,137,680 0 0 0
198803282017042005 MKG:13 0 251,014 0
Pengatur Tk.I-2D 0 2001369507
51 0
16.455.691.2-733.000 3,594,991 0 284,791 0
0 3,310,200
32 ANITA FITRIANI ,AM.Keb K -1 2,801,500 0 0 0 0 0 32 .............
2 280,150 0 0 0 0 0
112,060 240,000 289,680 0 34,337
26-05-1990 4 3,193,710 0 0 0
199005262017042001 MKG:13 0 255,497 0
Pengatur Tk.I-2D 0 2001369377
44 0
76.948.212.6-732.000 3,723,434 0 289,834 0
0 3,433,600
33 NUNI PUSPITA SARI ,A.Md.Keb K -1 2,474,700 0 0 0 0 0 33 .............
0 247,470 0 0 0 0 0
0 240,000 144,840 0 29,622
03-09-1994 2 2,722,170 0 0 0
199409032019032008 MKG: 6 0 217,774 0
Pengatur Tk.I-2D 0 2001370653
86 0
81.690.706.7-732.000 3,107,096 0 247,396 0
0 2,859,700
34 EKO SUPIYANTORO K -1 2,687,800 0 0 0 0 0 34 .............
0 268,780 0 0 0 0 0
0 240,000 144,840 0 31,966
14-07-1976 2 2,956,580 0 0 0 0
197607142009031004 MKG:13 0 236,526 0
Pengatur-2C 0 2001344865
72 0
15.582.513.6-732.000 3,341,492 0 268,492 0
0 3,073,000
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAJAU PECAH
(002) D50500100200007 BULAN : DESEMBER 2022 HALAMAN : 6

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
35 NUR LAILI ,A.Md.AK K -1 1,841,440 0 0 0 0 0 35 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
07-08-1994 3 2,062,413 0 0 0
199408072022032006 MKG: 3 0 164,993 0
Pengatur-2C 0 3200399877
44 0
937575488732000 2,459,717 0 187,417 0
0 2,272,300
36 UNTUNG ADI WARSETO ,A.Md.Gz K -1 1,841,440 0 0 0 0 0 36 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
13-04-1995 3 2,062,413 0 0 0
199504132022031006 MKG: 3 0 164,993 0
Pengatur-2C 0 3200400371
44 0
831534326732000 2,459,717 0 187,417 0
0 2,272,300
37 MISDAWATI ,A.Md.Kes TK-0 1,841,440 0 0 0 0 0 37 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
04-03-1999 1 1,841,440 0 0 0
199903042022032001 MKG: 3 0 147,315 0
Pengatur-2C 0 3200405772
69 0
411340698732000 2,093,929 0 167,529 0
0 1,926,400
SUB TOTAL PERGOLONGAN : 25,141,220 0 0 0 0 0
PEG: 10 1,742,918 540,000 0 0 0 0
IST: 7 JIWA= 24 360,980 1,680,000 1,738,080 0 294,651
27,245,118 0 0 0
ANK: 7 0 2,179,609 0
562 0 0
31,203,760 0 2,474,260
0 28,729,500
TOTAL PER SATKER 116,601,860 0 0 0 0 0
PEG: 37 7,026,000 1,465,000 0 0 0 0
IST: 22 JIWA= 85 1,779,762 11,005,000 6,155,700 0 1,378,776
ANK: 26 125,407,622 0 0 0
0 10,032,612 0
0 0
1,666 0 11,411,388
144,034,988
0 132,623,600

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS ASAM-ASAM
(002) D50500100200008 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 dr, H. ADI HARTONO K -1 4,798,300 0 0 0 36,346 0 1 .............
2 479,830 0 0 0 0 0
191,932 1,200,000 289,680 0 66,701
19-09-1967 4 5,470,062 0 36,346 0
196709192002121005 MKG:24 0 437,605 0
Pembina Utama Muda-4C 0 2001343036
64 0
05.980.361.9-732.000 6,996,152 0 540,652 0
0 6,455,500
2 DR, M.LUFTILAH ROMALI K -1 3,901,500 0 0 0 0 0 2 .............
2 390,150 0 0 0 0 0
156,060 1,200,000 289,680 0 56,477
03-05-1971 4 4,447,710 0 0 0
197105032005011008 MKG:16 0 355,817 0
Pembina-4A 0 2001345705
4 0
14.314.162.0-731.000 5,937,394 0 412,294 0
0 5,525,100
3 drg, ERLINA DYAH WULANDARI K -1 3,782,400 0 0 0 0 0 3 .............
2 378,240 0 0 0 0 0
151,296 1,200,000 289,680 0 55,119
28-02-1981 4 4,311,936 0 0 0
198102282009032007 MKG:14 0 344,955 0
Pembina-4A 0 2001349603
58 0
26.638.104.5-732.000 5,801,674 0 400,074 0
0 5,401,600
4 H. AGUS SUTRISNO ,S.Kep K -1 4,699,300 0 0 0 0 0 4 .............
2 469,930 0 0 0 0 0
187,972 500,000 289,680 0 58,572
17-08-1968 4 5,357,202 0 0 0
196808171988031008 MKG:28 0 428,576 0
Pembina-4A 0 2001357088
66 0
15.767.453.2-732.000 6,146,948 0 487,148 0
0 5,659,800
SUB TOTAL PERGOLONGAN : IV 17,181,500 0 0 0 36,346 0
PEG: 4 1,718,150 0 0 0 0 0
IST: 4 JIWA= 16 687,260 4,100,000 1,158,720 0 236,869
19,586,910 0 36,346 0
ANK: 8 0 1,566,953 0
192 0 0
24,882,168 0 1,840,168
0 23,042,000
5 MARLIANI ,SKM K -0 3,410,600 0 0 0 0 0 5 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 40,106
11-07-1986 1 3,410,600 0 0 0
198607112011012008 MKG:11 0 272,848 0
Penata Tk.I-3D 0 2001364009
34 0
57.822.626.8-732.000 4,083,054 0 312,954 0
0 3,770,100
6 Hj. ISMAWATI ,AM.Keb TK-0 4,370,900 0 0 0 0 0 6 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 48,709
12-05-1969 1 4,370,900 0 0 0
196905121990032010 MKG:26 0 349,672 0
Penata Tk.I-3D 0 2001345543
61 0
16.282.276.1-732.000 4,943,381 0 398,381 0
0 4,545,000
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS ASAM-ASAM
(002) D50500100200008 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
7 Hj. NORKAMILAH ,A.Md.Keb TK-0 4,370,900 0 0 0 0 0 7 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 48,709
05-11-1969 1 4,370,900 0 0 0
196911051991012004 MKG:26 0 349,672 0
Penata Tk.I-3D 0 2001357452
61 0
15.767.454.0-732.000 4,943,381 0 398,381 0
0 4,545,000
8 KASPUL ANWAR ,AM.KEP K -1 4,370,900 0 0 0 0 0 8 .............
1 437,090 0 0 0 0 0
87,418 500,000 217,260 0 53,954
10-12-1970 3 4,895,408 0 0 0 0
197012101991011002 MKG:26 0 391,633 0
Penata Tk.I-3D 0 2001357096
19 0
16.001.023.7-732.000 5,612,687 0 445,587 0
0 5,167,100
9 SULASTRI K -1 4,237,500 0 0 0 0 0 9 .............
1 423,750 0 0 0 0 0
84,750 500,000 217,260 0 52,460
15-05-1974 3 4,746,000 0 0 0
197405151993022002 MKG:24 0 379,680 0
Penata Tk.I-3D 0 2001356618
80 0
16.000.932.0-732.000 5,463,340 0 432,140 0
0 5,031,200
10 HAIRUNNISA ,S.ST K -0 3,821,000 0 0 0 0 0 10 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 44,210
14-03-1977 1 3,821,000 0 0 0
197703142005012007 MKG:20 0 305,680 0
Penata-3C 0 2001356917
70 0
15.582.991.4-732.000 4,493,490 0 349,890 0
0 4,143,600
11 ERDAYANI ,AMd.Keb K -0 3,941,400 0 0 0 0 0 11 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 44,414
08-10-1976 1 3,941,400 0 0 0
197610082000032006 MKG:22 0 315,312 0
Penata-3C 0 2001357118
6 0
16.000.936.1-732.000 4,513,826 0 359,726 0
0 4,154,100
12 DEWI ERAWATI ,AMK TK-0 3,591,200 0 0 0 0 0 12 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 40,912
31-03-1981 1 3,591,200 0 0 0
198103312006042021 MKG:16 0 287,296 0
Penata-3C 0 2001356391
88 0
15.042.016.4-732.000 4,163,708 0 328,208 0
0 3,835,500
13 SUBARJO ,AMK K -1 3,481,600 0 0 0 0 0 13 .............
1 348,160 0 0 0 0 0
69,632 500,000 217,260 0 43,994
18-02-1975 3 3,899,392 0 0 0
197502182005011005 MKG:14 0 311,951 0
Penata-3C 0 2001356294
93 0
15.358.163.2-732.000 4,616,745 0 355,945 0
0 4,260,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS ASAM-ASAM
(002) D50500100200008 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 RAUDHATUL JANNAH ,AMG K -1 3,481,600 0 0 0 0 0 14 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
08-07-1982 4 3,969,024 0 0 0
198207082005012008 MKG:14 0 317,522 0
Penata-3C 0 2001355972
8 0
15.154.286.7-732.000 4,758,712 0 362,212 0
0 4,396,500
15 SRI SUMARTINI ,AMD K -1 3,272,200 0 0 0 0 0 15 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
26-03-1987 4 3,730,308 0 0 0
198703262009032004 MKG:11 0 298,425 0
Penata-3C 0 2001345907
40 0
16.125.376.0-732.000 4,520,028 0 340,728 0
0 4,179,300
16 ISMANIAR WAHYUNI MAKMUR ,AM.KEB K -1 3,272,200 0 0 0 0 0 16 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
19-08-1980 4 3,730,308 0 0 0
198008192010012012 MKG:10 0 298,425 0
Penata-3C 0 2001356456
40 0
15.478.707.1-732.000 4,520,028 0 340,728 0
0 4,179,300
17 SUGIARTI ,AMd.Keb K -1 3,043,600 0 0 0 0 0 17 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
12-07-1988 4 3,469,704 0 0 0
198807122011012006 MKG: 8 0 277,576 0
Penata Muda Tk.I-3B 0 2001362065
39 0
57.822.268.9-732.000 4,024,423 0 314,923 0
0 3,709,500
18 NORALISA NOVITA S ,AM.Keb K -0 3,554,000 0 0 0 0 0 18 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 37,390
03-08-1975 1 3,554,000 0 0 0
197508032007012015 MKG:18 0 284,320 0
Penata Muda Tk.I-3B 0 2001343044
90 0
16.571.139.1-732.000 3,811,510 0 321,710 0
0 3,489,800
19 FAUZI MUSLIMIN K -1 3,106,900 0 0 0 0 0 19 .............
2 310,690 0 0 0 0 0
124,276 265,000 289,680 0 38,069
12-10-1981 4 3,541,866 0 0 0 0
198110122007011007 MKG:12 0 283,349 0
Penata Muda-3A 0 2001356383
72 0
16.407.587.1-732.000 4,096,618 0 321,418 0
0 3,775,200
20 RINA KURNIAWATI ,AMK K -1 2,920,100 0 0 0 0 0 20 .............
2 292,010 0 0 0 0 0
116,804 265,000 289,680 0 35,939
11-10-1982 4 3,328,914 0 0 0
198210112011012004 MKG: 8 0 266,313 0
Penata Muda-3A 0 2001369302
58 0
16.183.747.1-732.000 3,883,652 0 302,252 0
0 3,581,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS ASAM-ASAM
(002) D50500100200008 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
SUB TOTAL PERGOLONGAN : III 58,246,600 0 0 0 0 0
PEG: 16 3,118,660 185,000 0 0 0 0
IST: 9 JIWA= 40 1,005,664 6,995,000 2,896,800 0 695,509
62,370,924 0 0 0
ANK: 15 0 4,989,674 0
859 0 0
72,448,583 0 5,685,183
0 66,763,400
21 SANTI HANDAYANI ,AM.KG JD-0 2,980,800 0 0 0 0 0 21 .............
2 0 0 0 0 0 0
119,232 240,000 217,260 0 33,400
09-12-1980 3 3,100,032 0 0 0
198012092007012013 MKG:17 0 248,003 0
Pengatur Tk.I-2D 0 2001357487
11 0
163089782732000 3,557,303 0 281,403 0
0 3,275,900
22 LINA ERLIANI ,AMK K -0 2,474,700 0 0 0 0 0 22 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 27,147
23-12-1990 1 2,474,700 0 0 0
199012232019032009 MKG: 6 0 197,976 0
Pengatur Tk.I-2D 0 2001370556
3 0
90.799.774.6-732.000 2,787,123 0 225,123 0
0 2,562,000
23 ARDIANSYAH ,A.Md. RMIK K -1 2,374,300 0 0 0 0 0 23 .............
0 237,430 0 0 0 0 0
0 360,000 144,840 0 29,717
11-11-1988 2 2,611,730 0 0 0
198811112020121013 MKG: 5 0 208,938 0
Pengatur-2C 0 2001372548
85 0
73.214.549.5-711.000 3,116,655 0 238,655 0
0 2,878,000
24 YULI ASTUTI ANGGREINI K -1 3,042,800 0 0 0 0 0 24 .............
2 304,280 0 0 0 0 0
121,712 240,000 289,680 0 37,088
03-07-1981 4 3,468,792 0 0 0
198107032014062004 MKG:21 0 277,503 0
Pengatur-2C 0 2001369148
19 0
14.735.822.4-732.000 3,998,491 0 314,591 0
0 3,683,900
25 FATMAWATI ,A.Md. Keb K -1 2,374,300 0 0 0 0 0 25 .............
2 237,430 0 0 0 0 0
94,972 240,000 289,680 0 29,467
17-03-1991 4 2,706,702 0 0 0
199103172020122016 MKG: 5 0 216,536 0
Pengatur-2C 0 2001373253
21 0
96.990.772.4-732.000 3,236,403 0 246,003 0
0 2,990,400
26 PUTRI NOVITA WAHYUNI ,A.Md.Kep TK-0 1,841,440 0 0 0 0 0 26 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
06-11-1994 1 1,841,440 0 0 0
199411062022032006 MKG: 3 0 147,315 0
Pengatur-2C 0 3200406973
69 0
802696013732000 2,093,929 0 167,529 0
0 1,926,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS ASAM-ASAM
(002) D50500100200008 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
27 ADELIA MAULIDA ,A.Md.Kes TK-0 1,841,440 0 0 0 0 0 27 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
02-08-1998 1 1,841,440 0 0 0
199808022022032007 MKG: 3 0 147,315 0
Pengatur-2C 0 3200408054
69 0
933654311734000 2,093,929 0 167,529 0
0 1,926,400
28 FAHLINA K -1 2,660,000 0 0 0 0 0 28 .............
1 266,000 0 0 0 0 0
53,200 240,000 217,260 0 32,192
29-08-1980 3 2,979,200 0 0 0 0
198008292006042009 MKG:15 0 238,336 0
Pengatur Muda Tk.I-2B 0 2001344261
68 0
16.483.052.3-732.000 3,436,528 0 270,528 0
0 3,166,000
SUB TOTAL PERGOLONGAN : 19,589,780 0 0 0 0 0
PEG: 8 1,045,140 360,000 0 0 0 0
IST: 4 JIWA= 19 389,116 1,560,000 1,375,980 0 229,439
21,024,036 0 0 0
ANK: 7 0 1,681,922 0
345 0 0
24,320,361 0 1,911,361
0 22,409,000
TOTAL PER SATKER 95,017,880 0 0 0 36,346 0
PEG: 28 5,881,950 545,000 0 0 0 0
IST: 17 JIWA= 75 2,082,040 12,655,000 5,431,500 0 1,161,817
ANK: 30 102,981,870 0 36,346 0
0 8,238,549 0
0 0
1,396 0 9,436,712
121,651,112
0 112,214,400

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS JORONG
(002) D50500100200009 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 drg, YULIA TAN ,MM K -1 4,066,500 0 0 0 0 0 1 .............
2 406,650 0 0 0 0 0
162,660 1,200,000 289,680 0 58,358
04-06-1974 4 4,635,810 0 0 0
197406042005012010 MKG:16 0 370,865 0
Pembina Tk.I-4B 0 2001344277
33 0
15.042.265.7-732.000 6,125,523 0 429,223 0
0 5,696,300
SUB TOTAL PERGOLONGAN : IV 4,066,500 0 0 0 0 0
PEG: 1 406,650 0 0 0 0 0
IST: 1 JIWA= 4 162,660 1,200,000 289,680 0 58,358
4,635,810 0 0 0
ANK: 2 0 370,865 0
33 0 0
6,125,523 0 429,223
0 5,696,300
2 dr, JAUHARI RAHMANI K -1 3,518,100 0 0 0 0 0 2 .............
2 351,810 0 0 0 0 0
140,724 750,000 289,680 0 47,606
30-01-1984 4 4,010,634 0 0 0
198401302010011003 MKG:12 0 320,851 0
Penata Tk.I-3D 0 2001346318
43 0
15.042.291.3-732.000 5,050,357 0 368,457 0
0 4,681,900
3 dr, EFFI ULY DERMAWATY SARAGIH K -1 3,410,600 0 0 0 0 0 3 .............
0 341,060 0 0 0 0 0
0 750,000 144,840 0 45,017
06-04-1984 2 3,751,660 0 0 0
198404062014112001 MKG:10 0 300,133 0
Penata Tk.I-3D 0 2001362588
50 0
66.420.544.0-732.000 4,646,550 0 345,150 0
0 4,301,400
4 HERLIANSYAH, AMKL K -1 4,508,600 0 0 0 0 0 4 .............
1 450,860 0 0 0 0 0
90,172 500,000 217,260 0 55,496
25-05-1968 3 5,049,632 0 0 0
196805251989031011 MKG:28 0 403,971 0
Penata Tk.I-3D 0 2001356979
75 0
16.000.935.3-732.000 5,766,967 0 459,467 0
0 5,307,500
5 ANIK NURHAYATI ,AM.KEB TK-0 4,508,600 0 0 0 5,642 0 5 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 50,086
23-08-1969 1 4,508,600 0 5,642 0
196908231989022001 MKG:28 0 360,688 0
Penata Tk.I-3D 0 2001346361
54 0
15.478.657.8-732.000 5,086,716 0 416,416 0
0 4,670,300
6 NORMA BAKTI TK-0 4,508,600 0 0 0 5,642 0 6 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 50,086
09-05-1970 1 4,508,600 0 5,642 0 0
197005091989032001 MKG:28 0 360,688 0
Penata Tk.I-3D 0 2001357177
54 0
15.582.991.4-732.000 5,086,716 0 416,416 0
0 4,670,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS JORONG
(002) D50500100200009 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
7 MUHAMMAD RIFKIE ,AMK K -1 4,370,900 0 0 0 0 0 7 .............
2 437,090 0 0 0 0 0
174,836 500,000 289,680 0 54,828
16-08-1969 4 4,982,826 0 0 0
196908161990031015 MKG:26 0 398,626 0
Penata Tk.I-3D 0 2001346388
48 0
15.478.838.4-732.000 5,772,554 0 453,454 0
0 5,319,100
8 DAHLINA K -1 4,108,100 0 0 0 0 0 8 .............
2 410,810 0 0 0 0 0
164,324 500,000 289,680 0 51,832
04-03-1973 4 4,683,234 0 0 0
197303041994032005 MKG:22 0 374,659 0
Penata Tk.I-3D 0 2001346377
77 0
16.571.033.6-732.000 5,472,991 0 426,491 0
0 5,046,500
9 MULIANSYAH K -1 3,982,600 0 0 0 0 0 9 .............
2 398,260 0 0 0 0 0
159,304 500,000 289,680 0 50,402
05-08-1974 4 4,540,164 0 0 0
197408051997021002 MKG:20 0 363,213 0
Penata Tk.I-3D 0 2001346442
71 0
15.582.577.1-732.000 5,329,915 0 413,615 0
0 4,916,300
10 MUHAMMAD SURYA DHARMA ,AMK K -1 3,821,000 0 0 0 0 0 10 .............
2 382,100 0 0 0 0 0
152,840 265,000 289,680 0 46,209
07-09-1976 4 4,355,940 0 0 0
197609071996031003 MKG:20 0 348,475 0
Penata-3C 0 2001346434
64 0
15.767.200.7-732.000 4,910,684 0 394,684 0
0 4,516,000
11 apt, MEGA PERMATA SARI ,S. Farm TK-0 2,688,500 0 0 0 0 0 11 .............
0 0 0 0 0 0 0
0 325,000 72,420 0 30,135
03-10-1994 1 2,688,500 0 0 0
199410032020122016 MKG: 1 0 215,080 0
Penata Muda Tk.I-3B 0 2001372508
95 0
85.461.840.2-732.000 3,086,015 0 245,215 0
0 2,840,800
12 BUDIARTI ,AM.KEB TK-0 3,554,000 0 0 0 0 0 12 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 38,190
18-08-1977 1 3,554,000 0 0 0 0
197708182005012009 MKG:18 0 284,320 0
Penata Muda Tk.I-3B 0 2001335548
90 0
15.042.470.3-732.000 3,891,510 0 322,510 0
0 3,569,000
13 ISNAWATI K -1 3,554,000 0 0 0 0 0 13 .............
2 355,400 0 0 0 0 0
142,160 265,000 289,680 0 43,166
01-12-1978 4 4,051,560 0 0 0 0
197812012005012010 MKG:18 0 324,125 0
Penata Muda Tk.I-3B 0 2001356324
51 0
16.571.021.1-732.000 4,606,291 0 367,291 0
0 4,239,000
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS JORONG
(002) D50500100200009 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 FITRIA DAHLIANI DEWI ,AMK TK-0 3,139,400 0 0 0 0 0 14 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
13-11-1983 1 3,139,400 0 0 0
198311132009032008 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001346407
76 0
16.571.133.4-732.000 3,476,896 0 285,196 0
0 3,191,700
15 EUNIKE EGASARI ,AMD TK-0 3,139,400 0 0 0 0 0 15 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
31-05-1987 1 3,139,400 0 0 0
198705312009032010 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001345519
76 0
57.822.800.9-731.000 3,476,896 0 285,196 0
0 3,191,700
16 NENENG MURNIA SARI ,AM.Keb K -0 3,139,400 0 0 0 0 0 16 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
28-09-1987 1 3,139,400 0 0 0
198709282010012009 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001359943
76 0
57.822.807.4-732.000 3,476,896 0 285,196 0
0 3,191,700
17 TRI EVA MANDASARI ,AM.Keb TK-0 3,043,600 0 0 0 0 0 17 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,086
25-05-1988 1 3,043,600 0 0 0
198805252011012010 MKG: 9 0 243,488 0
Penata Muda Tk.I-3B 0 2001369183
54 0
16.360.323.6-731.000 3,381,074 0 276,574 0
0 3,104,500
18 NANI IVANA ,AMK K -0 3,340,300 0 0 0 0 0 18 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 35,803
21-04-1984 1 3,340,300 0 0 0
198404212006042023 MKG:14 0 267,224 0
Penata Muda Tk.I-3B 0 2001346458
7 0
46.018.131.6-732.000 3,652,727 0 303,027 0
0 3,349,700
19 ARIFIAH YANIATI TK-0 4,280,800 0 0 0 0 0 19 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 44,658
05-06-1965 1 4,280,800 0 0 0
196506051987032023 MKG:30 0 342,464 0
Penata Muda Tk.I-3B 0 2001346418
2 0
16.183.710.9-732.000 4,538,222 0 387,122 0
0 4,151,100
20 SRIE MELDA OKTARY ,AM.Keb TK-0 2,920,100 0 0 0 0 0 20 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 31,851
27-10-1986 1 2,920,100 0 0 0
198610272011012009 MKG: 8 0 233,608 0
Penata Muda-3A 0 2001369272
39 0
16.483.051.5-732.000 3,257,559 0 265,459 0
0 2,992,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS JORONG
(002) D50500100200009 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 IRLIZA KHARINA ,AM.Keb TK-0 2,920,100 0 0 0 0 0 21 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 31,851
11-07-1989 1 2,920,100 0 0 0
198907112011012004 MKG: 8 0 233,608 0
Penata Muda-3A 0 2001359919
39 0
46.018.305.6-732.000 3,257,559 0 265,459 0
0 2,992,100
SUB TOTAL PERGOLONGAN : III 72,456,700 0 0 0 11,284 0
PEG: 20 3,127,390 185,000 0 0 0 0
IST: 8 JIWA= 41 1,024,360 7,450,000 2,969,220 0 842,434
76,608,450 0 11,284 0
ANK: 13 0 6,128,677 0
1,141 0 0
87,225,095 0 6,982,395
0 80,242,700
22 M. ALIP PAISAL AMRULLAH AGE K -1 2,980,800 0 0 0 0 0 22 .............
2 298,080 0 0 0 0 0
119,232 240,000 289,680 0 36,381
01-01-1983 4 3,398,112 0 0 0
198301012007011005 MKG:17 0 271,849 0
Pengatur Tk.I-2D 0 2001345365
38 0
14.314.154.7-732.000 3,927,830 0 308,230 0
0 3,619,600
23 YUDI RAHMADANI IKHSAN K -1 2,687,800 0 0 0 0 0 23 .............
2 268,780 0 0 0 0 0
107,512 240,000 289,680 0 33,041
16-04-1989 4 3,064,092 0 0 0 0
198904162009031001 MKG:13 0 245,127 0
Pengatur-2C 0 2001339799
96 0
16.482.882.4-732.000 3,593,868 0 278,168 0
0 3,315,700
24 RAHMAD HERMAWAN ,AMK K -1 2,374,300 0 0 0 0 0 24 .............
0 237,430 0 0 0 0 0
0 240,000 144,840 0 28,517
16-03-1991 2 2,611,730 0 0 0
199103162020121011 MKG: 5 0 208,938 0
Pengatur-2C 0 2001373261
85 0
41.146.073.6-732.000 2,996,655 0 237,455 0
0 2,759,200
25 ABRAR VALENTIONO ,A.Md.Kep K -1 2,374,300 0 0 0 0 0 25 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
14-12-1993 3 2,659,216 0 0 0
199312142019031010 MKG: 5 0 212,737 0
Pengatur-2C 0 2001371641
53 0
90.501.788.5-732.000 3,116,529 0 241,729 0
0 2,874,800
26 RIDO ALPIANOR ,A.Md.Kep K -1 2,526,200 0 0 0 0 0 26 .............
0 252,620 180,000 0 0 0 0
0 0 144,840 0 29,588
30-06-1991 2 2,778,820 0 0 0
199106302015021002 MKG: 9 0 222,306 0
Pengatur-2C 0 2001369256
34 0
73.874.279.0-732.000 3,103,694 0 251,894 0
0 2,851,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS JORONG
(002) D50500100200009 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
27 LIA AGUSTINA ,AMG TK-0 1,841,440 0 0 0 0 0 27 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
20-08-1989 1 1,841,440 0 0 0
198908202022032003 MKG: 3 0 147,315 0
Pengatur-2C 0 3200406434
69 0
163782824732000 2,093,929 0 167,529 0
0 1,926,400
SUB TOTAL PERGOLONGAN : 14,784,840 0 0 0 0 0
PEG: 6 1,294,340 360,000 0 0 0 0
IST: 5 JIWA= 16 274,230 960,000 1,158,720 0 176,733
16,353,410 0 0 0
ANK: 5 0 1,308,272 0
375 0 0
18,832,505 0 1,485,005
0 17,347,500
TOTAL PER SATKER 91,308,040 0 0 0 11,284 0
PEG: 27 4,828,380 545,000 0 0 0 0
IST: 14 JIWA= 61 1,461,250 9,610,000 4,417,620 0 1,077,525
ANK: 20 97,597,670 0 11,284 0
0 7,807,814 0
0 0
1,549 0 8,896,623
112,183,123
0 103,286,500

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS SUNGAI RIAM
(002) D50500100200010 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 Hj. GT. LINA . R ,S.Farm, Apt, TK-0 3,518,100 0 0 0 0 0 1 .............
MPH 0 0 0 0 0 0 0
0 750,000 72,420 0 42,681
14-07-1982 1 3,518,100 0 0 0
198207142009032013 MKG:12 0 281,448 0
Penata Tk.I-3D 0 007.03.28.02342.1
9 0
15.767.441.7-732.000 4,340,529 0 324,129 0
0 4,016,400
2 drg, SENJA ANNISA HAKIM K -1 3,410,600 0 0 0 0 0 2 .............
2 341,060 0 0 0 0 0
136,424 750,000 289,680 0 46,381
11-12-1987 4 3,888,084 0 0 0
198712112014112001 MKG:10 0 311,047 0
Penata Tk.I-3D 0 2001369744
64 0
66.538.648.8-732.000 4,927,828 0 357,428 0
0 4,570,400
3 dr, QORY PRATIWI APRILIYANTI K -1 3,306,500 0 0 0 0 0 3 .............
2 330,650 0 0 0 0 0
132,260 750,000 289,680 0 45,194
16-04-1986 4 3,769,410 0 0 0
198604162014022001 MKG: 8 0 301,553 0
Penata Tk.I-3D 0 2001369717
57 0
16.717.655.1-732.000 4,809,147 0 346,747 0
0 4,462,400
4 AGUS MAYURI ,MM.KES K -1 4,108,100 0 0 0 0 0 4 .............
2 410,810 0 0 0 0 0
164,324 600,000 289,680 0 52,832
06-06-1973 4 4,683,234 0 0 0
197306061994031008 MKG:22 0 374,659 0
Penata Tk.I-3D 0 2001360755
77 0
16.077.646.4-732.000 5,572,991 0 427,491 0
0 5,145,500
5 SUWARNI K -1 4,370,900 0 0 0 3,842 0 5 .............
0 437,090 0 0 0 0 0
0 500,000 144,840 0 53,080
01-12-1968 2 4,807,990 0 3,842 0
196812011991012003 MKG:26 0 384,639 0
Penata Tk.I-3D 0 2001323442
89 0
57.822.639.1-732.000 5,456,761 0 441,561 0
0 5,015,200
6 MUJIONO ,AMK K -1 4,370,900 0 0 0 0 0 6 .............
2 437,090 0 0 0 0 0
174,836 500,000 289,680 0 54,828
21-04-1971 4 4,982,826 0 0 0
197104211991011002 MKG:26 0 398,626 0
Penata Tk.I-3D 0 2001350105
48 0
57.822.634.2-732.000 5,772,554 0 453,454 0
0 5,319,100
7 Hj. MARIATI TK-0 4,370,900 0 0 0 0 0 7 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 48,709
13-08-1971 1 4,370,900 0 0 0 0
197108131990022001 MKG:26 0 349,672 0
Penata Tk.I-3D 0 2001323628
61 0
15.767.448.2-732.000 4,943,381 0 398,381 0
0 4,545,000
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS SUNGAI RIAM
(002) D50500100200010 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 Hj. IDA ROYANI TK-0 4,370,900 0 0 0 0 0 8 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 48,709
10-07-1972 1 4,370,900 0 0 0
197207101991012001 MKG:26 0 349,672 0
Penata Tk.I-3D 0 2001323094
61 0
16.038.852.6-732.000 4,943,381 0 398,381 0
0 4,545,000
9 SUHARTI K -1 4,237,500 0 0 0 0 0 9 .............
0 423,750 0 0 0 0 0
0 500,000 144,840 0 51,613
17-12-1968 2 4,661,250 0 0 0
196812171992022002 MKG:24 0 372,900 0
Penata Tk.I-3D 0 2001323302
23 0
57.822.641.7-732.000 5,306,113 0 424,513 0
0 4,881,600
10 HARTATI ,AMG K -1 3,481,600 0 0 0 0 0 10 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
13-12-1979 4 3,969,024 0 0 0
197912132008012019 MKG:15 0 317,522 0
Penata-3C 0 2001323078
8 0
57.822.633.4-732.000 4,758,712 0 362,212 0
0 4,396,500
11 dr, ZESIKA NUR ANNISA ABIDIN K -1 2,773,200 0 0 0 0 0 11 .............
2 277,320 0 0 0 0 0
110,928 325,000 289,680 0 34,864
08-08-1992 4 3,161,448 0 0 0
199208082020122031 MKG: 2 0 252,916 0
Penata Muda Tk.I-3B 0 2001373024
52 0
80.131.725.6-732.000 3,776,180 0 287,780 0
0 3,488,400
12 SITI NOOR SYA'BIYAH ,AMK K -0 3,139,400 0 0 0 0 0 12 .............
2 0 0 0 0 0 0
125,576 265,000 217,260 0 35,300
11-06-1981 3 3,264,976 0 0 0
198106112006042015 MKG:11 0 261,198 0
Penata Muda Tk.I-3B 0 2001339737
62 0
46.024.461.9-732.000 3,747,298 0 296,498 0
0 3,450,800
13 ANGGRAINI HASNA ,A.Md.Keb TK-0 3,139,400 0 0 0 0 0 13 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
12-04-1988 1 3,139,400 0 0 0
198804122009032001 MKG:11 0 251,152 0
Penata Muda Tk.I-3B 0 2001325356
76 0
57.822.636.7-732.000 3,476,896 0 285,196 0
0 3,191,700
14 NUNING NUR WIDYAWATI ,AMK K -1 3,139,400 0 0 0 0 0 14 .............
0 313,940 0 0 0 0 0
0 265,000 144,840 0 37,183
26-02-1984 2 3,453,340 0 0 0
198402262010012006 MKG:10 0 276,267 0
Penata Muda Tk.I-3B 0 2001350156
70 0
57.822.638.3-732.000 3,863,250 0 313,450 0
0 3,549,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS SUNGAI RIAM
(002) D50500100200010 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
15 DWI LIANA SUKMAWATI ,AMK K -1 3,043,600 0 0 0 0 0 15 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
03-07-1989 4 3,469,704 0 0 0
198907032011012005 MKG: 8 0 277,576 0
Penata Muda Tk.I-3B 0 2001358904
39 0
16.482.849.3-732.000 4,024,423 0 314,923 0
0 3,709,500
16 MUHAMMAD AULIA RAHMAN ,AMK K -1 3,139,400 0 0 0 0 0 16 .............
1 313,940 0 0 0 0 0
62,788 240,000 217,260 0 37,561
24-03-1987 3 3,516,128 0 0 0
198703242009031001 MKG:11 0 281,290 0
Penata Muda Tk.I-3B 0 2001350075
63 0
57.822.850.8-732.000 3,973,451 0 318,851 0
0 3,654,600
17 RUDI ARIDINATA K -1 3,106,900 0 0 0 0 0 17 .............
2 310,690 0 0 0 0 0
124,276 265,000 289,680 0 38,069
21-11-1984 4 3,541,866 0 0 0 0
198411212008011008 MKG:12 0 283,349 0
Penata Muda-3A 0 2001323318
72 0
57.822.644.1-732.000 4,096,618 0 321,418 0
0 3,775,200
18 NOR JANAH ,AMd.Keb K -1 2,744,500 0 0 0 0 0 18 .............
1 274,450 0 0 0 0 0
54,890 265,000 217,260 0 33,388
13-11-1993 3 3,073,840 0 0 0
199311132015022002 MKG: 5 0 245,907 0
Penata Muda-3A 0 2001369175
95 0
72.554.842.4-732.000 3,556,195 0 279,295 0
0 3,276,900
19 RUSMA HAYATI ,SKM TK-0 2,063,520 0 0 0 0 0 19 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 22,485
03-12-1988 1 2,063,520 0 0 0
198812032022032002 MKG: 0 0 165,082 0
Penata Muda-3A 0 3200406728
27 0
162529390731000 2,320,967 0 187,567 0
0 2,133,400
SUB TOTAL PERGOLONGAN : III 65,835,320 0 0 0 3,842 0
PEG: 19 4,523,310 185,000 0 0 0 0
IST: 13 JIWA= 52 1,347,310 8,005,000 3,765,840 0 798,958
71,705,940 0 3,842 0
ANK: 20 0 5,736,475 0
1,053 0 0
83,666,675 0 6,539,275
0 77,127,400
20 DWI HANDAYANI ,A.Md Keb K -0 2,980,800 0 0 0 0 0 20 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 32,208
14-02-1984 1 2,980,800 0 0 0
198402142017042002 MKG:17 0 238,464 0
Pengatur Tk.I-2D 0 2001368624
52 0
66.514.873.0-732.000 3,293,272 0 270,672 0
0 3,022,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS SUNGAI RIAM
(002) D50500100200010 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 NORMAH K -1 2,716,000 0 0 0 0 0 21 .............
2 271,600 0 0 0 0 0
108,640 240,000 289,680 0 33,362
01-03-1981 4 3,096,240 0 0 0
198103012010012004 MKG:12 0 247,699 0
Pengatur Tk.I-2D 0 2001323183
41 0
15.582.991.4-732.000 3,625,961 0 281,061 0
0 3,344,900
22 HANESTY BUNGA RAFLESIA ,AMK K -0 2,474,700 0 0 0 0 0 22 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 27,147
02-07-1991 1 2,474,700 0 0 0
199107022019032007 MKG: 6 0 197,976 0
Pengatur Tk.I-2D 0 2001371587
3 0
72.399.009.9-732.000 2,787,123 0 225,123 0
0 2,562,000
23 NIKEN SEPTIANA ,A.Md.Keb K -1 1,841,440 0 0 0 0 0 23 .............
2 184,144 180,000 0 0 0 0
73,658 0 289,680 0 22,792
18-09-1992 4 2,099,242 0 0 0
199209182022032007 MKG: 3 0 167,939 0
Pengatur-2C 0 3200401106
9 0
637276700732000 2,568,931 0 190,731 0
0 2,378,200
24 MA'RUF AFFANDI ,A.Md.Kep TK-0 1,841,440 0 0 0 0 0 24 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
22-05-1994 1 1,841,440 0 0 0
199405222022031005 MKG: 3 0 147,315 0
Pengatur-2C 0 3200400077
69 0
836195990732000 2,093,929 0 167,529 0
0 1,926,400
SUB TOTAL PERGOLONGAN : 11,854,380 0 0 0 0 0
PEG: 5 455,744 360,000 0 0 0 0
IST: 2 JIWA= 11 182,298 720,000 796,620 0 135,723
12,492,422 0 0 0
ANK: 4 0 999,393 0
174 0 0
14,369,216 0 1,135,116
0 13,234,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS SUNGAI RIAM
(002) D50500100200010 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 77,689,700 0 0 0 3,842 0
PEG: 24 4,979,054 545,000 0 0 0 0
IST: 15 JIWA= 63 1,529,608 8,725,000 4,562,460 0 934,681
ANK: 24 84,198,362 0 3,842 0
0 6,735,868 0
0 0
1,227 0 7,674,391
98,035,891
0 90,361,500

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PANYIPATAN
(002) D50500100200011 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 HANIYAH K -0 4,237,500 0 0 0 0 0 1 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 47,375
26-05-1972 1 4,237,500 0 0 0
197205261992022001 MKG:24 0 339,000 0
Penata Tk.I-3D 0 2001350113
55 0
15.993.330.8-732.000 4,809,975 0 386,375 0
0 4,423,600
2 ARLANI ,AMK K -1 3,982,600 0 0 0 0 0 2 .............
2 398,260 0 0 0 0 0
159,304 500,000 289,680 0 50,402
18-12-1975 4 4,540,164 0 0 0
197512181997031002 MKG:20 0 363,213 0
Penata Tk.I-3D 0 2001320893
71 0
79.771.569.5-732.000 5,329,915 0 413,615 0
0 4,916,300
3 dr, SILVAN JUWITA TK-0 2,890,500 0 0 0 0 0 3 .............
0 0 0 0 0 0 0
0 750,000 72,420 0 36,405
02-07-1991 1 2,890,500 0 0 0
199107022019032006 MKG: 3 0 231,240 0
Penata-3C 0 2001370289
25 0
72.781.392.5-734.000 3,712,945 0 267,645 0
0 3,445,300
4 SUSILAWATI ,AM.Keb TK-0 3,481,600 0 0 0 0 0 4 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 39,816
06-02-1982 1 3,481,600 0 0 0
198202062006042010 MKG:14 0 278,528 0
Penata-3C 0 2001325337
24 0
79.771.570.3-732.000 4,054,044 0 318,344 0
0 3,735,700
5 AHMAD DAIROBI ,S.Gz K -1 3,941,400 0 0 0 0 0 5 .............
2 394,140 0 0 0 0 0
157,656 265,000 289,680 0 47,582
10-09-1969 4 4,493,196 0 0 0
196909101994031015 MKG:22 0 359,456 0
Penata-3C 0 2001319747
62 0
79.711.568.7-732.000 5,047,938 0 407,038 0
0 4,640,900
6 dr, DIANA SRIASTUTIK INDRAWATI TK-0 2,773,200 0 0 0 0 0 6 .............
0 0 0 0 0 0 0
0 325,000 72,420 0 30,982
19-12-1989 1 2,773,200 0 0 0
198912192020122014 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 2001373617
18 0
71.124.589.4-732.000 3,170,638 0 252,838 0
0 2,917,800
7 SRI ANITA RAHAYU K -1 3,781,400 0 0 0 0 0 7 .............
1 378,140 0 0 0 0 0
75,628 265,000 217,260 0 45,002
01-08-1973 3 4,235,168 0 0 0
197308012006042012 MKG:22 0 338,813 0
Penata Muda Tk.I-3B 0 2001325224
87 0
57.822.815.7-732.000 4,717,515 0 383,815 0
0 4,333,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PANYIPATAN
(002) D50500100200011 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 ASMARA SRI ISWATI ,AMd.Keb K -0 3,665,900 0 0 0 0 0 8 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 39,309
05-10-1975 1 3,665,900 0 0 0
197510052006042028 MKG:20 0 293,272 0
Penata Muda Tk.I-3B 0 2001324422
61 0
15.582.991.4-732.000 4,003,381 0 332,581 0
0 3,670,800
9 MUSLIMAH K -1 3,238,300 0 0 0 0 0 9 .............
2 323,830 0 0 0 0 0
129,532 265,000 289,680 0 39,567
10-05-1980 4 3,691,662 0 0 0
198005102008012048 MKG:13 0 295,333 0
Penata Muda Tk.I-3B 0 2001325801
58 0
57.822.822.3-732.000 4,246,400 0 334,900 0
0 3,911,500
10 MARIA ULFAH ,AMK JD-0 3,139,400 0 0 0 0 0 10 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
03-04-1988 1 3,139,400 0 0 0
198804032010012007 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001350218
76 0
57.822.819.9-732.000 3,476,896 0 285,196 0
0 3,191,700
11 DESY HAVIANA ,A.Md.Far TK-0 3,043,600 0 0 0 0 0 11 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,086
31-03-1989 1 3,043,600 0 0 0
198903312011012007 MKG: 8 0 243,488 0
Penata Muda Tk.I-3B 0 2001503467
54 0
157673807732000 3,381,074 0 276,574 0
0 3,104,500
12 drg, RIZKY KARTIKA K -1 2,150,800 0 0 0 0 0 12 .............
1 215,080 185,000 0 0 0 0
43,016 0 217,260 0 25,939
12-04-1989 3 2,408,896 0 0 0
198904122022032001 MKG: 0 0 192,712 0
Penata Muda Tk.I-3B 0 3200402269
95 0
981875313017000 2,811,251 0 218,651 0
0 2,592,600
13 NOVIE NADIAH ,AMK K -1 3,305,700 0 0 0 0 0 13 .............
2 330,570 0 0 0 0 0
132,228 265,000 289,680 0 40,335
28-11-1981 4 3,768,498 0 0 0
198111282006042021 MKG:16 0 301,480 0
Penata Muda-3A 0 2001320931
37 0
57.822.820.7-732.000 4,323,215 0 341,815 0
0 3,981,400
14 KHOIRUNNISA YULIAWARDANI TK-0 2,063,520 0 0 0 0 0 14 .............
,S.Tr.Keb 0 0 185,000 0 0 0 0
0 0 72,420 0 22,485
14-07-1997 1 2,063,520 0 0 0
199707142022032007 MKG: 0 0 165,082 0
Penata Muda-3A 0 3200141546
27 0
537516171732000 2,320,967 0 187,567 0
0 2,133,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PANYIPATAN
(002) D50500100200011 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
SUB TOTAL PERGOLONGAN : III 45,695,420 0 0 0 0 0
PEG: 14 2,040,020 370,000 0 0 0 0
IST: 6 JIWA= 30 697,364 4,430,000 2,172,600 0 532,329
48,432,804 0 0 0
ANK: 10 0 3,874,625 0
750 0 0
55,406,154 0 4,406,954
0 50,999,200
15 MUHAMMAD WAHYUDI ,AMK K -1 2,801,500 0 0 0 0 0 15 .............
1 280,150 0 0 0 0 0
56,030 240,000 217,260 0 33,777
24-09-1987 3 3,137,680 0 0 0
198709242011011002 MKG:13 0 251,014 0
Pengatur Tk.I-2D 0 2001369515
51 0
16.483.058.0-732.000 3,594,991 0 284,791 0
0 3,310,200
16 FEBRI AHYUNING TYAS ,AM.KEB K -0 2,633,100 0 0 0 0 0 16 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 28,731
13-02-1990 1 2,633,100 0 0 0
199002132015022001 MKG: 9 0 210,648 0
Pengatur Tk.I-2D 0 2001369299
59 0
66.536.791.8-732.000 2,945,579 0 239,379 0
0 2,706,200
17 EMBAN ARIE SUSANTI K -1 3,339,400 0 0 0 0 0 17 .............
2 333,940 0 0 0 0 0
133,576 240,000 289,680 0 40,469
30-09-1975 4 3,806,916 0 0 0
197509302006042015 MKG:27 0 304,553 0
Pengatur-2C 0 2001350008
26 0
57.822.806.6-732.000 4,336,622 0 345,022 0
0 3,991,600
18 M FIQRI SAHRAWARDANI ,AMK K -1 2,374,300 0 0 0 0 0 18 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
25-11-1992 3 2,659,216 0 0 0
199211252019031005 MKG: 5 0 212,737 0
Pengatur-2C 0 2001371102
53 0
81.595.831.9-732.000 3,116,529 0 241,729 0
0 2,874,800
19 EKA HARTINA ,A.Md.KL TK-0 2,374,300 0 0 0 0 0 19 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
27-04-1996 1 2,374,300 0 0 0
199604272019032010 MKG: 5 0 189,944 0
Pengatur-2C 0 2001370157
67 0
84.150.851.8-807.000 2,686,787 0 216,087 0
0 2,470,700
20 ANGGUN ANGGRAENI ,A.Md.Kes TK-0 2,374,300 0 0 0 0 0 20 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
23-09-1998 1 2,374,300 0 0 0
199809232020122003 MKG: 5 0 189,944 0
Pengatur-2C 0 2001372338
67 0
96.886.614.5-732.000 2,686,787 0 216,087 0
0 2,470,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PANYIPATAN
(002) D50500100200011 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 SRI LISTIA UTAMI ,AMK K -1 1,841,440 0 0 0 0 0 21 .............
2 184,144 180,000 0 0 0 0
73,658 0 289,680 0 22,792
13-02-1990 4 2,099,242 0 0 0
199002132022032001 MKG: 3 0 167,939 0
Pengatur-2C 0 3200407597
9 0
854698305732000 2,568,931 0 190,731 0
0 2,378,200
SUB TOTAL PERGOLONGAN : 17,738,340 0 0 0 0 0
PEG: 7 1,035,664 180,000 0 0 0 0
IST: 4 JIWA= 17 310,750 1,440,000 1,231,140 0 207,047
19,084,754 0 0 0
ANK: 6 0 1,526,779 0
332 0 0
21,936,226 0 1,733,826
0 20,202,400
TOTAL PER SATKER 63,433,760 0 0 0 0 0
PEG: 21 3,075,684 550,000 0 0 0 0
IST: 10 JIWA= 47 1,008,114 5,870,000 3,403,740 0 739,376
ANK: 16 67,517,558 0 0 0
0 5,401,404 0
0 0
1,082 0 6,140,780
77,342,380
0 71,201,600

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KINTAP
(002) D50500100200012 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 H. BUDI DARMAWAN ,S.Kep K -1 4,281,800 0 0 0 0 0 1 .............
1 428,180 0 0 0 0 0
85,636 850,000 217,260 0 56,456
20-02-1973 3 4,795,616 0 0 0
197302201994031002 MKG:23 0 383,649 0
Pembina-4A 0 2001349727
29 0
15.092.780.4-732.000 5,862,905 0 440,105 0
0 5,422,800
2 H. SUBIRIN ,SKM,MAP K -1 4,555,800 0 0 0 0 0 2 .............
2 455,580 0 0 0 0 0
182,232 500,000 289,680 0 56,936
07-07-1968 4 5,193,612 0 0 0
196807071990021002 MKG:26 0 415,489 0
Pembina-4A 0 2001339877
33 0
15.032.471.3-732.000 5,983,325 0 472,425 0
0 5,510,900
SUB TOTAL PERGOLONGAN : IV 8,837,600 0 0 0 0 0
PEG: 2 883,760 0 0 0 0 0
IST: 2 JIWA= 7 267,868 1,350,000 506,940 0 113,392
9,989,228 0 0 0
ANK: 3 0 799,138 0
62 0 0
11,846,230 0 912,530
0 10,933,700
3 dr, HOTMAR SYUHADA K -1 3,518,100 0 0 0 0 0 3 .............
2 351,810 0 0 0 0 0
140,724 750,000 289,680 0 47,606
19-10-1982 4 4,010,634 0 0 0
198210192010011009 MKG:12 0 320,851 0
Penata Tk.I-3D 0 2001349557
43 0
16.657.172.9-732.000 5,050,357 0 368,457 0
0 4,681,900
4 HAIRUDIN ,S.KEP K -1 4,108,100 0 0 0 0 0 4 .............
2 410,810 0 0 0 0 0
164,324 600,000 289,680 0 52,832
02-02-1976 4 4,683,234 0 0 0
197602021996031007 MKG:22 0 374,659 0
Penata Tk.I-3D 0 2001343052
77 0
15.046.670.4-732.000 5,572,991 0 427,491 0
0 5,145,500
5 H. KASPUL ANWAR K -1 4,370,900 0 0 0 0 0 5 .............
2 437,090 0 0 0 0 0
174,836 500,000 289,680 0 54,828
09-09-1969 4 4,982,826 0 0 0
196909091991011001 MKG:26 0 398,626 0
Penata Tk.I-3D 0 2001349627
48 0
57.822.628.4-732.000 5,772,554 0 453,454 0
0 5,319,100
6 RIDUAN K -1 4,370,900 0 0 0 0 0 6 .............
1 437,090 0 0 0 0 0
87,418 500,000 217,260 0 53,954
12-05-1970 3 4,895,408 0 0 0
197005121991011001 MKG:26 0 391,633 0
Penata Tk.I-3D 0 2001339818
19 0
16.183.603.6-372.000 5,612,687 0 445,587 0
0 5,167,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KINTAP
(002) D50500100200012 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
7 drg, HERIYADI TK-0 2,890,500 0 0 0 0 0 7 .............
0 0 0 0 0 0 0
0 750,000 72,420 0 36,405
21-09-1990 1 2,890,500 0 0 0
199009212019031007 MKG: 3 0 231,240 0
Penata-3C 0 2001371037
25 0
90.819.570.4-732.000 3,712,945 0 267,645 0
0 3,445,300
8 IMAS REDI WIJAYA ,S.Kep,N.s K -1 3,375,300 0 0 0 0 0 8 .............
2 337,530 0 0 0 0 0
135,012 600,000 289,680 0 44,478
05-07-1983 4 3,847,842 0 0 0
198307052008031001 MKG:12 0 307,827 0
Penata-3C 0 2001349848
83 0
15.042.020.6-732.000 4,737,605 0 352,305 0
0 4,385,300
9 SUHAIDA K -0 3,821,000 0 0 0 0 0 9 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 43,210
19-03-1968 1 3,821,000 0 0 0
196803191997032002 MKG:20 0 305,680 0
Penata-3C 0 2001361662
70 0
15.566.089.7-734.000 4,393,490 0 348,890 0
0 4,044,600
10 NANIK NURJANAH ,AM.KG K -0 3,375,300 0 0 0 0 0 10 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 38,753
30-11-1981 1 3,375,300 0 0 0
198111302005012009 MKG:12 0 270,024 0
Penata-3C 0 2001349654
57 0
57.822.630.0-732.000 3,947,777 0 308,777 0
0 3,639,000
11 PARIDAH K -1 3,375,300 0 0 0 0 0 11 .............
2 337,530 0 0 0 0 0
135,012 500,000 289,680 0 43,478
01-10-1985 4 3,847,842 0 0 0
198510012005012003 MKG:12 0 307,827 0
Penata-3C 0 2001343068
83 0
57.822.271.3-732.000 4,637,605 0 351,305 0
0 4,286,300
12 TARTI ,AMK K -1 3,272,200 0 0 0 0 0 12 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
22-08-1978 4 3,730,308 0 0 0
197808222010012008 MKG:10 0 298,425 0
Penata-3C 0 2001349689
40 0
16.401.553.3-732.000 4,520,028 0 340,728 0
0 4,179,300
13 RAHMAWATI ASERANI ,A.Md.Keb TK-0 3,272,200 0 0 0 0 0 13 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
25-02-1986 1 3,272,200 0 0 0
198602252009032012 MKG:10 0 261,776 0
Penata-3C 0 2001343001
78 0
16.282.255.5-732.000 3,844,698 0 299,498 0
0 3,545,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KINTAP
(002) D50500100200012 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 YANTI ,AMK K -0 3,272,200 0 0 0 0 0 14 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
19-10-1986 1 3,272,200 0 0 0
198610192010012011 MKG:10 0 261,776 0
Penata-3C 0 2001359625
78 0
16.282.254.8-732.000 3,844,698 0 299,498 0
0 3,545,200
15 RINA ,AM.Keb K -1 3,272,200 0 0 0 0 0 15 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
27-05-1987 4 3,730,308 0 0 0
198705272010012014 MKG:10 0 298,425 0
Penata-3C 0 2001359517
40 0
57.822.270.5-732.000 4,520,028 0 340,728 0
0 4,179,300
16 WIDYA SCAISARA . D ,AMK TK-0 3,043,600 0 0 0 0 0 16 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,086
10-05-1989 1 3,043,600 0 0 0
198905102011012006 MKG: 9 0 243,488 0
Penata Muda Tk.I-3B 0 2001359536
54 0
15.767.445.8-732.000 3,381,074 0 276,574 0
0 3,104,500
17 dr, RAMANDA CAHYA UMBARRA TK-0 2,773,200 0 0 0 0 0 17 .............
0 0 0 0 0 0 0
0 0 72,420 0 27,732
26-03-1991 1 2,773,200 0 0 0
199103262020121011 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 2001373237
68 0
73.731.296.7-724.000 2,845,688 0 249,588 0
0 2,596,100
18 apt, RAHMI FIRLIA ,S.Farm TK-0 2,150,800 0 0 0 0 0 18 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
06-07-1996 1 2,150,800 0 0 0
199607062022032004 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200406717
2 0
928153097734000 2,408,222 0 195,422 0
0 2,212,800
19 MELKA SUSANTI K -1 3,627,900 0 0 0 0 0 19 .............
2 362,790 0 0 0 0 0
145,116 265,000 289,680 0 44,008
03-06-1974 4 4,135,806 0 0 0
197406032006042019 MKG:22 0 330,864 0
Penata Muda-3A 0 2001349816
86 0
15.582.991.4-732.000 4,690,572 0 374,872 0
0 4,315,700
20 ELLYSABETH YULIANA ,A.Md.Keb K -1 3,627,900 0 0 0 0 0 20 .............
1 362,790 0 0 0 0 0
72,558 265,000 217,260 0 43,282
12-10-1974 3 4,063,248 0 0 0
197410122006042025 MKG:22 0 325,060 0
Penata Muda-3A 0 2001349832
34 0
16.717.401.0-732.000 4,545,542 0 368,342 0
0 4,177,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KINTAP
(002) D50500100200012 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 BAHRIATY TK-0 3,409,800 0 0 0 0 0 21 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 36,748
26-06-1974 1 3,409,800 0 0 0 0
197406262006042024 MKG:18 0 272,784 0
Penata Muda-3A 0 2001343028
12 0
57.822.273.9-732.000 3,747,232 0 309,532 0
0 3,437,700
22 SITI HAMDANAH TK-0 3,106,900 0 0 0 0 0 22 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,719
06-01-1976 1 3,106,900 0 0 0 0
197601062007012010 MKG:12 0 248,552 0
Penata Muda-3A 0 2001342994
51 0
16.001.013.8-732.000 3,444,371 0 282,271 0
0 3,162,100
23 ARINA K -1 2,830,900 0 0 0 0 0 23 .............
2 283,090 0 0 0 0 0
113,236 265,000 289,680 0 34,922
27-01-1990 4 3,227,226 0 0 0
199001272010012001 MKG: 7 0 258,178 0
Penata Muda-3A 0 2001339845
94 0
57.822.269.7-732.000 3,782,000 0 293,100 0
0 3,488,900
24 NATA LISA ERVIANA SARI ,SKM K -1 2,063,520 0 0 0 0 0 24 .............
1 206,352 185,000 0 0 0 0
41,270 0 217,260 0 24,961
01-09-1990 3 2,311,142 0 0 0
199009012022032002 MKG: 0 0 184,891 0
Penata Muda-3A 0 3200407155
50 0
637208448732000 2,713,452 0 209,852 0
0 2,503,600
25 EKA AYUNINGTYASTUTI ,S.Tr.Keb TK-0 2,063,520 0 0 0 0 0 25 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 22,485
30-07-1996 1 2,063,520 0 0 0
199612302022032013 MKG: 0 0 165,082 0
Penata Muda-3A 0 3200400215
27 0
425865094732000 2,320,967 0 187,567 0
0 2,133,400
SUB TOTAL PERGOLONGAN : III 74,992,240 0 0 0 0 0
PEG: 23 4,181,322 555,000 0 0 0 0
IST: 12 JIWA= 56 1,471,282 8,790,000 4,055,520 0 899,895
80,644,844 0 0 0
ANK: 21 0 6,451,588 0
1,219 0 0
94,046,583 0 7,351,483
0 86,695,100
26 HANI NUR HASANAH ,A.Md Kep K -1 2,374,300 0 0 0 0 0 26 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
01-02-1994 3 2,659,216 0 0 0
199402012020122023 MKG: 5 0 212,737 0
Pengatur-2C 0 2001373512
53 0
41.094.546.3-732.000 3,116,529 0 241,729 0
0 2,874,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KINTAP
(002) D50500100200012 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
27 NURELA SARI ,A.Md.AK TK-0 1,841,440 0 0 0 0 0 27 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
23-09-1995 1 1,841,440 0 0 0
199509232022032010 MKG: 3 0 147,315 0
Pengatur-2C 0 3200403605
69 0
854500543731000 2,093,929 0 167,529 0
0 1,926,400
28 MITA DWI ROCHMANIYAH ,A.Md.Kes K -1 1,841,440 0 0 0 0 0 28 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
30-09-1995 3 2,062,413 0 0 0
199509302022032004 MKG: 3 0 164,993 0
Pengatur-2C 0 3200406876
44 0
637207754732000 2,459,717 0 187,417 0
0 2,272,300
29 DWI MIA JUNITA ,A.Md.Kes TK-0 1,841,440 0 0 0 0 0 29 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
03-06-1997 1 1,841,440 0 0 0
199706032022032004 MKG: 3 0 147,315 0
Pengatur-2C 0 3200406965
69 0
959151234732000 2,093,929 0 167,529 0
0 1,926,400
SUB TOTAL PERGOLONGAN : 7,898,620 0 0 0 0 0
PEG: 4 421,574 540,000 0 0 0 0
IST: 2 JIWA= 8 84,315 240,000 579,360 0 91,844
8,404,509 0 0 0
ANK: 2 0 672,360 0
235 0 0
9,764,104 0 764,204
0 8,999,900
TOTAL PER SATKER 91,728,460 0 0 0 0 0
PEG: 29 5,486,656 1,095,000 0 0 0 0
IST: 16 JIWA= 71 1,823,465 10,380,000 5,141,820 0 1,105,131
ANK: 26 99,038,581 0 0 0
0 7,923,086 0
0 0
1,516 0 9,028,217
115,656,917
0 106,628,700

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAMBANG ULANG
(002) D50500100200013 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 dr, DAHLIA BR. KAROSEKALI K -1 4,024,400 0 0 0 0 0 1 .............
2 402,440 0 0 0 0 0
160,976 1,200,000 289,680 0 57,878
13-07-1973 4 4,587,816 0 0 0
197307132006042017 MKG:18 0 367,025 0
Pembina-4A 0 2001335367
7 0
15.582.991.4-732.000 6,077,503 0 424,903 0
0 5,652,600
2 drg, EMI ROHMAWATI K -0 4,024,400 0 0 0 0 0 2 .............
2 0 0 0 0 0 0
160,976 1,200,000 217,260 0 53,854
19-03-1976 3 4,185,376 0 0 0
197603192006042012 MKG:18 0 334,830 0
Pembina-4A 0 2001350307
48 0
14.351.037.8-732.000 5,602,684 0 388,684 0
0 5,214,000
SUB TOTAL PERGOLONGAN : IV 8,048,800 0 0 0 0 0
PEG: 2 402,440 0 0 0 0 0
IST: 1 JIWA= 7 321,952 2,400,000 506,940 0 111,732
8,773,192 0 0 0
ANK: 4 0 701,855 0
55 0 0
11,680,187 0 813,587
0 10,866,600
3 dr, AULIA RACHMAN K -1 3,518,100 0 0 0 0 0 3 .............
2 351,810 0 0 0 0 0
140,724 750,000 289,680 0 47,606
11-05-1983 4 4,010,634 0 0 0
198305112014111001 MKG:12 0 320,851 0
Penata Tk.I-3D 0 2001368756
43 0
15.425.498.1-733.000 5,050,357 0 368,457 0
0 4,681,900
4 HJ. PARISTIN K -1 4,508,600 0 0 0 10,675 0 4 .............
0 450,860 0 0 0 0 0
0 500,000 144,840 0 54,595
13-07-1968 2 4,959,460 0 10,675 0
196807131989032010 MKG:28 0 396,757 0
Penata Tk.I-3D 0 2001368837
52 0
15.767.276.7-732.000 5,615,027 0 462,027 0
0 5,153,000
5 HAIRINA ,AM.KEP K -1 3,743,100 0 0 0 0 0 5 .............
2 374,310 0 0 0 0 0
149,724 500,000 289,680 0 47,671
01-03-1979 4 4,267,134 0 0 0 0
197903012006042028 MKG:16 0 341,371 0
Penata Tk.I-3D 0 2001334355
28 0
16.257.860.3-732.000 5,056,842 0 389,042 0
0 4,667,800
6 DEVI SULASTRI KUSUMA ,SST TK-0 3,272,200 0 0 0 0 0 6 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 38,722
10-10-1985 1 3,272,200 0 0 0
198510102009032019 MKG:10 0 261,776 0
Penata-3C 0 2001325267
78 0
79.771.573.7-732.000 3,944,698 0 300,498 0
0 3,644,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAMBANG ULANG
(002) D50500100200013 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
7 HAMIDHAN ,AMK K -1 3,591,200 0 0 0 0 0 7 .............
2 359,120 0 0 0 0 0
143,648 500,000 289,680 0 45,940
16-12-1977 4 4,093,968 0 0 0
197712162006041012 MKG:16 0 327,517 0
Penata-3C 0 2001322338
9 0
16.620.021.2-732.000 4,883,657 0 373,457 0
0 4,510,200
8 LINDA ARISTIANI ,AM.KEB K -1 3,481,600 0 0 0 0 0 8 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
03-07-1983 4 3,969,024 0 0 0
198307032006042007 MKG:14 0 317,522 0
Penata-3C 0 2001323191
8 0
87.655.542.6-732.000 4,758,712 0 362,212 0
0 4,396,500
9 HENY MUSTIKA ,A.Md.Keb TK-0 3,272,200 0 0 0 0 0 9 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
23-06-1985 1 3,272,200 0 0 0
198506232009032007 MKG:11 0 261,776 0
Penata-3C 0 2001322551
78 0
85.655.541.8-732.000 3,844,698 0 299,498 0
0 3,545,200
10 AINUN, AM.KL K -1 3,272,200 0 0 0 0 0 10 .............
1 327,220 0 0 0 0 0
65,444 500,000 217,260 0 41,649
12-02-1975 3 3,664,864 0 0 0
197502122010012009 MKG:10 0 293,189 0
Penata-3C 0 2001369264
14 0
15.767.446.6-732.000 4,382,138 0 334,838 0
0 4,047,300
11 HOLIYEH ,AM.KEB K -1 3,272,200 0 0 0 0 0 11 .............
1 327,220 0 0 0 0 0
65,444 500,000 217,260 0 41,649
08-01-1986 3 3,664,864 0 0 0
198601082010012019 MKG:10 0 293,189 0
Penata-3C 0 2001335076
14 0
16.257.865.2-732.000 4,382,138 0 334,838 0
0 4,047,300
12 H. MUSLAINI ,AMK K -1 4,325,600 0 0 0 0 0 12 .............
0 432,560 0 0 0 0 0
0 265,000 144,840 0 50,232
15-01-1968 2 4,758,160 0 0 0
196801151989111001 MKG:28 0 380,653 0
Penata-3C 0 2001368896
85 0
87.655.540.0-731.000 5,168,085 0 430,885 0
0 4,737,200
13 YANIE OKTAVIA K -1 2,950,600 0 0 0 0 0 13 .............
2 295,060 0 0 0 0 0
118,024 300,000 289,680 0 36,637
12-10-1975 4 3,363,684 0 0 0 0
197510122010012004 MKG: 6 0 269,095 0
Penata Muda Tk.I-3B 0 2001325712
68 0
16.657.196.8-732.000 3,953,432 0 305,732 0
0 3,647,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAMBANG ULANG
(002) D50500100200013 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 SUDIYARTI ,AM.KEP K -1 3,445,500 0 0 0 0 0 14 .............
2 344,550 0 0 0 0 0
137,820 265,000 289,680 0 41,929
11-05-1982 4 3,927,870 0 0 0 0
198205112006042024 MKG:16 0 314,230 0
Penata Muda Tk.I-3B 0 2001322934
9 0
88.508.921.9-732.000 4,482,559 0 356,159 0
0 4,126,400
15 ASMAUL CHUSNAH AFIATI ,AM.KG K -1 3,238,300 0 0 0 0 0 15 .............
2 323,830 0 0 0 0 0
129,532 265,000 289,680 0 39,567
07-04-1979 4 3,691,662 0 0 0
197904072005012018 MKG:12 0 295,333 0
Penata Muda Tk.I-3B 0 2001323175
58 0
88.508.925.0-732.000 4,246,400 0 334,900 0
0 3,911,500
16 INSANUL KAMILAH ,AMK K -1 3,139,400 0 0 0 0 0 16 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
06-03-1985 4 3,578,916 0 0 0
198503062009032015 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001323547
56 0
79.771.571.1-732.000 4,133,652 0 324,752 0
0 3,808,900
17 ABDUL HALIM ,AMK K -1 3,139,400 0 0 0 0 0 17 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
27-04-1987 4 3,578,916 0 0 0
198704272009041002 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001153245
56 0
15.582.991.4-732.000 4,133,652 0 324,752 0
0 3,808,900
18 apt, MUTIA SAFITRI ,S.Farm TK-0 2,150,800 0 0 0 0 0 18 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
31-01-1996 1 2,150,800 0 0 0
199601312022032008 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200403206
2 0
947155362732000 2,408,222 0 195,422 0
0 2,212,800
19 RIZKI AMELIA ,S.Tr.Gz TK-0 2,660,700 0 0 0 0 0 19 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 29,607
18-06-1997 1 2,660,700 0 0 0
199706182020122022 MKG: 2 0 212,856 0
Penata Muda-3A 0 2001373644
43 0
96.178.216.6-732.000 3,033,163 0 242,463 0
0 2,790,700
20 RAUDATUL JANNAH K -1 3,517,200 0 0 0 0 0 20 .............
1 351,720 0 0 0 0 0
70,344 265,000 217,260 0 42,043
09-07-1973 3 3,939,264 0 0 0
197307092006042020 MKG:20 0 315,141 0
Penata Muda-3A 0 2001322519
60 0
15.548.932.1-732.000 4,421,584 0 357,184 0
0 4,064,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAMBANG ULANG
(002) D50500100200013 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 NORMASARI.KEB ,Am.Keb TK-0 3,517,200 0 0 0 0 0 21 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 37,822
02-05-1976 1 3,517,200 0 0 0
197605022006042022 MKG:20 0 281,376 0
Penata Muda-3A 0 2001322907
78 0
88.508.920.1-732.000 3,854,698 0 319,198 0
0 3,535,500
22 Hj. DIAN FITRI ANGGRAINI K -1 3,517,200 0 0 0 0 0 22 .............
2 351,720 0 0 0 0 0
140,688 265,000 289,680 0 42,746
26-11-1979 4 4,009,608 0 0 0
197911262007012013 MKG:20 0 320,769 0
Penata Muda-3A 0 2001323124
27 0
87.655.539.2-732.000 4,564,315 0 363,515 0
0 4,200,800
SUB TOTAL PERGOLONGAN : III 67,533,300 0 0 0 10,675 0
PEG: 20 5,266,020 185,000 0 0 0 0
IST: 15 JIWA= 58 1,551,808 7,570,000 4,200,360 0 821,063
74,351,128 0 10,675 0
ANK: 23 0 5,948,091 0
866 0 0
86,318,029 0 6,779,829
0 79,538,200
23 SUFI RIDHANA YULIANI ,A.Md.Kg K -1 2,474,700 0 0 0 0 0 23 .............
1 247,470 0 0 0 0 0
49,494 240,000 217,260 0 30,117
01-07-1994 3 2,771,664 0 0 0
199407012019032013 MKG: 6 0 221,733 0
Pengatur Tk.I-2D 0 2001370602
26 0
90.813.873.8-732.000 3,228,950 0 251,850 0
0 2,977,100
24 EVA AGUSTINA RAHAYU TK-0 3,138,600 0 0 0 0 0 24 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 33,786
17-08-1979 1 3,138,600 0 0 0 0
197908172007012015 MKG:23 0 251,088 0
Pengatur-2C 0 2001322896
54 0
88.508.924.3-732.000 3,451,074 0 284,874 0
0 3,166,200
25 RIZKI AMALIA TK-0 2,687,800 0 0 0 0 0 25 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 29,278
14-12-1988 1 2,687,800 0 0 0
198812142009032001 MKG:13 0 215,024 0
Pengatur-2C 0 2001322818
82 0
16.071.878.9-731.000 3,000,302 0 244,302 0
0 2,756,000
SUB TOTAL PERGOLONGAN : 8,301,100 0 0 0 0 0
PEG: 3 247,470 0 0 0 0 0
IST: 1 JIWA= 5 49,494 720,000 362,100 0 93,181
8,598,064 0 0 0
ANK: 1 0 687,845 0
162 0 0
9,680,326 0 781,026
0 8,899,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS TAMBANG ULANG
(002) D50500100200013 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 83,883,200 0 0 0 10,675 0
PEG: 25 5,915,930 185,000 0 0 0 0
IST: 17 JIWA= 70 1,923,254 10,690,000 5,069,400 0 1,025,976
ANK: 28 91,722,384 0 10,675 0
0 7,337,791 0
0 0
1,083 0 8,374,442
107,678,542
0 99,304,100

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KAIT-KAIT
(002) D50500100200014 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 Hj. PUJIAH ,S.ST TK-0 4,555,800 0 0 0 24,396 0 1 .............
0 0 0 0 0 0 0
0 850,000 72,420 0 54,058
07-08-1969 1 4,555,800 0 24,396 0
196908071991012004 MKG:26 0 364,464 0
Pembina-4A 0 2001354747
2 0
15.582.583.1-732.000 5,502,618 0 442,918 0
0 5,059,700
2 ELYANI ,M.KES TK-0 3,901,500 0 0 0 0 0 2 .............
0 0 190,000 0 0 0 0
0 0 72,420 0 40,915
20-03-1978 1 3,901,500 0 0 0
197803202005012017 MKG:16 0 312,120 0
Pembina-4A 0 2001323043
15 0
15.607.111.0-732.000 4,163,935 0 353,035 0
0 3,810,900
SUB TOTAL PERGOLONGAN : IV 8,457,300 0 0 0 24,396 0
PEG: 2 0 190,000 0 0 0 0
IST: 0 JIWA= 2 0 850,000 144,840 0 94,973
8,457,300 0 24,396 0
ANK: 0 0 676,584 0
17 0 0
9,666,553 0 795,953
0 8,870,600
3 SITI FITRIAH ,SST TK-0 4,108,100 0 0 0 0 0 3 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 47,081
05-10-1975 1 4,108,100 0 0 0
197510052006042019 MKG:22 0 328,648 0
Penata Tk.I-3D 0 2001353187
9 0
16.232.466.9-732.000 4,780,529 0 375,729 0
0 4,404,800
4 YUSUF PURWANTO ,AMK K -1 4,508,600 0 0 0 10,675 0 4 .............
0 450,860 0 0 0 0 0
0 500,000 144,840 0 54,595
14-10-1968 2 4,959,460 0 10,675 0
196810141988031003 MKG:28 0 396,757 0
Penata Tk.I-3D 0 2001353767
52 0
16.232.474.3-732.000 5,615,027 0 462,027 0
0 5,153,000
5 MARYATUL JANNAH ,AM.Keb TK-0 4,237,500 0 0 0 0 0 5 .............
2 0 0 0 0 0 0
169,500 500,000 217,260 0 49,070
10-07-1972 3 4,407,000 0 0 0
197207101992022004 MKG:24 0 352,560 0
Penata Tk.I-3D 0 2001321504
70 0
15.042.272.3-732.000 5,124,330 0 401,630 0
0 4,722,700
6 NINA SETIANI ,AM.KEB K -1 4,237,500 0 0 0 0 0 6 .............
1 423,750 0 0 0 0 0
84,750 500,000 217,260 0 52,460
29-09-1974 3 4,746,000 0 0 0
197409291993032001 MKG:24 0 379,680 0
Penata Tk.I-3D 0 2001351055
80 0
16.232.465.1-732.000 5,463,340 0 432,140 0
0 5,031,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KAIT-KAIT
(002) D50500100200014 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
7 RAMADHANIYAH K -1 4,108,100 0 0 0 0 0 7 .............
0 410,810 0 0 0 0 0
0 500,000 144,840 0 50,189
19-09-1974 2 4,518,910 0 0 0
197409191995032001 MKG:22 0 361,513 0
Penata Tk.I-3D 0 2001323205
52 0
16.232.469.3-732.000 5,163,802 0 411,702 0
0 4,752,100
8 AGUS HERIYANTO ,AMK K -1 3,982,600 0 0 0 0 0 8 .............
2 398,260 0 0 0 0 0
159,304 500,000 289,680 0 50,402
18-08-1971 4 4,540,164 0 0 0
197108181997031008 MKG:20 0 363,213 0
Penata Tk.I-3D 0 2001322462
71 0
16.232.481.8-732.000 5,329,915 0 413,615 0
0 4,916,300
9 MARLIA ,AM.KEP K -1 3,861,000 0 0 0 0 0 9 .............
2 386,100 0 0 0 0 0
154,440 500,000 289,680 0 49,015
07-03-1980 4 4,401,540 0 0 0
198003071999032001 MKG:18 0 352,123 0
Penata Tk.I-3D 0 2001322594
18 0
15.582.991.4-732.000 5,191,238 0 401,138 0
0 4,790,100
10 drg, HALIMATUSSADDIAH MASTUR K -1 3,272,200 0 0 0 0 0 10 .............
1 327,220 0 0 0 0 0
65,444 750,000 217,260 0 44,149
09-09-1981 3 3,664,864 0 0 0
198109092017042001 MKG:10 0 293,189 0
Penata-3C 0 2001369558
14 0
16.691.920.9-801.000 4,632,138 0 337,338 0
0 4,294,800
11 SEPTERINA PURWASETYA K -1 2,890,500 0 0 0 0 0 11 .............
1 289,050 0 0 0 0 0
57,810 750,000 217,260 0 39,874
20-09-1992 3 3,237,360 0 0 0
199209202019032006 MKG: 3 0 258,989 0
Penata-3C 0 2001370297
43 0
76.603.269.2-732.000 4,204,663 0 298,863 0
0 3,905,800
12 MUHAMMAD SURYADI ,AM.KEP TK-0 3,481,600 0 0 0 0 0 12 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 39,816
16-09-1978 1 3,481,600 0 0 0
197809162006041009 MKG:14 0 278,528 0
Penata-3C 0 2001355147
24 0
16.232.470.1-732.000 4,054,044 0 318,344 0
0 3,735,700
13 DWI PURNAMASARI ,AMK K -1 3,272,200 0 0 0 0 0 13 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
18-03-1984 4 3,730,308 0 0 0
198403182009032003 MKG:11 0 298,425 0
Penata-3C 0 2001321617
40 0
16.232.454.4-732.000 4,520,028 0 340,728 0
0 4,179,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KAIT-KAIT
(002) D50500100200014 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 DIANA NOVITA ,AMG TK-0 3,272,200 0 0 0 0 0 14 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
29-11-1976 1 3,272,200 0 0 0
197611292009032006 MKG:10 0 261,776 0
Penata-3C 0 2001321512
78 0
16.184.806.4-732.000 3,844,698 0 299,498 0
0 3,545,200
15 MIFTAHUL JANNAH ,S.Kep.,Ns TK-0 2,150,800 0 0 0 0 0 15 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
12-05-1993 1 2,150,800 0 0 0
199305122022032009 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200400509
2 0
959609819732000 2,408,222 0 195,422 0
0 2,212,800
16 DJICKRY WAHYUDI ,AM.KG K -1 3,106,900 0 0 0 0 0 16 .............
2 310,690 0 0 0 0 0
124,276 265,000 289,680 0 38,069
20-05-1982 4 3,541,866 0 0 0
198205202008011018 MKG:12 0 283,349 0
Penata Muda-3A 0 2001355042
72 0
16.232.463.6-732.000 4,096,618 0 321,418 0
0 3,775,200
SUB TOTAL PERGOLONGAN : III 50,489,800 0 0 0 10,675 0
PEG: 14 3,323,960 185,000 0 0 0 0
IST: 9 JIWA= 36 946,412 6,865,000 2,607,120 0 618,103
54,760,172 0 10,675 0
ANK: 13 0 4,380,814 0
625 0 0
64,428,592 0 5,009,592
0 59,419,000
17 HARIS KERTAPATI, AM.KG K -1 2,801,500 0 0 0 0 0 17 .............
1 280,150 0 0 0 0 0
56,030 240,000 217,260 0 33,777
26-09-1987 3 3,137,680 0 0 0
198709262009031002 MKG:13 0 251,014 0
Pengatur Tk.I-2D 0 2001319771
51 0
79.771.577.8-732.000 3,594,991 0 284,791 0
0 3,310,200
18 PRIMA IFMEIDA HIDAYANTI ,A.Md. TK-0 2,374,300 0 0 0 0 0 18 .............
RMIK 0 0 0 0 0 0 0
0 360,000 72,420 0 27,343
13-05-1995 1 2,374,300 0 0 0
199505132020122026 MKG: 5 0 189,944 0
Pengatur-2C 0 2001372575
67 0
85.423.177.6-732.000 2,806,787 0 217,287 0
0 2,589,500
19 ACHMAD PUTRA SETIYAWAN ,AMK K -1 2,374,300 0 0 0 0 0 19 .............
2 237,430 0 0 0 0 0
94,972 240,000 289,680 0 29,467
23-09-1990 4 2,706,702 0 0 0
199009232020121014 MKG: 5 0 216,536 0
Pengatur-2C 0 2001373083
21 0
81.373.580.0-732.000 3,236,403 0 246,003 0
0 2,990,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KAIT-KAIT
(002) D50500100200014 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
20 HANAFI RIZANI ,A.Md.Kep K -1 2,374,300 0 0 0 0 0 20 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
13-08-1992 3 2,659,216 0 0 0
199208132019031005 MKG: 5 0 212,737 0
Pengatur-2C 0 2001371072
53 0
76.224.587.6-732.000 3,116,529 0 241,729 0
0 2,874,800
21 ERLINA ASTUTI ,A.Md.Keb K -1 2,374,300 0 0 0 0 0 21 .............
0 237,430 0 0 0 0 0
0 240,000 144,840 0 28,517
13-03-1993 2 2,611,730 0 0 0
199303132020122031 MKG: 5 0 208,938 0
Pengatur-2C 0 2001372753
85 0
83.434.859.1-732.000 2,996,655 0 237,455 0
0 2,759,200
22 RICO ARIESANDI ,A.Md.KL K -1 2,374,300 0 0 0 0 0 22 .............
0 237,430 0 0 0 0 0
0 240,000 144,840 0 28,517
23-06-1996 2 2,611,730 0 0 0
199606232019031002 MKG: 5 0 208,938 0
Pengatur-2C 0 2001370197
85 0
84.906.644.4-732.000 2,996,655 0 237,455 0
0 2,759,200
23 YENI ARISKA ,A.Md. Farm TK-0 1,841,440 0 0 0 0 0 23 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
12-06-1997 1 1,841,440 0 0 0
199706122022032007 MKG: 3 0 147,315 0
Pengatur-2C 0 3200402188
69 0
959898073734000 2,093,929 0 167,529 0
0 1,926,400
SUB TOTAL PERGOLONGAN : 16,514,440 0 0 0 0 0
PEG: 7 1,229,870 180,000 0 0 0 0
IST: 5 JIWA= 16 198,488 1,560,000 1,158,720 0 196,827
17,942,798 0 0 0
ANK: 4 0 1,435,422 0
431 0 0
20,841,949 0 1,632,249
0 19,209,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KAIT-KAIT
(002) D50500100200014 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 75,461,540 0 0 0 35,071 0
PEG: 23 4,553,830 555,000 0 0 0 0
IST: 14 JIWA= 54 1,144,900 9,275,000 3,910,680 0 909,903
ANK: 17 81,160,270 0 35,071 0
0 6,492,820 0
0 0
1,073 0 7,437,794
94,937,094
0 87,499,300

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PADANG LUAS
(002) D50500100200015 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 SUAIDI A ,S.Sos K -1 4,508,600 0 0 0 0 0 1 .............
0 450,860 0 0 0 0 0
0 500,000 144,840 0 54,595
01-04-1966 2 4,959,460 0 0 0
196604011988011002 MKG:28 0 396,757 0
Penata Tk.I-3D 0 2001322349
52 0
16.232.494.1-732.000 5,604,352 0 451,352 0
0 5,153,000
2 PARIDAHWATI K -1 4,370,900 0 0 0 0 0 2 .............
1 437,090 0 0 0 0 0
87,418 500,000 217,260 0 53,954
14-06-1971 3 4,895,408 0 0 0 0
197106141991012002 MKG:26 0 391,633 0
Penata Tk.I-3D 0 2001323523
19 0
16.038.849.2-732.000 5,612,687 0 445,587 0
0 5,167,100
3 FAHMI K -1 4,370,900 0 0 0 0 0 3 .............
0 437,090 185,000 0 0 0 0
0 0 144,840 0 49,930
17-02-1968 2 4,807,990 0 0 0
196802171990021001 MKG:26 0 384,639 0
Penata Tk.I-3D 0 2001322608
39 0
15.548.969.3-732.000 5,137,869 0 434,569 0
0 4,703,300
4 RUHANA ,AM.KEB K -1 3,591,200 0 0 0 0 0 4 .............
2 359,120 0 0 0 0 0
143,648 500,000 289,680 0 45,940
21-04-1981 4 4,093,968 0 0 0
198104212006042021 MKG:16 0 327,517 0
Penata-3C 0 2001334339
9 0
16.717.717.9-732.000 4,883,657 0 373,457 0
0 4,510,200
5 ZUHAIRIYAH ,AM.KL TK-0 3,481,600 0 0 0 0 0 5 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 39,816
04-01-1980 1 3,481,600 0 0 0
198001042007012006 MKG:14 0 278,528 0
Penata-3C 0 2001334215
24 0
16.257.869.4-732.000 4,054,044 0 318,344 0
0 3,735,700
6 NOORHAYANI ,AM.KEB K -1 3,481,600 0 0 0 0 0 6 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
30-05-1980 4 3,969,024 0 0 0
198005302006042010 MKG:14 0 317,522 0
Penata-3C 0 2001334363
8 0
16.257.866.0-732.000 4,758,712 0 362,212 0
0 4,396,500
7 SITI AISYAH ,A.Md.Ak K -1 3,272,200 0 0 0 0 0 7 .............
1 327,220 0 0 0 0 0
65,444 500,000 217,260 0 41,649
27-11-1984 3 3,664,864 0 0 0
198411272009032009 MKG:10 0 293,189 0
Penata-3C 0 2001334207
14 0
16.257.873.6-732.000 4,382,138 0 334,838 0
0 4,047,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PADANG LUAS
(002) D50500100200015 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 SITI NORMEILAWATI ,AMK K -1 3,272,200 0 0 0 0 0 8 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
13-05-1988 4 3,730,308 0 0 0
198805132010012009 MKG:10 0 298,425 0
Penata-3C 0 2001359021
40 0
16.257.863.7-732.000 4,520,028 0 340,728 0
0 4,179,300
9 YUHYIL HUSNA ,S.KM K -1 3,375,300 0 0 0 0 0 9 .............
0 337,530 0 0 0 0 0
0 300,000 144,840 0 40,128
17-09-1984 2 3,712,830 0 0 0
198409172010011005 MKG:12 0 297,026 0
Penata-3C 0 2001369612
84 0
14.961.445.5-732.000 4,157,754 0 337,154 0
0 3,820,600
10 dr, AKBAR RIHANSYAH K -1 2,890,500 0 0 0 0 0 10 .............
1 289,050 0 0 0 0 0
57,810 0 217,260 0 32,374
24-06-1992 3 3,237,360 0 0 0
199206242019031005 MKG: 3 0 258,989 0
Penata-3C 0 2001371129
43 0
72.126.182.5-732.000 3,454,663 0 291,363 0
0 3,163,300
11 MULYADI ,S.K.M K -1 2,773,200 0 0 0 0 0 11 .............
0 277,320 0 0 0 0 0
0 300,000 144,840 0 33,505
29-03-1997 2 3,050,520 0 0 0
199703292019031001 MKG: 3 0 244,042 0
Penata Muda Tk.I-3B 0 2001370246
87 0
90.799.542.7-732.000 3,495,447 0 277,547 0
0 3,217,900
12 ANNA SUKMAWATI ,AM.KEB K -1 3,139,400 0 0 0 0 0 12 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
16-10-1986 4 3,578,916 0 0 0
198610162010012022 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001322705
56 0
16.570.987.4-732.000 4,133,652 0 324,752 0
0 3,808,900
13 dr, SHOREA SYLVIANA PUTERI K -1 2,150,800 0 0 0 0 0 13 .............
1 215,080 185,000 0 0 0 0
43,016 0 217,260 0 25,939
31-07-1991 3 2,408,896 0 0 0
199107312022032001 MKG: 0 0 192,712 0
Penata Muda Tk.I-3B 0 3200406841
95 0
714580222731000 2,811,251 0 218,651 0
0 2,592,600
SUB TOTAL PERGOLONGAN : III 44,678,400 0 0 0 0 0
PEG: 13 4,119,680 370,000 0 0 0 0
IST: 12 JIWA= 37 793,064 4,365,000 2,679,540 0 543,262
49,591,144 0 0 0
ANK: 12 0 3,967,292 0
570 0 0
57,006,254 0 4,510,554
0 52,495,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PADANG LUAS
(002) D50500100200015 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 DESIARIANI BR SEMBIRING ,AM.Keb K -0 2,980,800 0 0 0 0 0 14 .............
2 0 0 0 0 0 0
119,232 240,000 217,260 0 33,400
18-12-1981 3 3,100,032 0 0 0
198112182017042001 MKG:17 0 248,003 0
Pengatur Tk.I-2D 0 2001369019
11 0
66.497.259.3-731.000 3,557,303 0 281,403 0
0 3,275,900
15 SITI LESTARI ,AMK K -1 2,474,700 0 0 0 0 0 15 .............
1 247,470 0 0 0 0 0
49,494 240,000 217,260 0 30,117
09-09-1991 3 2,771,664 0 0 0
199109092019032010 MKG: 6 0 221,733 0
Pengatur Tk.I-2D 0 2001371552
26 0
73.542.725.4-732.000 3,228,950 0 251,850 0
0 2,977,100
16 BAITUL ASKAH ,A.Md.KL TK-0 2,474,700 0 0 0 0 0 16 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 27,147
09-06-1996 1 2,474,700 0 0 0
199606092019032009 MKG: 6 0 197,976 0
Pengatur Tk.I-2D 0 2001370928
3 0
90.785.352.7-732.000 2,787,123 0 225,123 0
0 2,562,000
17 DONY ANDRIAN ,A.Md.Kep K -1 2,859,800 0 0 0 0 0 17 .............
2 285,980 0 0 0 0 0
114,392 240,000 289,680 0 35,002
11-08-1979 4 3,260,172 0 0 0
197908112005011006 MKG:17 0 260,814 0
Pengatur-2C 0 2001335092
64 0
46.022.961.0-732.000 3,789,916 0 295,816 0
0 3,494,100
18 NINA YUNITA ,A.Md.Kg K -1 2,374,300 0 0 0 0 0 18 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
11-06-1994 3 2,659,216 0 0 0
199406112019032010 MKG: 5 0 212,737 0
Pengatur-2C 0 2001370599
53 0
90.807.060.0-732.000 3,116,529 0 241,729 0
0 2,874,800
19 KHAIRUNISA ,A.Md.Keb K -1 1,841,440 0 0 0 0 0 19 .............
2 184,144 180,000 0 0 0 0
73,658 0 289,680 0 22,792
10-05-1993 4 2,099,242 0 0 0
199305102022032005 MKG: 3 0 167,939 0
Pengatur-2C 0 3200395513
9 0
537993669732000 2,568,931 0 190,731 0
0 2,378,200
20 DEDE CANDRA ,A.Md.Kep K -1 1,841,440 0 0 0 0 0 20 .............
0 184,144 180,000 0 0 0 0
0 0 144,840 0 22,056
03-11-1996 2 2,025,584 0 0 0
199611032022031006 MKG: 3 0 162,047 0
Pengatur-2C 0 3200388247
79 0
421629478732000 2,350,503 0 184,103 0
0 2,166,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS PADANG LUAS
(002) D50500100200015 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 AJENG TRIANY WININGTIAS SAPUTRI K -1 1,841,440 0 0 0 0 0 21 .............
,A.Md.Farm 1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
01-12-1997 3 2,062,413 0 0 0
199712012022032010 MKG: 3 0 164,993 0
Pengatur-2C 0 3200402967
44 0
415778182732000 2,459,717 0 187,417 0
0 2,272,300
22 YUNA MULYANI ,A.Md.Gz TK-0 1,841,440 0 0 0 0 0 22 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
09-01-1998 1 1,841,440 0 0 0
199801092022032005 MKG: 3 0 147,315 0
Pengatur-2C 0 3200404008
69 0
953710811732000 2,093,929 0 167,529 0
0 1,926,400
SUB TOTAL PERGOLONGAN : 20,530,060 0 0 0 0 0
PEG: 9 1,323,312 720,000 0 0 0 0
IST: 6 JIWA= 24 441,091 1,200,000 1,738,080 0 242,144
22,294,463 0 0 0
ANK: 9 0 1,783,557 0
358 0 0
25,952,901 0 2,025,701
0 23,927,200
TOTAL PER SATKER 65,208,460 0 0 0 0 0
PEG: 22 5,442,992 1,090,000 0 0 0 0
IST: 18 JIWA= 61 1,234,155 5,565,000 4,417,620 0 785,406
ANK: 21 71,885,607 0 0 0
0 5,750,849 0
0 0
928 0 6,536,255
82,959,155
0 76,422,900

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KURAU
(002) D50500100200016 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 KURDIANSYAH ,AMK K -1 4,650,600 0 0 0 6,613 0 1 .............
1 465,060 0 0 0 0 0
93,012 500,000 217,260 0 57,087
14-03-1966 3 5,208,672 0 6,613 0
196603141987031006 MKG:30 0 416,694 0
Penata Tk.I-3D 0 2001334193
49 0
15.580.348.9-732.000 5,932,594 0 480,394 0
0 5,452,200
2 BAHRANIANSYAH ,AMK K -1 4,370,900 0 0 0 0 0 2 .............
2 437,090 0 0 0 0 0
174,836 500,000 289,680 0 54,828
05-11-1971 4 4,982,826 0 0 0
197111051991011001 MKG:26 0 398,626 0
Penata Tk.I-3D 0 2001368977
48 0
63.020.605.1-171.000 5,772,554 0 453,454 0
0 5,319,100
3 Hj. FAHRIAH ,A.Md.Kes TK-0 4,108,100 0 0 0 0 0 3 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 46,081
28-04-1974 1 4,108,100 0 0 0
197404281995032002 MKG:22 0 328,648 0
Penata Tk.I-3D 0 2001322578
9 0
16.115.110.5-732.000 4,680,529 0 374,729 0
0 4,305,800
4 ASLAM ,SKM K -1 3,704,300 0 0 0 0 0 4 .............
2 370,430 0 0 0 0 0
148,172 600,000 289,680 0 48,229
27-10-1978 4 4,222,902 0 0 0
197810272011011001 MKG:18 0 337,832 0
Penata-3C 0 2001360585
79 0
16.034.616.9-731.000 5,112,661 0 386,061 0
0 4,726,600
5 IMAM ERA WAHYUDI ,S.Kep., Ns K -1 3,375,300 0 0 0 0 0 5 .............
2 337,530 0 0 0 0 0
135,012 600,000 289,680 0 44,478
11-09-1977 4 3,847,842 0 0 0
197709112005011006 MKG:12 0 307,827 0
Penata-3C 0 2001321539
83 0
16.282.360.3-732.000 4,737,605 0 352,305 0
0 4,385,300
6 HALIMAH ,A.Md.Keb TK-0 3,821,000 0 0 0 0 0 6 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 43,210
20-11-1972 1 3,821,000 0 0 0
197211202005012006 MKG:21 0 305,680 0
Penata-3C 0 2001334328
70 0
15.307.344.0-732.000 4,393,490 0 348,890 0
0 4,044,600
7 HIDAYATINNAJAH ,AM.KEB K -1 3,481,600 0 0 0 0 0 7 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
26-07-1982 4 3,969,024 0 0 0
198207262006042010 MKG:14 0 317,522 0
Penata-3C 0 2001369027
8 0
16.432.779.3-732.000 4,758,712 0 362,212 0
0 4,396,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KURAU
(002) D50500100200016 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 HARRI MULIANI ,AMG TK-0 3,272,200 0 0 0 0 0 8 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
05-10-1975 1 3,272,200 0 0 0
197510052009032007 MKG:11 0 261,776 0
Penata-3C 0 2001321498
78 0
16.232.496.6-732.000 3,844,698 0 299,498 0
0 3,545,200
9 LAILA FITHRIANI, AM.KG K -1 3,272,200 0 0 0 0 0 9 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
23-02-1983 4 3,730,308 0 0 0
198302232009032006 MKG:11 0 298,425 0
Penata-3C 0 2001368985
40 0
16.257.604.5-732.000 4,520,028 0 340,728 0
0 4,179,300
10 dr, SYAHRIZAL HAFIDZ K -1 3,272,200 0 0 0 0 0 10 .............
2 327,220 0 0 0 0 0
130,888 325,000 289,680 0 40,553
25-11-1977 4 3,730,308 0 0 0
197711252011011004 MKG:10 0 298,425 0
Penata-3C 0 2001368853
90 0
15.970.156.4-731.000 4,345,078 0 338,978 0
0 4,006,100
11 dr, WIDA HIDAYATI K -1 2,773,200 0 0 0 0 0 11 .............
2 277,320 0 0 0 0 0
110,928 325,000 289,680 0 34,864
27-05-1985 4 3,161,448 0 0 0
198505272020122004 MKG: 2 0 252,916 0
Penata Muda Tk.I-3B 0 2001372238
52 0
41.006.633.6-732.000 3,776,180 0 287,780 0
0 3,488,400
12 Hj. PAHRINAWATI K -1 3,781,400 0 0 0 0 0 12 .............
1 378,140 0 0 0 0 0
75,628 265,000 217,260 0 45,002
06-01-1973 3 4,235,168 0 0 0
197301062006042025 MKG:22 0 338,813 0
Penata Muda Tk.I-3B 0 2001359428
87 0
16.282.361.1-732.000 4,717,515 0 383,815 0
0 4,333,700
13 ERNA ,AMd.Keb K -1 3,781,400 0 0 0 0 0 13 .............
2 378,140 0 0 0 0 0
151,256 265,000 289,680 0 45,758
26-03-1976 4 4,310,796 0 0 0
197603262006042017 MKG:22 0 344,864 0
Penata Muda Tk.I-3B 0 2001322748
46 0
16.232.497.4-732.000 4,865,522 0 390,622 0
0 4,474,900
14 MUHAMMAD MUCHSIN ,AMK K -1 3,139,400 0 0 0 0 0 14 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
14-09-1986 4 3,578,916 0 0 0
198609142009031005 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001368942
56 0
16.118.804.0-731.000 4,133,652 0 324,752 0
0 3,808,900
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KURAU
(002) D50500100200016 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
15 MUSLIMAH ,AMK TK-0 3,043,600 0 0 0 0 0 15 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,086
15-02-1988 1 3,043,600 0 0 0
198802152011012007 MKG: 8 0 243,488 0
Penata Muda Tk.I-3B 0 2001358955
54 0
16.257.601.1-732.000 3,381,074 0 276,574 0
0 3,104,500
16 NIDA RAHMAYANTI ,S.Tr.Keb TK-0 2,660,700 0 0 0 0 0 16 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 29,607
02-05-1996 1 2,660,700 0 0 0
199605022020122028 MKG: 2 0 212,856 0
Penata Muda-3A 0 2001373687
43 0
41.127.641.3-732.000 3,033,163 0 242,463 0
0 2,790,700
17 EKA DAMAYANTI K -1 3,106,900 0 0 0 0 0 17 .............
2 310,690 0 0 0 0 0
124,276 265,000 289,680 0 38,069
20-08-1984 4 3,541,866 0 0 0
198408202007012002 MKG:13 0 283,349 0
Penata Muda-3A 0 2001321636
72 0
16.232.499.0-732.000 4,096,618 0 321,418 0
0 3,775,200
18 DIAN TRIASTUTI JD-0 2,920,100 0 0 0 0 0 18 .............
1 0 0 0 0 0 0
58,402 265,000 144,840 0 32,435
26-10-1979 2 2,978,502 0 0 0
197910262009032005 MKG: 8 0 238,280 0
Penata Muda-3A 0 2001336188
73 0
15.582.991.4-732.000 3,388,415 0 270,715 0
0 3,117,700
19 INDAH HARIYAWATI ,S.Gz TK-0 2,063,520 0 0 0 0 0 19 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 22,485
18-08-1992 1 2,063,520 0 0 0
199208182022032005 MKG: 0 0 165,082 0
Penata Muda-3A 0 3200408704
27 0
952724607732000 2,320,967 0 187,567 0
0 2,133,400
SUB TOTAL PERGOLONGAN : III 64,598,620 0 0 0 6,613 0
PEG: 19 4,270,940 185,000 0 0 0 0
IST: 12 JIWA= 54 1,598,138 7,240,000 3,910,680 0 778,926
70,467,698 0 6,613 0
ANK: 23 0 5,637,416 0
1,064 0 0
81,811,055 0 6,422,955
0 75,388,100
20 AKHMAD FADLANSYAH K -0 2,980,800 0 0 0 0 0 20 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 32,208
29-12-1982 1 2,980,800 0 0 0
198212292005011002 MKG:17 0 238,464 0
Pengatur Tk.I-2D 0 2001322446
52 0
16.257.603.7-732.000 3,293,272 0 270,672 0
0 3,022,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KURAU
(002) D50500100200016 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 MUHAMMAD SYARIPUDDIN K -1 2,980,800 0 0 0 0 0 21 .............
2 298,080 180,000 0 0 0 0
119,232 0 289,680 0 35,781
04-07-1974 4 3,398,112 0 0 0
197407042010011001 MKG:17 0 271,849 0
Pengatur Tk.I-2D 0 2001321474
38 0
16.257.601.9-732.000 3,867,830 0 307,630 0
0 3,560,200
22 ABI JAYANDI ,A.Md.Far K -1 2,374,300 0 0 0 0 0 22 .............
2 237,430 0 0 0 0 0
94,972 240,000 289,680 0 29,467
02-06-1990 4 2,706,702 0 0 0
199006022019031004 MKG: 5 0 216,536 0
Pengatur-2C 0 2001370874
21 0
73.694.005.7-732.000 3,236,403 0 246,003 0
0 2,990,400
23 IZZATUL LAILY ,A.Md.Kes TK-0 2,374,300 0 0 0 0 0 23 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
13-07-1997 1 2,374,300 0 0 0
199707132020122016 MKG: 5 0 189,944 0
Pengatur-2C 0 2001373757
67 0
41.012.244.4-732.000 2,686,787 0 216,087 0
0 2,470,700
24 IKHA SEPTIANA PUTRI ,A.Md.,Farm TK-0 2,374,300 0 0 0 0 0 24 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
20-09-1997 1 2,374,300 0 0 0
199709202020122018 MKG: 5 0 189,944 0
Pengatur-2C 0 2001372761
67 0
96.280.698.0-732.000 2,686,787 0 216,087 0
0 2,470,700
25 FITRIANI ,A.Md.Kes K -1 2,374,300 0 0 0 0 0 25 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
15-02-1998 3 2,659,216 0 0 0
199802152020122006 MKG: 5 0 212,737 0
Pengatur-2C 0 2001373725
53 0
96.989.295.9-732.000 3,116,529 0 241,729 0
0 2,874,800
SUB TOTAL PERGOLONGAN : 15,458,800 0 0 0 0 0
PEG: 6 772,940 180,000 0 0 0 0
IST: 3 JIWA= 14 261,690 1,200,000 1,013,880 0 178,734
16,493,430 0 0 0
ANK: 5 0 1,319,474 0
298 0 0
18,887,608 0 1,498,208
0 17,389,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS KURAU
(002) D50500100200016 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 80,057,420 0 0 0 6,613 0
PEG: 25 5,043,880 365,000 0 0 0 0
IST: 15 JIWA= 68 1,859,828 8,440,000 4,924,560 0 957,660
ANK: 28 86,961,128 0 6,613 0
0 6,956,890 0
0 0
1,362 0 7,921,163
100,698,663
0 92,777,500

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BATAKAN
(002) D50500100200017 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 YULI HOSIANA SITANGGANG ,SST TK-0 4,108,100 0 0 0 0 0 1 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 47,081
05-07-1976 1 4,108,100 0 0 0
197607052006042013 MKG:22 0 328,648 0
Penata Tk.I-3D 0 2001319798
9 0
79.771.576.0-732.000 4,780,529 0 375,729 0
0 4,404,800
2 H. BADERAN ,SKM K -1 4,508,600 0 0 0 10,675 0 2 .............
0 450,860 0 0 0 0 0
0 500,000 144,840 0 54,595
11-10-1968 2 4,959,460 0 10,675 0
196810111989021002 MKG:28 0 396,757 0
Penata Tk.I-3D 0 2001323655
52 0
79.771.565.3-732.000 5,615,027 0 462,027 0
0 5,153,000
3 WENING TRI AMBARYANI ,S.ST K -0 3,704,300 0 0 0 0 0 3 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 43,043
30-05-1980 1 3,704,300 0 0 0
198005302005012013 MKG:18 0 296,344 0
Penata-3C 0 2001323639
67 0
48.496.993.6-732.000 4,376,787 0 339,387 0
0 4,037,400
4 ERWIEN WAHYUDI ,AMd.Gz K -1 3,172,300 0 0 0 0 0 4 .............
1 317,230 0 0 0 0 0
63,446 500,000 217,260 0 40,530
19-06-1987 3 3,552,976 0 0 0
198706192011011003 MKG: 9 0 284,238 0
Penata-3C 0 2001359714
32 0
87.669.141.1-732.000 4,270,268 0 324,768 0
0 3,945,500
5 apt, GUSTIAN ANESTESIA ,S.Farm K -1 2,773,200 0 0 0 0 0 5 .............
2 277,320 0 0 0 0 0
110,928 325,000 289,680 0 34,864
03-08-1992 4 3,161,448 0 0 0
199208032020121017 MKG: 2 0 252,916 0
Penata Muda Tk.I-3B 0 2001372303
52 0
81.349.004.2-732.000 3,776,180 0 287,780 0
0 3,488,400
6 FAHYUDI ,AMK TK-0 3,139,400 0 0 0 0 0 6 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 34,394
01-01-1988 1 3,139,400 0 0 0
198801012010011003 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001323752
26 0
87.669.138.7-732.000 3,511,846 0 285,546 0
0 3,226,300
7 AULIANA RACHMAN ,SKM TK-0 2,773,200 0 0 0 0 0 7 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 30,732
21-02-1992 1 2,773,200 0 0 0
199202212019032012 MKG: 3 0 221,856 0
Penata Muda Tk.I-3B 0 2001370912
68 0
73.664.818.9-732.000 3,145,688 0 252,588 0
0 2,893,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BATAKAN
(002) D50500100200017 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 dr, AJENG SETIYORINI K -1 2,150,800 0 0 0 0 0 8 .............
1 215,080 185,000 0 0 0 0
43,016 0 217,260 0 25,939
04-06-1990 3 2,408,896 0 0 0
199006042022032004 MKG: 0 0 192,712 0
Penata Muda Tk.I-3B 0 3200407643
95 0
721937332732000 2,811,251 0 218,651 0
0 2,592,600
9 YANTI NOVITA SARI ,S. Kep., Ns TK-0 2,660,700 0 0 0 0 0 9 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 29,607
07-11-1994 1 2,660,700 0 0 0
199411072020122021 MKG: 2 0 212,856 0
Penata Muda-3A 0 2001372311
43 0
96.094.945.1-732.000 3,033,163 0 242,463 0
0 2,790,700
10 RENI ANNISA K -1 2,830,900 0 0 0 0 0 10 .............
1 283,090 0 0 0 0 0
56,618 265,000 217,260 0 34,356
17-07-1991 3 3,170,608 0 0 0
199107172010012001 MKG: 7 0 253,649 0
Penata Muda-3A 0 2001323221
37 0
87.669.137.9-732.000 3,652,905 0 288,005 0
0 3,364,900
11 NIRINDA AZKIYA ,S.Tr.Keb TK-0 2,063,520 0 0 0 0 0 11 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 22,485
14-01-1997 1 2,063,520 0 0 0
199701142022032005 MKG: 0 0 165,082 0
Penata Muda-3A 0 3200400223
27 0
947808697732000 2,320,967 0 187,567 0
0 2,133,400
SUB TOTAL PERGOLONGAN : III 33,885,020 0 0 0 10,675 0
PEG: 11 1,543,580 370,000 0 0 0 0
IST: 5 JIWA= 21 274,008 3,690,000 1,520,820 0 397,626
35,702,608 0 10,675 0
ANK: 5 0 2,856,210 0
508 0 0
41,294,611 0 3,264,511
0 38,030,100
12 TITUS JULI ISMANTO ,AMK K -1 2,889,800 0 0 0 0 0 12 .............
2 288,980 0 0 0 0 0
115,592 240,000 289,680 0 35,344
27-07-1984 4 3,294,372 0 0 0
198407272009031009 MKG:15 0 263,550 0
Pengatur Tk.I-2D 0 2001323132
42 0
79.771.574.5-732.000 3,824,094 0 298,894 0
0 3,525,200
13 AFRIZAL ,AM.KL TK-0 2,374,300 0 0 0 0 0 13 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
21-04-1991 1 2,374,300 0 0 0
199104212019031012 MKG: 5 0 189,944 0
Pengatur-2C 0 2001370823
67 0
90.781.389.3-732.000 2,686,787 0 216,087 0
0 2,470,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BATAKAN
(002) D50500100200017 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 M. SYAHID FAKHRIDANI ,A.Md.AK K -1 2,374,300 0 0 0 0 0 14 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
29-11-1994 3 2,659,216 0 0 0
199411292020121014 MKG: 5 0 212,737 0
Pengatur-2C 0 2001372559
53 0
41.012.419.2-732.000 3,116,529 0 241,729 0
0 2,874,800
15 BAGUS HARIANTO ,AMK K -1 1,841,440 0 0 0 0 0 15 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
14-09-1992 3 2,062,413 0 0 0
199209142022031003 MKG: 3 0 164,993 0
Pengatur-2C 0 3200406507
44 0
764907598732000 2,459,717 0 187,417 0
0 2,272,300
16 SITI RAHMAH ,A.Md.Kes TK-0 1,841,440 0 0 0 0 0 16 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
15-01-2000 1 1,841,440 0 0 0
200001152022032002 MKG: 3 0 147,315 0
Pengatur-2C 0 3200406027
69 0
637272915732000 2,093,929 0 167,529 0
0 1,926,400
SUB TOTAL PERGOLONGAN : 11,321,280 0 0 0 0 0
PEG: 5 710,554 360,000 0 0 0 0
IST: 3 JIWA= 12 199,907 720,000 869,040 0 133,117
12,231,741 0 0 0
ANK: 4 0 978,539 0
275 0 0
14,181,056 0 1,111,656
0 13,069,400
TOTAL PER SATKER 45,206,300 0 0 0 10,675 0
PEG: 16 2,254,134 730,000 0 0 0 0
IST: 8 JIWA= 33 473,915 4,410,000 2,389,860 0 530,743
ANK: 9 47,934,349 0 10,675 0
0 3,834,749 0
0 0
783 0 4,376,167
55,475,667
0 51,099,500

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS SUNGAI CUKA
(002) D50500100200018 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 drg, NURRAHMAH K -1 3,410,600 0 0 0 0 0 1 .............
2 341,060 0 0 0 0 0
136,424 750,000 289,680 0 46,381
15-02-1982 4 3,888,084 0 0 0
198202152014112001 MKG:10 0 311,047 0
Penata Tk.I-3D 0 2001363193
64 0
66.426.048.6-732.000 4,927,828 0 357,428 0
0 4,570,400
2 WITAYA ,S.Kep,N.s K -1 3,743,100 0 0 0 0 0 2 .............
2 374,310 0 0 0 0 0
149,724 600,000 289,680 0 48,671
01-02-1980 4 4,267,134 0 0 0
198002012009031004 MKG:16 0 341,371 0
Penata Tk.I-3D 0 2001349573
28 0
16.482.875.8-732.000 5,156,842 0 390,042 0
0 4,766,800
3 IKA DAMAYANTI ,AMK K -0 4,108,100 0 0 0 0 0 3 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 46,081
23-11-1973 1 4,108,100 0 0 0
197311231998032008 MKG:22 0 328,648 0
Penata Tk.I-3D 0 2001349638
9 0
16.077.633.2-732.000 4,680,529 0 374,729 0
0 4,305,800
4 ERNA PRAHESTY ,AM.Keb K -1 3,628,900 0 0 0 0 0 4 .............
2 362,890 0 0 0 0 0
145,156 500,000 289,680 0 46,369
30-03-1982 4 4,136,946 0 0 0
198203302006042010 MKG:14 0 330,956 0
Penata Tk.I-3D 0 2001349662
99 0
46.026.329.4-732.000 4,926,725 0 377,325 0
0 4,549,400
5 YUNI HARTATI ,A.Md.Keb K -1 3,272,200 0 0 0 0 0 5 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
16-07-1988 4 3,730,308 0 0 0
198807162009032003 MKG:11 0 298,425 0
Penata-3C 0 2001345508
40 0
15.767.432.6-732.000 4,520,028 0 340,728 0
0 4,179,300
6 PUJIATI WULANDARI ,AMK K -0 3,272,200 0 0 0 0 0 6 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
28-12-1982 1 3,272,200 0 0 0
198212282010012014 MKG:10 0 261,776 0
Penata-3C 0 2001369628
78 0
16.482.877.4-732.000 3,844,698 0 299,498 0
0 3,545,200
7 SANTI TAMBUNAN K -1 3,781,400 0 0 0 0 0 7 .............
2 378,140 0 0 0 0 0
151,256 265,000 289,680 0 45,758
10-12-1969 4 4,310,796 0 0 0 0
196912102005012010 MKG:22 0 344,864 0
Penata Muda Tk.I-3B 0 2001349597
46 0
46.024.172.2-732.000 4,865,522 0 390,622 0
0 4,474,900
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS SUNGAI CUKA
(002) D50500100200018 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 KUSDIANA ,AM.KEB TK-0 3,665,900 0 0 0 0 0 8 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 39,309
16-03-1977 1 3,665,900 0 0 0 0
197703162005012012 MKG:20 0 293,272 0
Penata Muda Tk.I-3B 0 2001339721
61 0
16.493.572.8-732.000 4,003,381 0 332,581 0
0 3,670,800
9 WIDYA KUSUMA NINGRUM ,AM.Keb K -1 3,139,400 0 0 0 0 0 9 .............
1 313,940 0 0 0 0 0
62,788 240,000 217,260 0 37,561
12-10-1986 3 3,516,128 0 0 0
198610122010012012 MKG:10 0 281,290 0
Penata Muda Tk.I-3B 0 2001342967
63 0
46.025.965.8-732.000 3,973,451 0 318,851 0
0 3,654,600
10 dr, ABLISAR SAMAD K -1 2,150,800 0 0 0 0 0 10 .............
1 215,080 185,000 0 0 0 0
43,016 0 217,260 0 25,939
20-05-1989 3 2,408,896 0 0 0
198905202022031005 MKG: 0 0 192,712 0
Penata Muda Tk.I-3B 0 3200406914
95 0
900310475831000 2,811,251 0 218,651 0
0 2,592,600
11 NI KADEK USMINTARI ,S.Kep.,Ns TK-0 2,150,800 0 0 0 0 0 11 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
03-12-1994 1 2,150,800 0 0 0
199412032022032004 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200406957
2 0
636946543732000 2,408,222 0 195,422 0
0 2,212,800
12 ROZY HERMAWAN ,SKM K -1 2,660,700 0 0 0 0 0 12 .............
1 266,070 0 0 0 0 0
53,214 300,000 217,260 0 32,800
12-03-1996 3 2,979,984 0 0 0
199603122020121015 MKG: 2 0 238,399 0
Penata Muda-3A 0 2001373245
55 0
91.126.950.4-734.000 3,497,299 0 271,199 0
0 3,226,100
13 Hj. WIWIK ROHMIATI K -1 3,627,900 0 0 0 0 0 13 .............
1 362,790 0 0 0 0 0
72,558 265,000 217,260 0 43,282
01-02-1967 3 4,063,248 0 0 0
196702012006042010 MKG:22 0 325,060 0
Penata Muda-3A 0 2001339756
34 0
16.442.880.8-732.000 4,545,542 0 368,342 0
0 4,177,200
14 HABIBAH ,A.Md.Keb K -0 3,517,200 0 0 0 0 0 14 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 37,822
14-09-1977 1 3,517,200 0 0 0
197709142006042015 MKG:20 0 281,376 0
Penata Muda-3A 0 2001349538
78 0
46.025.828.8-732.000 3,854,698 0 319,198 0
0 3,535,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS SUNGAI CUKA
(002) D50500100200018 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
SUB TOTAL PERGOLONGAN : III 46,129,200 0 0 0 0 0
PEG: 14 2,941,500 370,000 0 0 0 0
IST: 9 JIWA= 37 945,024 4,950,000 2,679,540 0 553,356
50,015,724 0 0 0
ANK: 14 0 4,001,260 0
752 0 0
58,016,016 0 4,554,616
0 53,461,400
15 MUHAMMAD FAUZI SANTOSO TK-0 2,716,000 0 0 0 0 0 15 .............
0 0 0 0 0 0 0
0 220,000 72,420 0 29,360
25-03-1985 1 2,716,000 0 0 0 0
198503252011011001 MKG:11 0 217,280 0
Pengatur Tk.I-2D 0 2001359439
20 0
16.183.627.5-732.000 3,008,440 0 246,640 0
0 2,761,800
16 RUKMINI SINGGI ,AMKL K -1 1,841,440 0 0 0 0 0 16 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
12-07-1988 3 2,062,413 0 0 0
198807122022032003 MKG: 3 0 164,993 0
Pengatur-2C 0 3200409007
44 0
984208280734000 2,459,717 0 187,417 0
0 2,272,300
17 EKE EVIANA YULIYANI ,A.Md.Keb K -1 1,841,440 0 0 0 0 0 17 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
26-07-1990 3 2,062,413 0 0 0
199007262022032003 MKG: 3 0 164,993 0
Pengatur-2C 0 3200407945
44 0
537745143732000 2,459,717 0 187,417 0
0 2,272,300
18 HAMIDAH ,A.Md.AK TK-0 1,841,440 0 0 0 0 0 18 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
16-09-1996 1 1,841,440 0 0 0
199609162022032011 MKG: 3 0 147,315 0
Pengatur-2C 0 3200405209
69 0
433690146734000 2,093,929 0 167,529 0
0 1,926,400
SUB TOTAL PERGOLONGAN : 8,240,320 0 0 0 0 0
PEG: 4 368,288 540,000 0 0 0 0
IST: 2 JIWA= 8 73,658 220,000 579,360 0 94,422
8,682,266 0 0 0
ANK: 2 0 694,581 0
177 0 0
10,021,803 0 789,003
0 9,232,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS SUNGAI CUKA
(002) D50500100200018 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 54,369,520 0 0 0 0 0
PEG: 18 3,309,788 910,000 0 0 0 0
IST: 11 JIWA= 45 1,018,682 5,170,000 3,258,900 0 647,778
ANK: 16 58,697,990 0 0 0
0 4,695,841 0
0 0
929 0 5,343,619
68,037,819
0 62,694,200

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS ANGSAU
(002) D50500100200019 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 drg, DIANA SUSANTI TK-0 3,901,500 0 0 0 11,496 0 1 .............
0 0 0 0 0 0 0
0 1,200,000 72,420 0 51,015
10-09-1978 1 3,901,500 0 11,496 0
197809102006042026 MKG:16 0 312,120 0
Pembina-4A 0 2001325631
15 0
15.767.332.8-732.000 5,185,431 0 374,631 0
0 4,810,800
2 DRG, ITEM GANDHI WATI K -1 3,782,400 0 0 0 0 0 2 .............
1 378,240 0 0 0 0 0
75,648 1,200,000 217,260 0 54,363
22-12-1980 3 4,236,288 0 0 0
198012222009032007 MKG:14 0 338,903 0
Pembina-4A 0 2001322497
18 0
15.993.254.0-732.000 5,653,566 0 393,266 0
0 5,260,300
3 dr, MARIATUL KIPTIAH TK-0 3,666,900 0 0 0 913 0 3 .............
0 0 0 0 0 0 0
0 1,200,000 72,420 0 48,669
30-06-1980 1 3,666,900 0 913 0
198006302009032009 MKG:12 0 293,352 0
Pembina-4A 0 2001325658
1 0
79.771.567.9-732.000 4,940,234 0 342,934 0
0 4,597,300
SUB TOTAL PERGOLONGAN : IV 11,350,800 0 0 0 12,409 0
PEG: 3 378,240 0 0 0 0 0
IST: 1 JIWA= 5 75,648 3,600,000 362,100 0 154,047
11,804,688 0 12,409 0
ANK: 1 0 944,375 0
34 0 0
15,779,231 0 1,110,831
0 14,668,400
4 dr, NURLATIFAH APRIANI K -1 3,205,500 0 0 0 0 0 4 .............
1 320,550 0 0 0 0 0
64,110 750,000 217,260 0 43,402
27-04-1988 3 3,590,160 0 0 0
198804272015022003 MKG: 6 0 287,213 0
Penata Tk.I-3D 0 2001369078
95 0
72.401.368.5-732.000 4,557,515 0 330,615 0
0 4,226,900
5 KATARINA SINAGA ,AMK K -1 4,370,900 0 0 0 0 0 5 .............
1 437,090 0 0 0 0 0
87,418 500,000 217,260 0 53,954
09-03-1968 3 4,895,408 0 0 0
196803091991012001 MKG:26 0 391,633 0
Penata Tk.I-3D 0 2001323582
19 0
15.871.962.5-732.000 5,612,687 0 445,587 0
0 5,167,100
6 RABIATUL ADAWIAH ,AM.KEB TK-0 4,237,500 0 0 0 0 0 6 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 47,375
26-06-1974 1 4,237,500 0 0 0
197406261993012001 MKG:24 0 339,000 0
Penata Tk.I-3D 0 2001322713
55 0
15.767.279.1-732.000 4,809,975 0 386,375 0
0 4,423,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS ANGSAU
(002) D50500100200019 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
7 RAHMIWATI K -1 4,108,100 0 0 0 0 0 7 .............
1 410,810 0 0 0 0 0
82,162 500,000 217,260 0 51,011
01-02-1971 3 4,601,072 0 0 0
197102011994022003 MKG:22 0 368,086 0
Penata Tk.I-3D 0 2001321253
65 0
79.436.947.0-732.000 5,318,397 0 419,097 0
0 4,899,300
8 dr, ADISTIA FITRI MEIRIANTI TK-0 3,172,300 0 0 0 0 0 8 .............
0 0 0 0 0 0 0
0 750,000 72,420 0 39,223
24-05-1987 1 3,172,300 0 0 0
198705242014122001 MKG: 8 0 253,784 0
Penata-3C 0 2001972057
87 0
73.299.015.5-734.000 3,994,807 0 293,007 0
0 3,701,800
9 dr, YANTARI TIYORA K -1 2,890,500 0 0 0 0 0 9 .............
2 289,050 0 0 0 0 0
115,620 750,000 289,680 0 40,452
08-06-1992 4 3,295,170 0 0 0
199206082019032011 MKG: 3 0 263,614 0
Penata-3C 0 2001370181
16 0
72.821.137.6-732.000 4,334,866 0 304,066 0
0 4,030,800
10 HERLINA ABDI ,AMK K -1 3,704,300 0 0 0 0 0 10 .............
2 370,430 0 0 0 0 0
148,172 500,000 289,680 0 47,229
29-11-1978 4 4,222,902 0 0 0
197811292006042012 MKG:18 0 337,832 0
Penata-3C 0 2001361735
79 0
15.486.442.5-732.000 5,012,661 0 385,061 0
0 4,627,600
11 FITRIYANI ,AMK JD-0 3,591,200 0 0 0 0 0 11 .............
2 0 0 0 0 0 0
143,648 500,000 217,260 0 42,348
15-08-1979 3 3,734,848 0 0 0
197908152005012013 MKG:16 0 298,788 0
Penata-3C 0 2001139153
28 0
15.556.021.0-734.000 4,452,136 0 341,136 0
0 4,111,000
12 ERNA NINGSIH ,AMK K -1 3,591,200 0 0 0 0 0 12 .............
2 359,120 0 0 0 0 0
143,648 500,000 289,680 0 45,940
26-10-1981 4 4,093,968 0 0 0
198110262006042012 MKG:16 0 327,517 0
Penata-3C 0 2001320958
9 0
16.000.927.0-732.000 4,883,657 0 373,457 0
0 4,510,200
13 TRI WIDI ASTUTI ,AMd.Keb K -1 3,481,600 0 0 0 0 0 13 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
31-08-1978 4 3,969,024 0 0 0
197808312005012006 MKG:15 0 317,522 0
Penata-3C 0 2001359797
8 0
15.042.243.4-732.000 4,758,712 0 362,212 0
0 4,396,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS ANGSAU
(002) D50500100200019 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 ANWAR ,AM.KG K -1 3,481,600 0 0 0 0 0 14 .............
0 348,160 0 0 0 0 0
0 500,000 144,840 0 43,298
19-06-1982 2 3,829,760 0 0 0
198206192006041008 MKG:15 0 306,381 0
Penata-3C 0 2001319698
79 0
16.000.933.8-732.000 4,474,679 0 349,679 0
0 4,125,000
15 ERNI SASMITA ,A.Md.Keb TK-0 3,272,200 0 0 0 0 0 15 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
05-08-1984 1 3,272,200 0 0 0
198408052009032009 MKG:11 0 261,776 0
Penata-3C 0 2001350528
78 0
85.508.918.5-732.000 3,844,698 0 299,498 0
0 3,545,200
16 SYARIFAH YARTINAH ALKAF K -1 3,272,200 0 0 0 0 0 16 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
02-01-1984 4 3,730,308 0 0 0
198401022009032010 MKG:10 0 298,425 0
Penata-3C 0 2001348577
40 0
15.504.093.4-732.000 4,520,028 0 340,728 0
0 4,179,300
17 TRISNA ANGGRIYANI ,AM.Keb K -0 3,272,200 0 0 0 0 0 17 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
01-01-1986 1 3,272,200 0 0 0
198601012010012028 MKG:10 0 261,776 0
Penata-3C 0 2001324325
78 0
16.407.634.1-732.000 3,844,698 0 299,498 0
0 3,545,200
18 EVA RUKMANA ,AMK K -1 3,272,200 0 0 0 0 0 18 .............
1 327,220 0 0 0 0 0
65,444 500,000 217,260 0 41,649
29-05-1988 3 3,664,864 0 0 0
198805292010012006 MKG:10 0 293,189 0
Penata-3C 0 2001321393
14 0
16.257.864.5-732.000 4,382,138 0 334,838 0
0 4,047,300
19 YULIANI, AM.KG K -1 3,272,200 0 0 0 0 0 19 .............
0 327,220 0 0 0 0 0
0 500,000 144,840 0 40,994
13-07-1988 2 3,599,420 0 0 0
198807132010012004 MKG:10 0 287,954 0
Penata-3C 0 2001333855
88 0
16.232.500.5-732.000 4,244,348 0 328,948 0
0 3,915,400
20 LILI SHAFWATUNNIDA ,Apt TK-0 2,773,200 0 0 0 0 0 20 .............
0 0 0 0 0 0 0
0 325,000 72,420 0 30,982
26-03-1987 1 2,773,200 0 0 0
198703262019032008 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 2001371088
18 0
45.081.857.0-732.000 3,170,638 0 252,838 0
0 2,917,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS ANGSAU
(002) D50500100200019 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 DEWI RETNO ASTUTI ,AMD.KEB TK-0 3,139,400 0 0 0 0 0 21 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 34,394
09-03-1987 1 3,139,400 0 0 0
198703092009032006 MKG:11 0 251,152 0
Penata Muda Tk.I-3B 0 2001274964
26 0
46.023.936.1-732.000 3,511,846 0 285,546 0
0 3,226,300
22 LIA PUSPASARI ,S.ST TK-0 3,139,400 0 0 0 0 0 22 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 34,394
25-02-1986 1 3,139,400 0 0 0
198602252009032011 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001320419
26 0
16.571.090.6-732.000 3,511,846 0 285,546 0
0 3,226,300
23 SYARIFAH NURUL HUDA ,S.K.M TK-0 2,773,200 0 0 0 0 0 23 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 30,732
20-04-1994 1 2,773,200 0 0 0
199404202019032013 MKG: 3 0 221,856 0
Penata Muda Tk.I-3B 0 2001370637
68 0
90.784.109.2-732.000 3,145,688 0 252,588 0
0 2,893,100
24 SAPTININGSIH TK-0 3,781,400 0 0 0 0 0 24 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 40,464
24-06-1975 1 3,781,400 0 0 0 0
197506242006042021 MKG:22 0 302,512 0
Penata Muda Tk.I-3B 0 2001337419
56 0
15.993.344.9-732.000 4,118,876 0 342,976 0
0 3,775,900
25 ARBAINAH ,A.Md.AK TK-0 3,238,300 0 0 0 0 0 25 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 35,033
18-01-1985 1 3,238,300 0 0 0
198501182006042004 MKG:12 0 259,064 0
Penata Muda Tk.I-3B 0 2001325607
77 0
15.042.076.8-732.000 3,575,797 0 294,097 0
0 3,281,700
26 NI LUH EKA KARYANI ,AMK TK-0 3,139,400 0 0 0 0 0 26 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
08-10-1984 1 3,139,400 0 0 0
198410082009032011 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001362049
76 0
25.818.943.0-542.000 3,476,896 0 285,196 0
0 3,191,700
27 PUTRI AMALIA ,A.Md.Kep K -1 3,139,400 0 0 0 0 0 27 .............
1 313,940 0 0 0 0 0
62,788 265,000 217,260 0 37,811
29-12-1989 3 3,516,128 0 0 0
198912292010012001 MKG:10 0 281,290 0
Penata Muda Tk.I-3B 0 2000663452
13 0
71.737.916.8-734.000 3,998,401 0 319,101 0
0 3,679,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS ANGSAU
(002) D50500100200019 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
28 HENNY RAHIMAH ,AMK TK-0 3,043,600 0 0 0 0 0 28 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,086
06-10-1988 1 3,043,600 0 0 0
198810062011012005 MKG: 8 0 243,488 0
Penata Muda Tk.I-3B 0 2001358928
54 0
15.767.257.7-732.000 3,381,074 0 276,574 0
0 3,104,500
29 YUNI KRISTIANI TK-0 3,409,800 0 0 0 0 0 29 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 37,098
05-06-1977 1 3,409,800 0 0 0
197706052007012026 MKG:18 0 272,784 0
Penata Muda-3A 0 2001369337
62 0
35.278.938.2-732.000 3,782,282 0 309,882 0
0 3,472,400
30 DENI YUNITA SARI K -1 2,830,900 0 0 0 0 0 30 .............
2 283,090 0 0 0 0 0
113,236 265,000 289,680 0 34,922
06-04-1987 4 3,227,226 0 0 0
198704062010012022 MKG: 7 0 258,178 0
Penata Muda-3A 0 2001359854
94 0
16.482.836.0-732.000 3,782,000 0 293,100 0
0 3,488,900
SUB TOTAL PERGOLONGAN : III 90,603,700 0 0 0 0 0
PEG: 27 4,462,060 0 0 0 0 0
IST: 13 JIWA= 59 1,296,398 11,865,000 4,272,780 0 1,082,272
96,362,158 0 0 0
ANK: 19 0 7,708,974 0
1,408 0 0
112,501,346 0 8,791,246
0 103,710,100
31 PAHLIANA MULIDA TK-0 2,801,500 0 0 0 0 0 31 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 30,415
10-11-1987 1 2,801,500 0 0 0
198711102009032006 MKG:13 0 224,120 0
Pengatur Tk.I-2D 0 2001323717
15 0
15.548.839.8-732.000 3,113,935 0 254,535 0
0 2,859,400
32 ANNISA SORAYA ,AM.Keb TK-0 2,801,500 0 0 0 0 0 32 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 30,415
20-03-1988 1 2,801,500 0 0 0
198803202017042004 MKG:13 0 224,120 0
Pengatur Tk.I-2D 0 2001368877
15 0
64.217.583.0-732.000 3,113,935 0 254,535 0
0 2,859,400
33 YULIA NASARI ,AM.Keb K -1 2,801,500 0 0 0 0 0 33 .............
2 280,150 0 0 0 0 0
112,060 240,000 289,680 0 34,337
10-03-1989 4 3,193,710 0 0 0
198903102017042002 MKG:13 0 255,497 0
Pengatur Tk.I-2D 0 2001369566
44 0
66.483.802.6-732.000 3,723,434 0 289,834 0
0 3,433,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS ANGSAU
(002) D50500100200019 BULAN : DESEMBER 2022 HALAMAN : 6

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
34 NIKMATUL HUSNA ,AM.Keb K -0 2,474,700 0 0 0 0 0 34 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 27,147
15-05-1990 1 2,474,700 0 0 0
199005152019032011 MKG: 6 0 197,976 0
Pengatur Tk.I-2D 0 2001371056
3 0
90.780.012.2-732.000 2,787,123 0 225,123 0
0 2,562,000
35 FARIDHATUL MAULIA ,A.Md.Kep K -1 2,374,300 0 0 0 0 0 35 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
24-07-1997 3 2,659,216 0 0 0
199707242020122025 MKG: 5 0 212,737 0
Pengatur-2C 0 2001372427
53 0
95.533.387.7-732.000 3,116,529 0 241,729 0
0 2,874,800
36 DEWI HARKIT PERTIWI ,A.Md.AK TK-0 1,841,440 0 0 0 0 0 36 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
20-05-1991 1 1,841,440 0 0 0
199105202022032005 MKG: 3 0 147,315 0
Pengatur-2C 0 3200402544
69 0
791051568732000 2,093,929 0 167,529 0
0 1,926,400
37 DEVI FITRI PATIMAH ,A.Md, RMIK K -1 1,841,440 0 0 0 0 0 37 .............
2 184,144 180,000 0 0 0 0
73,658 0 289,680 0 22,792
18-12-1993 4 2,099,242 0 0 0
199312182022032004 MKG: 3 0 167,939 0
Pengatur-2C 0 3200405292
9 0
637039678732000 2,568,931 0 190,731 0
0 2,378,200
SUB TOTAL PERGOLONGAN : 16,936,380 0 0 0 0 0
PEG: 7 701,724 360,000 0 0 0 0
IST: 3 JIWA= 15 233,204 1,200,000 1,086,300 0 194,312
17,871,308 0 0 0
ANK: 5 0 1,429,704 0
208 0 0
20,517,816 0 1,624,016
0 18,893,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS ANGSAU
(002) D50500100200019 BULAN : DESEMBER 2022 HALAMAN : 7

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 118,890,880 0 0 0 12,409 0
PEG: 37 5,542,024 360,000 0 0 0 0
IST: 17 JIWA= 79 1,605,250 16,665,000 5,721,180 0 1,430,631
ANK: 25 126,038,154 0 12,409 0
0 10,083,053 0
0 0
1,650 0 11,526,093
148,798,393
0 137,272,300

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BUMI MAKMUR
(002) D50500100200020 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 dr, NURUL HIDAYAH K -1 3,518,100 0 0 0 0 0 1 .............
2 351,810 0 0 0 0 0
140,724 750,000 289,680 0 47,606
18-06-1979 4 4,010,634 0 0 0
197906182009032007 MKG:12 0 320,851 0
Penata Tk.I-3D 0 2001368958
43 0
15.767.399.7-732.000 5,050,357 0 368,457 0
0 4,681,900
2 dr, CHAIRUNNISA K -1 3,410,600 0 0 0 0 0 2 .............
2 341,060 0 0 0 0 0
136,424 750,000 289,680 0 46,381
29-04-1984 4 3,888,084 0 0 0
198404292014112001 MKG:10 0 311,047 0
Penata Tk.I-3D 0 2001363495
64 0
34.406.645.1-518.000 4,927,828 0 357,428 0
0 4,570,400
3 drg, CATRI ERA PAKARTI K -1 3,205,500 0 0 0 0 0 3 .............
1 320,550 0 0 0 0 0
64,110 750,000 217,260 0 43,402
25-06-1982 3 3,590,160 0 0 0
198206252015022001 MKG: 6 0 287,213 0
Penata Tk.I-3D 0 2001368993
95 0
66.439.593.6-732.000 4,557,515 0 330,615 0
0 4,226,900
4 EUIS TITA FARIDA ,S.Kep K -1 3,628,900 0 0 0 0 0 4 .............
1 362,890 0 0 0 0 0
72,578 600,000 217,260 0 46,644
20-02-1984 3 4,064,368 0 0 0
198402202006042016 MKG:14 0 325,149 0
Penata Tk.I-3D 0 2001335874
65 0
15.030.803.9-731.000 4,881,693 0 371,793 0
0 4,509,900
5 YUSSIANI ,A.Md.Keb TK-0 3,554,000 0 0 0 0 0 5 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 38,190
23-07-1979 1 3,554,000 0 0 0
197907232007012007 MKG:18 0 284,320 0
Penata Muda Tk.I-3B 0 2001321377
90 0
16.570.964.3-732.000 3,891,510 0 322,510 0
0 3,569,000
6 ANITA ,A.Md.Keb K -1 3,554,000 0 0 0 0 0 6 .............
2 355,400 0 0 0 0 0
142,160 265,000 289,680 0 43,166
12-12-1979 4 4,051,560 0 0 0
197912122007012010 MKG:18 0 324,125 0
Penata Muda Tk.I-3B 0 2001334371
51 0
16.702.882.8-732.000 4,606,291 0 367,291 0
0 4,239,000
7 RINA ,A.Md.Keb TK-0 3,554,000 0 0 0 0 0 7 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 38,190
08-08-1980 1 3,554,000 0 0 0
198008082007012010 MKG:18 0 284,320 0
Penata Muda Tk.I-3B 0 2001322438
90 0
15.064.324.5-732.000 3,891,510 0 322,510 0
0 3,569,000
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BUMI MAKMUR
(002) D50500100200020 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 Hj. HELDAWATI ,A.Md.Keb K -0 3,554,000 0 0 0 0 0 8 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 38,190
14-09-1980 1 3,554,000 0 0 0
198009142007012005 MKG:18 0 284,320 0
Penata Muda Tk.I-3B 0 2001321792
90 0
16.282.363.7-732.000 3,891,510 0 322,510 0
0 3,569,000
9 RATNA SARI ,AMK K -1 3,340,300 0 0 0 0 0 9 .............
2 334,030 0 0 0 0 0
133,612 265,000 289,680 0 40,729
16-04-1983 4 3,807,942 0 0 0
198304162007012011 MKG:14 0 304,635 0
Penata Muda Tk.I-3B 0 2001369906
42 0
16.136.157.1-734.000 4,362,664 0 345,364 0
0 4,017,300
10 IRAWATI ,AMG K -1 3,139,400 0 0 0 0 0 10 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
11-03-1980 4 3,578,916 0 0 0
198003112009032004 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001321016
56 0
57.822.821.5-732.000 4,133,652 0 324,752 0
0 3,808,900
11 ROSIANA RAHMAH ,AMK K -1 3,139,400 0 0 0 0 0 11 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
03-03-1981 4 3,578,916 0 0 0
198103032010012016 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001359161
56 0
78.354.923.1-732.000 4,133,652 0 324,752 0
0 3,808,900
12 FARIDHA ELLIYAWATI ,AM.Keb K -1 3,043,600 0 0 0 0 0 12 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
05-10-1988 4 3,469,704 0 0 0
198810052011012005 MKG: 9 0 277,576 0
Penata Muda Tk.I-3B 0 2001368907
39 0
16.257.871.0-732.000 4,024,423 0 314,923 0
0 3,709,500
13 KASPUL ANWAR ,A.Md K -1 3,139,400 0 0 0 0 0 13 .............
2 313,940 185,000 0 0 0 0
125,576 0 289,680 0 37,639
01-05-1980 4 3,578,916 0 0 0
198005012009041005 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001372095
56 0
16.072.214.6-734.000 4,053,652 0 323,952 0
0 3,729,700
14 apt, SURYO ANGGORO PAMUNGKAS K -0 2,150,800 0 0 0 0 0 14 .............
,S.Farm 0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
12-05-1992 1 2,150,800 0 0 0
199205122022031002 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200404911
2 0
824970677702000 2,408,222 0 195,422 0
0 2,212,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BUMI MAKMUR
(002) D50500100200020 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
15 SUCI CAHYANINGRUM ,SKM TK-0 2,660,700 0 0 0 0 0 15 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 29,607
07-06-1994 1 2,660,700 0 0 0
199406072020122027 MKG: 2 0 212,856 0
Penata Muda-3A 0 2001373164
43 0
91.665.675.4-732.000 3,033,163 0 242,463 0
0 2,790,700
16 NURLAILA ,A.Md.Keb K -1 2,744,500 0 0 0 0 0 16 .............
1 274,450 0 0 0 0 0
54,890 265,000 217,260 0 33,388
17-04-1993 3 3,073,840 0 0 0
199304172015022002 MKG: 5 0 245,907 0
Penata Muda-3A 0 2001368829
95 0
72.554.628.7-732.000 3,556,195 0 279,295 0
0 3,276,900
SUB TOTAL PERGOLONGAN : III 51,337,200 0 0 0 0 0
PEG: 16 3,586,370 370,000 0 0 0 0
IST: 11 JIWA= 46 1,242,970 5,535,000 3,331,320 0 620,715
56,166,540 0 0 0
ANK: 19 0 4,493,322 0
977 0 0
65,403,837 0 5,114,037
0 60,289,800
17 SORAYA ,A.Md.Keb JD-0 2,801,500 0 0 0 0 0 17 .............
1 0 0 0 0 0 0
56,030 240,000 144,840 0 30,975
15-05-1978 2 2,857,530 0 0 0
197805152019042001 MKG:13 0 228,602 0
Pengatur Tk.I-2D 0 2001371967
7 0
66.497.312.7-310.000 3,242,377 0 259,577 0
0 2,982,800
18 MUZDALIPAH ,AM.Keb TK-0 2,801,500 0 0 0 0 0 18 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 30,415
18-02-1986 1 2,801,500 0 0 0
198602182017042004 MKG:13 0 224,120 0
Pengatur Tk.I-2D 0 2001368845
15 0
66.507.392.0-732.000 3,113,935 0 254,535 0
0 2,859,400
19 EKA DESI ANDARI ,AM.Keb K -1 2,801,500 0 0 0 0 0 19 .............
2 280,150 0 0 0 0 0
112,060 240,000 289,680 0 34,337
13-12-1990 4 3,193,710 0 0 0
199012132017042002 MKG:13 0 255,497 0
Pengatur Tk.I-2D 0 2001368818
44 0
15.582.991.4-732.000 3,723,434 0 289,834 0
0 3,433,600
20 LENY RISMONIKA ,A.Md.Kep K -1 2,474,700 0 0 0 0 0 20 .............
0 247,470 0 0 0 0 0
0 240,000 144,840 0 29,622
26-06-1993 2 2,722,170 0 0 0
199306262019032017 MKG: 6 0 217,774 0
Pengatur Tk.I-2D 0 2001371005
86 0
90.799.716.7-732.000 3,107,096 0 247,396 0
0 2,859,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BUMI MAKMUR
(002) D50500100200020 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 HIDAYATULLAH ,A.Md K -1 2,633,100 0 0 0 0 0 21 .............
2 263,310 180,000 0 0 0 0
105,324 0 289,680 0 31,817
26-06-1990 4 3,001,734 0 0 0
199006262015021003 MKG: 9 0 240,139 0
Pengatur Tk.I-2D 0 2001369752
42 0
72.693.684.2-731.000 3,471,456 0 271,956 0
0 3,199,500
22 LATIFAH HEFNI ,A.Md, Far K -1 2,374,300 0 0 0 0 0 22 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
01-09-1989 3 2,659,216 0 0 0
198909012020122013 MKG: 5 0 212,737 0
Pengatur-2C 0 2001372478
53 0
81.453.891.4-732.000 3,116,529 0 241,729 0
0 2,874,800
23 LENY KARLINA BENADITA ,A.M.KG TK-0 2,374,300 0 0 0 0 0 23 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
12-01-1990 1 2,374,300 0 0 0
199001122020122012 MKG: 5 0 189,944 0
Pengatur-2C 0 2001373822
67 0
73.131.377.1-726.000 2,686,787 0 216,087 0
0 2,470,700
24 ANRI JAYA S ,A.Md.KL K -1 2,374,300 0 0 0 0 0 24 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
28-10-1994 3 2,659,216 0 0 0
199410282020121021 MKG: 5 0 212,737 0
Pengatur-2C 0 2001373695
53 0
84.811.941.8-734.000 3,116,529 0 241,729 0
0 2,874,800
25 M FARIS SAHRODANA ,A.Md.Kes K -1 2,374,300 0 0 0 0 0 25 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
03-07-1997 3 2,659,216 0 0 0
199707032019031002 MKG: 5 0 212,737 0
Pengatur-2C 0 2001370742
53 0
90.799.319.0-732.000 3,116,529 0 241,729 0
0 2,874,800
26 KHAIRATI ,AMK K -1 1,841,440 0 0 0 0 0 26 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
02-09-1989 3 2,062,413 0 0 0
198909022022032002 MKG: 3 0 164,993 0
Pengatur-2C 0 3200407139
44 0
636941353732000 2,459,717 0 187,417 0
0 2,272,300
27 FITRIANI ,A.Md.Keb K -1 1,841,440 0 0 0 0 0 27 .............
0 184,144 180,000 0 0 0 0
0 0 144,840 0 22,056
05-03-1997 2 2,025,584 0 0 0
199703052022032010 MKG: 3 0 162,047 0
Pengatur-2C 0 3200408728
79 0
636843104732000 2,350,503 0 184,103 0
0 2,166,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BUMI MAKMUR
(002) D50500100200020 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
SUB TOTAL PERGOLONGAN : 26,692,380 0 0 0 0 0
PEG: 11 1,871,508 540,000 0 0 0 0
IST: 8 JIWA= 28 452,701 1,920,000 2,027,760 0 314,765
29,016,589 0 0 0
ANK: 9 0 2,321,327 0
543 0 0
33,504,892 0 2,636,092
0 30,868,800
TOTAL PER SATKER 78,029,580 0 0 0 0 0
PEG: 27 5,457,878 910,000 0 0 0 0
IST: 19 JIWA= 74 1,695,671 7,455,000 5,359,080 0 935,480
ANK: 28 85,183,129 0 0 0
0 6,814,649 0
0 0
1,520 0 7,750,129
98,908,729
0 91,158,600

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 NUN ZAIRINA ,Apt, Sp.FRS JD-0 5,431,900 0 0 0 80,554 0 1 .............
0 0 0 0 0 0 0
0 1,200,000 72,420 0 66,319
14-09-1963 1 5,431,900 0 80,554 0
196309141990022001 MKG:32 0 434,552 0
Pembina Utama Muda-4C 0 2001368659
51 0
05.812.887.7-606.000 6,784,925 0 581,425 0
0 6,203,500
2 APRIYANTO ARIES K ,SP.PD K -1 4,949,400 0 0 0 44,117 0 2 .............
2 494,940 0 0 0 0 0
197,976 1,200,000 289,680 0 68,423
15-04-1967 4 5,642,316 0 44,117 0
196704151999031008 MKG:26 0 451,385 0
Pembina Utama Muda-4C 0 2001334727
12 0
14.560.048.2-732.000 7,176,125 0 563,925 0
0 6,612,200
3 dr, H. AJI SUPIAN NOOR ,M.M K -1 4,372,000 0 0 0 14,417 0 3 .............
2 437,200 0 0 0 0 0
174,880 1,200,000 289,680 0 61,841
13-09-1973 4 4,984,080 0 14,417 0
197309132005011004 MKG:18 0 398,726 0
Pembina Utama Muda-4C 0 2001348585
7 0
15.154.127.3-732.000 6,488,184 0 474,984 0
0 6,013,200
4 dr, ISNA FARIDA K -1 4,066,500 1,260,000 0 0 1,550 0 4 .............
2 406,650 0 0 0 0 0
162,660 0 289,680 0 58,958
12-06-1974 4 4,635,810 0 1,550 0
197406122005012016 MKG:16 0 370,865 0
Pembina Tk.I-4B 0 2001322737
33 0
15.475.492.3-732.000 6,187,073 0 431,373 0
0 5,755,700
5 MAHANI TK-0 4,748,500 540,000 0 0 18,367 0 5 .............
0 0 0 0 0 0 0
0 0 72,420 0 52,885
25-11-1970 1 4,748,500 0 18,367 0
197011251991032007 MKG:26 0 379,880 0
Pembina Tk.I-4B 0 2001336757
45 0
15.582.522.7.732.000 5,379,332 0 451,132 0
0 4,928,200
6 DR, H. A. SYAIFULLAH, MM K -1 4,194,600 0 0 0 28,338 0 6 .............
0 419,460 0 0 0 0 0
0 1,200,000 144,840 0 58,141
12-12-1970 2 4,614,060 0 28,338 0
197012122002121010 MKG:19 0 369,125 0
Pembina Tk.I-4B 0 2001360704
66 0
14.314.163.8-731.000 5,987,304 0 455,604 0
0 5,531,700
7 HAERAN KURNIA HUSEN K -1 4,066,500 0 0 0 0 0 7 .............
2 406,650 0 0 0 0 0
162,660 1,200,000 289,680 0 58,358
10-06-1978 4 4,635,810 0 0 0
197806102006041019 MKG:16 0 370,865 0
Pembina Tk.I-4B 0 2001334487
33 0
14.350.814.1-732.000 6,125,523 0 429,223 0
0 5,696,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 WINDU NAFIKA TK-0 4,066,500 0 0 0 18,942 0 8 .............
0 0 0 0 0 0 0
0 1,200,000 72,420 0 52,665
01-06-1979 1 4,066,500 0 18,942 0
197906012006042014 MKG:16 0 325,320 0
Pembina Tk.I-4B 0 2001368586
65 0
14.560.047.4-732.000 5,357,927 0 396,927 0
0 4,961,000
9 ANNA APRIYANTI ,APT K -1 4,066,500 0 0 0 21,979 0 9 .............
0 406,650 0 0 0 0 0
0 1,200,000 144,840 0 56,732
25-04-1981 2 4,473,150 0 21,979 0
198104252005012025 MKG:16 0 357,852 0
Pembina Tk.I-4B 0 2001336803
94 0
14.904.339.0-732.000 5,840,063 0 436,563 0
0 5,403,500
10 Hj. SUDI HASTUTI ,SKM.MM K -1 4,898,100 0 0 0 24,858 0 10 .............
2 489,810 0 0 0 0 0
195,924 850,000 289,680 0 64,338
15-09-1967 4 5,583,834 0 24,858 0
196709151988032009 MKG:29 0 446,707 0
Pembina Tk.I-4B 0 2001336692
31 0
14.350.785.3-732.000 6,748,403 0 535,903 0
0 6,212,500
11 SYAFANGAT ,S.KM K -1 4,555,800 980,000 0 0 24,621 0 11 .............
1 455,580 0 0 0 0 0
91,116 0 217,260 0 60,825
01-01-1969 3 5,102,496 0 24,621 0
196901011991011003 MKG:26 0 408,200 0
Pembina-4A 0 2001323116
69 0
16.038.851.8-732.000 6,324,446 0 493,646 0
0 5,830,800
12 dr, Hj. WIWIK RAKHMAWATI K -0 3,901,500 980,000 0 0 0 0 12 .............
0 0 0 0 0 0 0
0 0 72,420 0 48,815
09-11-1979 1 3,901,500 0 0 0
197911092007012010 MKG:16 0 312,120 0
Pembina-4A 0 2001351578
15 0
14.828.432.6-732.000 4,953,935 0 360,935 0
0 4,593,000
13 R.M.NUR HARYONO NOVIANTO TK-0 3,666,900 980,000 0 0 0 0 13 .............
0 0 0 0 0 0 0
0 0 72,420 0 46,469
08-11-1978 1 3,666,900 0 0 0
197811082009031003 MKG:12 0 293,352 0
Pembina-4A 0 2001337176
1 0
14.904.029.7-732.000 4,719,321 0 339,821 0
0 4,379,500
14 NELLY MEILIANA K -1 3,782,400 540,000 0 0 0 0 14 .............
2 378,240 0 0 0 0 0
151,296 0 289,680 0 48,519
14-05-1978 4 4,311,936 0 0 0
197805142008012020 MKG:14 0 344,955 0
Pembina-4A 0 2001349678
58 0
15.478.960.6-732.000 5,141,674 0 393,474 0
0 4,748,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
15 dr, LAILI WAHYUNI HASSAN TK-0 3,666,900 540,000 0 0 0 0 15 .............
0 0 0 0 0 0 0
0 0 72,420 0 42,069
10-06-1982 1 3,666,900 0 0 0
198206102009032007 MKG:12 0 293,352 0
Pembina-4A 0 2001321245
1 0
14.560.070.6-732.000 4,279,321 0 335,421 0
0 3,943,900
16 DR, I GEDE MAHARDITHA.A ,SP K -1 4,555,800 0 0 0 23,871 0 16 .............
2 455,580 0 0 0 0 0
182,232 1,200,000 289,680 0 63,936
02-09-1968 4 5,193,612 0 23,871 0
196809021998031002 MKG:26 0 415,489 0
Pembina-4A 0 2001334697
33 0
67.112.811.4.903.000 6,707,196 0 503,296 0
0 6,203,900
17 MORIKO SUHARIS ,SP.KFR K -1 4,151,100 0 0 0 3,054 0 17 .............
2 415,110 0 0 0 0 0
166,044 1,200,000 289,680 0 59,323
16-03-1974 4 4,732,254 0 3,054 0
197403162005011009 MKG:20 0 378,580 0
Pembina-4A 0 2001362324
69 0
25.893.972.7-732.000 6,225,057 0 440,957 0
0 5,784,100
18 ANUNG SRI GUTOMOKG ,SP K -1 4,024,400 0 0 0 19,892 0 18 .............
0 402,440 0 0 0 0 0
0 1,200,000 144,840 0 56,268
19-08-1978 2 4,426,840 0 19,892 0
197808192006041015 MKG:18 0 354,147 0
Pembina-4A 0 2001360747
35 0
14.560.239.7.732.000 5,791,607 0 430,307 0
0 5,361,300
19 FAJRIAN NOOR ,SP.AN K -1 3,901,500 0 0 0 0 0 19 .............
2 390,150 0 0 0 0 0
156,060 1,200,000 289,680 0 56,477
05-08-1974 4 4,447,710 0 0 0
197408052005011013 MKG:16 0 355,817 0
Pembina-4A 0 2001369598
4 0
25.398.961.5.732.000 5,937,394 0 412,294 0
0 5,525,100
20 AGUSTIN NURLIANI K -1 3,901,500 0 0 0 0 0 20 .............
2 390,150 0 0 0 0 0
156,060 1,200,000 289,680 0 56,477
02-08-1978 4 4,447,710 0 0 0
197808022007012024 MKG:16 0 355,817 0
Pembina-4A 0 2001369426
4 0
87.409.499.8-731.000 5,937,394 0 412,294 0
0 5,525,100
21 HUSNI THAMRIN ,SP.M K -1 3,901,500 0 0 0 0 0 21 .............
2 390,150 0 0 0 0 0
156,060 1,200,000 289,680 0 56,477
16-08-1979 4 4,447,710 0 0 0
197908162007011009 MKG:16 0 355,817 0
Pembina-4A 0 2001368648
4 0
25.819.386.1.732.000 5,937,394 0 412,294 0
0 5,525,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
22 I PUTU ARDIKA YUDA.A ,M.SC K -1 3,901,500 0 0 0 0 0 22 .............
2 390,150 0 0 0 0 0
156,060 1,200,000 289,680 0 56,477
24-07-1980 4 4,447,710 0 0 0
198007242007011007 MKG:16 0 355,817 0
Pembina-4A 0 2001362227
4 0
25.818.943.0-542.000 5,937,394 0 412,294 0
0 5,525,100
23 DR, ARIF PRASSETYO ,Sp.KJ K -1 3,782,400 0 0 0 0 0 23 .............
2 378,240 0 0 0 0 0
151,296 1,200,000 289,680 0 55,119
18-05-1980 4 4,311,936 0 0 0
198005182008031004 MKG:14 0 344,955 0
Pembina-4A 0 2001322586
58 0
14.560.256.1-732.000 5,801,674 0 400,074 0
0 5,401,600
24 DR, RIJAL ILMI BASRI ,Sp.OG K -1 3,782,400 0 0 0 0 0 24 .............
2 378,240 0 0 0 0 0
151,296 1,200,000 289,680 0 55,119
22-02-1982 4 4,311,936 0 0 0
198202222008031001 MKG:14 0 344,955 0
Pembina-4A 0 2001320688
58 0
79.771.566.1-732.000 5,801,674 0 400,074 0
0 5,401,600
25 DR, I KETUT SUARDANA ,M.Biomed, K -1 3,666,900 0 0 0 0 0 25 .............
Sp.PD 2 366,690 0 0 0 0 0
146,676 1,200,000 289,680 0 53,803
16-06-1981 4 4,180,266 0 0 0
198106162009031007 MKG:13 0 334,421 0
Pembina-4A 0 2001342986
78 0
15.870.752.1-732.000 5,670,024 0 388,224 0
0 5,281,800
26 WURYANTI ,AMK TK-0 4,847,300 0 0 0 37,550 0 26 .............
0 0 0 0 0 0 0
0 850,000 72,420 0 56,973
12-04-1970 1 4,847,300 0 37,550 0
197012041994032002 MKG:30 0 387,784 0
Pembina-4A 0 2001336943
37 0
15.659.875.7-732.000 5,807,307 0 482,307 0
0 5,325,000
27 MARLIYAH ,S.ST TK-0 4,555,800 0 0 0 24,396 0 27 .............
0 0 0 0 0 0 0
0 850,000 72,420 0 54,058
05-12-1970 1 4,555,800 0 24,396 0
197012051991032005 MKG:26 0 364,464 0
Pembina-4A 0 2001360313
2 0
16.000.866.0.732.000 5,502,618 0 442,918 0
0 5,059,700
28 NOORHASANAH ,S.Kep., Ns JD-0 4,416,700 0 0 0 6,792 0 28 .............
1 0 0 0 0 0 0
88,334 850,000 144,840 0 53,550
21-01-1972 2 4,505,034 0 6,792 0
197201211993012002 MKG:24 0 360,403 0
Pembina-4A 0 2001320947
79 0
78.345.696.5-732.000 5,506,745 0 420,745 0
0 5,086,000
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
29 AULIA ULFAH ,AM.KEB K -1 4,281,800 0 0 0 0 0 29 .............
2 428,180 0 0 0 0 0
171,272 850,000 289,680 0 57,313
06-11-1974 4 4,881,252 0 0 0
197411061994022001 MKG:22 0 390,500 0
Pembina-4A 0 2001335173
81 0
18.208.709.4.732.000 6,021,013 0 447,813 0
0 5,573,200
30 ASMA NOOR LAILA, S.ST JD-0 4,281,800 0 0 0 0 0 30 .............
2 0 0 0 0 0 0
171,272 850,000 217,260 0 53,031
18-05-1975 3 4,453,072 0 0 0
197505181997032002 MKG:22 0 356,246 0
Pembina-4A 0 2001337052
45 0
18.358.009.7.732.000 5,520,377 0 409,277 0
0 5,111,100
31 DESY BUNGA SARI.NS ,S.KEP K -1 3,666,900 0 0 0 0 0 31 .............
2 366,690 0 0 0 0 0
146,676 850,000 289,680 0 50,303
25-12-1984 4 4,180,266 0 0 0
198412252010012018 MKG:12 0 334,421 0
Pembina-4A 0 2001333995
78 0
15.330.140.3-732.000 5,320,024 0 384,724 0
0 4,935,300
32 NORMILA ,S.Kep.Ns,M.KEP K -1 3,666,900 0 0 0 0 0 32 .............
2 366,690 0 0 0 0 0
146,676 850,000 289,680 0 50,303
18-04-1986 4 4,180,266 0 0 0
198604182010012012 MKG:12 0 334,421 0
Pembina-4A 0 2001336951
78 0
15.358.049.3-732.000 5,320,024 0 384,724 0
0 4,935,300
33 DR, SINGGIH SIDARTA ,S.POG K -1 4,151,100 0 0 0 0 0 33 .............
1 415,110 0 0 0 0 0
83,022 750,000 217,260 0 53,992
24-12-1974 3 4,649,232 0 0 0
197412242002121002 MKG:20 0 371,939 0
Pembina-4A 0 2001334495
39 0
16.183.802.4.732.000 5,616,531 0 425,931 0
0 5,190,600
SUB TOTAL PERGOLONGAN : IV 137,871,300 5,820,000 0 0 393,298 0
PEG: 33 9,428,750 0 0 0 0 0
IST: 23 JIWA= 97 3,365,548 27,950,000 7,024,740 0 1,844,356
150,665,598 0 393,298 0
ANK: 41 0 12,053,249 0
1,367 0 0
191,855,003 0 14,290,903
0 177,564,100
34 MAHYUNI HIDAYAT ,SE K -1 3,861,000 980,000 0 0 0 0 34 .............
2 386,100 0 0 0 0 0
154,440 0 289,680 0 53,815
06-06-1978 4 4,401,540 0 0 0
197806062008011026 MKG:18 0 352,123 0
Penata Tk.I-3D 0 2001361077
18 0
78.734.320.0-732.000 5,671,238 0 405,938 0
0 5,265,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 6

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
35 TAUFIQ HIDAYAT ,AM.KEP K -1 3,982,600 540,000 0 0 0 0 35 .............
2 398,260 0 0 0 0 0
159,304 0 289,680 0 50,802
14-04-1978 4 4,540,164 0 0 0
197804142006041027 MKG:20 0 363,213 0
Penata Tk.I-3D 0 2001348437
71 0
16.482.824.6.732.000 5,369,915 0 414,015 0
0 4,955,900
36 IBNUL QOYIM ,SH K -1 3,410,600 540,000 0 0 0 0 36 .............
2 341,060 0 0 0 0 0
136,424 0 289,680 0 44,281
01-04-1986 4 3,888,084 0 0 0
198604012011011002 MKG:11 0 311,047 0
Penata Tk.I-3D 0 2001361905
64 0
15.993.322.5-732.000 4,717,828 0 355,328 0
0 4,362,500
37 NOVITA SARI ,Apt K -0 3,306,500 540,000 0 0 0 0 37 .............
0 0 0 0 0 0 0
0 0 72,420 0 38,465
13-11-1986 1 3,306,500 0 0 0
198611132014022002 MKG: 8 0 264,520 0
Penata Tk.I-3D 0 2001362359
65 0
16.657.114.1-732.000 3,918,985 0 302,985 0
0 3,616,000
38 DR, BAMBANG ARINEKSO K -1 3,518,100 0 0 0 0 0 38 .............
2 351,810 0 0 0 0 0
140,724 1,200,000 289,680 0 52,106
11-11-1982 4 4,010,634 0 0 0
198211112009031010 MKG:12 0 320,851 0
Penata Tk.I-3D 0 2001337017
43 0
15.504.091.8-732.000 5,500,357 0 372,957 0
0 5,127,400
39 I WAYAN SUTAMA ,Sp.B K -1 4,237,500 0 0 0 0 0 39 .............
2 423,750 0 0 0 0 0
169,500 750,000 289,680 0 55,808
10-10-1971 4 4,830,750 0 0 0
197110102000031010 MKG:25 0 386,460 0
Penata Tk.I-3D 0 2001369547
38 0
48.043.287.1-811.000 5,870,468 0 442,268 0
0 5,428,200
40 DR, RIJANI RAIS ,SP.An K -1 3,743,100 0 0 0 0 0 40 .............
2 374,310 0 0 0 0 0
149,724 750,000 289,680 0 50,171
20-08-1977 4 4,267,134 0 0 0
197708202007011028 MKG:16 0 341,371 0
Penata Tk.I-3D 0 2001363452
28 0
14.225.987.8-732.000 5,306,842 0 391,542 0
0 4,915,300
41 DR, HJ. NOVRIANTI HAWARINI K -1 3,518,100 0 0 0 0 0 41 .............
1 351,810 0 0 0 0 0
70,362 750,000 217,260 0 46,903
12-11-1979 3 3,940,272 0 0 0
197911122009032004 MKG:12 0 315,222 0
Penata Tk.I-3D 0 2001369418
93 0
15.042.330.9-732.000 4,907,625 0 362,125 0
0 4,545,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 7

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
42 dr, SIGIT PRASETIA KURNIAWAN K -1 3,518,100 0 0 0 0 0 42 .............
,Sp.PD 1 351,810 0 0 0 0 0
70,362 750,000 217,260 0 46,903
05-06-1980 3 3,940,272 0 0 0
198006052009031007 MKG:12 0 315,222 0
Penata Tk.I-3D 0 2001369477
93 0
15.084.139.3-732.000 4,907,625 0 362,125 0
0 4,545,500
43 DR, CITA KRISTIANTI K -1 3,518,100 0 0 0 0 0 43 .............
1 351,810 0 0 0 0 0
70,362 750,000 217,260 0 46,903
29-06-1982 3 3,940,272 0 0 0
198206292010012002 MKG:12 0 315,222 0
Penata Tk.I-3D 0 2001323067
93 0
15.767.331.0-732.000 4,907,625 0 362,125 0
0 4,545,500
44 DR, PANDE PUTU ADHYKA SRI D.S TK-0 3,518,100 0 0 0 0 0 44 .............
0 0 0 0 0 0 0
0 750,000 72,420 0 42,681
19-10-1983 1 3,518,100 0 0 0
198310192010012014 MKG:12 0 281,448 0
Penata Tk.I-3D 0 2001337346
9 0
24.679.759.1-907.000 4,340,529 0 324,129 0
0 4,016,400
45 dr, KOMANG AGUS SUKENDAR ,Sp.S K -1 3,518,100 0 0 0 0 0 45 .............
1 351,810 0 0 0 0 0
70,362 750,000 217,260 0 46,903
25-05-1984 3 3,940,272 0 0 0
198405252010011020 MKG:12 0 315,222 0
Penata Tk.I-3D 0 2001321679
93 0
15.582.537.5-732.000 4,907,625 0 362,125 0
0 4,545,500
46 DR, EKO SURYO PUJIASTONO K -1 3,518,100 0 0 0 0 0 46 .............
2 351,810 0 0 0 0 0
140,724 750,000 289,680 0 47,606
28-02-1985 4 4,010,634 0 0 0
198502282009031008 MKG:12 0 320,851 0
Penata Tk.I-3D 0 2001369728
43 0
15.607.363.7.732.000 5,050,357 0 368,457 0
0 4,681,900
47 DR, PUJI UTAMI K -1 3,410,600 0 0 0 0 0 47 .............
2 341,060 0 0 0 0 0
136,424 750,000 289,680 0 46,381
11-10-1984 4 3,888,084 0 0 0
198410112011012004 MKG:10 0 311,047 0
Penata Tk.I-3D 0 2001360771
64 0
15.582.967.4.732.000 4,927,828 0 357,428 0
0 4,570,400
48 DARYAN, ,SST K -1 4,370,900 0 0 0 0 0 48 .............
1 437,090 0 0 0 0 0
87,418 600,000 217,260 0 54,954
18-01-1970 3 4,895,408 0 0 0
196807101991011002 MKG:26 0 391,633 0
Penata Tk.I-3D 0 2001337311
19 0
16.000.863.7.732.000 5,712,687 0 446,587 0
0 5,266,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 8

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
49 ANA YULIANI ,S.KM TK-0 4,237,500 0 0 0 0 0 49 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 48,375
31-07-1972 1 4,237,500 0 0 0
197207311992022002 MKG:24 0 339,000 0
Penata Tk.I-3D 0 2001335009
55 0
14.166.170.2.731.001 4,909,975 0 387,375 0
0 4,522,600
50 SUCI LESTARI ,SST K -0 4,237,500 0 0 0 0 0 50 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 48,375
25-10-1973 1 4,237,500 0 0 0
197310251993022003 MKG:24 0 339,000 0
Penata Tk.I-3D 0 2001348283
55 0
09.800.466.6-732.001 4,909,975 0 387,375 0
0 4,522,600
51 NOORHIDAYATULLAH ,S.KM K -1 3,982,600 0 0 0 0 0 51 .............
2 398,260 0 0 0 0 0
159,304 600,000 289,680 0 51,402
06-08-1976 4 4,540,164 0 0 0
197608061996031002 MKG:20 0 363,213 0
Penata Tk.I-3D 0 2001347608
71 0
15.042.047.9.732.000 5,429,915 0 414,615 0
0 5,015,300
52 SRI SUPATMININGSIH ,S.Kep,N.s K -1 3,743,100 0 0 0 0 0 52 .............
2 374,310 0 0 0 0 0
149,724 600,000 289,680 0 48,671
06-03-1978 4 4,267,134 0 0 0
197803062006042013 MKG:17 0 341,371 0
Penata Tk.I-3D 0 2001348674
28 0
16.007.428.2-732.000 5,156,842 0 390,042 0
0 4,766,800
53 YUMILA HERLIATI ,AMK JD-0 3,743,100 0 0 0 0 0 53 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 43,431
07-06-1978 1 3,743,100 0 0 0
197806072006042028 MKG:16 0 299,448 0
Penata Tk.I-3D 0 2001337044
59 0
16.007.425.8.732.000 4,415,579 0 342,879 0
0 4,072,700
54 ANA JUHAIDA ,SST K -1 3,743,100 0 0 0 0 0 54 .............
0 374,310 0 0 0 0 0
0 600,000 144,840 0 47,174
30-08-1978 2 4,117,410 0 0 0
197808302006042013 MKG:16 0 329,393 0
Penata Tk.I-3D 0 2001348429
17 0
15.993.284.7.732.000 4,862,267 0 376,567 0
0 4,485,700
55 FITRI HARIANI ,S.Kep K -1 3,743,100 0 0 0 0 0 55 .............
2 374,310 0 0 0 0 0
149,724 600,000 289,680 0 48,671
30-08-1981 4 4,267,134 0 0 0
198108302006042018 MKG:16 0 341,371 0
Penata Tk.I-3D 0 2001348418
28 0
15.504.094.2-732.000 5,156,842 0 390,042 0
0 4,766,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 9

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
56 TRI AYU ANDRIANY ,S.Kep.NS K -1 3,743,100 0 0 0 0 0 56 .............
0 374,310 0 0 0 0 0
0 600,000 144,840 0 47,174
27-09-1982 2 4,117,410 0 0 0
198209272006042025 MKG:16 0 329,393 0
Penata Tk.I-3D 0 2001348631
17 0
15.358.365.3-732.000 4,862,267 0 376,567 0
0 4,485,700
57 LAILA KURNIATI TK-0 3,743,100 0 0 0 0 0 57 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 43,431
15-06-1983 1 3,743,100 0 0 0
198306152007012005 MKG:16 0 299,448 0
Penata Tk.I-3D 0 2001348062
59 0
15.993.285-4.732.000 4,415,579 0 342,879 0
0 4,072,700
58 MENIK MUTIARINI ,S.ST TK-0 3,628,900 0 0 0 0 0 58 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 42,289
03-12-1982 1 3,628,900 0 0 0
198212032005012005 MKG:14 0 290,312 0
Penata Tk.I-3D 0 2001336878
81 0
16.000.969.2-732.000 4,301,401 0 332,601 0
0 3,968,800
59 ISNANIAH ,AM.KEP K -1 3,628,900 0 0 0 0 0 59 .............
2 362,890 0 0 0 0 0
145,156 600,000 289,680 0 47,369
01-10-1984 4 4,136,946 0 0 0
198410012006042007 MKG:14 0 330,956 0
Penata Tk.I-3D 0 2001348151
99 0
16.007.432.4.732.000 5,026,725 0 378,325 0
0 4,648,400
60 NOORMILA MEGAWATI ,AM.KEB K -1 3,628,900 0 0 0 0 0 60 .............
2 362,890 0 0 0 0 0
145,156 600,000 289,680 0 47,369
21-01-1985 4 4,136,946 0 0 0
198501212006042007 MKG:14 0 330,956 0
Penata Tk.I-3D 0 2001336908
99 0
14.904.338.2.732.000 5,026,725 0 378,325 0
0 4,648,400
61 WINDA MULIA RASIOBAR, S.GZ TK-0 3,518,100 0 0 0 0 0 61 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 41,181
06-11-1986 1 3,518,100 0 0 0
198611092010012016 MKG:12 0 281,448 0
Penata Tk.I-3D 0 2001337249
9 0
15.795.920.8-731.000 4,190,529 0 322,629 0
0 3,867,900
62 NORHAKIMAH.NS ,S.KEP K -1 3,410,600 0 0 0 0 0 62 .............
2 341,060 0 0 0 0 0
136,424 600,000 289,680 0 44,881
05-09-1983 4 3,888,084 0 0 0
198309052009032009 MKG:11 0 311,047 0
Penata Tk.I-3D 0 2001348623
64 0
15.478.907.7-732.000 4,777,828 0 355,928 0
0 4,421,900
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 10

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
63 FITRI SUHARIYANTI.NS ,S.KEP K -1 3,410,600 0 0 0 0 0 63 .............
2 341,060 0 0 0 0 0
136,424 600,000 289,680 0 44,881
27-03-1988 4 3,888,084 0 0 0
198803272011012005 MKG:10 0 311,047 0
Penata Tk.I-3D 0 2001358939
64 0
15.993.276.3-732.000 4,777,828 0 355,928 0
0 4,421,900
64 Hj. MASNIAH TK-0 4,650,600 0 0 0 12,050 0 64 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 51,506
21-01-1966 1 4,650,600 0 12,050 0
196601211989032012 MKG:30 0 372,048 0
Penata Tk.I-3D 0 2001348224
34 0
15.767.215.5.732.000 5,235,104 0 435,604 0
0 4,799,500
65 AKHMAD KUSASI K -1 4,650,600 0 0 0 6,613 0 65 .............
1 465,060 0 0 0 0 0
93,012 500,000 217,260 0 57,087
21-04-1966 3 5,208,672 0 6,613 0
196604211987031007 MKG:30 0 416,694 0
Penata Tk.I-3D 0 2001347945
49 0
16.115.119.6.732.000 5,932,594 0 480,394 0
0 5,452,200
66 Hj. SUMIATI K -1 4,650,600 0 0 0 6,613 0 66 .............
1 465,060 0 0 0 0 0
93,012 500,000 217,260 0 57,087
15-05-1966 3 5,208,672 0 6,613 0
196605051986032016 MKG:30 0 416,694 0
Penata Tk.I-3D 0 2001360291
49 0
15.582.533.4.732.000 5,932,594 0 480,394 0
0 5,452,200
67 H. MUHIDIN ,AMD K -1 4,508,600 0 0 0 0 0 67 .............
2 450,860 0 0 0 0 0
180,344 500,000 289,680 0 56,398
09-10-1965 4 5,139,804 0 0 0
196510091989011002 MKG:28 0 411,184 0
Penata Tk.I-3D 0 2001350253
98 0
78.345.693.2-732.000 5,929,582 0 467,582 0
0 5,462,000
68 MAHPIAH ,Amd.Keb K -1 4,508,600 0 0 0 10,675 0 68 .............
0 450,860 0 0 0 0 0
0 500,000 144,840 0 54,595
03-05-1967 2 4,959,460 0 10,675 0
196705031988022005 MKG:28 0 396,757 0
Penata Tk.I-3D 0 2001337729
52 0
57.822.816.5-732.000 5,615,027 0 462,027 0
0 5,153,000
69 Hj. HENNY MULYANI TK-0 4,508,600 0 0 0 5,642 0 69 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 50,086
16-01-1968 1 4,508,600 0 5,642 0
196801161989032006 MKG:28 0 360,688 0
Penata Tk.I-3D 0 2001360305
54 0
14.089.534.3-732.001 5,086,716 0 416,416 0
0 4,670,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 11

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
70 ETIKA SARI ,AM.KEP TK-0 4,508,600 0 0 0 5,642 0 70 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 50,086
12-07-1969 1 4,508,600 0 5,642 0
196907121989022002 MKG:28 0 360,688 0
Penata Tk.I-3D 0 2001336706
54 0
14.166.133.0.731.000 5,086,716 0 416,416 0
0 4,670,300
71 Hj. SITI AISYAH ,A.Md.Keb JD-0 4,370,900 0 0 0 0 0 71 .............
1 0 0 0 0 0 0
87,418 500,000 144,840 0 49,583
18-04-1972 2 4,458,318 0 0 0
197204181991012001 MKG:26 0 356,665 0
Penata Tk.I-3D 0 2001336935
90 0
80.769.546.5-732.000 5,103,248 0 406,248 0
0 4,697,000
72 WIYATNO ,A.MK K -1 4,237,500 0 0 0 0 0 72 .............
2 423,750 0 0 0 0 0
169,500 500,000 289,680 0 53,308
03-10-1970 4 4,830,750 0 0 0
197010031993031003 MKG:24 0 386,460 0
Penata Tk.I-3D 0 2001348615
38 0
14.350.446.1.731.000 5,620,468 0 439,768 0
0 5,180,700
73 ARPANI ,AM.KEP K -1 4,237,500 0 0 0 0 0 73 .............
1 423,750 0 0 0 0 0
84,750 500,000 217,260 0 52,460
11-12-1970 3 4,746,000 0 0 0
197012111992021003 MKG:24 0 379,680 0
Penata Tk.I-3D 0 2001360321
80 0
25.049.572.8.732.000 5,463,340 0 432,140 0
0 5,031,200
74 SUHARTINI TK-0 4,237,500 0 0 0 0 0 74 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 47,375
10-02-1972 1 4,237,500 0 0 0
197202101992022003 MKG:24 0 339,000 0
Penata Tk.I-3D 0 2001334029
55 0
15.358.006.3.732.000 4,809,975 0 386,375 0
0 4,423,600
75 MURSIDAH K -1 4,237,500 0 0 0 0 0 75 .............
1 423,750 0 0 0 0 0
84,750 500,000 217,260 0 52,460
13-07-1972 3 4,746,000 0 0 0
197207131992022002 MKG:24 0 379,680 0
Penata Tk.I-3D 0 2001337125
80 0
15.504.061.1.732.000 5,463,340 0 432,140 0
0 5,031,200
76 MASRIAH K -1 4,237,500 0 0 0 0 0 76 .............
1 423,750 0 0 0 0 0
84,750 500,000 217,260 0 52,460
05-04-1973 3 4,746,000 0 0 0
197304051993032003 MKG:24 0 379,680 0
Penata Tk.I-3D 0 2001336978
80 0
15.064.109.0-732.000 5,463,340 0 432,140 0
0 5,031,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 12

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
77 TUTIK NURHIDAYATI ,A.MK TK-0 4,237,500 0 0 0 0 0 77 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 47,375
24-06-1973 1 4,237,500 0 0 0
197306241993032003 MKG:24 0 339,000 0
Penata Tk.I-3D 0 2001336738
55 0
15.504.064.5-732.000 4,809,975 0 386,375 0
0 4,423,600
78 NABAHAN ,A.MG K -1 4,108,100 0 0 0 0 0 78 .............
2 410,810 0 0 0 0 0
164,324 500,000 289,680 0 51,832
04-02-1968 4 4,683,234 0 0 0
196802041995031003 MKG:22 0 374,659 0
Penata Tk.I-3D 0 2001369221
77 0
16.657.195.0-732.000 5,472,991 0 426,491 0
0 5,046,500
79 NORLIANI K -1 4,108,100 0 0 0 0 0 79 .............
1 410,810 0 0 0 0 0
82,162 500,000 217,260 0 51,011
16-12-1970 3 4,601,072 0 0 0
197012161994032007 MKG:22 0 368,086 0
Penata Tk.I-3D 0 2001337222
65 0
15.993.207.1-732.000 5,318,397 0 419,097 0
0 4,899,300
80 RIFA'I ,A.MK K -1 4,108,100 0 0 0 0 0 80 .............
2 410,810 0 0 0 0 0
164,324 500,000 289,680 0 51,832
27-04-1974 4 4,683,234 0 0 0
197404271994031004 MKG:22 0 374,659 0
Penata Tk.I-3D 0 2001335278
77 0
15.478.722.0-732.000 5,472,991 0 426,491 0
0 5,046,500
81 TINA AYU SARI ,AMD.RO TK-0 3,982,600 0 0 0 0 0 81 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 44,826
10-10-1973 1 3,982,600 0 0 0
197310102005012011 MKG:20 0 318,608 0
Penata Tk.I-3D 0 2001336781
14 0
15.504.080.1-732.000 4,555,034 0 363,434 0
0 4,191,600
82 RUSMADI ,AMK K -1 3,982,600 0 0 0 0 0 82 .............
0 398,260 0 0 0 0 0
0 500,000 144,840 0 48,809
02-04-1975 2 4,380,860 0 0 0
197504021997031008 MKG:20 0 350,469 0
Penata Tk.I-3D 0 2001335041
78 0
15.504.092.6.732.000 5,025,778 0 399,278 0
0 4,626,500
83 DWI HELFRIDA SUCIATY TK-0 3,982,600 0 0 0 0 0 83 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 44,826
07-09-1976 1 3,982,600 0 0 0
197609071996032002 MKG:20 0 318,608 0
Penata Tk.I-3D 0 2001336797
14 0
25.079.979.8.732.000 4,555,034 0 363,434 0
0 4,191,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 13

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
84 WUARLINA ,AMD.KEP K -1 3,982,600 0 0 0 0 0 84 .............
2 398,260 0 0 0 0 0
159,304 500,000 289,680 0 50,402
16-02-1977 4 4,540,164 0 0 0
197702162000032002 MKG:20 0 363,213 0
Penata Tk.I-3D 0 2001360337
71 0
16.000.871.0.732.000 5,329,915 0 413,615 0
0 4,916,300
85 VIDIA TAHMIDILLAH ,AMK K -1 3,982,600 0 0 0 0 0 85 .............
2 398,260 0 0 0 0 0
159,304 500,000 289,680 0 50,402
19-03-1977 4 4,540,164 0 0 0
197703191996031001 MKG:20 0 363,213 0
Penata Tk.I-3D 0 2001348248
71 0
15.993.408.2.732.000 5,329,915 0 413,615 0
0 4,916,300
86 HAMIDAH ,AM.KEP K -1 3,628,900 0 0 0 0 0 86 .............
2 362,890 0 0 0 0 0
145,156 500,000 289,680 0 46,369
16-09-1982 4 4,136,946 0 0 0
198209162006042016 MKG:15 0 330,956 0
Penata Tk.I-3D 0 2001337109
99 0
25.767.389.8-732.000 4,926,725 0 377,325 0
0 4,549,400
87 ERNI MASITAH ,AM.KEB TK-0 3,628,900 0 0 0 0 0 87 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 41,289
06-03-1977 1 3,628,900 0 0 0
197703062006042007 MKG:14 0 290,312 0
Penata Tk.I-3D 0 2001359803
81 0
15.767.346.8.732.000 4,201,401 0 331,601 0
0 3,869,800
88 SRI SEDIYANI ,AM.KEP K -1 3,628,900 0 0 0 0 0 88 .............
1 362,890 0 0 0 0 0
72,578 500,000 217,260 0 45,644
25-02-1978 3 4,064,368 0 0 0
197802252006042019 MKG:14 0 325,149 0
Penata Tk.I-3D 0 2001335238
65 0
15.042.331.7-732.000 4,781,693 0 370,793 0
0 4,410,900
89 IKA RAKHMADANIATY ,A.Md.Kep TK-0 3,628,900 0 0 0 0 0 89 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 41,289
22-06-1983 1 3,628,900 0 0 0
198306222006042010 MKG:14 0 290,312 0
Penata Tk.I-3D 0 2001348364
81 0
14.560.247.0-732.000 4,201,401 0 331,601 0
0 3,869,800
90 RISNAWATI ,AM.KEP K -1 3,628,900 0 0 0 0 0 90 .............
2 362,890 0 0 0 0 0
145,156 500,000 289,680 0 46,369
13-03-1985 4 4,136,946 0 0 0
198503132006042009 MKG:14 0 330,956 0
Penata Tk.I-3D 0 2001337028
99 0
16.007.431.6.732.000 4,926,725 0 377,325 0
0 4,549,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 14

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
91 DR, RAHMAD RIZKY APRIAL ,Sp.Rad TK-0 3,628,900 0 0 0 5,608 0 91 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 49,639
24-04-1979 1 3,628,900 1,150,000 5,608 0
197904242008031003 MKG:14 0 290,312 0
Penata Tk.I-3D 0 2001342269
31 0
87.409.500.3.731.000 5,041,959 0 345,559 0
0 4,696,400
92 dr, TYAS ILHAMY ,Sp.Rad K -0 3,410,600 0 0 0 0 0 92 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 47,456
08-01-1986 1 3,410,600 1,150,000 0 0
198601082011012004 MKG:10 0 272,848 0
Penata Tk.I-3D 0 2001369434
84 0
16.004.533.2-731.000 4,818,104 0 320,304 0
0 4,497,800
93 ISTIQOMAH K -1 3,591,200 540,000 0 0 0 0 93 .............
2 359,120 0 0 0 0 0
143,648 0 289,680 0 46,340
07-06-1979 4 4,093,968 0 0 0
197906072006042025 MKG:16 0 327,517 0
Penata-3C 0 2001348135
9 0
16.007.430.8.732.000 4,923,657 0 373,857 0
0 4,549,800
94 FAZRIANNOOR ,S.Kep K -1 3,272,200 540,000 0 0 0 0 94 .............
2 327,220 0 0 0 0 0
130,888 0 289,680 0 42,703
27-04-1987 4 3,730,308 0 0 0
198704272009031002 MKG:11 0 298,425 0
Penata-3C 0 2001342951
40 0
16.483.067.1-732.000 4,560,028 0 341,128 0
0 4,218,900
95 dr, GILANG MAULADI RAHMAN ,Sp.JP K -1 3,172,300 0 0 0 0 0 95 .............
2 317,230 0 0 0 0 0
126,892 750,000 289,680 0 43,664
05-11-1988 4 3,616,422 0 0 0
198811052014061001 MKG: 8 0 289,314 0
Penata-3C 0 2001369868
76 0
16.768.679.9-732.000 4,656,178 0 332,978 0
0 4,323,200
96 R M ARDANI FITRIANSYAH SY ,SP.B K -1 3,075,500 0 0 0 0 0 96 .............
2 307,550 0 0 0 0 0
123,020 750,000 289,680 0 42,561
14-08-1980 4 3,506,070 0 0 0
198008142015021003 MKG: 6 0 280,486 0
Penata-3C 0 2001369458
97 0
14.960.327.6-307.000 4,545,847 0 323,047 0
0 4,222,800
97 ERNA SURI SUDARTI ,A.Md.Keb TK-0 3,821,000 0 0 0 0 0 97 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 44,210
01-01-1974 1 3,821,000 0 0 0
197401012007012023 MKG:20 0 305,680 0
Penata-3C 0 2001321083
70 0
57.822.654.0-732.000 4,493,490 0 349,890 0
0 4,143,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 15

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
98 HAIRIYAH ,S.Kep K -1 3,591,200 0 0 0 0 0 98 .............
2 359,120 0 0 0 0 0
143,648 600,000 289,680 0 46,940
04-01-1981 4 4,093,968 0 0 0
198101042006042030 MKG:16 0 327,517 0
Penata-3C 0 2001336854
9 0
16.000.874.4-732.000 4,983,657 0 374,457 0
0 4,609,200
99 SRI SUMARTINI.T ,S.SI JD-0 3,591,200 0 0 0 0 0 99 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 41,912
07-01-1981 1 3,591,200 0 0 0
198101072005012013 MKG:16 0 287,296 0
Penata-3C 0 2001360488
88 0
15.504.098.3-732.000 4,263,708 0 329,208 0
0 3,934,500
100 NORHIDA WIDIARTI ,SKM.S.Kep. K -1 3,591,200 0 0 0 0 0 100 .............
Ners 2 359,120 0 0 0 0 0
143,648 600,000 289,680 0 46,940
04-05-1982 4 4,093,968 0 0 0
198205042006042031 MKG:16 0 327,517 0
Penata-3C 0 2001335197
9 0
25.047.940.9-732.000 4,983,657 0 374,457 0
0 4,609,200
101 CICILIA ADI ARTANTI ,A.MK K -1 3,481,600 0 0 0 0 0 101 .............
2 348,160 0 0 0 0 0
139,264 600,000 289,680 0 45,690
25-07-1982 4 3,969,024 0 0 0
198207252005012011 MKG:14 0 317,522 0
Penata-3C 0 2001348097
8 0
15.767.366.6-732.000 4,858,712 0 363,212 0
0 4,495,500
102 DEWI INDRIYANI ,S.Kep.NS K -0 3,481,600 0 0 0 0 0 102 .............
1 0 0 0 0 0 0
69,632 600,000 144,840 0 41,512
02-01-1983 2 3,551,232 0 0 0
198301022006042022 MKG:14 0 284,099 0
Penata-3C 0 2001348348
39 0
15.767.427.6-732.000 4,296,111 0 325,611 0
0 3,970,500
103 RINA MEGASARI ,SST TK-0 3,375,300 0 0 0 0 0 103 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 39,753
18-03-1984 1 3,375,300 0 0 0
198403182007012004 MKG:13 0 270,024 0
Penata-3C 0 2001324748
57 0
15.767.227.0-732.000 4,047,777 0 309,777 0
0 3,738,000
104 ENDAH PRASETIYA.N ,AMF TK-0 3,375,300 0 0 0 0 0 104 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 39,753
13-11-1985 1 3,375,300 0 0 0
198511132008032001 MKG:12 0 270,024 0
Penata-3C 0 2001348658
57 0
15.582.974.0-732.000 4,047,777 0 309,777 0
0 3,738,000
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 16

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
105 H.M. IQBAL ,S.Kep TK-0 3,272,200 0 0 0 0 0 105 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 38,722
11-03-1982 1 3,272,200 0 0 0
198203112009031008 MKG:10 0 261,776 0
Penata-3C 0 2001337378
78 0
14.904.339.0-732.000 3,944,698 0 300,498 0
0 3,644,200
106 BAINUL HUSAINI ,AMK K -1 3,272,200 0 0 0 0 0 106 .............
2 327,220 0 0 0 0 0
130,888 600,000 289,680 0 43,303
13-08-1984 4 3,730,308 0 0 0
198408132010011014 MKG:10 0 298,425 0
Penata-3C 0 2001347848
40 0
15.504.099.1-732.000 4,620,028 0 341,728 0
0 4,278,300
107 TIARA FAULINA ,S.Kep,N.s TK-0 3,272,200 0 0 0 0 0 107 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 38,722
08-11-1985 1 3,272,200 0 0 0
198511082011012008 MKG:10 0 261,776 0
Penata-3C 0 2001359285
78 0
15.993.274.8-732.000 3,944,698 0 300,498 0
0 3,644,200
108 IRMA DESIANA ,AMK K -1 3,272,200 0 0 0 0 0 108 .............
2 327,220 0 0 0 0 0
130,888 600,000 289,680 0 43,303
23-12-1986 4 3,730,308 0 0 0
198612232010012013 MKG:10 0 298,425 0
Penata-3C 0 2001348313
40 0
15.504.083.5-732.000 4,620,028 0 341,728 0
0 4,278,300
109 ANITA KUSUMA PUTRI K -1 3,272,200 0 0 0 0 0 109 .............
1 327,220 0 0 0 0 0
65,444 600,000 217,260 0 42,649
28-12-1986 3 3,664,864 0 0 0
198612282010012012 MKG:10 0 293,189 0
Penata-3C 0 2001348143
14 0
16.657.086.1-732.000 4,482,138 0 335,838 0
0 4,146,300
110 HENNY PUSPASARI ,S.Kep K -1 3,272,200 0 0 0 0 0 110 .............
2 327,220 0 0 0 0 0
130,888 600,000 289,680 0 43,303
11-03-1987 4 3,730,308 0 0 0
198703112009032005 MKG:10 0 298,425 0
Penata-3C 0 2001337168
40 0
15.504.095.9-732.000 4,620,028 0 341,728 0
0 4,278,300
111 NOVITA APRIANTI ,AMK K -0 3,272,200 0 0 0 0 0 111 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 38,722
08-07-1987 1 3,272,200 0 0 0
198707082010012008 MKG:10 0 261,776 0
Penata-3C 0 2001337095
78 0
16.115.074.3-732.000 3,944,698 0 300,498 0
0 3,644,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 17

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
112 HJ. NORMALIAH.NS ,S.KEP K -1 3,272,200 0 0 0 0 0 112 .............
2 327,220 0 0 0 0 0
130,888 600,000 289,680 0 43,303
29-07-1987 4 3,730,308 0 0 0
198707292011012005 MKG:10 0 298,425 0
Penata-3C 0 2001360787
40 0
15.993.275.5-732.000 4,620,028 0 341,728 0
0 4,278,300
113 IMAM CHUDORI ,A.MA.K K -1 4,065,500 0 0 0 0 0 113 .............
2 406,550 0 0 0 0 0
162,620 500,000 289,680 0 51,347
28-02-1973 4 4,634,670 0 0 0
197302281993031006 MKG:24 0 370,774 0
Penata-3C 0 2001360356
71 0
25.145.925.1-732.000 5,424,421 0 422,121 0
0 5,002,300
114 ANDRA DWI RAHAYU ,AMD.AK K -1 3,704,300 0 0 0 0 0 114 .............
2 370,430 0 0 0 0 0
148,172 500,000 289,680 0 47,229
11-12-1975 4 4,222,902 0 0 0
197512111998032005 MKG:18 0 337,832 0
Penata-3C 0 2001361042
79 0
14.324.400.2.732.000 5,012,661 0 385,061 0
0 4,627,600
115 RAHMI ,A.Md.Farm JD-0 3,704,300 0 0 0 0 0 115 .............
1 0 0 0 0 0 0
74,086 500,000 144,840 0 42,784
08-04-1977 2 3,778,386 0 0 0
197704081998032006 MKG:18 0 302,271 0
Penata-3C 0 2001325027
29 0
89.701.667.1-731.000 4,423,255 0 345,055 0
0 4,078,200
116 SULISTARI ,A.MG K -1 3,591,200 0 0 0 0 0 116 .............
2 359,120 0 0 0 0 0
143,648 500,000 289,680 0 45,940
20-06-1978 4 4,093,968 0 0 0
197806262006042020 MKG:16 0 327,517 0
Penata-3C 0 2001337338
9 0
15.993.286.2.732.000 4,883,657 0 373,457 0
0 4,510,200
117 NITA ASNIYANTI ,AMK K -1 3,591,200 0 0 0 0 0 117 .............
1 359,120 0 0 0 0 0
71,824 500,000 217,260 0 45,221
02-11-1981 3 4,022,144 0 0 0
198111022006042026 MKG:16 0 321,772 0
Penata-3C 0 2001348259
89 0
16.482.825.3-732.000 4,739,493 0 366,993 0
0 4,372,500
118 BAMBANG SAFARI, ,AMK K -1 3,481,600 0 0 0 0 0 118 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
22-04-1977 4 3,969,024 0 0 0
197704222005011007 MKG:14 0 317,522 0
Penata-3C 0 2001348666
8 0
15.504.091.8-732.000 4,758,712 0 362,212 0
0 4,396,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 18

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
119 IKA DEWA NITA SARI ,AM.KEB JD-0 3,481,600 0 0 0 0 0 119 .............
1 0 0 0 0 0 0
69,632 500,000 144,840 0 40,512
12-06-1979 2 3,551,232 0 0 0
197906122006042020 MKG:14 0 284,099 0
Penata-3C 0 2001337605
39 0
15.358.808.9-732.000 4,196,111 0 324,611 0
0 3,871,500
120 KARTINI ,AM.KEP K -1 3,481,600 0 0 0 0 0 120 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
06-10-1980 4 3,969,024 0 0 0
198010062006042024 MKG:14 0 317,522 0
Penata-3C 0 2001348119
8 0
15.504.096.7-732.000 4,758,712 0 362,212 0
0 4,396,500
121 MUJIMAN ,AM.KEP K -1 3,481,600 0 0 0 0 0 121 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
26-12-1982 4 3,969,024 0 0 0
198212262006041012 MKG:14 0 317,522 0
Penata-3C 0 2001337157
8 0
64.217.523.6-732.000 4,758,712 0 362,212 0
0 4,396,500
122 LISTINA ,AM.KEP K -1 3,481,600 0 0 0 0 0 122 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
20-09-1984 4 3,969,024 0 0 0
198409202006042008 MKG:14 0 317,522 0
Penata-3C 0 2001342258
8 0
15.478.944.0-732.000 4,758,712 0 362,212 0
0 4,396,500
123 AULIA AZIZAH, AM.KL K -1 3,272,200 0 0 0 0 0 123 .............
1 327,220 0 0 0 0 0
65,444 500,000 217,260 0 41,649
25-05-1975 3 3,664,864 0 0 0
197505252009032003 MKG:11 0 293,189 0
Penata-3C 0 2001346469
14 0
15.767.324.5-732.000 4,382,138 0 334,838 0
0 4,047,300
124 ERNI KURNIAWAN ,AMK K -0 3,272,200 0 0 0 0 0 124 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
13-06-1985 1 3,272,200 0 0 0
198506132009032012 MKG:11 0 261,776 0
Penata-3C 0 2001348542
78 0
15.358.364.6-732.000 3,844,698 0 299,498 0
0 3,545,200
125 DEWI FATMAWATI LEGAWA ,AM.KG TK-0 3,272,200 0 0 0 0 0 125 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
20-03-1988 1 3,272,200 0 0 0
198803202009032001 MKG:11 0 261,776 0
Penata-3C 0 2001345101
78 0
57.822.811.6-732.000 3,844,698 0 299,498 0
0 3,545,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 19

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
126 MUJIYEM ,AMK K -1 3,272,200 0 0 0 0 0 126 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
25-08-1977 4 3,730,308 0 0 0
197708252010012007 MKG:10 0 298,425 0
Penata-3C 0 2001336967
40 0
16.000.873.6-732.000 4,520,028 0 340,728 0
0 4,179,300
127 IDA LESTARI ,AMK K -1 3,272,200 0 0 0 0 0 127 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
07-09-1977 4 3,730,308 0 0 0
197709072010012001 MKG:10 0 298,425 0
Penata-3C 0 2001348569
40 0
16.257.840.5-732.000 4,520,028 0 340,728 0
0 4,179,300
128 YASMIDINAH ,AMK TK-0 3,272,200 0 0 0 0 0 128 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
28-11-1982 1 3,272,200 0 0 0
198211282010012013 MKG:10 0 261,776 0
Penata-3C 0 2001337087
78 0
15.358.406.5-732.000 3,844,698 0 299,498 0
0 3,545,200
129 SUSILOWATI ENDAH LESTARI ,AMK TK-0 3,272,200 0 0 0 0 0 129 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
09-06-1983 1 3,272,200 0 0 0
198306092010012014 MKG:10 0 261,776 0
Penata-3C 0 2001348558
78 0
16.482.845.1-732.000 3,844,698 0 299,498 0
0 3,545,200
130 AHMAD HAMIDI ,AMK K -1 3,272,200 0 0 0 0 0 130 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
25-10-1984 4 3,730,308 0 0 0
198410252010011014 MKG:10 0 298,425 0
Penata-3C 0 2001337141
40 0
15.582.985.6-732.000 4,520,028 0 340,728 0
0 4,179,300
131 AHMAD MUHAIMIN K -1 3,272,200 0 0 0 0 0 131 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
14-12-1984 4 3,730,308 0 0 0
198412142010011012 MKG:10 0 298,425 0
Penata-3C 0 2001332778
40 0
15.504.059.5-732.000 4,520,028 0 340,728 0
0 4,179,300
132 DENI KRISTIANA ,AMK K -1 3,272,200 0 0 0 0 0 132 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
31-12-1984 4 3,730,308 0 0 0
198412312009032013 MKG:10 0 298,425 0
Penata-3C 0 2001321695
40 0
16.257.862.9-732.000 4,520,028 0 340,728 0
0 4,179,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 20

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
133 MISLAWATI, ,AMK TK-0 3,272,200 0 0 0 0 0 133 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
16-01-1985 1 3,272,200 0 0 0
198501162010012014 MKG:10 0 261,776 0
Penata-3C 0 2001360388
78 0
15.504.089.2-732.000 3,844,698 0 299,498 0
0 3,545,200
134 MUTTAQIN ,AMK K -0 3,272,200 0 0 0 0 0 134 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
10-06-1985 1 3,272,200 0 0 0
198506102010011013 MKG:10 0 261,776 0
Penata-3C 0 2001334479
78 0
15.504.086.8-732.000 3,844,698 0 299,498 0
0 3,545,200
135 SARI NARULITA ,AMK TK-0 3,272,200 0 0 0 0 0 135 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
14-06-1985 1 3,272,200 0 0 0
198506142009032010 MKG:10 0 261,776 0
Penata-3C 0 2001337214
78 0
15.767.327.8-732.000 3,844,698 0 299,498 0
0 3,545,200
136 YOHANNA HARTATYANINGSIH ,AMK TK-0 3,272,200 0 0 0 0 0 136 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
05-07-1985 1 3,272,200 0 0 0
198507052010012026 MKG:10 0 261,776 0
Penata-3C 0 2001348399
78 0
15.504.085.0-732.000 3,844,698 0 299,498 0
0 3,545,200
137 SITI JURAIDA, ,AMK K -1 3,272,200 0 0 0 0 0 137 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
16-10-1985 4 3,730,308 0 0 0
198510162009032007 MKG:10 0 298,425 0
Penata-3C 0 2001347732
40 0
15.504.087.6-732.000 4,520,028 0 340,728 0
0 4,179,300
138 RINI IRIANI ,AMD.KEB K -1 3,272,200 0 0 0 0 0 138 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
25-12-1985 4 3,730,308 0 0 0
198512252009032009 MKG:10 0 298,425 0
Penata-3C 0 2001337303
40 0
57.822.810.8-732.000 4,520,028 0 340,728 0
0 4,179,300
139 RHOMIE SUHERMA DANIANSYAH ,AMK K -1 3,272,200 0 0 0 0 0 139 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
23-03-1986 4 3,730,308 0 0 0
198603232010011011 MKG:10 0 298,425 0
Penata-3C 0 2001348054
40 0
15.504.088.4-732.000 4,520,028 0 340,728 0
0 4,179,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 21

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
140 HERIAN IRAWAN ,AMK K -1 3,272,200 0 0 0 0 0 140 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
16-04-1986 4 3,730,308 0 0 0
198604162010011003 MKG:10 0 298,425 0
Penata-3C 0 2001337036
40 0
16.007.429.0-732.000 4,520,028 0 340,728 0
0 4,179,300
141 ENDRA PERMANA ,AMK K -1 3,272,200 0 0 0 0 0 141 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
04-10-1986 4 3,730,308 0 0 0
198610042010011006 MKG:10 0 298,425 0
Penata-3C 0 2001336919
40 0
15.504.097.5-732.000 4,520,028 0 340,728 0
0 4,179,300
142 MAULANA YUSMA ,S.Kep,Ns K -1 3,272,200 0 0 0 0 0 142 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
30-11-1986 4 3,730,308 0 0 0
198611302010011008 MKG:10 0 298,425 0
Penata-3C 0 2001348127
40 0
14.314.090.3-732.000 4,520,028 0 340,728 0
0 4,179,300
143 RETNOWATI ,Amd.Keb K -1 3,272,200 0 0 0 0 0 143 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
29-12-1986 4 3,730,308 0 0 0
198612292010012010 MKG:10 0 298,425 0
Penata-3C 0 2001360437
40 0
16.483.029.1-732.000 4,520,028 0 340,728 0
0 4,179,300
144 YUDHA IRAWAN K -1 3,272,200 0 0 0 0 0 144 .............
1 327,220 0 0 0 0 0
65,444 500,000 217,260 0 41,649
03-04-1987 3 3,664,864 0 0 0
198704032010011005 MKG:10 0 293,189 0
Penata-3C 0 2001333979
14 0
15.478.719.6-732.000 4,382,138 0 334,838 0
0 4,047,300
145 SWASTRI SAKTI DEWI ARLIANI K -1 3,272,200 0 0 0 0 0 145 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
10-01-1987 4 3,730,308 0 0 0
198710012009032005 MKG:10 0 298,425 0
Penata-3C 0 2001334169
40 0
16.007.424.1-732.000 4,520,028 0 340,728 0
0 4,179,300
146 PUSPA ANGGRIANI ,A.Mk K -1 3,272,200 0 0 0 0 0 146 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
27-01-1988 4 3,730,308 0 0 0
198801272009032005 MKG:10 0 298,425 0
Penata-3C 0 2000642757
40 0
148567126734000 4,520,028 0 340,728 0
0 4,179,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 22

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
147 ROSYIDA ANGGRAINI ,AM.KEB TK-0 3,272,200 0 0 0 0 0 147 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
20-03-1988 1 3,272,200 0 0 0
198803202010012010 MKG:10 0 261,776 0
Penata-3C 0 2001337718
78 0
15.767.349.2-732.000 3,844,698 0 299,498 0
0 3,545,200
148 FATHIMAH ,AMK K -0 3,272,200 0 0 0 0 0 148 .............
1 0 0 0 0 0 0
65,444 500,000 144,840 0 38,376
14-04-1988 2 3,337,644 0 0 0
198804142010012006 MKG:10 0 267,012 0
Penata-3C 0 2001359118
4 0
15.993.383.7-732.000 3,982,488 0 305,388 0
0 3,677,100
149 LINDA MAYA SARI K -1 3,272,200 0 0 0 0 0 149 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
23-10-1988 4 3,730,308 0 0 0
198810232010012001 MKG:10 0 298,425 0
Penata-3C 0 2001348275
40 0
16.657.079.6-732.000 4,520,028 0 340,728 0
0 4,179,300
150 dr, HENDERI SAPUTRA K -1 3,075,500 0 0 0 0 0 150 .............
1 307,550 0 0 0 0 0
61,510 0 217,260 0 34,446
20-06-1989 3 3,444,560 0 0 0
198906202015021004 MKG: 6 0 275,565 0
Penata-3C 91 0 0
709799415732000 3,661,911 0 310,011 0
0 3,351,900
151 MUHAMMAD SYAM'ANI ,SKM K -1 3,238,300 540,000 0 0 0 0 151 .............
2 323,830 0 0 0 0 0
129,532 0 289,680 0 42,317
14-01-1980 4 3,691,662 0 0 0
198001142005011004 MKG:12 0 295,333 0
Penata Muda Tk.I-3B 0 2001320346
8 0
71.066.940.9-732.000 4,521,350 0 337,650 0
0 4,183,700
152 I MADE GEDE DARMA SUSILA ,Sp.OG TK-0 3,665,900 0 0 0 0 0 152 .............
0 0 0 0 0 0 0
0 750,000 72,420 0 44,159
22-09-1974 1 3,665,900 0 0 0
197409222002121003 MKG:20 0 293,272 0
Penata Muda Tk.I-3B 0 2001334517
11 0
34.175.850.6-906.000 4,488,331 0 337,431 0
0 4,150,900
153 drg, RIZKI YULITA RAHMAH K -0 2,773,200 0 0 0 0 0 153 .............
0 0 0 0 0 0 0
0 750,000 72,420 0 35,232
21-07-1992 1 2,773,200 0 0 0
199207212019032005 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 2001371118
68 0
84.669.607.8-732.000 3,595,688 0 257,088 0
0 3,338,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 23

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
154 EKA FREDA YUNITA K -1 3,043,600 0 0 0 0 0 154 .............
2 304,360 0 0 0 0 0
121,744 600,000 289,680 0 40,697
28-06-1989 4 3,469,704 0 0 0
198906282011012007 MKG: 8 0 277,576 0
Penata Muda Tk.I-3B 0 2001359827
89 0
15.767.337.7-732.000 4,359,473 0 318,273 0
0 4,041,200
155 ANNASTASIA PRAWITA SARI K -1 3,043,600 0 0 0 0 0 155 .............
0 304,360 0 0 0 0 0
0 600,000 144,840 0 39,480
23-08-1989 2 3,347,960 0 0 0
198908232011012006 MKG: 8 0 267,837 0
Penata Muda Tk.I-3B 0 2001359811
17 0
15.767.336.9-732.000 4,092,817 0 307,317 0
0 3,785,500
156 DIDIK TRI PRASETYO K -1 3,340,300 0 0 0 0 0 156 .............
2 334,030 0 0 0 0 0
133,612 500,000 289,680 0 43,079
26-06-1983 4 3,807,942 0 0 0
198306262008011010 MKG:14 0 304,635 0
Penata Muda Tk.I-3B 0 2001348388
92 0
15.338.169.9-732.000 4,597,714 0 347,714 0
0 4,250,000
157 TITIN SUHARTINI ,AMK K -1 3,139,400 0 0 0 0 0 157 .............
2 313,940 0 0 0 0 0
125,576 500,000 289,680 0 40,789
08-08-1981 4 3,578,916 0 0 0
198108082009032013 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001324667
6 0
57.822.649.0-732.000 4,368,602 0 327,102 0
0 4,041,500
158 SRI ANDAYANI ,AM.GZ K -1 3,139,400 0 0 0 0 0 158 .............
2 313,940 0 0 0 0 0
125,576 500,000 289,680 0 40,789
07-10-1986 4 3,578,916 0 0 0
198610072010012017 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001337354
6 0
15.767.314.6-732.000 4,368,602 0 327,102 0
0 4,041,500
159 apt, ANTUNG MAS RIZKI KUSUMA TK-0 2,773,200 0 0 0 0 0 159 .............
WARDHANI ,S.Far 0 0 0 0 0 0 0
0 325,000 72,420 0 30,982
20-11-1987 1 2,773,200 0 0 0
198711202020122005 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 2001372184
18 0
45.460.221.0-732.000 3,170,638 0 252,838 0
0 2,917,800
160 dr, CITRA DEWI WAHYUNINGSIH TK-0 2,773,200 0 0 0 0 0 160 .............
0 0 0 0 0 0 0
0 325,000 72,420 0 30,982
03-08-1994 1 2,773,200 0 0 0
199408032020122023 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 2001373628
18 0
82.898.102.7-732.000 3,170,638 0 252,838 0
0 2,917,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 24

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
161 ADIYANTI A. FABANYO ,AM.KEP K -1 3,340,300 0 0 0 0 0 161 .............
2 334,030 0 0 0 0 0
133,612 300,000 289,680 0 41,079
20-08-1983 4 3,807,942 0 0 0
198308202006042015 MKG:15 0 304,635 0
Penata Muda Tk.I-3B 0 2001336889
92 0
16.007.427.4-732.000 4,397,714 0 345,714 0
0 4,052,000
162 NELLY ROSANA ,A.Md.Keb TK-0 3,340,300 0 0 0 0 0 162 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 36,403
29-10-1975 1 3,340,300 0 0 0
197510292003122008 MKG:14 0 267,224 0
Penata Muda Tk.I-3B 0 2001347783
7 0
15.358.007.1.732.000 3,712,727 0 303,627 0
0 3,409,100
163 M. SUBHAN NOOR ,S.Kep K -1 3,139,400 0 0 0 0 0 163 .............
2 313,940 0 0 0 0 0
125,576 300,000 289,680 0 38,789
27-01-1988 4 3,578,916 0 0 0
198801272010011001 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001360461
6 0
16.001.019.5-732.000 4,168,602 0 325,102 0
0 3,843,500
164 ISELLA LOVIANA ,S. Psi., M.Psi TK-0 2,773,200 0 0 0 0 0 164 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 30,732
24-05-1988 1 2,773,200 0 0 0
198805242020122014 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 2001373563
68 0
93.926.504.7-732.000 3,145,688 0 252,588 0
0 2,893,100
165 NOORLAIDAH JD-0 3,445,500 0 0 0 0 0 165 .............
2 0 0 0 0 0 0
137,820 265,000 217,260 0 38,483
17-07-1978 3 3,583,320 0 0 0
197807172006042017 MKG:17 0 286,666 0
Penata Muda Tk.I-3B 0 2001336927
69 0
15.582.659.7-732.000 4,065,649 0 325,149 0
0 3,740,500
166 SRI HARINI OKTAVIA ,A.Md.Farm K -1 3,238,300 0 0 0 0 0 166 .............
2 323,830 0 0 0 0 0
129,532 265,000 289,680 0 39,567
21-10-1977 4 3,691,662 0 0 0
197710212007012007 MKG:12 0 295,333 0
Penata Muda Tk.I-3B 0 2001335211
58 0
16.482.891.5-732.000 4,246,400 0 334,900 0
0 3,911,500
167 MARIANA ,AMG TK-0 3,238,300 0 0 0 0 0 167 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 35,033
09-09-1981 1 3,238,300 0 0 0
198109092009042003 MKG:12 0 259,064 0
Penata Muda Tk.I-3B 0 2001368608
77 0
68.142.351.3-734.000 3,575,797 0 294,097 0
0 3,281,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 25

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
168 RINA JULIANA ,A.Md. Farm JD-0 3,238,300 0 0 0 0 0 168 .............
2 0 0 0 0 0 0
129,532 265,000 217,260 0 36,328
03-07-1982 3 3,367,832 0 0 0
198207032006042019 MKG:12 0 269,427 0
Penata Muda Tk.I-3B 0 2001319868
63 0
16.257.701.9-732.000 3,850,155 0 305,755 0
0 3,544,400
169 RISKA SURYANI ,A.MA.K K -1 3,238,300 0 0 0 0 0 169 .............
2 323,830 0 0 0 0 0
129,532 265,000 289,680 0 39,567
13-05-1985 4 3,691,662 0 0 0
198505132008032001 MKG:12 0 295,333 0
Penata Muda Tk.I-3B 0 2001337672
58 0
16.657.121.6-732.000 4,246,400 0 334,900 0
0 3,911,500
170 MAULIDA RAMAYANTI TK-0 3,139,400 0 0 0 0 0 170 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
19-01-1982 1 3,139,400 0 0 0
198201192006042037 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001348496
76 0
14.797.066.9-731.000 3,476,896 0 285,196 0
0 3,191,700
171 NAHDATUN NISA ,A.Md. Farm K -1 3,139,400 0 0 0 0 0 171 .............
1 313,940 0 0 0 0 0
62,788 265,000 217,260 0 37,811
02-09-1985 3 3,516,128 0 0 0
198509022006042002 MKG:10 0 281,290 0
Penata Muda Tk.I-3B 0 2001357107
13 0
16.717.407.0.732.000 3,998,401 0 319,101 0
0 3,679,300
172 MARIANA PAKADANG ,AMK K -0 3,139,400 0 0 0 0 0 172 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
23-09-1985 1 3,139,400 0 0 0
198509232010012019 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001360399
76 0
15.767.353.4-732.000 3,476,896 0 285,196 0
0 3,191,700
173 NOORMAIDA HAYATI, ,AMK K -1 3,139,400 0 0 0 0 0 173 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
22-02-1987 4 3,578,916 0 0 0
198702222010012009 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001347961
56 0
15.504.090.0-732.000 4,133,652 0 324,752 0
0 3,808,900
174 ISNA AMALIA JULIANTI ,A.Md. Farm TK-0 3,139,400 0 0 0 0 0 174 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
09-07-1985 1 3,139,400 0 0 0
198707092006042001 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001337567
76 0
16.657.074.7.732.000 3,476,896 0 285,196 0
0 3,191,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 26

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
175 RIZKI AMALIA ,AMK K -1 3,139,400 0 0 0 0 0 175 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
12-09-1987 4 3,578,916 0 0 0
198709122009032009 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001360453
56 0
15.607.429.6-732.000 4,133,652 0 324,752 0
0 3,808,900
176 DEWI SEPTINA ,A.Md. Farm TK-0 3,139,400 0 0 0 0 0 176 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
17-09-1985 1 3,139,400 0 0 0
198709172006042002 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001347562
76 0
16.657.112.5.732.000 3,476,896 0 285,196 0
0 3,191,700
177 ITA PURNAMASARI ,AMK TK-0 3,139,400 0 0 0 0 0 177 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
17-07-1988 1 3,139,400 0 0 0
198807172010012011 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2002343347
76 0
68.150.113.6-731.000 3,476,896 0 285,196 0
0 3,191,700
178 PAKHRUDDIN FAUZY ,A.MK K -1 3,043,600 0 0 0 0 0 178 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
20-02-1987 4 3,469,704 0 0 0
198702202011011004 MKG: 9 0 277,576 0
Penata Muda Tk.I-3B 0 2001360445
39 0
16.657.071.3-732.000 4,024,423 0 314,923 0
0 3,709,500
179 PUJIASTUTI SETYANINGRUM ,AMK K -1 3,043,600 0 0 0 0 0 179 .............
0 304,360 0 0 0 0 0
0 265,000 144,840 0 36,130
28-12-1979 2 3,347,960 0 0 0
197912282011012003 MKG: 8 0 267,837 0
Penata Muda Tk.I-3B 0 2001360496
67 0
15.993.363.9-732.000 3,757,867 0 303,967 0
0 3,453,900
180 IKA KUSUMANING TYAS ,AM.KEB K -1 3,043,600 0 0 0 0 0 180 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
08-08-1985 4 3,469,704 0 0 0
198508082011012006 MKG: 8 0 277,576 0
Penata Muda Tk.I-3B 0 2001360801
39 0
16.657.078.8-732.000 4,024,423 0 314,923 0
0 3,709,500
181 DESSY ARIYANTI TK-0 3,043,600 0 0 0 0 0 181 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,086
26-12-1986 1 3,043,600 0 0 0
198612262011012006 MKG: 8 0 243,488 0
Penata Muda Tk.I-3B 0 2001359579
54 0
15.767.312.0-732.000 3,381,074 0 276,574 0
0 3,104,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 27

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
182 PUPUT IKA RETNOWATI ,AMK K -1 3,043,600 0 0 0 0 0 182 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
07-10-1987 4 3,469,704 0 0 0
198710072010012012 MKG: 8 0 277,576 0
Penata Muda Tk.I-3B 0 2001360798
39 0
54.720.496.6.732.000 4,024,423 0 314,923 0
0 3,709,500
183 HARPIKA ,AMK K -1 3,043,600 0 0 0 0 0 183 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
15-10-1987 4 3,469,704 0 0 0
198710152011012007 MKG: 8 0 277,576 0
Penata Muda Tk.I-3B 0 2001360828
39 0
15.767.326.0-732.000 4,024,423 0 314,923 0
0 3,709,500
184 ERIE INDRA PUSPITA ,A.MA.K TK-0 3,043,600 0 0 0 0 0 184 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,086
29-02-1988 1 3,043,600 0 0 0
198802292011011001 MKG: 8 0 243,488 0
Penata Muda Tk.I-3B 0 2001360836
54 0
16.657.073.9.732.000 3,381,074 0 276,574 0
0 3,104,500
185 LATIFAH AZMIYAH ,AMK TK-0 3,043,600 0 0 0 0 0 185 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,086
09-09-1988 1 3,043,600 0 0 0
198809092011012007 MKG: 8 0 243,488 0
Penata Muda Tk.I-3B 0 2001359102
54 0
16.115.009.9-732.000 3,381,074 0 276,574 0
0 3,104,500
186 YENNY RAHMAH ,AMK TK-0 3,043,600 0 0 0 0 0 186 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 33,086
06-10-1988 1 3,043,600 0 0 0
198810062011012006 MKG: 8 0 243,488 0
Penata Muda Tk.I-3B 0 2001359196
54 0
15.767.258.5-732.000 3,381,074 0 276,574 0
0 3,104,500
187 LISTIYANI RAHAYU ,AMK K -1 3,043,600 0 0 0 0 0 187 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
26-04-1989 4 3,469,704 0 0 0
198904262011012004 MKG: 8 0 277,576 0
Penata Muda Tk.I-3B 0 2001359358
39 0
16.657.077.0-732.000 4,024,423 0 314,923 0
0 3,709,500
188 DUMASARI SILALAHI ,AMK K -1 3,043,600 0 0 0 0 0 188 .............
1 304,360 0 0 0 0 0
60,872 265,000 217,260 0 36,738
10-05-1989 3 3,408,832 0 0 0
198905102011012005 MKG: 8 0 272,707 0
Penata Muda Tk.I-3B 0 2001359207
53 0
15.767.255.1-732.000 3,891,145 0 309,445 0
0 3,581,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 28

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
189 NINA MUFDALIFAH ,AM.KEB K -1 3,043,600 0 0 0 0 0 189 .............
1 304,360 0 0 0 0 0
60,872 265,000 217,260 0 36,738
22-05-1989 3 3,408,832 0 0 0
198905222011012004 MKG: 8 0 272,707 0
Penata Muda Tk.I-3B 0 2001359226
53 0
15.767.373.2-732.000 3,891,145 0 309,445 0
0 3,581,700
190 M. SYAHDIAR FIRDAUS ,A.MA.K K -1 3,043,600 0 0 0 0 0 190 .............
2 304,360 0 0 0 0 0
121,744 265,000 289,680 0 37,347
05-12-1989 4 3,469,704 0 0 0
198912052011011002 MKG: 8 0 277,576 0
Penata Muda Tk.I-3B 0 2001359528
39 0
16.657.124.0.732.000 4,024,423 0 314,923 0
0 3,709,500
191 HAYATUNNISA K -1 3,781,400 0 0 0 0 0 191 .............
2 378,140 0 0 0 0 0
151,256 240,000 289,680 0 45,508
22-05-1976 4 4,310,796 0 0 0
197605222006042021 MKG:22 0 344,864 0
Penata Muda Tk.I-3B 0 2001348518
96 0
15.208.708.6.732.000 4,840,572 0 390,372 0
0 4,450,200
192 AGIARTI, ,AMK TK-0 3,139,400 0 0 0 0 0 192 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 33,794
28-05-1986 1 3,139,400 0 0 0
198605282010012009 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001325078
26 0
15.504.084.3-732.000 3,451,846 0 284,946 0
0 3,166,900
193 RASPIAH TK-0 4,150,100 0 0 0 0 0 193 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 43,351
03-01-1965 1 4,150,100 0 0 0
196501031988032012 MKG:28 0 332,008 0
Penata Muda Tk.I-3B 0 2001336773
39 0
15.767.218.9.732.000 4,407,559 0 375,359 0
0 4,032,200
194 SRI LESTARI TK-0 3,900,500 0 0 0 0 0 194 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 40,855
11-07-1967 1 3,900,500 0 0 0
196707111986032001 MKG:24 0 312,040 0
Penata Muda Tk.I-3B 0 2001348305
75 0
15.767.213.0-732.000 4,157,995 0 352,895 0
0 3,805,100
195 drg, ENDYTIASTUTI K -1 2,688,500 0 0 0 0 0 195 .............
1 268,850 0 0 0 0 0
53,770 0 217,260 0 30,111
09-11-1991 3 3,011,120 0 0 0
199111092020122023 MKG: 1 0 240,890 0
Penata Muda Tk.I-3B 0 007.03.28.06945.1
21 0
73.420.232.8-732.000 3,228,401 0 271,001 0
0 2,957,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 29

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
196 dr, ANISA IKA WATI TK-0 2,150,800 0 0 0 0 0 196 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
14-09-1989 1 2,150,800 0 0 0
198909142022032003 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200405508
2 0
705774040732000 2,408,222 0 195,422 0
0 2,212,800
197 SELVIANI ,S. Kep., Ns TK-0 2,150,800 0 0 0 0 0 197 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
11-11-1992 1 2,150,800 0 0 0
199211112022032005 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200405713
2 0
708287065732000 2,408,222 0 195,422 0
0 2,212,800
198 LELI NAILUL MUNA ,M.PSI,Psikolog TK-0 2,150,800 0 0 0 0 0 198 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
29-06-1993 1 2,150,800 0 0 0
199306292022032002 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200404512
2 0
948942453732000 2,408,222 0 195,422 0
0 2,212,800
199 dr, RIZQI AMALIA TK-0 2,150,800 0 0 0 0 0 199 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
19-09-1994 1 2,150,800 0 0 0
199409192022032004 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200403265
2 0
861489284732000 2,408,222 0 195,422 0
0 2,212,800
200 apt., KURNIA HASANAH ,S. Farm TK-0 2,150,800 0 0 0 0 0 200 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
21-09-1995 1 2,150,800 0 0 0
199509212022032006 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200403017
2 0
924313497734000 2,408,222 0 195,422 0
0 2,212,800
201 apt., NURAINA MARDIAH ,S. Farm TK-0 2,150,800 0 0 0 0 0 201 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
17-10-1996 1 2,150,800 0 0 0
199610172022032004 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200403028
2 0
426597175732000 2,408,222 0 195,422 0
0 2,212,800
202 RASYIDAH JD-0 3,517,200 0 0 0 0 0 202 .............
2 0 0 0 0 0 0
140,688 265,000 217,260 0 39,229
04-09-1974 3 3,657,888 0 0 0
197409042005012009 MKG:21 0 292,631 0
Penata Muda-3A 0 2001325728
12 0
16.664.765.1-735.000 4,140,160 0 331,860 0
0 3,808,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 30

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
203 YUSTI HANI ,AMK K -1 3,409,800 0 0 0 0 0 203 .............
2 340,980 0 0 0 0 0
136,392 265,000 289,680 0 41,522
27-11-1973 4 3,887,172 0 0 0
197311272014062004 MKG:18 0 310,974 0
Penata Muda-3A 0 2001369442
44 0
71.382.947.1-732.000 4,441,896 0 352,496 0
0 4,089,400
204 TIWIK LISTYANI TK-0 3,204,700 0 0 0 0 0 204 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,697
22-09-1979 1 3,204,700 0 0 0
197909222006042030 MKG:14 0 256,376 0
Penata Muda-3A 0 2001334002
53 0
15.504.060.3.732.000 3,542,173 0 291,073 0
0 3,251,100
205 MERRY ANGGRAINI JD-0 3,106,900 0 0 0 0 0 205 .............
1 0 0 0 0 0 0
62,138 265,000 144,840 0 34,340
07-03-1985 2 3,169,038 0 0 0
198503072007012002 MKG:12 0 253,523 0
Penata Muda-3A 0 2001337583
85 0
66.462.034.1-732.000 3,578,963 0 287,863 0
0 3,291,100
206 IKAWATI NOVITASARI K -1 3,106,900 0 0 0 0 0 206 .............
2 310,690 0 0 0 0 0
124,276 265,000 289,680 0 38,069
22-11-1985 4 3,541,866 0 0 0
198511222007012001 MKG:12 0 283,349 0
Penata Muda-3A 0 2001322543
72 0
87.655.538.4-732.000 4,096,618 0 321,418 0
0 3,775,200
207 AYU ZARA SHOLICA ,AM.Keb K -0 2,920,100 0 0 0 0 0 207 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 31,851
23-12-1988 1 2,920,100 0 0 0
198812232011012005 MKG: 9 0 233,608 0
Penata Muda-3A 0 2001369671
39 0
16.098.296.3-732.000 3,257,559 0 265,459 0
0 2,992,100
208 ABDULLAH ABERANI ,AMK K -1 2,920,100 0 0 0 0 0 208 .............
1 292,010 0 0 0 0 0
58,402 265,000 217,260 0 35,355
06-07-1987 3 3,270,512 0 0 0
198707062011011002 MKG: 8 0 261,641 0
Penata Muda-3A 0 2001360817
24 0
16.657.089.5-732.000 3,752,796 0 296,996 0
0 3,455,800
209 LASMITA PURNAMASARI ,AMK TK-0 2,920,100 0 0 0 0 0 209 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 31,851
15-08-1987 1 2,920,100 0 0 0
198708152011012006 MKG: 8 0 233,608 0
Penata Muda-3A 0 2001358898
39 0
16.657.088.7-732.000 3,257,559 0 265,459 0
0 2,992,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 31

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
210 LINA SUSANTI ,AMK K -1 2,744,500 0 0 0 0 0 210 .............
1 274,450 0 0 0 0 0
54,890 265,000 217,260 0 33,388
23-02-1991 3 3,073,840 0 0 0
199102232015022005 MKG: 5 0 245,907 0
Penata Muda-3A 0 2001368926
95 0
72.428.407.0-732.000 3,556,195 0 279,295 0
0 3,276,900
211 MERAH BAGUS Y.B, AM.RAD K -1 2,920,100 0 0 0 0 0 211 .............
2 292,010 185,000 0 0 0 0
116,804 0 289,680 0 46,639
16-11-1989 4 3,328,914 1,150,000 0 0
198911162011011002 MKG: 8 0 266,313 0
Penata Muda-3A 0 2001360976
58 0
16.615.427.8.731.000 4,953,652 0 312,952 0
0 4,640,700
212 EVA MAI SAADAH ,S.Tr.KL TK-0 2,063,520 0 0 0 0 0 212 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 22,485
18-05-1995 1 2,063,520 0 0 0
199505182022032004 MKG: 0 0 165,082 0
Penata Muda-3A 0 3200406884
27 0
967462177732000 2,320,967 0 187,567 0
0 2,133,400
213 NADYA MARTONI ,S.E TK-0 2,063,520 0 0 0 0 0 213 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 22,485
20-06-1997 1 2,063,520 0 0 0
199706202022032006 MKG: 0 0 165,082 0
Penata Muda-3A 0 3200400266
27 0
537514168731000 2,320,967 0 187,567 0
0 2,133,400
214 RABIATUL ADAWIAH ,S.Tr.Gz TK-0 2,063,520 0 0 0 0 0 214 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 22,485
01-10-1999 1 2,063,520 0 0 0
199910012022032004 MKG: 0 0 165,082 0
Penata Muda-3A 0 3200408453
27 0
418134441735000 2,320,967 0 187,567 0
0 2,133,400
SUB TOTAL PERGOLONGAN : III 617,511,360 4,220,000 0 0 52,843 0
PEG: 181 36,958,660 2,590,000 0 0 0 0
IST: 106 JIWA= 476 13,092,130 76,455,000 34,471,920 0 7,542,769
667,562,150 3,450,000 52,843 0
ANK: 189 0 53,404,985 0
9,084 0 0
788,810,997 0 61,000,597
0 727,810,400
215 VERY YUSWANTO K -1 2,980,800 0 0 0 0 0 215 .............
2 298,080 0 0 0 0 0
119,232 240,000 289,680 0 36,381
22-02-1985 4 3,398,112 0 0 0
198502222007011006 MKG:17 0 271,849 0
Pengatur Tk.I-2D 0 2001334789
38 0
14.749.767.1-732.000 3,927,830 0 308,230 0
0 3,619,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 32

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
216 MASLIANI ULFAH ,AM. AK TK-0 2,980,800 0 0 0 0 0 216 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 32,208
26-09-1985 1 2,980,800 0 0 0
198509262007012002 MKG:17 0 238,464 0
Pengatur Tk.I-2D 0 2001323698
52 0
14.904.267.3-732.000 3,293,272 0 270,672 0
0 3,022,600
217 AGUS SRI NUGRAHA ,AMD K -1 2,889,800 0 0 0 0 0 217 .............
2 288,980 0 0 0 0 0
115,592 240,000 289,680 0 35,344
20-08-1982 4 3,294,372 0 0 0
198208202009031007 MKG:15 0 263,550 0
Pengatur Tk.I-2D 0 2001347805
42 0
16.717.418.4-732.000 3,824,094 0 298,894 0
0 3,525,200
218 AULIA FITRIANA, AM.KEB K -1 2,889,800 0 0 0 0 0 218 .............
2 288,980 0 0 0 0 0
115,592 240,000 289,680 0 35,344
10-08-1988 4 3,294,372 0 0 0
198808102017042003 MKG:15 0 263,550 0
Pengatur Tk.I-2D 0 2001368675
42 0
66.591.993.2-732.000 3,824,094 0 298,894 0
0 3,525,200
219 NANI SUMARNI ,AM.Keb K -0 2,801,500 0 0 0 0 0 219 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 30,415
04-11-1987 1 2,801,500 0 0 0
198711042017042004 MKG:13 0 224,120 0
Pengatur Tk.I-2D 0 2001369582
15 0
76.652.932.5-732.000 3,113,935 0 254,535 0
0 2,859,400
220 NORMALIANI ,AMD.Keb K -1 2,801,500 0 0 0 0 0 220 .............
2 280,150 0 0 0 0 0
112,060 240,000 289,680 0 34,337
07-03-1990 4 3,193,710 0 0 0
199003072017042002 MKG:13 0 255,497 0
Pengatur Tk.I-2D 0 2001369191
44 0
66.565.489.3-732.000 3,723,434 0 289,834 0
0 3,433,600
221 DIAJENG RAHAYU RHAMADANY K -1 2,716,000 0 0 0 0 0 221 .............
0 271,600 0 0 0 0 0
0 240,000 144,840 0 32,276
18-04-1990 2 2,987,600 0 0 0
199004182010012001 MKG:11 0 239,008 0
Pengatur Tk.I-2D 0 2001347538
44 0
16.657.093.7-732.000 3,372,484 0 271,284 0
0 3,101,200
222 AMALIA AZIZAH ,AM.KG K -1 2,474,700 0 0 0 0 0 222 .............
2 247,470 0 0 0 0 0
98,988 240,000 289,680 0 30,612
22-08-1984 4 2,821,158 0 0 0
198408222019032003 MKG: 6 0 225,693 0
Pengatur Tk.I-2D 0 2001371099
67 0
15.993.484.3-732.000 3,350,905 0 256,305 0
0 3,094,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 33

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
223 LISA PUDA JUNTIKA ,A.Md.Keb K -1 2,474,700 0 0 0 0 0 223 .............
2 247,470 0 0 0 0 0
98,988 240,000 289,680 0 30,612
05-06-1991 4 2,821,158 0 0 0
199106052019032007 MKG: 6 0 225,693 0
Pengatur Tk.I-2D 0 2001370955
67 0
80.045.178.3-732.000 3,350,905 0 256,305 0
0 3,094,600
224 ISTI KOMARIYAH ,A.Md.Kep TK-0 2,474,700 0 0 0 0 0 224 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 27,147
05-08-1995 1 2,474,700 0 0 0
199508052019032012 MKG: 6 0 197,976 0
Pengatur Tk.I-2D 0 2001371021
3 0
90.799.883.5-732.000 2,787,123 0 225,123 0
0 2,562,000
225 NANI WAHYU NINGTIYAS TK-0 3,074,700 0 0 0 0 0 225 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 32,547
08-12-1971 1 3,074,700 0 0 0
197112082007012016 MKG:19 0 245,976 0
Pengatur Tk.I-2D 0 2001348488
3 0
15.767.216.3-732.000 3,327,123 0 278,523 0
0 3,048,600
226 YUDI FIRMANSYAH ,A.Md.Kom TK-0 2,980,800 0 0 0 0 0 226 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 31,608
01-05-1981 1 2,980,800 0 0 0
198105012008011016 MKG:17 0 238,464 0
Pengatur Tk.I-2D 0 2001348445
52 0
15.767.232.0-732.000 3,233,272 0 270,072 0
0 2,963,200
227 HENDRIYANI K -1 2,980,800 0 0 0 0 0 227 .............
2 298,080 180,000 0 0 0 0
119,232 0 289,680 0 35,781
06-08-1983 4 3,398,112 0 0 0
198308062010011001 MKG:17 0 271,849 0
Pengatur Tk.I-2D 0 2001337192
38 0
15.767.214.8-732.000 3,867,830 0 307,630 0
0 3,560,200
228 HARTINI K -1 2,980,800 0 0 0 0 0 228 .............
2 298,080 180,000 0 0 0 0
119,232 0 289,680 0 35,781
17-01-1984 4 3,398,112 0 0 0
198401172010012001 MKG:17 0 271,849 0
Pengatur Tk.I-2D 0 2001348647
38 0
15.767.313.8-732.000 3,867,830 0 307,630 0
0 3,560,200
229 ISKA WAHYUDI.RAD ,AMD K -1 2,801,500 0 0 0 0 0 229 .............
2 280,150 180,000 0 0 0 0
112,060 0 289,680 0 45,237
11-12-1987 4 3,193,710 1,150,000 0 0
198712112011011003 MKG:13 0 255,497 0
Pengatur Tk.I-2D 0 2001359617
44 0
16.098.781.4-731.000 4,813,434 0 300,734 0
0 4,512,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 34

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
230 FITRIYANI BUNGA SARI ,Amd, Rad TK-0 2,374,300 0 0 0 0 0 230 .............
0 0 0 0 0 0 0
0 360,000 72,420 0 27,343
28-04-1990 1 2,374,300 0 0 0
199004282020122020 MKG: 5 0 189,944 0
Pengatur-2C 0 2001373318
67 0
95.494.016.9-732.000 2,806,787 0 217,287 0
0 2,589,500
231 FAUSIA ANAS ,AMD K -1 2,687,800 0 0 0 0 0 231 .............
2 268,780 0 0 0 0 0
107,512 240,000 289,680 0 33,041
06-11-1988 4 3,064,092 0 0 0
198811062011012006 MKG:13 0 245,127 0
Pengatur-2C 0 2001360941
96 0
16.657.122.4-732.000 3,593,868 0 278,168 0
0 3,315,700
232 DWI WAHYU CANDRA PURNOMO K -1 2,374,300 0 0 0 0 0 232 .............
,A.Md.Kep 2 237,430 0 0 0 0 0
94,972 240,000 289,680 0 29,467
11-11-1991 4 2,706,702 0 0 0
199111112019031005 MKG: 5 0 216,536 0
Pengatur-2C 0 2001370521
21 0
90.799.422.2-732.000 3,236,403 0 246,003 0
0 2,990,400
233 RUSTIFAH ,A.Md.Far TK-0 2,374,300 0 0 0 0 0 233 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
09-01-1993 1 2,374,300 0 0 0
199301092020122029 MKG: 5 0 189,944 0
Pengatur-2C 0 2001373326
67 0
82.136.891.7-734.000 2,686,787 0 216,087 0
0 2,470,700
234 NIDA ANISA ,A.Md.Kg TK-0 2,374,300 0 0 0 0 0 234 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
01-10-1994 1 2,374,300 0 0 0
199410012019032012 MKG: 5 0 189,944 0
Pengatur-2C 0 2001370483
67 0
81.589.357.3-732.000 2,686,787 0 216,087 0
0 2,470,700
235 IRMA ROUDIA ,A.Md.AK TK-0 2,374,300 0 0 0 0 0 235 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
02-10-1995 1 2,374,300 0 0 0
199510022019032007 MKG: 5 0 189,944 0
Pengatur-2C 0 2001370165
67 0
90.799.828.0-732.000 2,686,787 0 216,087 0
0 2,470,700
236 ANNISA RAGILIA ,A.Md. Kes TK-0 2,374,300 0 0 0 0 0 236 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
01-03-1997 1 2,374,300 0 0 0
199703012020122021 MKG: 5 0 189,944 0
Pengatur-2C 0 2001373105
67 0
95.628.816.1-732.000 2,686,787 0 216,087 0
0 2,470,700
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 35

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
237 SHIFA HILDANIA ARIFAH ,A.Md.Gz TK-0 2,374,300 0 0 0 0 0 237 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
21-03-1998 1 2,374,300 0 0 0
199803212020122012 MKG: 5 0 189,944 0
Pengatur-2C 0 2001372583
67 0
41.028.141.4-732.000 2,686,787 0 216,087 0
0 2,470,700
238 YUSYLIA ARAFANTY ,A.Md.Kes TK-0 2,374,300 0 0 0 0 0 238 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
05-04-1998 1 2,374,300 0 0 0
199804052020122004 MKG: 5 0 189,944 0
Pengatur-2C 0 2001372656
67 0
41.022.410.9-732.000 2,686,787 0 216,087 0
0 2,470,700
239 SUYONO K -1 3,553,100 0 0 0 0 0 239 .............
2 355,310 180,000 0 0 0 0
142,124 0 289,680 0 42,305
03-06-1969 4 4,050,534 0 0 0
196906052006041013 MKG:31 0 324,043 0
Pengatur-2C 0 2001336811
34 0
14.350.786.4.731.000 4,520,248 0 366,348 0
0 4,153,900
240 ERMA DWI WAHYUNINGSIH ,A.Md.Kom K -1 2,605,800 0 0 0 0 0 240 .............
2 260,580 180,000 0 0 0 0
104,232 0 289,680 0 31,506
29-05-1984 4 2,970,612 0 0 0
198405292011012004 MKG:11 0 237,649 0
Pengatur-2C 0 2001359382
63 0
15.993.499.1-732.000 3,440,355 0 269,155 0
0 3,171,200
241 YUDA HARI FAJAR SUKMONO ,AMK TK-0 1,841,440 0 0 0 0 0 241 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
09-08-1989 1 1,841,440 0 0 0
198908092022031002 MKG: 3 0 147,315 0
Pengatur-2C 0 3200403222
69 0
814315198732000 2,093,929 0 167,529 0
0 1,926,400
242 NOOR SYARIFAH ,AMK K -1 1,841,440 0 0 0 0 0 242 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
09-04-1990 3 2,062,413 0 0 0
199004092022032003 MKG: 3 0 164,993 0
Pengatur-2C 0 3200407309
44 0
112471891733000 2,459,717 0 187,417 0
0 2,272,300
243 YAUMA AHDIYATI ,A.Md.Far TK-0 1,841,440 0 0 0 0 0 243 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
11-05-1991 1 1,841,440 0 0 0
199105112022032004 MKG: 3 0 147,315 0
Pengatur-2C 0 3200401424
69 0
813553484732000 2,093,929 0 167,529 0
0 1,926,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 36

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
244 HELEN YUSLINAWATI ,A.Md.Kep K -1 1,841,440 0 0 0 0 0 244 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
13-07-1992 3 2,062,413 0 0 0
199207132022032003 MKG: 3 0 164,993 0
Pengatur-2C 0 3200403346
44 0
814233474732000 2,459,717 0 187,417 0
0 2,272,300
245 RICA NURCAHYATI ,AMK TK-0 1,841,440 0 0 0 0 0 245 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
15-01-1993 1 1,841,440 0 0 0
199301152022032003 MKG: 3 0 147,315 0
Pengatur-2C 0 3200405918
69 0
912525904732000 2,093,929 0 167,529 0
0 1,926,400
246 JONI PRATOMO ,A.Md.Kep K -1 1,841,440 0 0 0 0 0 246 .............
0 184,144 180,000 0 0 0 0
0 0 144,840 0 22,056
24-06-1993 2 2,025,584 0 0 0
199306242022031003 MKG: 3 0 162,047 0
Pengatur-2C 0 3200403737
79 0
863096806732000 2,350,503 0 184,103 0
0 2,166,400
247 DIAN SEPTIVIANA PUTRI ,A.Md.Far K -1 1,841,440 0 0 0 0 0 247 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
10-09-1993 3 2,062,413 0 0 0
199309102022032005 MKG: 3 0 164,993 0
Pengatur-2C 0 3200400479
44 0
849064928732000 2,459,717 0 187,417 0
0 2,272,300
248 MUHAMMAD WAIDI JAUHARI K -1 1,841,440 0 0 0 0 0 248 .............
,A.Md.RMIK 1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
18-04-1994 3 2,062,413 0 0 0
199404182022031001 MKG: 3 0 164,993 0
Pengatur-2C 0 3200402803
44 0
906387949732000 2,459,717 0 187,417 0
0 2,272,300
249 HASNAN HABIBI ,A.Md.OT TK-0 1,841,440 0 0 0 0 0 249 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
04-12-1994 1 1,841,440 0 0 0
199412042022031002 MKG: 3 0 147,315 0
Pengatur-2C 0 3200401378
69 0
815166301732000 2,093,929 0 167,529 0
0 1,926,400
250 AYU FITRIANI ,A.Md.Kep TK-0 1,841,440 0 0 0 0 0 250 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
15-04-1995 1 1,841,440 0 0 0
199504152022032007 MKG: 3 0 147,315 0
Pengatur-2C 0 3200407465
69 0
637280769732000 2,093,929 0 167,529 0
0 1,926,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 37

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
251 PENI MAYA SARI ,A.Md.Kep TK-0 1,841,440 0 0 0 0 0 251 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
15-05-1995 1 1,841,440 0 0 0
199505152022032011 MKG: 3 0 147,315 0
Pengatur-2C 0 3200402757
69 0
955751532732000 2,093,929 0 167,529 0
0 1,926,400
252 ANANDA INTAN PERTIWI IDIPASI TK-0 1,841,440 0 0 0 0 0 252 .............
,A.Md.Kep 0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
09-04-1996 1 1,841,440 0 0 0
199604092022032007 MKG: 3 0 147,315 0
Pengatur-2C 0 3200404717
69 0
921990909732000 2,093,929 0 167,529 0
0 1,926,400
253 CLAUDIA DEVI ,A.Md.Kep TK-0 1,841,440 0 0 0 0 0 253 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
06-07-1996 1 1,841,440 0 0 0
199607062022032007 MKG: 3 0 147,315 0
Pengatur-2C 0 3200405748
69 0
636873739732000 2,093,929 0 167,529 0
0 1,926,400
254 SITI RIZQA ULYA FIRDAUS ,A.Md.GZ K -1 1,841,440 0 0 0 0 0 254 .............
0 184,144 180,000 0 0 0 0
0 0 144,840 0 22,056
06-08-1997 2 2,025,584 0 0 0
199708062022032005 MKG: 3 0 162,047 0
Pengatur-2C 0 3200401572
79 0
427626619732000 2,350,503 0 184,103 0
0 2,166,400
255 REZKY AULIA DWI JAYA ,A.Md.Kep TK-0 1,841,440 0 0 0 0 0 255 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
19-06-1998 1 1,841,440 0 0 0
199806192022032003 MKG: 3 0 147,315 0
Pengatur-2C 0 3200407503
69 0
953945029732000 2,093,929 0 167,529 0
0 1,926,400
256 DEFRIL FARIZA FAJRI ,A.Md.Kes TK-0 1,841,440 0 0 0 0 0 256 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
28-08-1999 1 1,841,440 0 0 0
199908282022031002 MKG: 3 0 147,315 0
Pengatur-2C 0 3200405845
69 0
966012643732000 2,093,929 0 167,529 0
0 1,926,400
257 NOOR KHOFIFATURRAHMANIAH TK-0 1,841,440 0 0 0 0 0 257 .............
,A.Md.,T 0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
16-01-2000 1 1,841,440 0 0 0
200001162022032002 MKG: 3 0 147,315 0
Pengatur-2C 0 3200407015
69 0
637223652734000 2,093,929 0 167,529 0
0 1,926,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 38

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
258 SAPRIANI K -1 2,830,200 0 0 0 0 0 258 .............
2 283,020 180,000 0 0 0 0
113,208 0 289,680 0 34,064
05-10-1978 4 3,226,428 0 0 0
197810052007011009 MKG:19 0 258,114 0
Pengatur Muda Tk.I-2B 0 2001335227
70 0
15.582.995.5-732.000 3,696,178 0 292,178 0
0 3,404,000
259 GUSTI SUGIAN NOOR TK-0 2,743,800 0 0 0 0 0 259 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 29,238
05-03-1970 1 2,743,800 0 0 0
197003052014061002 MKG:17 0 219,504 0
Pengatur Muda Tk.I-2B 0 2001369396
22 0
71.457.765.7-732.000 2,996,242 0 248,742 0
0 2,747,500
260 GT. ALFIAN K -1 1,617,760 0 0 0 0 0 260 .............
1 161,776 180,000 0 0 0 0
32,355 0 217,260 0 19,919
05-12-1992 3 1,811,891 0 0 0
199212052022031003 MKG: 0 0 144,951 0
Pengatur Muda-2A 0 3200412647
19 0
811624147734000 2,209,170 0 164,870 0
0 2,044,300
SUB TOTAL PERGOLONGAN : 108,640,240 0 0 0 0 0
PEG: 46 5,470,800 4,860,000 0 0 0 0
IST: 22 JIWA= 101 1,752,695 4,680,000 7,314,420 0 1,265,533
115,863,735 1,150,000 0 0
ANK: 33 0 9,269,098 0
2,476 0 0
133,870,631 0 10,534,631
0 123,336,000
261 M. SAPARUDDIN K -1 2,525,000 0 0 0 0 0 261 .............
2 252,500 175,000 0 0 0 0
101,000 0 289,680 0 30,535
17-08-1984 4 2,878,500 0 0 0
198408172008011013 MKG:23 0 230,280 0
Juru Tk.I-1D 0 2001336749
35 0
15.504.070.2-732.000 3,343,215 0 260,815 0
0 3,082,400
262 ASMIAH K -1 2,300,700 0 0 0 0 0 262 .............
2 230,070 175,000 0 0 0 0
92,028 0 289,680 0 27,978
01-03-1975 4 2,622,798 0 0 0
197503042007012013 MKG:17 0 209,824 0
Juru Tk.I-1D 0 2001337273
24 0
15.993.288.8-732.000 3,087,502 0 237,802 0
0 2,849,700
SUB TOTAL PERGOLONGAN : I 4,825,700 0 0 0 0 0
PEG: 2 482,570 350,000 0 0 0 0
IST: 2 JIWA= 8 193,028 0 579,360 0 58,513
5,501,298 0 0 0
ANK: 4 0 440,104 0
59 0 0
6,430,717 0 498,617
0 5,932,100
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD H. BOEJASIN
(002) D50500100200021 BULAN : DESEMBER 2022 HALAMAN : 39

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 868,848,600 10,040,000 0 0 446,141 0
PEG: 262 52,340,780 7,800,000 0 0 0 0
IST: 153 JIWA= 682 18,403,401 109,085,000 49,390,440 0 10,711,171
ANK: 267 939,592,781 4,600,000 446,141 0
0 75,167,436 0
0 0
12,986 0 86,324,748
1,120,967,348
0 1,034,642,600

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD KH. MANSYUR KINTAP
(002) D50500100200022 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 SUTARNO ,S.Kep,N.s, MM K -1 4,024,400 0 0 0 0 0 1 .............
2 402,440 0 0 0 0 0
160,976 500,000 289,680 0 50,878
06-10-1973 4 4,587,816 0 0 0
197310061996021001 MKG:19 0 367,025 0
Pembina-4A 0 2001349565
7 0
15.582.991.4-732.000 5,377,503 0 417,903 0
0 4,959,600
SUB TOTAL PERGOLONGAN : IV 4,024,400 0 0 0 0 0
PEG: 1 402,440 0 0 0 0 0
IST: 1 JIWA= 4 160,976 500,000 289,680 0 50,878
4,587,816 0 0 0
ANK: 2 0 367,025 0
7 0 0
5,377,503 0 417,903
0 4,959,600
2 dr, ENDIK ARIFIANTO K -1 3,410,600 980,000 0 0 0 0 2 .............
2 341,060 0 0 0 0 0
136,424 0 289,680 0 48,681
21-03-1982 4 3,888,084 0 0 0
198203212010011002 MKG:10 0 311,047 0
Penata Tk.I-3D 0 2001339802
64 0
57.822.274.7-732.000 5,157,828 0 359,728 0
0 4,798,100
3 HARYONO K -1 4,370,900 540,000 0 0 0 0 3 .............
1 437,090 0 0 0 0 0
87,418 0 217,260 0 54,354
12-03-1969 3 4,895,408 0 0 0 0
196903121991011004 MKG:26 0 391,633 0
Penata Tk.I-3D 0 2001369167
19 0
15.358.351.3-732.000 5,652,687 0 445,987 0
0 5,206,700
4 SUNARNI ,AMK K -1 4,370,900 0 0 0 0 0 4 .............
1 437,090 0 0 0 0 0
87,418 500,000 217,260 0 53,954
06-12-1970 3 4,895,408 0 0 0
197012061994032007 MKG:26 0 391,633 0
Penata Tk.I-3D 0 2001349646
19 0
14.828.431.8-732.000 5,612,687 0 445,587 0
0 5,167,100
5 KARNI ,S.Kep K -1 3,481,600 540,000 0 0 0 0 5 .............
1 348,160 0 0 0 0 0
69,632 0 217,260 0 44,394
16-03-1978 3 3,899,392 0 0 0
197803162006041006 MKG:14 0 311,951 0
Penata-3C 0 2001349581
93 0
16.483.097.8-732.000 4,656,745 0 356,345 0
0 4,300,400
6 AGUS RIADY ,S.Kep K -1 3,375,300 540,000 0 0 0 0 6 .............
1 337,530 0 0 0 0 0
67,506 0 217,260 0 43,203
18-08-1982 3 3,780,336 0 0 0
198208182005011008 MKG:12 0 302,427 0
Penata-3C 0 2001343017
34 0
16.282.256.3-723.000 4,537,630 0 345,630 0
0 4,192,000
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD KH. MANSYUR KINTAP
(002) D50500100200022 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
7 MAHRIF K -1 3,821,000 0 0 0 0 0 7 .............
2 382,100 0 0 0 0 0
152,840 500,000 289,680 0 48,559
04-04-1975 4 4,355,940 0 0 0
197504041996031004 MKG:20 0 348,475 0
Penata-3C 0 2001349794
14 0
46.039.199.8-732.000 5,145,634 0 397,034 0
0 4,748,600
8 WAHYUNI NUR INDARSIH ,AM.AK K -1 3,272,200 0 0 0 0 0 8 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
23-01-1988 4 3,730,308 0 0 0
198801232010012003 MKG:10 0 298,425 0
Penata-3C 0 2001346426
40 0
16.483.057.2-732.000 4,520,028 0 340,728 0
0 4,179,300
9 dr, MUHAMMAD AKBAR ‘ANIFA K -1 2,773,200 0 0 0 0 0 9 .............
1 277,320 0 0 0 0 0
55,464 325,000 217,260 0 34,310
24-06-1991 3 3,105,984 0 0 0
199106242020121012 MKG: 2 0 248,479 0
Penata Muda Tk.I-3B 0 2001373547
45 0
44.691.485.5-526.000 3,648,289 0 282,789 0
0 3,365,500
10 apt, WINDI AYU APRILLIANI K -1 2,773,200 0 0 0 0 0 10 .............
,S.Farm 1 277,320 0 0 0 0 0
55,464 325,000 217,260 0 34,310
08-04-1993 3 3,105,984 0 0 0
199304082020122028 MKG: 2 0 248,479 0
Penata Muda Tk.I-3B 0 007.03.28.06834.4
45 0
81.533.313.3-732.000 3,648,289 0 282,789 0
0 3,365,500
11 drg, M. RIZA FIRDAUS K -1 2,773,200 0 0 0 0 0 11 .............
1 277,320 0 0 0 0 0
55,464 325,000 217,260 0 34,310
29-08-1993 3 3,105,984 0 0 0
199308292020121017 MKG: 2 0 248,479 0
Penata Muda Tk.I-3B 0 007.03.28.06935.6
45 0
93.093.644.8-734.000 3,648,289 0 282,789 0
0 3,365,500
12 dr, DESY RUSIANA TK-0 2,773,200 0 0 0 0 0 12 .............
0 0 0 0 0 0 0
0 325,000 72,420 0 30,982
25-12-1993 1 2,773,200 0 0 0
199312252020122033 MKG: 2 0 221,856 0
Penata Muda Tk.I-3B 0 007.03.28.06979.1
18 0
76.418.111.1-731.000 3,170,638 0 252,838 0
0 2,917,800
13 ARIF BUDI HARSONO ,AMK K -1 3,139,400 0 0 0 0 0 13 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
23-10-1987 4 3,578,916 0 0 0
198710232009041001 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001966998
56 0
681423554732000 4,133,652 0 324,752 0
0 3,808,900
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD KH. MANSYUR KINTAP
(002) D50500100200022 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
14 VERONICA SEPTIVANI ,S.Kep.,Ns TK-0 2,150,800 0 0 0 0 0 14 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
22-09-1989 1 2,150,800 0 0 0
198909222022032003 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200403818
2 0
814788188732000 2,408,222 0 195,422 0
0 2,212,800
15 UMMIL MU'MININ ,S. Kep., Ns K -1 2,150,800 0 0 0 0 0 15 .............
2 215,080 185,000 0 0 0 0
86,032 0 289,680 0 26,369
18-10-1990 4 2,451,912 0 0 0
199010182022032005 MKG: 0 0 196,153 0
Penata Muda Tk.I-3B 0 3200407422
30 0
665176616734000 2,926,622 0 222,522 0
0 2,704,100
16 RIZALI FITRI ,S.Kep.,Ns TK-0 2,150,800 0 0 0 0 0 16 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
26-03-1992 1 2,150,800 0 0 0
199203262022031003 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200401769
2 0
637204702734000 2,408,222 0 195,422 0
0 2,212,800
17 AGLITA JANIS RUPITA SEKTIRIANI TK-0 2,150,800 0 0 0 0 0 17 .............
,S.Kep.,Ners 0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
26-01-1993 1 2,150,800 0 0 0
199301262022032005 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200406906
2 0
420590598732000 2,408,222 0 195,422 0
0 2,212,800
18 RIZKI PUSPITA SARI ,S.Kep.,Ns K -1 2,150,800 0 0 0 0 0 18 .............
1 215,080 185,000 0 0 0 0
43,016 0 217,260 0 25,939
28-01-1993 3 2,408,896 0 0 0
199301282022032006 MKG: 0 0 192,712 0
Penata Muda Tk.I-3B 0 3200406817
95 0
833036221734000 2,811,251 0 218,651 0
0 2,592,600
19 ENDRA MULYADI ,S.Kep.,Ns TK-0 2,150,800 0 0 0 0 0 19 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
16-11-1994 1 2,150,800 0 0 0
199411162022031001 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200400916
2 0
538504309732000 2,408,222 0 195,422 0
0 2,212,800
20 dr, IHSAN WARDHANA K -1 2,150,800 0 0 0 0 0 20 .............
1 215,080 185,000 0 0 0 0
43,016 0 217,260 0 25,939
11-03-1995 3 2,408,896 0 0 0
199503112022031009 MKG: 0 0 192,712 0
Penata Muda Tk.I-3B 0 3200406744
95 0
909039687732000 2,811,251 0 218,651 0
0 2,592,600
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD KH. MANSYUR KINTAP
(002) D50500100200022 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
21 dr, CALVIN JONATHAN ,S.Ked TK-0 2,150,800 0 0 0 0 0 21 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
22-05-1995 1 2,150,800 0 0 0
199505222022031005 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200407821
2 0
917675068445000 2,408,222 0 195,422 0
0 2,212,800
22 dr, SABILA ROSADA TK-0 2,150,800 0 0 0 0 0 22 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
16-07-1995 1 2,150,800 0 0 0
199507162022032005 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200403826
2 0
928650837734000 2,408,222 0 195,422 0
0 2,212,800
23 RIANA NORTOYIBA ,S.Kep.,Ns TK-0 2,150,800 0 0 0 0 0 23 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 23,358
26-11-1995 1 2,150,800 0 0 0
199511262022032005 MKG: 0 0 172,064 0
Penata Muda Tk.I-3B 0 3200406892
2 0
637040577732000 2,408,222 0 195,422 0
0 2,212,800
24 ULFAH INA RAKHMAWATI ,S.K.M TK-0 2,660,700 0 0 0 0 0 24 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 29,607
12-07-1994 1 2,660,700 0 0 0
199407122020122029 MKG: 2 0 212,856 0
Penata Muda-3A 0 007.03.28.06882.3
43 0
80.986.084.4-732.000 3,033,163 0 242,463 0
0 2,790,700
25 DIAN KUSTANTI ,S.Kep.,Ners K -1 2,660,700 0 0 0 0 0 25 .............
0 266,070 0 0 0 0 0
0 300,000 144,840 0 32,268
15-07-1994 2 2,926,770 0 0 0
199407152020122025 MKG: 2 0 234,142 0
Penata Muda-3A 0 007.03.28.06915.5
0 0
85.824.125.0-732.000 3,371,610 0 266,410 0
0 3,105,200
26 BRENDA ELLYSE S ,S.K.M TK-0 2,660,700 0 0 0 0 0 26 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 29,607
24-12-1995 1 2,660,700 0 0 0
199512242020122017 MKG: 2 0 212,856 0
Penata Muda-3A 0 007.03.28.06831.9
43 0
96.993.924.8-734.000 3,033,163 0 242,463 0
0 2,790,700
27 RISQIANA RAHMANINGRUM ,S.Tr.Keb K -1 2,660,700 0 0 0 0 0 27 .............
0 266,070 0 0 0 0 0
0 300,000 144,840 0 32,268
15-05-1996 2 2,926,770 0 0 0
199605152020122024 MKG: 2 0 234,142 0
Penata Muda-3A 0 007.03.28.06936.1
0 0
96.981.696.6-732.000 3,371,610 0 266,410 0
0 3,105,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD KH. MANSYUR KINTAP
(002) D50500100200022 BULAN : DESEMBER 2022 HALAMAN : 5

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
28 AZIZAH FITRIAH RAHMAH ,S.Tr.Gz TK-0 2,660,700 0 0 0 0 0 28 .............
0 0 0 0 0 0 0
0 300,000 72,420 0 29,607
09-08-1997 1 2,660,700 0 0 0
199708092020122016 MKG: 2 0 212,856 0
Penata Muda-3A 0 007.03.28.06989.6
43 0
96.232.539.5-732.000 3,033,163 0 242,463 0
0 2,790,700
29 SUPARTINI ,AMd.Keb K -1 3,517,200 0 0 0 0 0 29 .............
2 351,720 0 0 0 0 0
140,688 265,000 289,680 0 42,746
11-11-1976 4 4,009,608 0 0 0
197611112006042041 MKG:20 0 320,769 0
Penata Muda-3A 0 2001349824
27 0
16.282.357.9-732.000 4,564,315 0 363,515 0
0 4,200,800
30 RISTAWATI TK-0 3,409,800 0 0 0 0 0 30 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 36,748
26-06-1976 1 3,409,800 0 0 0
197606262007012023 MKG:18 0 272,784 0
Penata Muda-3A 0 2001349767
12 0
57.822.272.1-732.000 3,747,232 0 309,532 0
0 3,437,700
31 JANAINAH K -0 3,409,800 0 0 0 0 0 31 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 36,748
23-09-1979 1 3,409,800 0 0 0
197909232007012010 MKG:18 0 272,784 0
Penata Muda-3A 0 2001339861
12 0
16.282.359.5-732.000 3,747,232 0 309,532 0
0 3,437,700
32 EKA MAULIDA NOVRIANTI ,AMG K -1 3,012,000 0 0 0 0 0 32 .............
2 301,200 0 0 0 0 0
120,480 265,000 289,680 0 36,987
14-11-1986 4 3,433,680 0 0 0
198611142010012019 MKG:10 0 274,694 0
Penata Muda-3A 0 2001335378
21 0
16.115.108.9-732.000 3,988,381 0 311,681 0
0 3,676,700
33 RIZKY AMELIA ,SST K -1 2,063,520 0 0 0 0 0 33 .............
0 206,352 185,000 0 0 0 0
0 0 144,840 0 24,549
27-06-1991 2 2,269,872 0 0 0
199106272022032003 MKG: 0 0 181,590 0
Penata Muda-3A 0 3200400339
27 0
846639318732000 2,599,739 0 206,139 0
0 2,393,600
34 SHELVI NURVIANI ,S.Tr.Keb TK-0 2,063,520 0 0 0 0 0 34 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 22,485
15-05-1997 1 2,063,520 0 0 0
199705152022032009 MKG: 0 0 165,082 0
Penata Muda-3A 0 3200406515
27 0
412364523732000 2,320,967 0 187,567 0
0 2,133,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD KH. MANSYUR KINTAP
(002) D50500100200022 BULAN : DESEMBER 2022 HALAMAN : 6

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
35 BAHJATANNOOR LAYYINA ,S.Tr.Gz TK-0 2,063,520 0 0 0 0 0 35 .............
0 0 185,000 0 0 0 0
0 0 72,420 0 22,485
25-04-1998 1 2,063,520 0 0 0
199804252022032008 MKG: 0 0 165,082 0
Penata Muda-3A 0 3200407007
27 0
635718745731000 2,320,967 0 187,567 0
0 2,133,400
SUB TOTAL PERGOLONGAN : III 94,685,560 2,600,000 0 0 0 0
PEG: 34 5,792,802 2,405,000 0 0 0 0
IST: 19 JIWA= 76 1,457,326 5,625,000 5,503,920 0 1,125,657
101,935,688 0 0 0
ANK: 23 0 8,154,859 0
1,008 0 0
118,070,616 0 9,280,516
0 108,790,100
36 FITRIA NURUL LATIFAH ,A.md Rad K -1 2,374,300 0 0 0 0 0 36 .............
2 237,430 0 0 0 0 0
94,972 360,000 289,680 0 30,667
07-06-1990 4 2,706,702 0 0 0
199006072020122021 MKG: 5 0 216,536 0
Pengatur-2C 0 2001373857
21 0
41.182.547.4-732.000 3,356,403 0 247,203 0
0 3,109,200
37 SHELLA FITRINA HAMADA ,A.Md.RMIK TK-0 2,374,300 0 0 0 0 0 37 .............
0 0 0 0 0 0 0
0 360,000 72,420 0 27,343
25-02-1995 1 2,374,300 0 0 0
199502252020122024 MKG: 5 0 189,944 0
Pengatur-2C 0 007.03.28.06897.4
67 0
92.488.512.2-732.000 2,806,787 0 217,287 0
0 2,589,500
38 WAHYU FEBRIANOOR ,AM.Kg K -1 2,374,300 0 0 0 0 0 38 .............
2 237,430 0 0 0 0 0
94,972 240,000 289,680 0 29,467
03-02-1988 4 2,706,702 0 0 0
198802032020121005 MKG: 5 0 216,536 0
Pengatur-2C 0 2001372826
21 0
54.721.779.4-732.000 3,236,403 0 246,003 0
0 2,990,400
39 IRMA YULANDA ,AMd.KL TK-0 2,374,300 0 0 0 0 0 39 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
28-02-1989 1 2,374,300 0 0 0
198902282020122012 MKG: 5 0 189,944 0
Pengatur-2C 0 2001373229
67 0
96.747.855.3-734.000 2,686,787 0 216,087 0
0 2,470,700
40 M.AGUS PRIYANDA ,AMK K -1 2,374,300 0 0 0 0 0 40 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
19-08-1990 3 2,659,216 0 0 0
199008192020121011 MKG: 5 0 212,737 0
Pengatur-2C 0 2001372265
53 0
86.291.918.0-732.000 3,116,529 0 241,729 0
0 2,874,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD KH. MANSYUR KINTAP
(002) D50500100200022 BULAN : DESEMBER 2022 HALAMAN : 7

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
41 NISA NUR RAHIMAH ,AMK K -1 2,374,300 0 0 0 0 0 41 .............
2 237,430 0 0 0 0 0
94,972 240,000 289,680 0 29,467
08-10-1992 4 2,706,702 0 0 0
199210082020122034 MKG: 5 0 216,536 0
Pengatur-2C 0 2001373598
21 0
41.147.557.7-736.000 3,236,403 0 246,003 0
0 2,990,400
42 SITI AISYAH ,AMd.Gz K -1 2,374,300 0 0 0 0 0 42 .............
0 237,430 0 0 0 0 0
0 240,000 144,840 0 28,517
16-02-1994 2 2,611,730 0 0 0
199402162020122015 MKG: 5 0 208,938 0
Pengatur-2C 0 007.03.28.06928.8
85 0
80.316.456.5-602.000 2,996,655 0 237,455 0
0 2,759,200
43 AULIA RAHMAH ,A.Md.Keb K -1 2,374,300 0 0 0 0 0 43 .............
0 237,430 0 0 0 0 0
0 240,000 144,840 0 28,517
16-12-1995 2 2,611,730 0 0 0
199512162020122031 MKG: 5 0 208,938 0
Pengatur-2C 0 007.03.28.06908.3
85 0
82.278.285.0-732.000 2,996,655 0 237,455 0
0 2,759,200
44 LAILI RUKHMINA ,A.Md.Farm TK-0 2,374,300 0 0 0 0 0 44 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
12-11-1996 1 2,374,300 0 0 0
199611122020122025 MKG: 5 0 189,944 0
Pengatur-2C 0 007.03.28.06952.1
67 0
91.640.491.6-734.000 2,686,787 0 216,087 0
0 2,470,700
45 MELLINDA PUTRIANA DEVI ,A.Md.Kes K -0 2,374,300 0 0 0 0 0 45 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
23-06-1997 1 2,374,300 0 0 0
199706232020122010 MKG: 5 0 189,944 0
Pengatur-2C 0 007.03.28.06954.4
67 0
96.995.657.2-732.000 2,686,787 0 216,087 0
0 2,470,700
46 AYU SAFITRI ,A.Md.Gz TK-0 2,374,300 0 0 0 0 0 46 .............
0 0 0 0 0 0 0
0 240,000 72,420 0 26,143
24-04-1998 1 2,374,300 0 0 0
199804242020122005 MKG: 5 0 189,944 0
Pengatur-2C 0 007.03.28.06977.6
67 0
41.022.647.6-732.000 2,686,787 0 216,087 0
0 2,470,700
47 RISDIANA ,AMK K -1 1,841,440 0 0 0 0 0 47 .............
2 184,144 180,000 0 0 0 0
73,658 0 289,680 0 22,792
29-03-1990 4 2,099,242 0 0 0
199003292022032002 MKG: 3 0 167,939 0
Pengatur-2C 0 3200405958
9 0
716040571733000 2,568,931 0 190,731 0
0 2,378,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD KH. MANSYUR KINTAP
(002) D50500100200022 BULAN : DESEMBER 2022 HALAMAN : 8

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
48 AMELIA ,A.Md.Keb K -1 1,841,440 0 0 0 0 0 48 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
29-03-1990 3 2,062,413 0 0 0
199003292022032003 MKG: 3 0 164,993 0
Pengatur-2C 0 3200403699
44 0
822553715732000 2,459,717 0 187,417 0
0 2,272,300
49 RIZKA AZIMAH ,AMK K -1 1,841,440 0 0 0 0 0 49 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
21-06-1990 3 2,062,413 0 0 0
199006212022032004 MKG: 3 0 164,993 0
Pengatur-2C 0 3200400808
44 0
813316155732000 2,459,717 0 187,417 0
0 2,272,300
50 MUHAMMAD ALDIANOR ,AMK K -1 1,841,440 0 0 0 0 0 50 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
19-07-1990 3 2,062,413 0 0 0
199007192022031005 MKG: 3 0 164,993 0
Pengatur-2C 0 3200404318
44 0
522610823732000 2,459,717 0 187,417 0
0 2,272,300
51 ILHAM ,A.Md.Kep K -1 1,841,440 0 0 0 0 0 51 .............
0 184,144 180,000 0 0 0 0
0 0 144,840 0 22,056
12-09-1990 2 2,025,584 0 0 0
199009122022031004 MKG: 3 0 162,047 0
Pengatur-2C 0 3200409182
79 0
433789641734000 2,350,503 0 184,103 0
0 2,166,400
52 NARIMA GURUH CARITO ,Amd. Kep K -1 1,841,440 0 0 0 0 0 52 .............
2 184,144 180,000 0 0 0 0
73,658 0 289,680 0 22,792
14-04-1991 4 2,099,242 0 0 0
199104142022031003 MKG: 3 0 167,939 0
Pengatur-2C 0 3200408534
9 0
700814940734000 2,568,931 0 190,731 0
0 2,378,200
53 AYU DEWI MURNI ,A.Md.Keb TK-0 1,841,440 0 0 0 0 0 53 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
08-05-1992 1 1,841,440 0 0 0
199205082022032005 MKG: 3 0 147,315 0
Pengatur-2C 0 3200400029
69 0
813307253732000 2,093,929 0 167,529 0
0 1,926,400
54 ELITA HAPIZAH ,A.Md.Keb TK-0 1,841,440 0 0 0 0 0 54 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
24-06-1992 1 1,841,440 0 0 0
199206242022032006 MKG: 3 0 147,315 0
Pengatur-2C 0 3200408477
69 0
637209230732000 2,093,929 0 167,529 0
0 1,926,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD KH. MANSYUR KINTAP
(002) D50500100200022 BULAN : DESEMBER 2022 HALAMAN : 9

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
55 DAHNIAR EKA SAPUTRI ,A.Md.Keb K -1 1,841,440 0 0 0 0 0 55 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
17-05-1993 3 2,062,413 0 0 0
199305172022032002 MKG: 3 0 164,993 0
Pengatur-2C 0 3200406787
44 0
849654827734000 2,459,717 0 187,417 0
0 2,272,300
56 MEITY KUSUMA DEWI ,Amd. Kep TK-0 1,841,440 0 0 0 0 0 56 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
22-05-1993 1 1,841,440 0 0 0
199305222022032004 MKG: 3 0 147,315 0
Pengatur-2C 0 3200408208
69 0
760114629734000 2,093,929 0 167,529 0
0 1,926,400
57 APRI JUANA ,A.Md.Far TK-0 1,841,440 0 0 0 0 0 57 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
29-04-1994 1 1,841,440 0 0 0
199404292022032009 MKG: 3 0 147,315 0
Pengatur-2C 0 3200406736
69 0
921162129734000 2,093,929 0 167,529 0
0 1,926,400
58 RAUDATI HELDAYANI ,A.Md. Kep TK-0 1,841,440 0 0 0 0 0 58 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
25-05-1994 1 1,841,440 0 0 0
199405252022032004 MKG: 3 0 147,315 0
Pengatur-2C 0 3200406795
69 0
832475164734000 2,093,929 0 167,529 0
0 1,926,400
59 HERMANSYAH ,A.Md. Kep TK-0 1,841,440 0 0 0 0 0 59 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
02-12-1994 1 1,841,440 0 0 0
199412022022031004 MKG: 3 0 147,315 0
Pengatur-2C 0 3200407163
69 0
537870792734000 2,093,929 0 167,529 0
0 1,926,400
60 YOHANNA LUMBAN TORUAN ,A.Md.Keb TK-0 1,841,440 0 0 0 0 0 60 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
06-02-1995 1 1,841,440 0 0 0
199502062022032007 MKG: 3 0 147,315 0
Pengatur-2C 0 3200404474
69 0
637341751732000 2,093,929 0 167,529 0
0 1,926,400
61 LISDA ARIANI ,A.Md.Keb K -1 1,841,440 0 0 0 0 0 61 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
16-03-1995 3 2,062,413 0 0 0
199503162022032001 MKG: 3 0 164,993 0
Pengatur-2C 0 3200405551
44 0
959415696732000 2,459,717 0 187,417 0
0 2,272,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD KH. MANSYUR KINTAP
(002) D50500100200022 BULAN : DESEMBER 2022 HALAMAN : 10

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
62 USWATUN HASANAH ,A.Md. Kep TK-0 1,841,440 0 0 0 0 0 62 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
10-07-1995 1 1,841,440 0 0 0
199507102022032009 MKG: 3 0 147,315 0
Pengatur-2C 0 3200405926
69 0
412380107732000 2,093,929 0 167,529 0
0 1,926,400
63 FATMALA AZIZA MUSLIMAH ,A.Md.Kep K -1 1,841,440 0 0 0 0 0 63 .............
1 184,144 180,000 0 0 0 0
36,829 0 217,260 0 22,424
06-09-1995 3 2,062,413 0 0 0
199509062022032002 MKG: 3 0 164,993 0
Pengatur-2C 0 3200403419
44 0
637364167732000 2,459,717 0 187,417 0
0 2,272,300
64 DIAN KUMALA PERTIWI ,A.Md.Keb TK-0 1,841,440 0 0 0 0 0 64 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
06-04-1996 1 1,841,440 0 0 0
199604062022032005 MKG: 3 0 147,315 0
Pengatur-2C 0 3200409228
69 0
637399114734000 2,093,929 0 167,529 0
0 1,926,400
65 MUHAMMAD FAJAR NURSYAMSI TK-0 1,841,440 0 0 0 0 0 65 .............
,A.Md.Kes 0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
07-05-1997 1 1,841,440 0 0 0
199705072022031002 MKG: 3 0 147,315 0
Pengatur-2C 0 3200406318
69 0
431401900734000 2,093,929 0 167,529 0
0 1,926,400
66 I PUTU EKA PUTRA ,A. Md. Kep TK-0 1,841,440 0 0 0 0 0 66 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
30-06-1997 1 1,841,440 0 0 0
199706302022031006 MKG: 3 0 147,315 0
Pengatur-2C 0 3200400835
69 0
911321081732000 2,093,929 0 167,529 0
0 1,926,400
67 MUHAMMAD SUPRIANTO ,A.Md. Kep TK-0 1,841,440 0 0 0 0 0 67 .............
0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
08-05-1999 1 1,841,440 0 0 0
199905082022031005 MKG: 3 0 147,315 0
Pengatur-2C 0 3200408232
69 0
434633657734000 2,093,929 0 167,529 0
0 1,926,400
68 MUHAMMAD AGUS ASHARIPUTRA TK-0 1,841,440 0 0 0 0 0 68 .............
,A.Md.AK 0 0 180,000 0 0 0 0
0 0 72,420 0 20,214
07-08-1999 1 1,841,440 0 0 0
199908072022031005 MKG: 3 0 147,315 0
Pengatur-2C 0 3200404148
69 0
412522617732000 2,093,929 0 167,529 0
0 1,926,400
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] RSUD KH. MANSYUR KINTAP
(002) D50500100200022 BULAN : DESEMBER 2022 HALAMAN : 11

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
SUB TOTAL PERGOLONGAN : 66,628,980 0 0 0 0 0
PEG: 33 3,081,876 3,960,000 0 0 0 0
IST: 15 JIWA= 65 700,692 2,880,000 4,707,300 0 772,508
70,411,548 0 0 0
ANK: 17 0 5,632,919 0
1,879 0 0
81,960,727 0 6,405,427
0 75,555,300
TOTAL PER SATKER 165,338,940 2,600,000 0 0 0 0
PEG: 68 9,277,118 6,365,000 0 0 0 0
IST: 35 JIWA= 145 2,318,994 9,005,000 10,500,900 0 1,949,043
ANK: 42 176,935,052 0 0 0
0 14,154,803 0
0 0
2,894 0 16,103,846
205,408,846
0 189,305,000

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS DURIAN BUNGKUK
(002) D50500100200023 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 dr, TOTO TRI HARTANTO K -1 3,410,600 0 0 0 0 0 1 .............
1 341,060 0 0 0 0 0
68,212 750,000 217,260 0 45,699
01-04-1986 3 3,819,872 0 0 0
198604012014111001 MKG:11 0 305,590 0
Penata Tk.I-3D 0 2001369051
57 0
55.284.860.8-732.000 4,787,189 0 351,289 0
0 4,435,900
2 YULIANA ,SST K -1 3,628,900 0 0 0 0 0 2 .............
2 362,890 0 0 0 0 0
145,156 600,000 289,680 0 47,369
07-07-1981 4 4,136,946 0 0 0
198107072007012008 MKG:15 0 330,956 0
Penata Tk.I-3D 0 2001345403
99 0
57.822.812.4-732.000 5,026,725 0 378,325 0
0 4,648,400
3 Hj. ISPRIANTI ,AMK K -1 4,508,600 0 0 0 0 0 3 .............
1 450,860 0 0 0 0 0
90,172 500,000 217,260 0 55,496
01-12-1968 3 5,049,632 0 0 0
196812011988032005 MKG:28 0 403,971 0
Penata Tk.I-3D 0 2001345187
75 0
15.548.946.1-732.000 5,766,967 0 459,467 0
0 5,307,500
4 M. HASAN ,AMK K -1 3,982,600 0 0 0 0 0 4 .............
2 398,260 0 0 0 0 0
159,304 500,000 289,680 0 50,402
11-11-1975 4 4,540,164 0 0 0
197511111996031002 MKG:20 0 363,213 0
Penata Tk.I-3D 0 2001356669
71 0
15.478.905.1-732.000 5,329,915 0 413,615 0
0 4,916,300
5 AGUS WIDODO ,S.GZ K -1 4,108,100 0 0 0 0 0 5 .............
2 410,810 0 0 0 0 0
164,324 265,000 289,680 0 49,482
18-08-1972 4 4,683,234 0 0 0
197208181994031010 MKG:22 0 374,659 0
Penata Tk.I-3D 0 2001344997
27 0
15.758.656.1-732.000 5,237,941 0 424,141 0
0 4,813,800
6 RINA ASTUTI ,AM,KEB K -1 3,481,600 0 0 0 0 0 6 .............
2 348,160 0 0 0 0 0
139,264 500,000 289,680 0 44,690
04-10-1977 4 3,969,024 0 0 0
197710042006042008 MKG:14 0 317,522 0
Penata-3C 0 2001345535
8 0
57.822.813.2-732.000 4,758,712 0 362,212 0
0 4,396,500
7 NADYA ERNA PERMITHASARY ,AMK K -1 3,272,200 0 0 0 0 0 7 .............
2 327,220 0 0 0 0 0
130,888 500,000 289,680 0 42,303
09-02-1985 4 3,730,308 0 0 0
198502092009032011 MKG:11 0 298,425 0
Penata-3C 0 2001324686
40 0
51.822.646.6-732.000 4,520,028 0 340,728 0
0 4,179,300
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS DURIAN BUNGKUK
(002) D50500100200023 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 drg, DESTIYA DEWI HARYANTI K -1 2,773,200 0 0 0 0 0 8 .............
0 277,320 0 0 0 0 0
0 325,000 144,840 0 33,755
05-12-1991 2 3,050,520 0 0 0
199112052020122021 MKG: 2 0 244,042 0
Penata Muda Tk.I-3B 0 2001372982
37 0
85.040.501.0-732.000 3,520,397 0 277,797 0
0 3,242,600
9 Hj. SUTIANI ANDIASTUTI ,AM.Keb JD-0 3,665,900 0 0 0 0 0 9 .............
1 0 0 0 0 0 0
73,318 265,000 144,840 0 40,042
21-01-1967 2 3,739,218 0 0 0
196701212002122002 MKG:20 0 299,137 0
Penata Muda Tk.I-3B 0 2001345764
21 0
08.360.889.7-732.000 4,149,079 0 339,179 0
0 3,809,900
10 SRI ASTUTI ,AM.Keb K -1 3,665,900 0 0 0 0 0 10 .............
2 366,590 0 0 0 0 0
146,636 265,000 289,680 0 44,441
27-09-1973 4 4,179,126 0 0 0
197309272006042012 MKG:20 0 334,330 0
Penata Muda Tk.I-3B 0 2001369639
65 0
16.184.891.6-732.000 4,733,871 0 378,771 0
0 4,355,100
11 AGUS HARIYANTI ,AM.Keb K -1 3,139,400 0 0 0 0 0 11 .............
2 313,940 0 0 0 0 0
125,576 265,000 289,680 0 38,439
17-08-1983 4 3,578,916 0 0 0
198308172010012020 MKG:10 0 286,313 0
Penata Muda Tk.I-3B 0 2001360372
56 0
15.767.372.4-732.000 4,133,652 0 324,752 0
0 3,808,900
12 YULIDA MUFIDAH ,A.Md.Keb TK-0 3,139,400 0 0 0 0 0 12 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 34,044
09-08-1987 1 3,139,400 0 0 0
198708092009032002 MKG:10 0 251,152 0
Penata Muda Tk.I-3B 0 2001321784
76 0
15.475.494.9-732.000 3,476,896 0 285,196 0
0 3,191,700
13 THANTI K -1 3,106,900 0 0 0 0 0 13 .............
1 310,690 0 0 0 0 0
62,138 265,000 217,260 0 37,447
15-06-1975 3 3,479,728 0 0 0 0
197506152006042028 MKG:13 0 278,378 0
Penata Muda-3A 0 2001345527
37 0
57.822.793.6-732.000 3,962,025 0 315,825 0
0 3,646,200
14 LAHMUDIN K -1 2,920,100 0 0 0 0 0 14 .............
1 292,010 0 0 0 0 0
58,402 265,000 217,260 0 35,355
21-10-1978 3 3,270,512 0 0 0 0
197810212009031004 MKG: 8 0 261,641 0
Penata Muda-3A 0 2001345958
24 0
16.270.485.2-731.000 3,752,796 0 296,996 0
0 3,455,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS DURIAN BUNGKUK
(002) D50500100200023 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
SUB TOTAL PERGOLONGAN : III 48,803,400 0 0 0 0 0
PEG: 14 4,199,810 0 0 0 0 0
IST: 12 JIWA= 45 1,363,390 5,530,000 3,258,900 0 598,964
54,366,600 0 0 0
ANK: 19 0 4,349,329 0
693 0 0
63,156,193 0 4,948,293
0 58,207,900
15 JULIAN MARTA, AMD K -1 2,633,100 0 0 0 0 0 15 .............
1 263,310 180,000 0 0 0 0
52,662 0 217,260 0 31,291
17-07-1990 3 2,949,072 0 0 0
199007172015021001 MKG: 9 0 235,926 0
Pengatur Tk.I-2D 0 2001369701
85 0
16.662.340.5-731.000 3,346,417 0 267,217 0
0 3,079,200
16 AULIA ANNISA ,A.Md.Keb K -1 2,374,300 0 0 0 0 0 16 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
05-04-1994 3 2,659,216 0 0 0
199404052020122029 MKG: 5 0 212,737 0
Pengatur-2C 0 2001372745
53 0
86.140.193.3-732.000 3,116,529 0 241,729 0
0 2,874,800
17 INDAH FITRI RAMADHANI ,A.Md.Farm K -1 2,374,300 0 0 0 0 0 17 .............
1 237,430 0 0 0 0 0
47,486 240,000 217,260 0 28,992
04-02-1997 3 2,659,216 0 0 0
199702042019032002 MKG: 5 0 212,737 0
Pengatur-2C 0 2001370618
53 0
72.459.591.3-732.000 3,116,529 0 241,729 0
0 2,874,800
SUB TOTAL PERGOLONGAN : 7,381,700 0 0 0 0 0
PEG: 3 738,170 180,000 0 0 0 0
IST: 3 JIWA= 9 147,634 480,000 651,780 0 89,275
8,267,504 0 0 0
ANK: 3 0 661,400 0
191 0 0
9,579,475 0 750,675
0 8,828,800
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS DURIAN BUNGKUK
(002) D50500100200023 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 56,185,100 0 0 0 0 0
PEG: 17 4,937,980 180,000 0 0 0 0
IST: 15 JIWA= 54 1,511,024 6,010,000 3,910,680 0 688,239
ANK: 22 62,634,104 0 0 0
0 5,010,729 0
0 0
884 0 5,698,968
72,735,668
0 67,036,700

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BENTOK KAMPUNG
(002) D50500100200024 BULAN : DESEMBER 2022 HALAMAN : 1

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
1 M. HARYANNOOR ,S.KM K -1 4,508,600 0 0 0 0 0 1 .............
2 450,860 0 0 0 0 0
180,344 500,000 289,680 0 56,398
07-04-1968 4 5,139,804 0 0 0
196804071989021002 MKG:28 0 411,184 0
Penata Tk.I-3D 0 2001334754
98 0
15.478.727.9-732.000 5,929,582 0 467,582 0
0 5,462,000
2 Hj. SARIFAH INDRIANI ,AM.Keb K -1 4,370,900 0 0 0 0 0 2 .............
1 437,090 0 0 0 0 0
87,418 500,000 217,260 0 53,954
18-07-1969 3 4,895,408 0 0 0
196907181990032009 MKG:26 0 391,633 0
Penata Tk.I-3D 0 2001355107
19 0
14.089.441.1-732.000 5,612,687 0 445,587 0
0 5,167,100
3 H. SAPUAN ,AMK K -1 4,108,100 0 0 0 0 0 3 .............
1 410,810 0 0 0 0 0
82,162 500,000 217,260 0 51,011
11-05-1969 3 4,601,072 0 0 0
196905111994021001 MKG:22 0 368,086 0
Penata Tk.I-3D 0 2001335319
65 0
88.508.923.5-732.000 5,318,397 0 419,097 0
0 4,899,300
4 dr, ANNASIA MAYASARI K -1 2,890,500 0 0 0 0 0 4 .............
0 289,050 0 0 0 0 0
0 750,000 144,840 0 39,296
24-07-1989 2 3,179,550 0 0 0
198907242019032007 MKG: 3 0 254,364 0
Penata-3C 0 2001371528
70 0
55.747.007.7-036.000 4,074,460 0 293,660 0
0 3,780,800
5 Hj. MURLINAH ,S.ST K -0 3,704,300 0 0 0 0 0 5 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 43,043
01-12-1979 1 3,704,300 0 0 0
197912012007012005 MKG:18 0 296,344 0
Penata-3C 0 2001361069
67 0
16.717.730.2-732.000 4,376,787 0 339,387 0
0 4,037,400
6 RIATUL JANNAH ,S.Kep K -0 3,481,600 0 0 0 0 0 6 .............
2 0 0 0 0 0 0
139,264 600,000 217,260 0 42,209
20-07-1977 3 3,620,864 0 0 0
197707202006042018 MKG:15 0 289,669 0
Penata-3C 0 2001355085
54 0
16.061.797.3-732.000 4,438,178 0 331,878 0
0 4,106,300
7 NI WAYAN SUDARMIYANI ,AMK TK-0 3,272,200 0 0 0 0 0 7 .............
0 0 0 0 0 0 0
0 600,000 72,420 0 38,722
11-01-1987 1 3,272,200 0 0 0
198701112010012009 MKG:10 0 261,776 0
Penata-3C 0 2001351098
78 0
16.353.406.8-732.000 3,944,698 0 300,498 0
0 3,644,200
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BENTOK KAMPUNG
(002) D50500100200024 BULAN : DESEMBER 2022 HALAMAN : 2

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
8 AISNA YUSTIANTI ,AM.Keb TK-0 3,941,400 0 0 0 0 0 8 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 44,414
11-03-1975 1 3,941,400 0 0 0
197503112006042020 MKG:22 0 315,312 0
Penata-3C 0 2001353813
6 0
15.478.844.2-732.000 4,513,826 0 359,726 0
0 4,154,100
9 ENY DWI RAHAYU NINGSIH ,A.Md.Keb TK-0 3,821,000 0 0 0 0 0 9 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 43,210
09-12-1976 1 3,821,000 0 0 0
197612092006042031 MKG:20 0 305,680 0
Penata-3C 0 2001322772
70 0
15.064.227.0-732.000 4,393,490 0 348,890 0
0 4,044,600
10 ALSYURAH ,AMK TK-0 3,272,200 0 0 0 0 0 10 .............
0 0 0 0 0 0 0
0 500,000 72,420 0 37,722
21-10-1981 1 3,272,200 0 0 0
198110212010012012 MKG:10 0 261,776 0
Penata-3C 0 2001347748
78 0
15.478.720.4-732.000 3,844,698 0 299,498 0
0 3,545,200
11 LAILATUL ULFAH ,Apt K -1 2,773,200 0 0 0 0 0 11 .............
0 277,320 0 0 0 0 0
0 325,000 144,840 0 33,755
16-11-1994 2 3,050,520 0 0 0
199411162019032008 MKG: 2 0 244,042 0
Penata Muda Tk.I-3B 0 2001370726
37 0
85.317.707.9-732.000 3,520,397 0 277,797 0
0 3,242,600
12 MAISARAH ,AM.KEB K -1 3,665,900 0 0 0 0 0 12 .............
2 366,590 0 0 0 0 0
146,636 265,000 289,680 0 44,441
16-07-1976 4 4,179,126 0 0 0
197607162006042019 MKG:20 0 334,330 0
Penata Muda Tk.I-3B 0 2001351462
65 0
15.409.068.2-731.000 4,733,871 0 378,771 0
0 4,355,100
13 RUSMIYATI ,AM.Keb JD-0 3,554,000 0 0 0 0 0 13 .............
2 0 0 0 0 0 0
142,160 265,000 217,260 0 39,612
11-10-1978 3 3,696,160 0 0 0
197810112006042010 MKG:18 0 295,693 0
Penata Muda Tk.I-3B 0 2001369043
85 0
15.516.559.0-733.000 4,178,505 0 335,305 0
0 3,843,200
14 YULIANA RAMADHANI PURNAMASARI K -0 3,340,300 0 0 0 0 0 14 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 36,053
16-07-1982 1 3,340,300 0 0 0
198207162007012004 MKG:14 0 267,224 0
Penata Muda Tk.I-3B 0 2001354313
57 0
16.548.782.8-732.000 3,677,777 0 303,277 0
0 3,374,500
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BENTOK KAMPUNG
(002) D50500100200024 BULAN : DESEMBER 2022 HALAMAN : 3

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
15 YAYUK SETEARI UTAMY K -1 3,204,700 0 0 0 0 0 15 .............
0 320,470 0 0 0 0 0
0 265,000 144,840 0 37,902
03-12-1980 2 3,525,170 0 0 0 0
198012032007012006 MKG:14 0 282,014 0
Penata Muda-3A 0 2001325194
6 0
16.257.693.8-732.000 3,935,016 0 319,916 0
0 3,615,100
16 ERLINDA HIKTIASARI ,AM.Keb K -0 2,744,500 0 0 0 0 0 16 .............
0 0 0 0 0 0 0
0 265,000 72,420 0 30,095
30-08-1992 1 2,744,500 0 0 0
199208302015022001 MKG: 5 0 219,560 0
Penata Muda-3A 0 2001368918
35 0
66.822.809.1-732.000 3,081,955 0 249,655 0
0 2,832,300
SUB TOTAL PERGOLONGAN : III 56,653,400 0 0 0 0 0
PEG: 16 2,552,190 0 0 0 0 0
IST: 7 JIWA= 33 777,984 7,200,000 2,389,860 0 671,837
59,983,574 0 0 0
ANK: 10 0 4,798,687 0
890 0 0
69,574,324 0 5,470,524
0 64,103,800
17 HILMI BUDIMAN K -1 3,171,500 0 0 0 0 0 17 .............
2 317,150 0 0 0 0 0
126,860 240,000 289,680 0 38,555
29-05-1981 4 3,615,510 0 0 0
198105292000121002 MKG:21 0 289,241 0
Pengatur Tk.I-2D 0 2001324977
6 0
87.669.143.7.732.000 4,145,196 0 327,796 0
0 3,817,400
18 ELLY MUNAWANTY ,A.Md.RMIK TK-0 2,374,300 0 0 0 0 0 18 .............
0 0 0 0 0 0 0
0 360,000 72,420 0 27,343
14-09-1994 1 2,374,300 0 0 0
199409142020122022 MKG: 5 0 189,944 0
Pengatur-2C 0 2001373458
67 0
90.385.699.5-732.000 2,806,787 0 217,287 0
0 2,589,500
SUB TOTAL PERGOLONGAN : 5,545,800 0 0 0 0 0
PEG: 2 317,150 0 0 0 0 0
IST: 1 JIWA= 5 126,860 600,000 362,100 0 65,898
5,989,810 0 0 0
ANK: 2 0 479,185 0
73 0 0
6,951,983 0 545,083
0 6,406,900
PEMERINTAH KABUPATEN TANAH LAUT
DAFTAR PEMBAYARAN GAJI INDUK PNSD
[ DINAS KESEHATAN ] PUSKESMAS BENTOK KAMPUNG
(002) D50500100200024 BULAN : DESEMBER 2022 HALAMAN : 4

NAMA PEGAWAI -STS P E N G H A S I L A N P O T O N G A N


NO KAWIN
-ANAK GAJI POKOK TUNJ.ESELON TUNJ.TERPENCIL BPJS KES POT.PAJAK TAPERA PK
TANGGAL LAHIR TUNJ.ISTRI/SMI TUNJ FUNG UMUM T K D TUNJ.JKK BPJS KES TAPERA PEG TANDA TANGAN
N I P -JMLH TUNJ.ANAK TJ.FUNGSIONAL TUNJ.BERAS TUNJ.JKM POT IWP 1 % HUTANG/LAIN-2 NO. DOSIR
STATUS PEGAWAI/GOLONGAN JIWA JUMLAH TJ.KHUSUS TUNJ.PAJAK TAPERA PK POT IWP 8 % BULOG NO. REKENING
NPWP PEMBULATAN POT.TAPERUM SEWA.RUMAH TPP
JUML.KOTOR POT.JKK POTONGAN
POT.JKM JUMLAH BERSIH
TOTAL PER SATKER 62,199,200 0 0 0 0 0
PEG: 18 2,869,340 0 0 0 0 0
IST: 8 JIWA= 38 904,844 7,800,000 2,751,960 0 737,735
ANK: 12 65,973,384 0 0 0
0 5,277,872 0
0 0
963 0 6,015,607
76,526,307
0 70,510,700

KEPALA DINAS KESEHATAN PELAIHARI,28 NOPEMBER 2022


BENDAHARA PENGELUARAN
PEMBUAT DAFTAR GAJI

HJ. NINA SANDRA, SKM., MM KHADAVI MUTTAQEIN ENDAH SULISTIYANINGSIH


NIP 196407101985112002 198305232010011026 197704012007012023

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