1.Ttd Honor TKS Januari 2017

TANDA TERIMA HONORARIUM PEGAWAI HONORER/TIDAK TETAP
KEGIATAN PENYEDIAAN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN

KODE REKENING : 5 2 1 02 02
TAHUN ANGGARAN 2017
Dinas Kesehatan Kota Tangerang Selatan
Bulan : Januari 2017
No Nama Status Profesi No Rekening Honor Pph 21
1 dr. Tanty Riyanti TK / 0 Dokter Umum 0056782176101 Rp 5,500,000 Rp 125,000
2 dr. Edna Fauziah. S TK / 0 Dokter Umum 0062662425100 Rp 5,500,000 Rp 125,000
3 dr. Anniesha Friezshia TK / 0 Dokter Umum 0056783644100 Rp 5,500,000 Rp 125,000
4 dr. Heru Indrawan K/0 Dokter Umum 0060479895100 Rp 5,500,000 Rp 112,500
5 dr. Sandra TK / 0 Dokter Umum 0062677546100 Rp 5,500,000 Rp 125,000
6 Marni Susanti, S.Si, Apt TK / 0 Apoteker 0014871713100 Rp 4,000,000 Rp 50,000
7 David Adam TK / 0 NERS 0064626957100 Rp 4,000,000 Rp 50,000
8 Firmansyah TK / 0 NERS 0069566189100 Rp 4,000,000 Rp 60,000
9 Ria Syukriawati,SKM TK / 0 SKM 0056787208100 Rp 2,500,000 Rp -
10 Nur Indah Pratiwi,SKM TK / 0 SKM 0064689266100 Rp 2,500,000 Rp -
11 Apriyani,SKM TK / 0 SKM 0065527847100 Rp 2,500,000 Rp -
12 Darozatun Nisa,SKM TK / 0 SKM 0065659441100 Rp 2,500,000 Rp -
13 Sarani, SKM K/2 SKM 0056774696100 Rp 2,500,000 Rp -
Siti Pipit Nurzeha Puspa

14 TK / 0 SKM 0057438762100 Rp 2,500,000 Rp -
Bhayangkari, SKM
15 Andini Hendrawati, SKM TK / 0 SKM 0057443340100 Rp 2,500,000 Rp -
16 Yusi Syamisa Cassandra, SKM TK / 0 SKM 0056783709100 Rp 2,500,000 Rp -
17 Putry Septy Lestary, SKM TK / 0 SKM 0056783946100 Rp 2,500,000 Rp -

Julyta Nurlenawati Sari Sinta Uli

18 TK / 0 SKM 0056797734100 Rp 2,500,000 Rp -
SKM
19 Laila Romlah TK / 0 SKM 0069572571100 Rp 2,500,000 Rp -
20 Laila Masturina TK / 0 SKM 0071671941100 Rp 2,500,000 Rp -
21 Raenanda Rifani,Amd Keb TK / 0 D III Bidan 0063422002100 Rp 2,500,000 Rp -
22 Anisa Maharani,Amd Keb TK / 0 D III Bidan 0060697620100 Rp 2,500,000 Rp -
23 Uswatun Hasanah,Amd Keb TK / 0 D III Bidan 0068669375100 Rp 2,500,000 Rp -
24 Elviyani,Amd Keb TK / 0 D III Bidan 0063836214100 Rp 2,500,000 Rp -
25 Atikah TK / 0 D III Bidan 0056773525100 Rp 2,500,000 Rp -
26 Eva Lestari TK / 0 D III Bidan 0063531782100 Rp 2,500,000 Rp -
27 Wayan Winasari TK / 0 D III Bidan 0072337883100 Rp 2,500,000 Rp -
28 Amalia Yuniarti TK / 0 SI Perawat 0068711789100 Rp 2,500,000 Rp -
29 Erwin Herdian Firmansyah S, kep TK / 0 SI Perawat 0056792831100 Rp 2,500,000 Rp -
30 Veliddita Rustianingrum TK / 0 SI Perawat 0059220284100 Rp 2,500,000 Rp -
31 Ricka Sulistiani TK / 0 SI Perawat 0025374010100 Rp 2,500,000 Rp -
32 Hendra Hartini TK / 0 D III Perawat 0062667591100 Rp 2,500,000 Rp -
33 Dendy Dwi Prawira TK / 0 D III Perawat 0063267961100 Rp 2,500,000 Rp -
34 Muhammad Rizal TK / 0 D III Perawat 0056791590100 Rp 2,500,000 Rp -
35 Supriyadi, Amd. Kep TK / 0 D III Perawat 0056111883101 Rp 2,500,000 Rp -
36 Fian Yusti Prsara, Amd. Kep TK / 0 D III Perawat 0056785116100 Rp 2,500,000 Rp -
37 Siti Nurkhairani,A.Md.Kep TK / 0 D III Perawat 0009851704100 Rp 2,500,000 Rp -

38 Hendra Saputra K/2 SPK Perawat 0021810800100 Rp 2,250,000 Rp -
39 Dian Nurlina TK / 0 SPK Perawat 0056785167100 Rp 2,250,000 Rp -
40 Tasman K/2 SPK Perawat 0056789936100 Rp 2,250,000 Rp -
41 M. Sirojudin TK / 0 D III Sanitarian 0056795510100 Rp 2,250,000 Rp -
42 Ikhsan Gustiana TK / 0 D III Sanitarian 0064722689100 Rp 2,250,000 Rp -
43 Saeful Nazar TK / 0 D III Sanitarian 0056792155100 Rp 2,250,000 Rp -
44 Rudy, S.Sos.I - Tenaga Administrasi 0009112146100 Rp 2,150,000 Rp -
45 Muhamad Irsad, SE - Tenaga Administrasi 0057442581100 Rp 2,150,000 Rp -
46 R. Yoga Premadha - Tenaga Administrasi 0057420766100 Rp 2,150,000 Rp -
47 Ajat Sudrajat, S.Kom - Tenaga Administrasi 0027316621100 Rp 2,150,000 Rp -
48 Iwan Haryanto - Tenaga Administrasi 0057012811100 Rp 2,150,000 Rp -
49 Listya Rahmadian, S. Ikom - Tenaga Administrasi 0066376613100 Rp 2,150,000 Rp -
50 Iin Pardilla, SE - Tenaga Administrasi 0057420138102 Rp 2,150,000 Rp -
51 Kristiyanti Hadiwiguno, S. Kom - Tenaga Administrasi 0057430605100 Rp 2,150,000 Rp -
52 Agus Sutiyanto, SE - Tenaga Administrasi 0056807160100 Rp 2,150,000 Rp -
53 Putra Satria Hardika - Tenaga Administrasi 0069376894100 Rp 2,150,000 Rp -
54 Andika Kusuma Putra, ST - Tenaga Administrasi 0070493683100 Rp 2,150,000 Rp -
55 Winda Oktarina Putri, SE - Tenaga Administrasi 0068879299100 Rp 2,150,000 Rp -
56 Saffana Profita Destian, S. Kom - Tenaga Administrasi 0068679621100 Rp 2,150,000 Rp -
57 Dina Handayani - Tenaga Administrasi 0068666708100 Rp 2,150,000 Rp -

58 Rima Safria Tuhulaula, S. Sy - Tenaga Administrasi 0068632323100 Rp 2,150,000 Rp -
59 Grevia Anggesti Putri - Tenaga Administrasi 0068920787100 Rp 2,150,000 Rp -
60 Dita Triastuti, SE - Tenaga Administrasi 0070148161100 Rp 2,150,000 Rp -
61 Muhamad Kiromi - Tenaga Administrasi 0057428740100 Rp 2,150,000 Rp -
62 Indriana Primasarie - Tenaga Administrasi 0067756886100 Rp 2,150,000 Rp -
63 Febby Fauziah - Tenaga Administrasi 0026729092100 Rp 1,900,000 Rp -
64 Rohando, A.Md - Tenaga Administrasi 0063266434100 Rp 1,900,000 Rp -
65 Sonny Permana Rahmat. Amd - Tenaga Administrasi 0057424877100 Rp 1,900,000 Rp -
66 Aneu Herawati - Tenaga Administrasi 0057419040100 Rp 1,900,000 Rp -
67 Dewi Setyorini - Tenaga Administrasi 0057419393100 Rp 1,900,000 Rp -
68 Marita Nurizki - Tenaga Administrasi 0022112376100 Rp 1,900,000 Rp -
69 Ahmad Sopian, A.Md - Tenaga Administrasi 0057485590100 Rp 1,900,000 Rp -
70 Dwi Yudi Hadiyanto - Tenaga Administrasi 0064007394100 Rp 1,900,000 Rp -
71 Lukman Nurhakim - Tenaga Administrasi 0057443091100 Rp 1,700,000 Rp -
72 Rahmat Basuki - Tenaga Administrasi 0056961658100 Rp 1,700,000 Rp -
73 Gusti Wahyudi - Tenaga Administrasi 0057441402100 Rp 1,700,000 Rp -
74 Andri Ramdani Sodikin - Tenaga Administrasi 0028129963100 Rp 1,700,000 Rp -
75 Deni Sueb - Tenaga Administrasi 0022046233101 Rp 1,700,000 Rp -
76 Aris Risdianto - Tenaga Administrasi 0025671112100 Rp 1,700,000 Rp -
77 Adi Kurniawan - Tenaga Administrasi 0063288381101 Rp 1,700,000 Rp -

78 Yayu Maria Sofiyani - Tenaga Administrasi 0068667119100 Rp 1,700,000 Rp -
79 Irfan - Tenaga Administrasi 0057468718100 Rp 1,700,000 Rp -
80 Jabbar Januar Rahim - Tenaga Administrasi 0063649538100 Rp 1,700,000 Rp -
81 Muhamad Soleh, Amd. Ak - Tenaga Administrasi 0075623941100 Rp 1,900,000 Rp -
Tenaga Pengaman Kantor dan Rumah

82 Abdul Azis Saputra - 0056841520100 Rp 2,000,000 Rp -
Dinas
83 Lukman Hakim - 0056913874100 Rp 2,000,000 Rp -
Dinas
84 Wardih Sarban - 0056973321100 Rp 2,000,000 Rp -
Dinas
85 Suhandi - 0056940022100 Rp 2,000,000 Rp -
Dinas
86 Mardi - 0056962591101 Rp 2,000,000 Rp -
Dinas
87 Nurhidayat - 0063152838100 Rp 2,000,000 Rp -
Dinas
88 Trisno Sugiarto - 0063689874100 Rp 2,000,000 Rp -
Dinas
89 Boy Ibadi Lesmana - 0068816017100 Rp 2,000,000 Rp -
Dinas
90 Muhriadi - 0057493968100 Rp 2,000,000 Rp -
Dinas
91 Anwar - 0057293195100 Rp 2,000,000 Rp -
Dinas
92 Maning - 0068721199100 Rp 2,000,000 Rp -
Dinas
93 Suhandi - 0068763479100 Rp 2,000,000 Rp -
Dinas
94 Angga Restiovan - Tenaga Cleaning Service 0059530852100 Rp 1,750,000 Rp -
95 Kasan - Tenaga Cleaning Service 0056927697100 Rp 1,750,000 Rp -
96 Iwan Indrawan - Tenaga Cleaning Service 0060156042100 Rp 1,750,000 Rp -
97 Sadiah - Tenaga Cleaning Service 0073605369101 Rp 1,750,000 Rp -

98 Jamal Lulael - Tenaga Cleaning Service 0072412389100 Rp 1,750,000 Rp -
99 Rofianti Dewi - Tenaga Cleaning Service 0069239617100 Rp 1,750,000 Rp -
100 Rachmat Nur - Supir Kendaraan Operasional 0026901839101 Rp 2,000,000 Rp -
101 Artono - Supir Kendaraan Operasional 0075626193100 Rp 2,000,000 Rp -
102 Uun Mulyawan - Supir Kendaraan Operasional 0057465301100 Rp 2,000,000 Rp -
103 Abdul Aziz - Supir Kendaraan Operasional 0064604368100 Rp 2,000,000 Rp -
104 Saefudin - Tekhnisi/ Pengelola Limbah Medis 0057488441100 Rp 1,500,000 Rp -
105 Iwan Setiawan - Tekhnisi/ Pengelola Limbah Medis 0057450002100 Rp 1,500,000 Rp -
Muhammad Dararie Qisthy Petugas Logistik Kegiatan Fogging &

106 - 0063236527100 Rp 1,500,000 Rp -
Habibie Gudang Obat P2M
Petugas Logistik Kegiatan Fogging &
107 Fadli Hilman Muhammad - 0072560231100 Rp 1,500,000 Rp -
Gudang Obat P2M
Total : Rp 248,950,000 Rp 772,500
Terbilang : Dua Ratus Empat Puluh Delapan Juta Sembilan Ratus Lima Puluh Ribu Rupiah
Mengetahui Lunas dibayar

Pengguna Anggaran Bendahara Pengeluaran
Hj. Listya Windyarti, S. Sos., M. KM Purwanto Amd, Kep

NIP. 196001021980032001
NIP. 19780521 201001 1 006
TAP
RKANTORAN
Terima NPWP Tanda Tangan
Rp 5,375,000 59.498.013.8.034.000 1
Rp 5,375,000 71.696.884.7-411.000 2
Rp 5,375,000 66.861.861.4-411.000 3
Rp 5,387,500 44.374.783.6-411.000 4
Rp 5,375,000 24.035.927.3-421.000 5
Rp 3,950,000 66.152.012.2-402.000 6
Rp 3,950,000 72.844.523.0-411.000 7
Rp 3,940,000 8
Rp 2,500,000 45.876.028.7-411.000 9
Rp 2,500,000 10
Rp 2,500,000 73.366.572.3-411.000 11
Rp 2,500,000 73.426.228.0-411.000 12
Rp 2,500,000 45.873.308.6-411.000 13
Rp 2,500,000 44.059.167.540.300 14
Rp 2,500,000 15
Rp 2,500,000 16
Rp 2,500,000 17
Rp 2,500,000 18
Rp 2,500,000 74.107.788.7.403.000 19
Rp 2,500,000 76.481.636.9-453.000 20
Rp 2,500,000 71.933.228.0.411.000 21
Rp 2,500,000 70.890.401.6-411.000 22
Rp 2,500,000 71.052.375.4-411.000 23
Rp 2,500,000 24
Rp 2,500,000 97.290.770.3-418.000 25
Rp 2,500,000 72.125.204.7.402.000 26
Rp 2,500,000 27
Rp 2,500,000 74.883.887.7-453.000 28
Rp 2,500,000 66.992.386.4-438.000 29
Rp 2,500,000 70.309.120.7-451.000 30
Rp 2,500,000 35.972.353.3-451.000 31
Rp 2,500,000 71.697.311.0-013.000 32
Rp 2,500,000 33
Rp 2,500,000 66.890.106.9-411.000 34
Rp 2,500,000 45.942.003.0-451.000 35
Rp 2,500,000 47.237.031.1-402.000 36
Rp 2,500,000 44.218.376.0-401.000 37
Rp 2,250,000 44.277.163.0-411.000 38
Rp 2,250,000 44.497.292.1-451.000 39
Rp 2,250,000 45.886.046.7-411.000 40
Rp 2,250,000 41
Rp 2,250,000 72.904.663.1.421.000 42
78500000
Rp 2,250,000 54.122.642.9.421.000 43
Rp 2,150,000 44
123450000
Rp 2,150,000 45
Rp 2,150,000 46
Rp 2,150,000 47
Rp 2,150,000 48
Rp 2,150,000 49
Rp 2,150,000 50
Rp 2,150,000 51
Rp 2,150,000 52
Rp 2,150,000 53
Rp 2,150,000 54
Rp 2,150,000 55
Rp 2,150,000 56
Rp 2,150,000 57
Rp 2,150,000 58
Rp 2,150,000 59
Rp 2,150,000 60
Rp 2,150,000 61
Rp 2,150,000 62
Rp 1,900,000 63
Rp 1,900,000 64
Rp 1,900,000 65
Rp 1,900,000 66
Rp 1,900,000 67
Rp 1,900,000 68
Rp 1,900,000 69
Rp 1,900,000 70
Rp 1,700,000 71
Rp 1,700,000 72
Rp 1,700,000 73
Rp 1,700,000 74
Rp 1,700,000 75
Rp 1,700,000 76
Rp 1,700,000 77
Rp 1,700,000 78
Rp 1,700,000 79
Rp 1,700,000 80
Rp 1,900,000 81
Rp 2,000,000 82
Rp 2,000,000 83
Rp 2,000,000 84
Rp 2,000,000 85
Rp 2,000,000 86
Rp 2,000,000 87
Rp 2,000,000 88
Rp 2,000,000 89
Rp 2,000,000 90
Rp 2,000,000 91
Rp 2,000,000 92
Rp 2,000,000 93
Rp 1,750,000 94
Rp 1,750,000 95
Rp 1,750,000 96
Rp 1,750,000 97
Rp 1,750,000 98
Rp 1,750,000 99
Rp 2,000,000 100
Rp 2,000,000 101
Rp 2,000,000 102
Rp 2,000,000 103
Rp 1,500,000 104
Rp 1,500,000 105
Rp 1,500,000 106
Rp 1,500,000 107
Rp 248,177,500
Tangerang Selatan, Januari 2017
Pejabat Pelaksana Kegiatan

(PPTK)
Syahlan King Syahnan Siregar, SE.,MA

NIP. 19840520 201001 1 009
41
TANDA TERIMA HONORARIUM PEG
KEGIATAN PENYEDIAAN DAN PEMELIHARAA
KODE REKENING
TAHUN ANGGA
Puskesmas : Pondok Aren
No Nama Status Profesi No Rekening
1 dr. Adhe Wira Dwi Reza K/1 Dokter Umum 0056786260100
2 dr Dina Ratnasari TK / 1 Dokter Umum 0056834915100
3 Dr.Novika Kristianti Manurung TK / 0 Dokter Umum 0058225142100
4 Dr. Pranoto K/0 Dokter Umum 0057012420100
5 Yoshiko Nurfaidah Sari S Farm Apt TK / 0 Apoteker 0058205923100
6 Adhari Evansyah TK / 0 NERS 0058224049100
7 Euis Suyanti TK / 0 D III Perawat 0056785043100
8 Junita Astuti Manurung TK / 0 D III Perawat 0056797076100
9 S. Muhamad Rajudin K/1 D III Perawat 0056775536100
10 Ike Damayanti TK / 0 D III Perawat 0059222481100
11 Hasmarni yetti TK / 0 D III Perawat 0071987655100
12 Putri Handayani TK / 0 SKM 0072327691100
13 Lia Lidiawati TK / 0 D III Bidan 0056786643100
14 Nurhidayah Nasution TK / 0 D III Bidan 0056785442100
15 Dewi Puspitasari TK / 0 D III Bidan 0056777581100
16 Nelly Apriyanti TK / 0 D III Bidan 0063422983100
17 Djam'an Nur TK / 0 SI Fisioteraphy 0056778101100
18 Age Riyadh Yuvianto TK / 0 Rekam Medis 0072506944100
19 Riadi Dwi Satrio TK / 0 D III Sanitarian 0062786027100
20 Megawati TK/0 Juru Masak 0056785779100
21 Ratna Sari TK/0 Juru Masak 0058430013100

22 Suwardi - Admin Perkantoran 0057431091100
23 Dewi Susilawati - Admin Perkantoran 0057429951100
24 Dede Hermansyah - Admin Perkantoran 0057431628100
25 Riki Rizki, S.Kom - Admin Perkantoran 0068781061100
26 Andi Prawono - Pengemudi Ambulans 0057441518100
27 Basuki - Pengemudi Ambulans 0057442409100
28 Toto Subari - Pengaman Kantor 0056833544100
29 Achmadi - Pengaman Kantor 0056833102100
30 Heriansyah - Pengaman Kantor 0060192774100
31 Kiki Yosef - Pengaman Kantor 0056833897100
32 Abdi Izzatullah - Cleaning Service 0056854533100
33 Aprilia Kartini - Cleaning Service 0056836306100
34 Ubay - Cleaning Service 0056837620100
35 Saidah - Cleaning Service 0068918111100
36 Pera Trisnawati - Bidan PTT 0067476093100
37 Ummatan Wahidah - Bidan PTT 0075635125101
Total :
Terbilang : Sembilan Puluh Tiga Juta Dua Ratus Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 006
DA TERIMA HONORARIUM PEGAWAI HONORER/TIDAK TETAP
NYEDIAAN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Honor Pph 21 Terima NPWP Tanda Tangan
Rp 5,500,000 Rp 100,000 Rp 5,400,000 36.364.460.0-416.000 1
Rp 5,500,000 Rp 112,000 Rp 5,388,000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 66.870.209.5-411.000 3
Rp 5,500,000 Rp 112,500 Rp 5,387,500 46.078.456.4-402.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 66.869.602.4-411.000 5
Rp 4,000,000 Rp 50,000 Rp 3,950,000 66.862.919.9-441.000
Rp 2,500,000 Rp - Rp 2,500,000 44.971.815.4-416.000 7
Rp 2,500,000 Rp - Rp 2,500,000 45.890.949.6-416.000
Rp 2,500,000 Rp - Rp 2,500,000 66.956.399.1-418.000 9
Rp 2,500,000 Rp - Rp 2,500,000 46.446.640.8-402.000
Rp 2,500,000 Rp - Rp 2,500,000 58.588.740.9-416.000 11
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 45.861.859.6-013.000 13
Rp 2,500,000 Rp - Rp 2,500,000 44.971.815.4-416.000
Rp 2,500,000 Rp - Rp 2,500,000 09.195.174.9-402.000 15
Rp 2,500,000 Rp - Rp 2,500,000 71.377.646.6.411.000
Rp 2,750,000 Rp - Rp 2,750,000 46.133.305.6-411.000 17
Rp 2,500,000 Rp - Rp 2,500,000 97.106.736.8-411.000
Rp 2,250,000 Rp - Rp 2,250,000 98.443.884.6-411.000 19
Rp 1,500,000 Rp - Rp 1,500,000 45.892.111.1-411.000
Rp 1,500,000 Rp - Rp 1,500,000 66.862.919.9-411.000 21

Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000 - 23
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000 - 25
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 - 27
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 - 29
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 - 31
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 - 33
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 35
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000 37
Rp 93,200,000 Rp 549,500 Rp 92,650,500
Lunas dibayar Pejabat Pelaksana Kegiatan

ndahara Pengeluaran (PPTK)
Purwanto Amd, Kep Syahlan King Syahnan Siregar, SE.,MA

19780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
12
62500000
29200000
14
16
18
20
Tanda Tangan
22
24
26
28
30
Rp 24,450,000
32
34
36
TANDA TERIMA HONORARIUM PEG
KEGIATAN PENYEDIAAN DAN PEMELIHARAA
KODE REKENING
TAHUN ANGGA
Puskesmas : Rengas
1 dr. Laurencia Retno Anggraeni TK / 0 Dokter Umum 0056773843100
2 dr. Reni Kriswiandari TK / 0 Dokter Umum 0058203408100
3 dr. Yeni Wulandari TK / 0 Dokter Umum 0056784896100
4 dr. Dessy Tristiviyanti TK / 0 Dokter Umum 0056788611100
5 drg Danty Melianingrum TK / 0 Dokter Gigi 0069923623100
6 Ully Dwi Primargawati TK / 0 Apoteker 0060483851100
7 Ns. Marningot Tua Sinaga, S.Kep TK / 0 NERS 0062880831100
8 Ratna Kamila TK / 0 D III Perawat 0056794239100
9 Ni Wayan Susi Yanti TK / 0 D III Perawat 0056782291100
10 Ayu Rahayu TK / 0 D III Perawat 0059224204100
11 Siti Nurhayati TK / 0 D III Bidan 0056788794100
12 Nani Heryantini TK / 0 D III Bidan 0056789502100
13 Lusi Handayani TK / 0 D III Bidan 0058221996101
14 Elis Nuraeni TK / 0 D III Bidan 0068714834100
15 Desy Anggraini TK / 0 D III Bidan 0070757184100
16 Ira Wiraswasti, SKM TK / 0 SKM 0056773649100
17 Frida Eva Nursanti TK / 0 D III Analis 0066184110100
18 M Fajar Ama Raya Goa TK / 0 D III Rekam Medis 0071816494100
19 Sunentih TK/0 Juru Masak 0056794743100
20 Acih TK/0 Juru Masak 0064007556100
21 Yolanda Destriana - Admin Perkantoran 0057429641100

22 Himawan Yogi Raharja - Admin Perkantoran 0068718228100
23 Andaru Nurbaiti - Admin Perkantoran 0057449055100
24 Rizal Abidin - Pengemudi Ambulans 0057444916100
25 Alfin Supriadin - Pengemudi Ambulans 0057448695100
26 Matrobin - Pengaman Kantor 0056918620100
27 Najih - Pengaman Kantor 0056924744100
28 Ferdyansyah Saputra - Pengaman Kantor 0056917780100
29 Alpian - Pengaman Kantor 0056926143100
30 Mario Adam - Cleaning Service 0056924108100
31 Hatiyah - Cleaning Service 0056924396100
32 Juleha - Cleaning Service 0056925112100
33 Samin - Cleaning Service 0056927409100
Total :
Terbilang : Sembilan Puluh Juta Dua Ratus Lima Puluh Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 006
ONORARIUM PEGAWAI HONORER/TIDAK TETAP
AN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 67.034.448.0-013.000 1
Rp 5,500,000 Rp 125,000 Rp 5,375,000 07.312.973.6-013.001
Rp 5,500,000 Rp 125,000 Rp 5,375,000 461942229411000 3
Rp 5,500,000 Rp 125,000 Rp 5,375,000 45.892.174.9-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 75.546.415.3.453.000 5
Rp 4,000,000 Rp 50,000 Rp 3,950,000 48.118.920.7-013.001
Rp 4,000,000 Rp 60,000 Rp 3,940,000 7
Rp 2,500,000 Rp - Rp 2,500,000 45.893.803.2-411.000
Rp 2,500,000 Rp - Rp 2,500,000 89.059.840.2-321.000 9
Rp 2,500,000 Rp - Rp 2,500,000 98.331.741.3-416.000
Rp 2,500,000 Rp - Rp 2,500,000 26.381.520.1-411.000 11
Rp 2,500,000 Rp - Rp 2,500,000 45.893.934.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 66.874.756.1-411.000 13
Rp 2,500,000 Rp - Rp 2,500,000 74.791.358.0-419.000
Rp 2,500,000 Rp - Rp 2,500,000 64.063.661.9-416.000 15
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 79.622.200.8-005.000 17
Rp 2,500,000 Rp - Rp 2,500,000
Rp 1,500,000 Rp - Rp 1,500,000 19
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,900,000 Rp - Rp 1,900,000 21
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000 23
Rp 1,750,000 Rp - Rp 1,750,000
Rp 1,750,000 Rp - Rp 1,750,000 25
Rp 2,000,000 Rp - Rp 2,000,000
Rp 2,000,000 Rp - Rp 2,000,000 27
Rp 2,000,000 Rp - Rp 2,000,000
Rp 2,000,000 Rp - Rp 2,000,000 29
Rp 1,750,000 Rp - Rp 1,750,000
Rp 1,750,000 Rp - Rp 1,750,000 31
Rp 1,750,000 Rp - Rp 1,750,000
Rp 1,750,000 Rp - Rp 1,750,000 33
Rp 90,250,000 Rp 735,000 Rp 89,515,000
nas dibayar Pejabat Pelaksana Kegiatan

ara Pengeluaran (PPTK)
anto Amd, Kep Syahlan King Syahnan Siregar, SE.,MA

0521 201001 1 006 NIP. 19840520 201001 1 009
da Tangan
10
12
14
16
18
20
da Tangan
22
24
Rp 63,000,000
Rp 27,250,000
26
28
30
32
TANDA TERIMA HONORARIUM P
KEGIATAN PENYEDIAAN DAN PEMELIHAR
KODE REKENI
TAHUN ANG
Puskesmas : Pondok Kacang Timur
1 dr. Iwan Darmawan K/1 Dokter Umum 0058208167100
2 dr Sherly Melwani TK / 0 Dokter Umum 0018359774100
3 dr Sadiqo Aksiani TK / 0 Dokter Umum 0072319869100
4 Farizal Malik K/0 NERS 0066186156101
5 Ria Juniarti Sari TK / 0 D III Perawat 0056791507100
6 A. Damanhuri K/2 D III Perawat 0056790942100
7 Dian Maulida TK / 0 D III Perawat 0072318013100
8 Ipad Padillah K/2 D III Perawat 0059223259100
9 Suwarnih TK / 0 D III Bidan 0056794646100
10 Nurmutmainah TK / 0 D III Bidan 0056791248100
11 Eva Fitria Ramdhona TK / 0 D III Bidan 0056789790100
12 Christina Mantili Murti Asih TK / 0 D III Bidan 0056791175100
13 Siti Latifah TK / 0 D III Bidan 0058222755100
14 Mariya Ulfa TK / 0 D III Bidan 0068646006100
15 Wulan Ayu Lestari TK / 0 D III Analis 0056791124100
16 Fitroh Handayani TK / 0 SKM 0057450681100
17 Ade Melania TK / 0 SPRG 0058224731100
18 KristyValentina Br Tarigan S.Gz TK / 0 SI Gizi 0058370274100
19 Elita Rokhmatun Naeli S.ST TK / 0 D IV Sanitarian 0058238899100

SI Farmasi ( Asisten
20 Tri Wahyuni Purwaningsih TK / 0 0067425723100
Apoteker)
21 Indah Susanti TK/0 Juru Masak 0056776117100
22 Robiyanah Nurbiyasari TK/0 Juru Masak 0056796290100
23 Nugroho Bagus Waseso - Admin Perkantoran 0057451051100
24 Edi Mulyadi - Admin Perkantoran 0057451521100
25 Trengginas Sujatmiko - Admin Perkantoran 0069022480100
26 Intan Baiduri - Admin Perkantoran 0063151114100
27 M. Irwansyah - Pengemudi Ambulans 0056855386100
28 Henhen Hermawan - Pengemudi Ambulans 0056839313100
29 Marwan - Pengaman Kantor 0056951131100
30 Mulyadi - Pengaman Kantor 0056949739100
31 Khairudin - Pengaman Kantor 0056949208100
32 Sahroni - Pengaman Kantor 0056950184100
33 Andika Purna Pradana - Cleaning Service 0056953973100
34 Suryana - Cleaning Service 0056952373100
35 Aep Saepuloh - Cleaning Service 0056953469100
36 Dedi Irawan - Cleaning Service 0069357660100
37 Imelda CH - Bidan PTT 0075613288100
38 Maesaroh - Bidan PTT 0063023949101
Total :
Terbilang : Sembilan Puluh Juta Empat Ratus Lima Puluh Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 00
HONORARIUM PEGAWAI HONORER/TIDAK TETAP
DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 100,000 Rp 5,400,000 66.841.619.1-013.000 1
Rp 5,500,000 Rp 125,000 Rp 5,375,000 35.084.853.7-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 71.949.641.6-411.000 3
Rp 4,000,000 Rp 37,500 Rp 3,962,500 45.896.184.4-418.000
Rp 2,500,000 Rp - Rp 2,500,000 89.112.296.2-411.000 5
Rp 2,500,000 Rp - Rp 2,500,000 44.956.524.1-418.000
Rp 2,500,000 Rp - Rp 2,500,000 72.956.503.6-423.000 7
Rp 2,500,000 Rp - Rp 2,500,000 66.782.203.5-419.000
Rp 2,500,000 Rp - Rp 2,500,000 45.892.846.2-416.000 9
Rp 2,500,000 Rp - Rp 2,500,000 45.896.905.2-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.892.356.2-411.000 11
Rp 2,500,000 Rp - Rp 2,500,000 69.488.506.2-416.000
Rp 2,500,000 Rp - Rp 2,500,000 66.883.177.9-416.000 13
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 45.892.457.8-411.000 15
Rp 2,500,000 Rp - Rp 2,500,000 45.892.619.3-416
Rp 2,250,000 Rp - Rp 2,250,000 24.346.913.7-321.000 17
Rp 2,500,000 Rp - Rp 2,500,000 16.150.079.8-321.000
Rp 2,250,000 Rp - Rp 2,250,000 19
Rp 2,250,000 Rp - Rp 2,250,000 72.019.492.7-411.000
Rp 1,500,000 Rp - Rp 1,500,000 21
Rp 1,500,000 Rp - Rp 1,500,000
Rp 2,150,000 Rp - Rp 2,150,000 - 23
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000 25
Rp 1,700,000 Rp - Rp 1,700,000
Rp 1,750,000 Rp - Rp 1,750,000 - 27
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 - 29
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 - 31
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 - 33
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 - 35
Rp 1,750,000 Rp - Rp 1,750,000
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 90,450,000 Rp 387,500 Rp 90,062,500

unas dibayar Pejabat Pelaksana Kegiatan

hara Pengeluaran (PPTK)
wanto Amd, Kep Syahlan King Syahnan Siregar, SE.,MA

80521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
12
14
16
18
Tanda Tangan
20
22
24
26
28
30
Rp 59,750,000
Rp 29,200,000
32
34
36
Tanda Tangan
A
TANDA TERIMA HONO
KEGIATAN PENYEDIAAN DAN
KO
T
Puskesmas : Situ Gintung
No Nama Status Profesi
1 dr Ajeng Paramita M.A TK / 0 Dokter Umum
2 drg Anindya Paramita TK / 0 Dokter Gigi
3 Zr . Fitri Kusmuliati TK / 0 D III Perawat
4 Fitria Alina Ekasari TK / 0 D III Perawat
5 RISKA DEWI,AMD.KEB TK / 0 D III Bidan
6 Depi Puspitasari TK / 0 D III Bidan
7 Priska Marina TK / 0 D III Bidan
8 Cahyami TK / 0 D III Perawat Gigi
9 Gatot Kurnianto K/2 SMAK Analis
10 Intan Bilqis Nabilah TK / 0 SI Gizi
11 Endarwati Nurul Aini TK / 0 D III Asisten Apoteker
12 Nika Rusmanika TK / 0 SKM
13 Hella Prihatiningtiyas TK / 0 D III Sanitarian
14 Mega Estika, A.Md - Admin Perkantoran
15 Lia Taslima - Admin Perkantoran
16 Yoga Prasetya - Admin Perkantoran
17 Beny Suhanda - Pengemudi Ambulans
18 Ade Suhendra - Pengaman Kantor
19 A. Sulaiman - Pengaman Kantor

No Nama Status Profesi
20 Achyar Abdul Fauzi Ginoga - Pengaman Kantor
21 Muhamad Rizki - Pengaman Kantor
22 Siti Fathonah - Cleaning Service
23 Nurhayati - Cleaning Service
24 Dahlia Rizki - Bidan PTT
Total :
Terbilang : Lima Puluh Enam Juta Lima Puluh Ribu Rupiah
Mengetahui
Pengguna Anggaran
Hj. Listya Windyarti, S. Sos., M. KM

NIP. 196001021980032001
EGIATAN PENYEDIAAN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
No Rekening Honor Pph 21 Terima
0072078391100 Rp 5,500,000 Rp 125,000 Rp 5,375,000
0071658775100 Rp 5,500,000 Rp 125,000 Rp 5,375,000
0056784217100 Rp 2,500,000 Rp - Rp 2,500,000
0068673275100 Rp 2,500,000 Rp - Rp 2,500,000
0056784969100 Rp 2,500,000 Rp - Rp 2,500,000
0056784292100 Rp 2,500,000 Rp - Rp 2,500,000
0063424544100 Rp 2,500,000 Rp - Rp 2,500,000
0056784349100 Rp 2,500,000 Rp - Rp 2,500,000
0056783059100 Rp 2,250,000 Rp - Rp 2,250,000
0068645727100 Rp 2,250,000 Rp - Rp 2,250,000
0068673321100 Rp 2,250,000 Rp - Rp 2,250,000
0057453443100 Rp 2,500,000 Rp - Rp 2,500,000
00772162382100 Rp 2,250,000 Rp - Rp 2,250,000
0057453222100 Rp 1,900,000 Rp - Rp 1,900,000
0057533994100 Rp 1,700,000 Rp - Rp 1,700,000
0071329909100 Rp 1,700,000 Rp - Rp 1,700,000
0014654453100 Rp 1,750,000 Rp - Rp 1,750,000
0064751311100 Rp 2,000,000 Rp - Rp 2,000,000
0057012161100 Rp 2,000,000 Rp - Rp 2,000,000

No Rekening Honor Pph 21 Terima
0057107855100 Rp 2,000,000 Rp - Rp 2,000,000
0069180655100 Rp 2,000,000 Rp - Rp 2,000,000
0057013729100 Rp 1,750,000 Rp - Rp 1,750,000
0016561878100 Rp 1,750,000 Rp - Rp 1,750,000
0062277432100 Rp 750,000 Rp - Rp 750,000
Rp 56,800,000 Rp 250,000 Rp 56,550,000
Tangerang Selatan,
Lunas dibayar Pejabat Pelak

Bendahara Pengeluaran (PP
Purwanto Amd, Kep Syahlan King Syahn

NIP. 19780521 201001 1 006 NIP. 19840520
NPWP Tanda Tangan
44.875.734.4-451.000 1
76.494.123.3-411.000 2
45.888.252.9-402.999 3
46.234.906.9-411.000 4
68.989.581.8-451.001 5
44.490.566.5-411.000 6
72.210.073.2.416.000 7
79.483.826.8-412.000 8
59.512.464.5-411.000 9
74.865.723.6-453.000 10
11
12
76.488.756.8-521.000 13
- 14
- 15
- 16
- 17
- 18
- 19
NPWP Tanda Tangan
- 20
21
- 22
- 23

(PPTK)

NIP. 19840520 201001 1 009
TANDA TERIMA HONORARIUM
KEGIATAN PENYEDIAAN DAN PEMELIH
KODE REKEN
TAHUN AN
Puskesmas : Pamulang
1 dr. Julianna Rezki Amaliah TK / 0 Dokter Umum 0056775366100
2 dr.IIF SYAIPUDIN K/1 Dokter Umum 0056784845100
3 dr. Nur Dewi Ariesta TK / 0 Dokter Umum 0058211974100
4 Fitriyani Syam TK / 0 Apoteker 56786600100
5 Eka Nisa Nurhasanah TK / 0 NERS 0058181978100
6 Riska Handayani TK / 0 D III Bidan 0056792236100
7 Dewi Rahmasari TK / 0 D III Bidan 0056792317100
8 Yuni Antika TK / 0 D III Bidan 0056776176100
9 Nurrullita Pratiwi TK / 0 D III Bidan 0056792090100
10 Asti almira TK / 0 D III Bidan 0063836109100
11 Nuraini Iskandar TK / 0 D III Bidan 0068674700100
12 Sukarti TK / 0 D III Perawat 0016599034100
13 Raudoh TK / 0 D III Perawat 0056792376100
14 Diyana Santri TK / 0 D III Perawat 0016210420100
15 Dwi Aryani TK / 0 D III Fisioteraphy 0056792287100
16 Gilar Dwi Cahya TK / 0 D III Rekam Medis 0058236632100
17 Rahmi Nisa TK / 0 D III Analis 0063265101100
18 Karmilah TK/0 Juru Masak 0056800141100
19 Juarsih TK/0 Juru Masak 0016590827100

20 Sanwani - Admin Perkantoran 0057451211100
21 Mardiyana - Admin Perkantoran 0057434554100
22 Abdul Aziz Hasbulloh - Admin Perkantoran 0057069716100
23 Ade Pasti Kurnia - Admin Perkantoran 0059693123100
24 Silvia Nurbaiti - Admin Perkantoran 0073998026100
25 Muhammad Santoso - Pengemudi Ambulans 0057460288100
26 Syaefudin Ali Shobaro - Pengemudi Ambulans 0058132500100
27 Shandy Firmansyah - Pengaman Kantor 0057253282100
28 Irfan Dody - Pengaman Kantor 0057408561100
29 Atik Kurtubi - Pengaman Kantor 0057332018100
30 Cahyo Dwi Setyaji - Pengaman Kantor 0057452021100
31 Eggy Virgiawan - Cleaning Service 0057184469100
32 Misbahul Farid - Cleaning Service 0057069368100
33 Herlinah - Cleaning Service 0057534672100
34 Surya - Cleaning Service 0059632280100
35 Harnita Ristanti - Bidan PTT 0075646054100
36 Siti Nurjanah - Bidan PTT 0075646453100
37 Yulianingsih - Bidan PTT 0075624794100
Total :
Terbilang : Delapan Puluh Tujuh Juta Dua Ratus Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 0
HONORARIUM PEGAWAI HONORER/TIDAK TETAP
DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Honor Pph 21 Terima NPWP Tanda Tanga
Rp 5,500,000 Rp 125,000 Rp 5,375,000 66.916.456.8-411.000 1
Rp 5,500,000 Rp 100,000 Rp 5,400,000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 45.888.265.1-411.000 3
Rp 4,000,000 Rp 50,000 Rp 3,950,000 66.936.098.4-411.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 66.854.655.9-411.000 5
Rp 2,500,000 Rp - Rp 2,500,000 45.899.541.2-451.000
Rp 2,500,000 Rp - Rp 2,500,000 45.893.761.2-411.000 7
Rp 2,500,000 Rp - Rp 2,500,000 45.170.218.7-411.000
Rp 2,500,000 Rp - Rp 2,500,000 36.004.346.7-411.000 9
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 11
Rp 2,500,000 Rp - Rp 2,500,000 58.558.514.4-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.899.433.2-411.000 13
Rp 2,500,000 Rp - Rp 2,500,000 69.292.740.3-411.000
Rp 2,500,000 Rp - Rp 2,500,000 15
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 17
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,500,000 Rp - Rp 1,500,000 19
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000 - 21
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000
Rp 1,750,000 Rp - Rp 1,750,000 - 25
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 - 27
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 - 29
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 - 31
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 - 33
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 750,000 Rp - Rp 750,000 35
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000 37
Rp 87,200,000 Rp 450,000 Rp 86,750,000
nas dibayar Pejabat Pelaksana Kegiatan


0521 201001 1 006 NIP. 19840520 201001 1 009
nda Tangan
10
52000000
30450000
12
14
16
18
nda Tangan
20
22
24
26
28
###
30
32
34
36
nda Tangan
KEGIATAN PENYEDIAAN DAN PEMELIHA
KODE REKEN
TAHUN AN
Puskesmas : Pondok Benda
1 dr. Faradiesa Addiena TK / 0 Dokter Umum 0056789121100
2 dr Putri Kemalasari TK / 0 Dokter Umum 0059218859100
3 Siti Ulfa TK / 0 Apoteker 0058254541100
4 Tris Noviyanti Permatasari TK / 0 NERS 0062673605100
5 Zr. Vinny Sabrina TK / 0 D III Perawat 0056786716100
6 Zr Tatik Hartati TK / 0 D III Perawat 0056794115100
7 Ervanny Rachim Suwandi TK / 0 D III Perawat 0056783288100
8 Nurlaela sari TK / 0 D III Bidan 0025753666100
9 Yuni Kartika Sari TK / 0 D III Bidan 0056786678100
10 Mela Sri Lidiawati TK / 0 D III Bidan 0056787127100
11 Tiarawati TK / 0 D III Bidan 0056784624100
12 Wiwit Riyana TK / 0 D III Bidan 0056791426100
13 Novi Farikkhah TK / 0 D III Bidan 0073920043100
14 Ade Amalia TK / 0 D III Bidan 0073916461100
15 Nia Kania TK / 0 D III Gizi 0056792716100
16 Zr. Debi Angraini TK / 0 SPRG 0056773371100
17 Muhamad Izzuddin Faiz TK / 0 D III Sanitarian 0071981959100
18 Dwi Sutrisno TK / 0 D III Analis 0066185265100
19 Iyus Sofha TK/0 Juru Masak 0056786171100
20 Sari Hartati Ningsih TK/0 Juru Masak 0058199214100
21 Anggiat Paima Torang Marpaung - Admin Perkantoran 0057455004100

22 Putri Dina Andriani - Admin Perkantoran 0057454083100
23 Julisa Pratiwi - Admin Perkantoran 0015765828100
24 Sandy Maulana - Admin Perkantoran 0069745008100
25 Dimas Afri Sulistyo - Pengemudi Ambulans 0056836640100
26 Bagas Maulana Putra Pengemudi Ambulans 0070427834100
27 Rano Basuki - Pengaman Kantor 0056831290100
28 Ahmad Fauzi - Pengaman Kantor 0056871217100
29 Joni Astari - Pengaman Kantor 0056838120100
30 Rudi Apriadi - Pengaman Kantor 0056949224100
31 Riandi Kusumah - Cleaning Service 0056838651100
32 Stephanus Daniel.B.Mooy - Cleaning Service 0056842349100
33 Yuliana - Cleaning Service 0056832831100
34 Anisah - Cleaning Service 0056834435100
35 Nila Desta Sari - Bidan PTT 0067809701100
Total :
Terbilang : Delapan Puluh Tiga Juta Enam Ratus Lima Puluh Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 006
RIMA HONORARIUM PEGAWAI HONORER/TIDAK TETAP
AAN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 69.686.526.0-412.999 1
Rp 5,500,000 Rp 125,000 Rp 5,375,000 55.033.479.1-017.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 69.714.890.6-411.000 3
Rp 4,000,000 Rp 50,000 Rp 3,950,000 71.705.259.1-451.000
Rp 2,500,000 Rp - Rp 2,500,000 45.887.916.0-411.000 5
Rp 2,500,000 Rp - Rp 2,500,000 35.353.076.9-411.000
Rp 2,500,000 Rp - Rp 2,500,000 66.849.883.5-411.000 7
Rp 2,500,000 Rp - Rp 2,500,000 35.511.266.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.893.212.4-416.000 9
Rp 2,500,000 Rp - Rp 2,500,000 45.879.098.7-411.000
Rp 2,500,000 Rp - Rp 2,500,000 46.832.377.9-411.000 11
Rp 2,500,000 Rp - Rp 2,500,000 46.802.402.9-411.000
Rp 2,500,000 Rp - Rp 2,500,000 13
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,250,000 Rp - Rp 2,250,000 15
Rp 2,250,000 Rp - Rp 2,250,000 45.888.147.1-411.000
Rp 2,250,000 Rp - Rp 2,250,000 76.488.404.5-523.000 17
Rp 2,500,000 Rp - Rp 2,500,000 55.984.091.3-442.000
Rp 1,500,000 Rp - Rp 1,500,000 19
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,700,000 Rp - Rp 1,700,000 - 21
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 2,150,000 Rp - Rp 2,150,000 - 23
Rp 2,150,000 Rp - Rp 2,150,000
Rp 1,750,000 Rp - Rp 1,750,000 - 25
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 - 27
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 - 29
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 - 31
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 - 33
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 750,000 Rp - Rp 750,000 35
Rp 83,650,000 Rp 350,000 Rp 83,300,000

ahara Pengeluaran (PPTK)

780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
46250000
10
12
14
16
18
20
Tanda Tangan
22
Rp 26,650,000
24
26
28
30
32
34
TANDA TERIMA HONORARIU
KEGIATAN PENYEDIAAN DAN PEMELI
KODE REK
TAHUN A
Puskesmas : Keranggan
1 dr Andika Chosa Putra S TK / 0 Dokter Umum 0056798102100
2 dr Septinna kurnia dewi TK / 0 Dokter Umum 0058632694100
3 dr Ibnu Achmad Enwars Bethan K/0 Dokter Umum 0056779418100
4 dr Butet Oyong Nurasiah TK / 0 Dokter Umum 0067204492100
5 drg Sylvia TK / 0 Dokter Gigi 0073923239100
6 Irin Intiani S Farm Apt TK / 0 Apoteker 0056784306100
7 Hikmatul Istiqomah TK / 0 NERS 0068712432100
8 Tyas Anggraeni TK / 0 D III Bidan 0056785493100
9 Lia Apriyani TK / 0 D III Bidan 0056776680100
10 Dewi Nurindah Sari TK / 0 D III Bidan 0056785701100
11 Wulandari TK / 0 D III Bidan 0056773703100
12 Dewi Yulita Anggraeni TK / 0 D III Bidan 0056773800100
13 Eviana, Amd.Keb TK / 0 D III Bidan 0056780815100
14 Okti Anisatun Muflihah TK / 0 D III Sanitarian 0062628499100
15 Mulia TK / 0 D III Perawat 0056773495100
16 Komariah TK / 0 D III Perawat 0057501707100
17 Nurlaili TK / 0 D III Perawat 0056784152100
18 Anindita Munggarani TK / 0 D IV Gizi 0067600061100

19 N Fenty Aryani TK/0 Juru Masak 0021884251100
20 Iswanti TK/0 Juru Masak 0063781924100
21 DENI SUPRIYANTO - Admin Perkantoran 0057466774100
22 NUR AHMAD FAUZY - Admin Perkantoran 0057530022100
23 AWALUDIN - Admin Perkantoran 0063248908100
24 SARNAN - Pengemudi Ambulans 0057469196100
25 JAMAL - Pengemudi Ambulans 0057467762100
26 PRIHADI - Pengaman Kantor 0056871241100
27 Ahmad Fadoli - Pengaman Kantor 0071438031100
28 Mahmudin Bin Niman - Pengaman Kantor 0071668258100
29 Juhroni - Pengaman Kantor 0071502341100
30 SITI NURJANAH - Cleaning Service 0063204005100
31 MAYSITAH - Cleaning Service 0056861025100
32 Nurdin - Cleaning Service 0070197553100
33 Ahyani - Cleaning Service 0075630026100
34 Apriyanti Rahayu - Bidan PTT 0075613636100
Total :
Terbilang : Sembilan Puluh Satu Juta Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 006
ERIMA HONORARIUM PEGAWAI HONORER/TIDAK TETAP
DIAAN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Honor Pph 21 Terima NPWP
Rp 5,500,000 Rp 125,000 Rp 5,375,000 69.275.638.0-451.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 45.428.624.6-646.000
Rp 5,500,000 Rp 112,500 Rp 5,387,500 44.434.377.6-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 35.082.290.4.402.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 46.211.730.0-411.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 66.794.344.3-644.000
Rp 2,500,000 Rp - Rp 2,500,000 44.568.887.2-451.000
Rp 2,500,000 Rp - Rp 2,500,000 45.880.121.4-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.129.112.4-411.000
Rp 2,500,000 Rp - Rp 2,500,000 54.263.131.2-411.000
Rp 2,500,000 Rp - Rp 2,500,000 54.546.441.4-411.000
Rp 2,500,000 Rp - Rp 2,500,000 66.912.685.6-403.000
Rp 2,250,000 Rp - Rp 2,250,000 71.694.402.0-521.000
Rp 2,500,000 Rp - Rp 2,500,000 45.884.389.3-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.888.601.7-451.000
Rp 2,500,000 Rp - Rp 2,500,000 48.206.482.1-401.000
Rp 2,500,000 Rp - Rp 2,500,000 74.525.939.0.452.000

Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000
Rp 1,750,000 Rp - Rp 1,750,000
Rp 750,000 Rp - Rp 750,000
Rp 91,000,000 Rp 712,500 Rp 90,287,500


80521 201001 1 006 NIP. 19840520 201001 1 009

Tanda Tangan
10
11
12
13
14
15
16
17
18
Tanda Tangan
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
Januari 2017
Kegiatan
Siregar, SE.,MA
Tanda Tangan
001 1 009
62750000
25750000
KEGIATAN PENYEDIAAN DAN PEMEL
KODE REK
TAHUN
Puskesmas : Ciputat
1 dr. Nuraisyah TK / 0 Dokter Umum 0056801545100
2 Ari Purwanti TK / 0 Apoteker 0060482438100
3 Ira Puspitadewi TK / 0 D III Perawat 0056793631100
4 Wahyu Sri Mulyati TK / 0 D III Perawat 0032060382100
5 Ulfi Herawati TK / 0 D III Perawat 0056786740100
6 Sutisna Kamara Makarim TK / 0 D III Perawat 0056786163100
7 Rahma Safitri TK / 0 D III Bidan 0056785787100
8 Afrita Riandini TK / 0 D III Fisioteraphy 0056785061100
9 Sindy Rahmatika TK / 0 D III Sanitarian 0058188255100
10 Suci Fadillah TK / 0 D III Analis 0070153221100
11 Dian Herian - Admin Perkantoran 0057451645100
12 Imam Wahyudi - Admin Perkantoran 0057452595100
13 Saidin Ibrahim Harahap - Admin Perkantoran 0063056332100
14 M A Hardiansyah - Admin Perkantoran 0073919444100
15 Agus Sukirman - Admin Perkantoran 0075613385100
16 Arbawi - Pengemudi Ambulans 0016595551100
17 Nano SA - Pengaman Kantor 0056905413100
18 Suryadi - Pengaman Kantor 0056903739100
19 Effendy - Pengaman Kantor 0056903127100
20 Surojo - Pengaman Kantor 0056903445100

21 Didi - Cleaning Service 0056904468100
22 Inawati - Cleaning Service 0056902767100
23 Neli Rosneli - Bidan PTT 0062276037100
24 Rina Astina - Bidan PTT 0062302194100
Total :
Terbilang : Lima Puluh Tiga Juta Seratus Lima Puluh Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 006
TERIMA HONORARIUM PEGAWAI HONORER/TIDAK TETAP
EDIAAN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 45.876.080.8-411.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 70.882.581.5-017.000
Rp 2,500,000 Rp - Rp 2,500,000 34.872.274.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 88.475.659.4-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.873.364.6-411.000
Rp 2,500,000 Rp - Rp 2,500,000 36.195.945.5-414.000
Rp 2,500,000 Rp - Rp 2,500,000 46.255.796.8-411.000
Rp 2,500,000 Rp - Rp 2,500,000 44.438.677.5-411.000
Rp 2,250,000 Rp - Rp 2,250,000 87.393.376.6017.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 1,900,000 Rp - Rp 1,900,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000
Rp 2,150,000 Rp - Rp 2,150,000
Rp 1,700,000 Rp - Rp 1,700,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 53,150,000 Rp 175,000 Rp 52,975,000
unas dibayar Rp

80521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
18
19
20
Tanda Tangan
21
22
23
24
Januari 2017
52,975,000
regar, SE.,MA
01 1 009
1 1
Rp 29,250,000
Rp 22,400,000
KODE REK
TAHUN
Puskesmas : Rawabuntu
1 drg Aldylla Sunaryo TK / 0 Dokter Gigi 0058393215100
2 dr Dyah Ardiani TK / 0 Dokter Umum 0056787720100
3 dr Nathasha Adjani TK / 0 Dokter Umum 0058203548100
4 dr Siti Khoirunisa TK / 0 Dokter Umum 0069784232100
5 drg Anindyajati Nuralifiana S TK / 0 Dokter Gigi 0065671123100
6 Dani Kurniawan S Farm Apt K/0 Apoteker 0056788093100
7 Ditya Gheamerani TK / 0 NERS 0062673699100
8 Wiwin Indrawati,A.Md.Kep TK / 0 D III Perawat 0056783296100
9 AlfiyantiA.Md.Kep TK / 0 D III Perawat 0056783091100
10 Angga Gumilar TK / 0 D III Perawat 0056776915100
11 Sureni TK / 0 D III Perawat 0059239481100
12 Dwi Utami TK / 0 D III Perawat 0056787348100
13 Lona Thesalonika TK / 0 D IV Fisioteraphy 0069556531100
14 Ismi Dzalva Alfiah TK / 0 SKM 0071716805100
15 Utami Surya Ika TK / 0 D III Analis 0056783806100
16 Nurhikmah Khasanah A Sst TK / 0 D IV Bidan 0056775935100
17 Ainil Mila,A.Md.keb TK / 0 D III Bidan 0056786661100
18 Hida Hidayati,A.Md.Keb TK / 0 D III Bidan 0056785434100
19 Dewi Purwanti,A.Md.Keb TK / 0 D III Bidan 0056785663100
20 Dewi Setyorini, A.Md.Keb TK / 0 D III Bidan 0056781897100

21 Laila Fadhillah TK / 0 D III Bidan 0068644976100
22 Mirna Wati Dewi TK / 0 D III Bidan 0068642795100
23 Nur'afni TK / 0 D III Perawat Gigi 0056783547100
24 Ita Dewi Susana TK / 0 D III Sanitarian 0056782206100
25 Anggrek Janur TK / 0 D III Rekam Medis 0070321009100
26 Supartini TK/0 Juru Masak 0014197389100
27 Aisah TK/0 Juru Masak 0056787194100
28 Ika Rachmawati - Admin Perkantoran 0057473533100
29 Jakariah - Admin Perkantoran 0057432551101
30 Sinta M - Admin Perkantoran 0057473975100
31 Yulius Usman - Admin Perkantoran 0057966858100
32 M. Romdoni - Pengemudi Ambulans 0064056689100
33 Rizky Hariansyah - Pengemudi Ambulans 0073239516100
34 Imam Sapi'i - Pengaman Kantor 0056893288100
35 Nasim B Kemang - Pengaman Kantor 0056854479100
36 Hamdani - Pengaman Kantor 0072647157100
37 Suhandi - Pengaman Kantor 0074749852100
38 Adi Tyana - Cleaning Service 0066728641100
39 Siti Mariam - Cleaning Service 0056854207100
40 Kiki Suwarsih - Cleaning Service 0059877208100
41 Komara Adi Surya - Tenaga Cleaning Service 0075656394100
42 Elis Muliwati - Bidan PTT 0062370572100
43 Rika Cendra Rika - Bidan PTT 0070843900100

44 Yantina - Bidan PTT 0070843706100
Total :
Terbilang : Seratus Sebelas Juta Sembilan Ratus Lima Puluh Ribu Rupiah

Pengguna Anggaran Bendahara Pengeluar

NIP. 196001021980032001
NIP. 19780521 201001 1
IMA HONORARIUM PEGAWAI HONORER/TIDAK TETAP
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 66.958.055.7-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 66.820.146.0-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 54.569.441.6-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 74.247.935.5.416.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 73.426.267.8-411.000
Rp 4,000,000 Rp 37,500 Rp 3,962,500 44.992.461.2-411.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 71.695.777.4-411.000
Rp 2,500,000 Rp - Rp 2,500,000 77.453.306.1-411.000
Rp 2,500,000 Rp - Rp 2,500,000 59.139.470.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 54.085.769.5-434.000
Rp 2,500,000 Rp - Rp 2,500,000 87.860.595.5-401.000
Rp 2,500,000 Rp - Rp 2,500,000 45.886.046.7-411.000
Rp 2,750,000 Rp - Rp 2,750,000 74.308.686.0-452.000
Rp 2,500,000 Rp - Rp 2,500,000 74.983.142.6-085.000
Rp 2,500,000 Rp - Rp 2,500,000 45.152.710.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.870.354.3-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.893.166.4-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.871.696.6-418.000
Rp 2,500,000 Rp - Rp 2,500,000 45.883.830.7-434.000
Rp 2,500,000 Rp - Rp 2,500,000 36.391.971.3-411.000

Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 45.870.063.0-411.000
Rp 2,250,000 Rp - Rp 2,250,000 45.870.094.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000
Rp 2,000,000 Rp - Rp 2,000,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 111,950,000 Rp 712,500 Rp 109,587,500

dahara Pengeluaran (PPTK)
urwanto Amd, Kep Syahlan King Syahnan Siregar, SE.,MA

9780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
18
19
20
Tanda Tangan
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
Tanda Tangan
44
Januari 2017
sana Kegiatan
PTK)
nan Siregar, SE.,MA

0 201001 1 009
Rp 78,000,000
27450000
Rp 78,000,000
Rp 24,300,000
Rp 78,000,000
KODE REKE
TAHUN A
Puskesmas : Parigi
1 drg. Rakhmadani TK / 0 Dokter Gigi 0058266493100
2 dr. Daruningsih TK / 0 Dokter Umum 0056783611100
3 dr. H. Panji Irawan Suharto TK / 0 Dokter Umum 0059209884100
4 dr Yuliyati TK / 0 Dokter Umum 0070269562100
5 Dita Pratiwi Hadiyani TK / 0 D III Bidan 0056778691100
6 Ronni Siagian TK / 0 D III Bidan 0056783962100
7 Detia Sagita TK / 0 D III Bidan 0056783271100
8 Khaerunnisah TK / 0 D III Bidan 0068645697100
9 Ni Kadek Dwi Juni Utari TK / 0 D III Bidan 0073906113100
10 Endang Idni Sari TK / 0 D III Perawat 0056795413100
11 Juni Rahayu TK / 0 D III Perawat 0060485429100
12 Siti Najiah TK / 0 D III Perawat 0068707757100
13 Fauziyah TK / 0 D III Gizi 0056780556100
14 Ratna Dwi W TK / 0 D III Analis 0071934101100
15 Fahrin Nurpatriotia TK / 0 D III Sanitarian 0058231754100
16 Chusnul Desti - SKM 0075462697100
17 Ridha Agustin - Ners 0075316801100
18 Namah Haryati TK/0 Juru Masak 0056781633100
19 Ade Emis TK/0 Juru Masak 0058621153100
20 Edo Saputra - Admin Perkantoran 0056842527100

21 Fenny Indra Novita - Admin Perkantoran 0056843701100
22 Sesi Maryani - Admin Perkantoran 0068695112100
23 Ridwan Pengemudi Ambulans 0057547091100
24 Wawan Suheri - Pengemudi Ambulans 0063929360100
25 Rahman Asikin - Pengaman Kantor 0056840011100
26 Junaedi - Pengaman Kantor 0056840869100
27 Rodin - Pengaman Kantor 0056904360100
28 Mian Sadik - Pengaman Kantor 0056971904100
29 Nurhasan - Cleaning Service 0056841113100
30 Aminudin - Cleaning Service 0056841695100
31 Rohmat - Cleaning Service 0056840461100
32 Usman - Cleaning Service 0071383164100
33 Jenia Nata Fitri - Bidan PTT 0075680376101
34 Lusi Juni Utami - Bidan PTT 0075686501101
Total :
Terbilang : Delapan Puluh Empat Juta Lima Ratus Ribu Rupiah

Pengguna Anggaran Bendahara Pengeluara

NIP. 196001021980032001
NIP. 19780521 201001 1 0
MA HONORARIUM PEGAWAI HONORER/TIDAK TETAP
AN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 66.875.386.6-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 46.423.715.5-086.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 54.575.831.0-024.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 78.303.455.1-451.000
Rp 2,500,000 Rp - Rp 2,500,000 66.807.272.1-416.000
Rp 2,500,000 Rp - Rp 2,500,000 45.876.618.5-009.000
Rp 2,500,000 Rp - Rp 2,500,000 66.947.754.6-451.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 45.893.080.7-411.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 78.885.114.5-402.000
Rp 2,250,000 Rp - Rp 2,250,000 46.810.984.8-411.000
Rp 2,500,000 Rp - Rp 2,500,000 98.482.765.9-416.000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 4,000,000 Rp 60,000 Rp 3,940,000
Rp 1,500,000 Rp - Rp 1,500,000 46.385.101.4-411.000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,750,000 Rp - Rp 1,750,000
Rp 1,750,000 Rp - Rp 1,750,000
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 84,500,000 Rp 560,000 Rp 83,940,000


780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
18
19
20
Tanda Tangan
21
22
23
24
25
26
27
28
29
30
31
32
Januari 2017
ana Kegiatan
TK)
an Siregar, SE.,MA
201001 1 009
44250000
27500000
Rp 22,750,000
KODE REKE
TAHUN AN
Puskesmas : Bakti Jaya
1 drg. Tiffany Suci Prathiwi TK / 0 Dokter Gigi 0056792775100
2 drg. Astri Anindita TK / 0 Dokter Gigi 0056775919100
3 dr. Luki Enggar Fitri TK / 0 Dokter Umum 0056774671100
4 dr. Ari Wulandari TK / 0 Dokter Umum 0062664721100
5 dr Sekar Ciptaningrum TK / 0 Dokter Umum 0062666897100
6 dr Ayu Wilda Ainusyifa TK / 0 Dokter Umum 0073949610100
7 Arif Romdhon H. TK / 0 SI FARMASI (Asisten Apoteker) 0058219071100
8 Yune Fitriasih, Amd.kep TK / 0 D III Perawat 0056792791100
9 Lenny Herawati, Amd.Keb TK / 0 D III Bidan 0056775757101
10 Iis Ismayati, Amd.Keb TK / 0 D III Bidan 0056792740100
11 Yuhni Chaerani, Amd.Keb TK / 0 D III Bidan 0056792805100
12 Aginta Meisarani F TK / 0 D III Bidan 0028643071100
13 Fitria TK / 0 D III Bidan 0067221109100
14 Ni'matul Izzah TK / 0 D III Bidan 0068691011100
15 Uci Wulandari TK / 0 D III Bidan 0074216633100
16 M Farid Wajdi Fauzi TK / 0 SKM 0068643813100
17 Yurina Safitri TK / 0 D III Analis 0073059410100

18 Yumiaty TK/0 Juru Masak 0056792848100
19 Atiah TK/0 Juru Masak 0058127795100
20 Elpiana - Admin Perkantoran 0016622941100
21 Laili Saodah - Admin Perkantoran 0057442786100
22 Handhika Candra, S.Ikom - Admin Perkantoran 0065180715100
23 Muhamad Hary Susanto - Admin Perkantoran 0070560232100
24 M. Salahuddin Jamal - Pengemudi Ambulans 0057473827100
25 Romansyah Sikumbang - Pengemudi Ambulans 0064479733100
26 Yusma Suhendar - Pengaman Kantor 0056959319100
27 M. Yasin - Pengaman Kantor 0056946837100
28 Sopiyandi - Pengaman Kantor 0063 169935100
Tenaga Pengaman Kantor dan

29 Juni Hari Wibowo -
Rumah Dinas
0075620381100
30 Anzas Asmara - Cleaning Service 0056946934100
31 Muhamad Faisal - Cleaning Service 0056947868100
32 Iwan - Cleaning Service 0056949119100
33 Dewi Maysaroh Soimah - Bidan PTT 0071093867100
34 Rina Junia - Bidan PTT 0071096084100
Total :
Terbilang : Delapan Puluh Sembilan Juta Empat Ratus Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 0
A HONORARIUM PEGAWAI HONORER/TIDAK TETAP
TAHUN ANGGARAN 2017
Honor Pph 21 Terima NPWP Tanda Tang
Rp 5,500,000 Rp 125,000 Rp 5,375,000 47.237.031.1-402.000 1
Rp 5,500,000 Rp 125,000 Rp 5,375,000 45.066.027.9-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 54.594.652.7-411.000 3
Rp 5,500,000 Rp 125,000 Rp 5,375,000 71.699.474.4-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 55.759.551.9-412.000 5
Rp 5,500,000 Rp 125,000 Rp 5,375,000 72.832.719.8-411.000
Rp 2,250,000 Rp - Rp 2,250,000 34.569.524.1-411.000 7
Rp 2,500,000 Rp - Rp 2,500,000 66.994.556.0-411.000
Rp 2,500,000 Rp - Rp 2,500,000 54.129.611.7-411.000 9
Rp 2,500,000 Rp - Rp 2,500,000 66.930.647.4-451.000
Rp 2,500,000 Rp - Rp 2,500,000 54.099.730.1-451.000 11
Rp 2,500,000 Rp - Rp 2,500,000 45.126.290.1-411.000
Rp 2,500,000 Rp - Rp 2,500,000 74.210.987.9.418.000 13
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 15
Rp 2,500,000 Rp - Rp 2,500,000 74.783.659.1-418.000
Rp 2,500,000 Rp - Rp 2,500,000 17
Rp 1,500,000 Rp - Rp 1,500,000 77.004.596.1-411.000
Rp 1,500,000 Rp - Rp 1,500,000 97.299.746.4-411.000 19
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000 - 21
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,900,000 Rp - Rp 1,900,000 - 23
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 - 25
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 - 27
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 29
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 - 31
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 750,000 Rp - Rp 750,000 33
Rp 750,000 Rp - Rp 750,000
Rp 89,400,000 Rp 750,000 Rp 88,650,000


80521 201001 1 006 NIP. 19840520 201001 1 009
anda Tangan
2
52750000
27650000
10
12
14
16
anda Tangan
18
20
22
24
26
###
28
30
32
34
anda Tangan
TANDA TERIMA HONOR
KEGIATAN PENYEDIAAN DAN PE
KOD
TA
Puskesmas : Pisangan
1 Nita Kurnia TK / 0 SKM 0070032694100
2 Surayah TK / 0 D III Bidan 0056777611100
3 Pipit Ernawati TK / 0 D III Bidan 0056777441100
4 Annisa Destiana TK / 0 D III Bidan 0056784047100
5 Badriyah Imamah TK / 0 D III Perawat 0028643209100
6 Masnur Siagian TK / 0 D III Perawat 0068690897100
7 Dian Mulya Sari TK / 0 D III Perawat 0059235087100
8 Resti Hilda Hanifah TK / 0 D III Perawat Gigi 0059207164100
9 Faouzi Ramdhani TK / 0 D III Analis 0064800434100
10 Babay Hasbiyah TK / 0 D III Sanitarian 0058181013100
11 Rina Rahayu TK / 0 Bidan 0075613601100
12 Setianingrum - Admin Perkantoran 0057528060100
13 Dara Ayu Damayanti - Admin Perkantoran 0057524197100
14 Ira Kartikasari - Admin Perkantoran 0068158877100
15 Toha Irmahi - Pengemudi Ambulans 0057504651100
16 Ade Syahrial - Pengaman Kantor 0057304952100
17 Zulfikar Ali Sani - Pengaman Kantor 0057303026100
18 Eros Mandela - Pengaman Kantor 0057304669100
19 Wirta - Pengaman Kantor 0071420086100

20 Fitriyah - Cleaning Service 0057301041100
21 Aris Tendri - Cleaning Service 0057303778100
22 Noviana Maulani - Bidan PTT 0075615116100
23 Septi Ariyanti - Bidan PTT 0075661241100
Total :
Terbilang : Empat Puluh Tujuh Juta Tujuh Ratus Lima Puluh Ribu Rupiah
Mengetahui Lunas diba

Pengguna Anggaran Bendahara Peng
Hj. Listya Windyarti, S. Sos., M. KM Purwanto Amd

NIP. 196001021980032001
NIP. 19780521 201
TAHUN ANGGARAN 2017
Rp 2,500,000 Rp - Rp 2,500,000 45.565.531.6-402.000
Rp 2,500,000 Rp - Rp 2,500,000 45.126.307.3-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.126.322.2-411.000
Rp 2,500,000 Rp - Rp 2,500,000 70.066.370.1-403.000
Rp 2,500,000 Rp - Rp 2,500,000 45.125.311.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 46.836.626.5-401.000
Rp 2,500,000 Rp - Rp 2,500,000 47.383.784.7-402.000
Rp 2,500,000 Rp - Rp 2,500,000 45.969.538.3-403.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,900,000 Rp - Rp 1,900,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 47,750,000 Rp - Rp 47,750,000


80521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
1
22500000
2
19000000
10
11
12
13
14
15
16
17
18
19
Tanda Tangan
20
21
22
23
Januari 2017
ana Kegiatan
K)
an Siregar, SE.,MA
201001 1 009
###
KODE REKE
TAHUN A
Puskesmas : Benda Baru
1 dr. Dimas Adi Patria K/2 Dokter Umum 0056794050100
2 dr Maydina Putri Anggita TK / 0 Dokter Umum 0069553915100
3 dr. Dita Ayuningtyas TK / 0 Dokter Umum 0059235362100
4 dr. Novita Krisnasari TK / 0 Dokter Umum 0056774947100
5 drg Etika sari Purnomowati TK / 0 Dokter Gigi 0065889730100
6 Raisani Rusli TK / 0 Apoteker 0069572448100
7 Nadia Larasati Radintya Dewi TK / 0 Ners 0068655625100
8 Ika Anggiani Pratiwi TK / 0 D III Bidan 0056792945100
9 Lina Herlina TK / 0 D IV Bidan 0056793021100
10 Tria Suselowati TK / 0 D III Bidan 0056792971100
11 Asih Nurul Asti TK / 0 D III Bidan 0056792937100
12 Nia Kaniasari TK / 0 D III Bidan 0062668326100
13 Ides Safitry TK / 0 D III Bidan 0063423947100
14 Amalia Khairunisa TK / 0 D III Bidan 0068677531100
15 Milatul Awaliyah TK / 0 D III Bidan 0074059414100
16 FT. Riaz Anassauri TK / 0 D III Fisioteraphy 0056784527100
17 Suci Masrurroh TK / 0 SKM 0068670748100
18 Septi Indriani TK / 0 D III Perawat 0056792899100
19 Sisca Susanti TK / 0 D III Perawat 0056802215100
20 Euis Umayati TK / 0 D III Perawat 0058148504100

21 Muhammad Jaelani Sanjaya TK / 0 D III Perawat 0073947601100
22 Affandi TK / 0 D III Perawat 0071693562100
23 Galuh Pradnya Dinindita TK / 0 D IV Gizi 0062672099100
24 Hilda Muwafiqoh TK / 0 D III Analis 0060696608100
25 Asop Waliyudin TK / 0 D III Rekam Medis 0072310772100
26 Dani Fachrizal TK / 0 SMF AA 0056802339100
27 Irvan Firdaus TK / 0 D III Sanitarian 0063632015100
28 Qiftiah TK/0 Juru Masak 0056792910100
29 Siti Rohami TK/0 Juru Masak 0056792961100
30 David Sulistio - Admin Perkantoran 0057475730100
31 Evie Ervina - Admin Perkantoran 0057470070100
32 Rizkia Nur Fauziana - Admin Perkantoran 0057474939100
33 Rega Alfian - Admin Perkantoran 0065016842100
34 Sahadi - Pengemudi Ambulans 0057466261100
35 Nurdin - Pengaman Kantor 0056903496100
36 Sunarto - Pengaman Kantor 0056904573100
37 Ade Irwan - Pengaman Kantor 0057297891100
38 Narwih - Pengaman Kantor 0073251842100
39 Hamdani - Cleaning Service 0056908307100
40 Sanusi - Cleaning Service 0056902351100
41 Taufik Fauzi - Cleaning Service 0061051589100
42 Siti Rohani - Cleaning Service 0016587508100
43 Riska Hardika - Bidan PTT 0075624050100

44 Vista Pramesti - Bidan PTT 0075625911100
Total :
Terbilang : Seratus Tiga Belas Juta Empat Ratus Lima Puluh Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 0
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 87,500 Rp 5,412,500 66.806.158.3-451.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 66.024.865.9-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 54.577.515.1-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 25.993.157.0-89000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 45.893.729.9-411.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 75.436.560.9-453.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 74.909.710.1-452.000
Rp 2,500,000 Rp - Rp 2,500,000 45.216.978.2-411.000
Rp 2,500,000 Rp - Rp 2,500,000 97.290.773.7-419.000
Rp 2,500,000 Rp - Rp 2,500,000 45.217.350.3-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.218.925.1-411.000
Rp 2,500,000 Rp - Rp 2,500,000 71.635.665.4-451.000
Rp 2,500,000 Rp - Rp 2,500,000 72.124.400.2.411.000
Rp 2,500,000 Rp - Rp 2,500,000 74.610.610.3-453.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 45.216.936.0-411.000
Rp 2,500,000 Rp - Rp 2,500,000 74.940.935.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 25.514.612.8-402.000
Rp 2,500,000 Rp - Rp 2,500,000 24.997.275.3-086.000
Rp 2,500,000 Rp - Rp 2,500,000 69.863.943.2-443.000

Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 57.187.562.4-419.000
Rp 2,500,000 Rp - Rp 2,500,000 71.695.666.9-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.642.982.8-443.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 1,750,000 Rp - Rp 1,750,000 55.262.439.7-416.000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 1,500,000 Rp - Rp 1,500,000 45.217.093.9-411.000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 113,450,000 Rp 687,500 Rp 112,762,500


780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
18
19
20
Tanda Tangan
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
Tanda Tangan
44
Januari 2017
ana Kegiatan
TK)
an Siregar, SE.,MA
201001 1 009
Rp 24,450,000
TANDA TERIMA HONOR
KOD
TA
Puskesmas : Pondok Ranji
1 dr Rita Julianti Ariza TK / 0 Dokter Umum 0058207470100
2 dr Adelita Tri Rahmawati TK / 0 Dokter Umum 00729955579100
3 dr Galih Parwita Ningrum TK / 0 Dokter Umum 0073923883100
4 drg Leli Amalia TK / 0 Dokter Gigi 0073256755100
5 Nurjawanto TK / 0 NERS 0073239524100
6 Janu Dwi Astuti TK / 0 Apoteker 0062675845100
7 Eli Yuniarti, Amd. Ak TK / 0 D III Analis 0056791744100
8 Sifa Fauziah, Amd Keb TK / 0 D III Bidan 0062669462100
9 Fani Maharani, Amd.Keb TK / 0 D III Bidan 0056794972100
10 Hannaa Nurfatima, Amd.Keb TK / 0 D III Bidan 0028466218100
11 Maratus Sholikah TK / 0 D III Bidan 0073948975100
12 Robiatul Adawiyah TK / 0 D III Bidan 0065048061100
13 Adriani Libra TK / 0 D III Bidan 0063420735100
14 Putri Megawati TK / 0 SI Gizi 0064604740100
15 Syihabudin Abdullah Azzam,A.Md.Kep TK / 0 D III Perawat 0056796851100
16 Nurcholis saman, Amd.Kep TK / 0 D III Perawat 0056787666100
17 Herma Mardiono Amd.Kep K/2 D III Perawat 0056795499100
18 Nuraevi Mardiana, Amd.Kep TK / 0 D III Perawat 0058234583100
19 Muning Herawati TK / 0 SKM 0063175463100

20 Rudi Wijaksono TK / 0 D III Sanitarian 0068704820100
21 Eruk Rukini TK/0 Juru Masak 0024075400101
22 Enah Nasmi TK/0 Juru Masak 0059499262100
23 Khotimah - Admin Perkantoran 0057922842100
24 Ratnasari, S.Kom - Admin Perkantoran 0064438336100
25 Adi Purnama - Admin Perkantoran 0069006000100
26 Supriyadi - Pengemudi Ambulans 0057471328100
27 Trio waldy - Pengemudi Ambulans 0061448225100
28 Muhammad Rusli - Pengaman Kantor 0056848738100
29 Nur Abdullah - Pengaman Kantor 0056849041100
30 Sugeng Winarko - Pengaman Kantor 0056919570100
31 Edi Supriyadi - Pengaman Kantor 0056848959100
32 Marfuah - Cleaning Service 0056848436100
33 Heri Efrijal - Cleaning Service 0056876677100
34 Sutrisno - Cleaning Service 0056848843100
35 Eka Budi Yanto - Cleaning Service 0064667114100
Total :
Terbilang : Sembilan Puluh Satu Juta Delapan Ratus Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 09.586.636.4-043.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 72.783.175.2-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 58.559.774.3-005.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 76.387.213.2-453.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 70.129.470.4-302.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 71.560.039.1-411.000
Rp 2,500,000 Rp - Rp 2,500,000 46.364.374.2-045.000
Rp 2,500,000 Rp - Rp 2,500,000 71.720.074.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.892.868.6-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.893.000.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 73.133.586.5.411.000
Rp 2,500,000 Rp - Rp 2,500,000 64.323.813.2.411.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 66.467.598.0-525.000
Rp 2,500,000 Rp - Rp 2,500,000 45.892.731.6-411.000
Rp 2,500,000 Rp - Rp 2,500,000 46.167.110.9-451.000
Rp 2,500,000 Rp - Rp 2,500,000 88.484.467.1-411.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 1,500,000 Rp - Rp 1,500,000 45.892.953.6-411.000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000
Rp 91,800,000 Rp 600,000 Rp 91,200,000


80521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
18
19
Tanda Tangan
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Januari 2017
ana Kegiatan
K)
an Siregar, SE.,MA
201001 1 009
60000000
27050000
Rp 24,050,000
TANDA TERIMA HONOR
KOD
TA
Puskesmas : Setu
1 drg. Kuncoro Priyatna Basdabella TK / 0 Dokter Gigi 0056788700100
2 dr Metalia Karina Zendrato TK / 0 Dokter Umum 0068718503100
3 Titi Aryanti TK / 0 D III Bidan 0056776079100
4 Yuyun Yulia S.St TK / 0 D IV Bidan 0068692385100
5 Imam Gofur K/2 D III Perawat 0056786211100
6 Rahmi Fauziah TK / 0 D III Perawat Gigi 0065201739100
7 Ririn Nur'aini TK / 0 D III Fisioteraphy 0069672639100
8 Nurul Azizah TK / 0 D III Sanitarian 0060507759100
9 Amiyana, Amd. Kesehatan Gizi TK / 0 D III Gizi 0056793259100
10 Ira Juhaeriah - Admin Perkantoran 0057472081101
11 Sevi Sofia - Admin Perkantoran 0069718000100
12 Fajar Agus Nugroho - Admin Perkantoran 0057482591100
13 Bahrudin - Pengemudi Ambulans 0057472359100
14 Hamid - Pengaman Kantor 0056905790100
15 Abdul Kholil - Pengaman Kantor 0056906290100
16 Eko Joko Sudarmono - Pengaman Kantor 0056906436100
17 Kurnia Agustian - Pengaman Kantor 0056906002100
18 Mirsah - Cleaning Service 0056905502100

19 Mursiti - Cleaning Service 0056905111100
20 Dewi Jayanti - Bidan PTT 0075639090100
Total :
Terbilang : Empat Puluh Tujuh Juta Tujuh Ratus Lima Puluh Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 34.815.289.3.017.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000
Rp 2,500,000 Rp - Rp 2,500,000 45.231.984.1-411.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 66.871.008.0-411.000
Rp 2,500,000 Rp - Rp 2,500,000 72.568.813.9-416.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,250,000 Rp - Rp 2,250,000 70.899.564.2-521.000
Rp 2,250,000 Rp - Rp 2,250,000 45.931.199.9-416.000
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,900,000 Rp - Rp 1,900,000 -
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 750,000 Rp - Rp 750,000
Rp 47,750,000 Rp 250,000 Rp 47,500,000


80521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
18
Tanda Tangan
19
20
Januari 2017
ana Kegiatan
K)
an Siregar, SE.,MA
201001 1 009
28000000
19000000
Rp 19,000,000
TANDA TERIMA HONOR
KODE
TAH
Puskesmas : Serpong 1
1 dr M Ali Hasymi K/1 Dokter Umum 0065531623100
2 dr. Yosa Rini TK / 0 Dokter Umum 0056787712100
3 dr. Yunniar Dewi Lestari TK / 0 Dokter Umum 0058186406100
4 dr Pramesti Perwira Kemilau K/1 Dokter Umum 0068818321100
5 drg Rora Sasmita TK / 0 Dokter Gigi 0063437972100
6 Voni Wahyuni, Ssi.Apt TK / 0 Apoteker 0060548870100
7 M. Husni Mubarok TK / 0 NERS 0069565761100
8 Nurrohman K/0 D III Perawat 0056784391100
9 Eva Nurul Fajriah TK / 0 D III Perawat 0060479941100
10 Ristiya Yudiantini TK / 0 SI Farmasi (Asisten Apoteker) 0056793437100
11 Dera Adiliyah TK / 0 D III Bidan 0056778373100
12 Ratih Kiswari Anggraeni TK / 0 D III Bidan 0058209007100
13 Mimi Sumiati Kulsum TK / 0 D III Bidan 0073924251100
14 Vidya Yusiana Pendani TK / 0 D III Bidan 0073944971100
15 Yezi Bellina , Amd.GZ TK / 0 D III Gizi 0056778543100
16 Zaenudin Arnas TK / 0 D III Analis Kesehatan 0062744881100
17 Insan Aidil Ichsan TK / 0 D IV Kesehatan Lingkungan 0074035949100
18 Erikha Wulan Sari, SKM TK / 0 SKM 0057430249100
19 Dede Sunaeti TK / 0 D III Bidan 0075474199100
20 Icih Maryani TK/0 Juru Masak 0056782702100

21 Hepiyah TK/0 Juru Masak 0072177851100
22 Trisni Wahyuni - Admin Perkantoran 0057449561100
23 Ruyadi - Admin Perkantoran 0057449403100
24 Nurhakiki - Admin Perkantoran 0065596407100
25 Abe Sadana - Admin Perkantoran 0073996244100
26 Abdul Aziz - Pengemudi Ambulans 0057449772100
27 Muhamad Nurfajri - Pengemudi Ambulans 0057460407100
28 Juanda - Pengaman Kantor 0056870210100
29 Ahmad Ramdhani - Pengaman Kantor 0056857321100
30 Rizky Arya Putra - Pengaman Kantor 0056871861100
31 Muhammad Ramdani - Pengaman Kantor 0056872469100
32 Agus Maemanah - Cleaning Service 0056851410100
33 Ajat Sudrajat - Cleaning Service 0056873211100
34 Hendra - Cleaning Service 0056873813100
35 Sumanah - Cleaning Service 0068590337100
36 Riskasari - Bidan PTT 0062886791100
Total :
Terbilang : Sembilan Puluh Empat Juta Tujuh Ratus Ribu Rupiah
Mengetahui Lunas dibay

Pengguna Anggaran Bendahara Penge

NIP. 196001021980032001
NIP. 19780521 2010
A HONORARIUM PEGAWAI HONORER/TIDAK TETAP
N DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 100,000 Rp 5,400,000 14.598.874.7-732.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 45.874.427.3-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 55.933.499.9-451.000
Rp 5,500,000 Rp 100,000 Rp 5,400,000 71.979.892.8-412.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 72.202.020.3-411.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 57.7222.276-027.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 75.754.776.5.418.000
Rp 2,500,000 Rp - Rp 2,500,000 77.750.000.0-411.000
Rp 2,500,000 Rp - Rp 2,500,000 70.850.974.0-434.000
Rp 2,250,000 Rp - Rp 2,250,000 34.572.692.1-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.874.109.7-411.000
Rp 2,500,000 Rp - Rp 2,500,000 66.868.866.6-411.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,250,000 Rp - Rp 2,250,000 45.899.272.4-411.000
Rp 2,500,000 Rp - Rp 2,500,000 71.780.047.8-405.000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000
Rp 2,150,000 Rp - Rp 2,150,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000
Rp 750,000 Rp - Rp 750,000
Rp 94,700,000 Rp 675,000 Rp 94,025,000


80521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
18
19
20
Tanda Tangan
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
Januari 2017
na Kegiatan
K)
n Siregar, SE.,MA
01001 1 009
Rp 57,500,000
Rp 29,200,000
###
TANDA TERIMA HONO
KEGIATAN PENYEDIAAN DAN P
KOD
T
Puskesmas : Serpong 2
1 dr. Aliefiya Sari TK / 0 Dokter Umum 0056790055100
2 dr. Muhammad Irfan K/2 Dokter Umum 0058224405100
3 dr Pamella Djakaria TK / 0 Dokter Umum 0064713280100
4 dr. Igehi Saqina TK / 0 Dokter Umum 0056788522100
5 drg. Nesa TK / 0 Dokter Gigi 0056773908100
6 Siti Nunung Nurlela TK / 0 D III Analis 0056775099100
7 Rika Nurvianty TK / 0 SMF 0056783474100
8 Restu arifiani ing tyas TK / 0 D III Bidan 0056775250100
9 Hindun TK / 0 D III Bidan 0056777741100
10 Indra Sirait TK / 0 D III Bidan 0068673283100
11 M.Romdoni TK/0 NERS 0071103201100
12 Erika Tambunan TK / 0 D III Perawat 0056787879100
13 Entih TK / 0 D III Perawat 0056779914100
14 Laela Fitriani TK / 0 D III Gizi 0056790594100
15 Indah Nur Abidah TK / 0 Sanitarian 0073986494100
16 Meah TK/0 Juru Masak 0056786872100
17 Sri Herawati TK/0 Juru Masak 0058189510100
18 Riyan Hendriyawan - Admin Perkantoran 0057468963100
19 Apriyani - Admin Perkantoran 0060446458100

20 Mutthahara - Admin Perkantoran 0069575773100
21 Simin - Pengemudi Ambulans 0057465123100
22 Heru Subekti - Pengemudi Ambulans 0057446773100
23 Imam Hidayat - Pengaman Kantor 0056877681100
24 Syahrillana - Pengaman Kantor 0056901329100
25 Hilman - Pengaman Kantor 0075388152100
26 Sri Purwatiningsih - Cleaning Service 0056880313100
27 Ahmad Baehaki - Cleaning Service 0056851968100
28 Dede Utami Apriyanti - Cleaning Service 0056907122100
29 Ade Mutmainah - Cleaning Service 0056880216100
30 Nuryasah Sintari - Bidan PTT 0075661754101
31 Ria Farida - Bidan PTT 0075661665101
32 Tami Septiani - Bidan PTT 0075648693100
Total :
Terbilang : Delapan Puluh Juta Lima Ratus Ribu Rupiah

Hj. Listya Windyarti, S. Sos., M. KM Purwanto Am

NIP. 196001021980032001
NIP. 19780521 201
IMA HONORARIUM PEGAWAI HONORER/TIDAK TETAP
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 35.584.498.6-731.000
Rp 5,500,000 Rp 87,500 Rp 5,412,500 36.670.529.1-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 55.846.037.4.416.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 68.110.584.7-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 46.108.658.9-411.000
Rp 2,500,000 Rp - Rp 2,500,000 77.704.038.7-403.000
Rp 1,750,000 Rp - Rp 1,750,000
Rp 2,500,000 Rp - Rp 2,500,000 45.879.420.3-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.874.042.0-411.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 71.362.784.2-418.000
Rp 2,500,000 Rp - Rp 2,500,000 56.427.339.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 48.065.327.8-418.000
Rp 2,250,000 Rp - Rp 2,250,000 46.341.657.8-411.000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 1,500,000 Rp - Rp 1,500,000 45.887.296.7-411.000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 80,500,000 Rp 637,500 Rp 79,862,500


780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
18
19
Tanda Tangan
20
21
22
23
24
25
26
27
28
29
30
31
32
Januari 2017
na Kegiatan
K)
n Siregar, SE.,MA
01001 1 009
Rp 52,750,000
25500000
Rp 22,500,000
Rp 52,750,000
TANDA TERIMA HO
KEGIATAN PENYEDIAAN DA
K
Puskesmas : Pondok Betung

1 dr Yusi Nurmalisa TK / 0 Dokter Umum 0066518892100
2 dr Aristya Indah Widiyanti TK / 0 Dokter Umum 0067598881101
3 dr Faisal Oesman K/1 Dokter Umum 0069554040100
4 Adi Prassanjaya TK / 0 Ners 0068681200100
5 Ratu Nia Fithriani TK / 0 D III Perawat 0056787984100
6 Rita Ruhita,A.Md.Kep TK / 0 D III Perawat 0056790233100
7 Tri Sulistiono TK / 0 D III Perawat 0056784454100
8 M Hidayatullah TK / 0 SKM 0068672090100
9 Nur'aini TK / 0 D III Bidan 0033714998100
10 Yati Nurhayati TK / 0 D III Bidan 0056778314100
11 Rahmawati TK / 0 D III Bidan 0056776834100
12 Tri Witianingsih TK / 0 D III Bidan 0056778896100
13 Nurul Zulfa TK / 0 D III Bidan 0068666228100
14 Bunga Asmara Arno TK / 0 D III Gizi 0058370525100
15 Eneng Santi TK / 0 D III Analis 0068696356100
16 Okti Maulita Dewi TK / 0 D III Sanitarian 0060498539100
17 Agus Wahrudianto TK / 0 SPRG 0056784683100

18 Azkiyatun Widad TK / 0 Rekam Medis 0073032113100
19 Lilis Suryani TK/0 Juru Masak 0056786732100
20 Misiyah TK/0 Juru Masak 0056877495100
21 Erma Yanti - Admin Perkantoran 0057446706100
22 Ibnu Iskandar Rizki - Admin Perkantoran 0060709424100
23 Indah Damayanti - Admin Perkantoran 0066301966100
24 Delza Albi - Admin Perkantoran 0068669626100
25 Tatang Rustandi - Pengemudi Ambulans 0057447109100
26 Muhammad Balady Thamrin - Pengemudi Ambulans 0075312271100
27 Abdul Zafar - Pengaman Kantor 0056870245100
28 Ugi Yunianto - Pengaman Kantor 0056871292100
29 Mulyono - Pengaman Kantor 0014630309100
30 Andrik Sophiyan - Pengaman Kantor 0063227579100
31 Ahmad Sujana - Cleaning Service 0056852670100
32 Sulastri Lis Sugiarti - Cleaning Service 0059618059100
33 Saripudin - Cleaning Service 0063733512100
34 Apriyuda - Cleaning Service 0070869934100
35 Fahim Martina - Bidan PTT 0075631693100
36 Resia Umul Kasanah - Bidan PTT 0075630573100
Total :
Terbilang : Delapan Puluh Lima Juta Dua Ratus Ribu Rupiah

Pengguna Anggaran Bendahara Pen

NIP. 196001021980032001
NIP. 19780521 20
ERIMA HONORARIUM PEGAWAI HONORER/TIDAK TETAP
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 64.076.639.0.416.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 09.072.537.5-031.000
Rp 5,500,000 Rp 120,000 Rp 5,380,000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 74.969.233.1-402.000
Rp 2,500,000 Rp - Rp 2,500,000 46.332.897.1-419.000
Rp 2,500,000 Rp - Rp 2,500,000 57.386.588.8-402.000
Rp 2,500,000 Rp - Rp 2,500,000 87.371.071.9-411.000
Rp 2,500,000 Rp - Rp 2,500,000 74.902.628.2-453.000
Rp 2,500,000 Rp - Rp 2,500,000 66.854.524.7-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.884.797.7-411.000
Rp 2,500,000 Rp - Rp 2,500,000 54.115.124.7-416.000
Rp 2,500,000 Rp - Rp 2,500,000 78.403.804.4-008.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 2,250,000 Rp - Rp 2,250,000 45.931.431.6-086.000

Rp 2,500,000 Rp - Rp 2,500,000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,900,000 Rp - Rp 1,900,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 85,200,000 Rp 420,000 Rp 84,780,000



780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
Tanda Tangan
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
Tanda Tangan
Januari 2017
a Kegiatan
Siregar, SE.,MA
1001 1 009
52250000
28950000
Rp 24,200,000
TANDA TERIMA HON
KO
Puskesmas : Jombang
1 drg Nurhayati TK / 0 Dokter Gigi 0065512378100
2 dr. Novi Chaerany TK / 0 Dokter Umum 0058595179100
3 dr. Sarry Anisa TK / 0 Dokter Umum 0058256900100
4 dr Yuni Nuraeni TK / 0 Dokter Umum 0064716425100
5 dr Kasih Vicky Nataly Samosir TK / 0 Dokter Umum 0066026531100
6 Hernita Anggraini TK / 0 Apoteker 0060483566100
7 Resti Aprianti TK / 0 NERS 0058181471100
8 Akni Restuning TK / 1 D III Perawat 0056789928100
9 Dwi Agestiowati TK / 0 D III Perawat 0056804382100
10 Iyus Susanati TK / 0 D III Perawat 0056789715100
11 Sigit Irawan TK / 0 D III Perawat 0056788654100
12 Sulistiono, A.Md.Kep TK / 0 D III Perawat 0027118984100
13 Annisa Nur Fitria TK / 0 SMF Asisten Apoteker 0063196800100
14 Rinna Fadilah TK / 0 D IV Bidan 0056788328100
15 Ani Sepya Mulyani TK / 0 D III Bidan 0056780300100
16 Selvia TK / 0 D III Bidan 0056787429100
17 Corina Wulandari TK / 0 D III Bidan 0056799133100
18 Maesaroh TK / 0 D III Bidan 0056789261100
19 Ernita Aryanti TK / 0 D III Bidan 0063267449100

20 Sari Hesti Juniati TK / 0 D III Perawat Gigi 0067220897100
21 Rindra Al Ubaidah TK / 0 SKM 0068683033100
22 Sulistianingsih TK / 0 D III Analis 0065046369100
23 Utiah Suhartini TK/ 0 Rekam Medis 0071737853100
24 Tri Marwati TK/0 Juru Masak 0056784136100
25 Nur Endah TK/0 Juru Masak 0058335428100
26 Mardinah - Admin Perkantoran 0059615467100
27 Nunik Setiani - Admin Perkantoran 0068684226100
28 Muhamad Satria Perkasa, S. Kom - Admin Perkantoran 0068946034100
29 Rezqi Amalia Rachmani, SE Admin Perkantoran 0075564473100
30 Khamalludin - Pengemudi Ambulans 0057443561100
31 Herlis Prayitno - Pengemudi Ambulans 0057450029100
32 Pipin Aripin - Pengaman Kantor 0057465395100
33 Sanusi Suheru - Pengaman Kantor 0057134615100
34 Vishnu Rajindra Bumi Bakti - Pengaman Kantor 0068857831100
35 Muhamad Sultani - Pengaman Kantor 0072745655100
36 David Ardiansyah - Cleaning Service 0056919325100
37 Abdul Rohim - Cleaning Service 0018214598100
38 Ibrahim - Cleaning Service 0061814078100
39 Gunawan - Cleaning Service 0059387200100
40 Siti Hartika - Bidan PTT 0075616775100
Total :
Terbilang : Seratus Lima Juta Seratus Lima Puluh Ribu Rupiah

Pengguna Anggaran Bendahara Pen

NIP. 196001021980032001
NIP. 19780521 20
RIMA HONORARIUM PEGAWAI HONORER/TIDAK TETAP
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 49.893.289.6-416.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 70.036.865.7-016.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 66.841.619.1-013.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 09.135.231.0.035.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 73.602.514.9-411.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 70.883.011.2-013.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 66.854.577.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.893.866.9-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.893.864.4-411.000
Rp 2,500,000 Rp - Rp 2,500,000 47.867.166.2-416.000
Rp 2,500,000 Rp - Rp 2,500,000 66.980.916.2-451.000
Rp 2,500,000 Rp - Rp 2,500,000 71.791.997.1-411.000
Rp 1,750,000 Rp - Rp 1,750,000
Rp 2,500,000 Rp - Rp 2,500,000 45.910.734.8-403.000
Rp 2,500,000 Rp - Rp 2,500,000 45.885.515.2-451.000
Rp 2,500,000 Rp - Rp 2,500,000 45.874.480.2-411.000
Rp 2,500,000 Rp - Rp 2,500,000 46.213.085.7-402.000
Rp 2,500,000 Rp - Rp 2,500,000 46.095.891.2-411.000
Rp 2,500,000 Rp - Rp 2,500,000 72.159.684.9.411.000

Rp 2,500,000 Rp - Rp 2,500,000 74.182.158.1.453.000
Rp 2,500,000 Rp - Rp 2,500,000 74.795.093.9-452.000
Rp 2,500,000 Rp - Rp 2,500,000 97.197.203.9-418.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 1,500,000 Rp - Rp 1,500,000 66.881.582.2-411.000
Rp 1,500,000 Rp - Rp 1,500,000 66.932.731.4-411.000
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000
Rp 2,150,000 Rp - Rp 2,150,000
Rp 2,150,000 Rp - Rp 2,150,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 750,000 Rp - Rp 750,000
Rp 105,150,000 Rp 725,000 Rp 104,425,000



780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
18
19
Tanda Tangan
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
Tanda Tangan
Januari 2017
na Kegiatan
)
n Siregar, SE.,MA
01001 1 009
74750000
29650000
TANDA TERIMA HONO
KOD
TA
Puskesmas : Pondok Pucung
1 dr Adhini Dwirespati TK / 0 Dokter Umum 0068679060100
2 dr Cynthia Fadhilla TK / 0 Dokter Umum 0070268094100
3 dr Mulki Rakhmawati TK / 0 Dokter Umum 0071659402100
4 Diah Jayanti.A.S,Kep TK / 0 NERS 0056775420100
5 Yeyen Apriyanthi,S.Farm.,Apt TK / 1 Apoteker 0056784950100
6 Neneng Suryanti TK / 0 D III Bidan 0056784268100
7 Nining Supriani TK / 0 D III Bidan 0027008461100
8 Annisa Narulita.N.S TK / 0 D III Bidan 0056773797100
9 Siti Solihat,Amd Keb TK / 0 D III Bidan 0056793518100
10 Mutmainnah.Amd.Keb TK / 0 D III Bidan 0056773975100
11 Inna Mariana TK / 1 D III Bidan 0064791869100
12 Ratna Yanti TK / 0 D III Bidan 0073947928100
13 Khoirunnisa Esa Putri TK / 0 D III Perawat Gigi 0065541084100
14 Renita Hardiah Isnaini S.Gz TK / 0 D III Gizi 0058365459100
15 Ena Mardianasari.Amd,Kep TK / 0 D III Perawat 0056777946100
16 Heri Herawan TK / 0 D III Perawat 0073873029100
17 Novia Eka Sulistiowati TK / 0 D III Perawat 0071678520100
18 Demanti Anisa Putri TK / 0 D III Sanitarian 0062674849100

19 Dany Akbar TK/0 D III Analis 0071693929100
20 Suhaini TK/0 Juru Masak 0058253081100
21 Neni Sudaryanti TK/0 Juru Masak 0056782338100
22 Ayanih - Admin Perkantoran 0057461535100
23 Yeni Anggraini - Admin Perkantoran 0057460601100
24 Sela Ali Yanti - Admin Perkantoran 0057461012100
25 Muhamad Roni - Pengemudi Ambulans 0057468815100
26 Barry Rianto - Pengemudi Ambulans 0057462711100
27 Dedi Sunardi - Pengaman Kantor 0056845331100
28 Sudisman - Pengaman Kantor 0056858741100
29 Elpin Pandu Nusa - Pengaman Kantor 0056826262100
30 Jaelani - Cleaning Service 0056844430100
31 Nursiah - Cleaning Service 0056846670100
32 Febi Ariansyah - Cleaning Service 0056846832100
33 Sukandi - Cleaning Service 0056845712100
Total :
Terbilang : Delapan Puluh Empat Juta Dua Ratus Lima Puluh Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 0
N PENYEDIAAN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 70.918.920.3-411.000
Rp 5,500,000 Rp 150,000 Rp 5,350,000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 70.957.756.3-411.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 45.766.709.5-411.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 44.626.054.9-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.924.365.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.952.382.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 54.591.709.9-451.000
Rp 2,500,000 Rp - Rp 2,500,000 45.880.683.3-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.935.446.0-411.000
Rp 2,500,000 Rp - Rp 2,500,000 72.974.512.5-451.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 38.522.172.0-411.000
Rp 2,250,000 Rp - Rp 2,250,000 66.933.488.0-013.000
Rp 2,500,000 Rp - Rp 2,500,000 57.616.146.7-416.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 16.926.468.6-411.000
Rp 2,250,000 Rp - Rp 2,250,000 71.690.515.3-017.000

Rp 2,500,000 Rp - Rp 2,500,000 76.211.466.8-401.000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,500,000 Rp - Rp 1,500,000 45.930.368.1-416.000
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,900,000 Rp - Rp 1,900,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 84,250,000 Rp 500,000 Rp 83,750,000

endahara Pengeluaran (PPTK)
Purwanto Amd, Kep Syahlan King Syahnan Siregar, SE.,

P. 19780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
18
Tanda Tangan
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
Januari 2017
ksana Kegiatan
PTK)
hnan Siregar, SE.,MA

0 201001 1 009
Rp 59,000,000
Rp 25,250,000
Rp 25,250,000
###
TANDA TERIMA HONO
KOD
TA
Puskesmas : Ciputat Timur
1 dr. Rachmi Desryani TK / 0 Dokter Umum 0056791965100
2 dr. Ita Septarita TK / 0 Dokter Umum 0060480907100
3 dr. Dewi Febriani TK / 0 Dokter Umum 0058208302100
4 dr Ratu Kurnia TK / 0 Dokter Umum 0069554172100
5 Drg.Tata Kartika Hartadi TK / 0 Dokter Gigi 0056791841100
6 Wulan Yuliastuti,S.Farm.,Apt TK / 0 Apoteker 0056784713100
7 Nabila Putri TK / 0 NERS 0071737950100
8 Eminita Krina Perangin Angin TK / 0 SI Gizi 0062625988100
9 Marantika Astriani TK / 0 D III Bidan 0056779183100
10 Arie Nurmalia Sukari TK / 0 D III Bidan 0056789758100
11 Wahyu Arini Kusumaningrum TK / 0 D III Bidan 0056781145100
12 Resti Juniar Utami TK / 0 D III Bidan 0068671647100
13 Siti Romlah TK / 0 D III Perawat 0056776540100
14 Lekha Mustika TK / 0 D III Perawat 0060480362100
15 Syarifah Ilmiyati TK / 0 D III Perawat 0016598771100
16 Cholifatun Aini TK / 0 D III Perawat 0068691001100
17 Puput Rosie Angraini TK / 0 D III Perawat 0068666521100

18 Br. Moch.Ridwan Apriyandi TK / 0 D III Perawat 0058212301100
19 Ika Ermaningsih TK / 0 D III Sanitarian 0060482391100
20 Merry Rezania TK / 0 D III Fisioteraphy 0056782591100
21 Asep Yuki Herdiansyah TK / 0 D IV Rekam Medis 0073476542100
22 Salbiah TK/0 Juru Masak 0056780750101
23 Saodah TK/0 Juru Masak 0058481734101
24 AZIZAH SETIAWATI - Admin Perkantoran 0021894842100
25 FALDI CAKRA ADISURYA - Admin Perkantoran 0057924586100
26 MISMARLINA HARAHAP - Admin Perkantoran 0062655437100
27 HENDRA - Pengemudi Ambulans 0057439742100
28 BAGINDA EKO SUSANTO - Pengemudi Ambulans 0056927761100
29 SANDRA BUDIMAN - Pengaman Kantor 0056926674100
30 MARWAN - Pengaman Kantor 0066127494100
31 DJUANDA - Pengaman Kantor 0056936335100
32 RUSMANI - Cleaning Service 0056928421100
33 SUHENDAR PRASETIO - Cleaning Service 0056926119100
34 MOHAMAD JAMALUDIN - Cleaning Service 0056925708100
35 Devi Ratnasari - Cleaning Service 0073567270100
36 Ratna Rosita Dewi - Bidan PTT 0075652739100
37 Sri Rahayu Erniawati - Bidan PTT 0075653344100

Total :
Terbilang : Sembilan Puluh Enam Juta Delapan Ratus Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 0
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 34.859.658.6-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 54.557.755.3-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 24.353.239.7-015.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 67.602.639.6-411.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 66.828.091.0-411.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 66.894.375.6-411.000
Rp 2,500,000 Rp - Rp 2,500,000 68.863.115.9-411.000
Rp 2,500,000 Rp - Rp 2,500,000 34.241.218.6-411.000
Rp 2,500,000 Rp - Rp 2,500,000 36.852.683.6-411.000
Rp 2,500,000 Rp - Rp 2,500,000 44.643.335.1-402.000
Rp 2,500,000 Rp - Rp 2,500,000 74.893.504.6-403.000
Rp 2,500,000 Rp - Rp 2,500,000 45.883.986.7-418.999
Rp 2,500,000 Rp - Rp 2,500,000 36.434.930.8-411.000
Rp 2,500,000 Rp - Rp 2,500,000 70.314.939.3.411.000
Rp 2,500,000 Rp - Rp 2,500,000 74.915.165.0-448.000
Rp 2,500,000 Rp - Rp 2,500,000 72.393.001.2-411.000

Rp 2,500,000 Rp - Rp 2,500,000 66.909.189.4-419.000
Rp 2,250,000 Rp - Rp 2,250,000 55.090.388.4-531.000
Rp 2,500,000 Rp - Rp 2,500,000 45.884.988.2-411.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 1,500,000 Rp - Rp 1,500,000 45.570.583.8-411.000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 96,800,000 Rp 725,000 Rp 96,075,000


. 19780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
Tanda Tangan
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
Tanda Tangan
Januari 2017
ksana Kegiatan
PTK)

0 201001 1 009
67750000
23300000
Rp 20,300,000
TANDA TERIMA HONO
KOD
T
Puskesmas : Kampung Sawah
1 dr Nina Anggraini TK / 0 Dokter Umum 0067236807100
2 dr Fatmi Andari TK / 0 Dokter Umum 0068709687100
3 Gita Destharina TK / 0 NERS 0068654971100
4 Ahmad Rihena TK / 0 SKM 0071673588100
5 Yuni Purwatmi TK / 0 SMAK Analis 0056791728100
6 Intan Komala Dewi TK / 0 D III Bidan 0056788077100
7 Nina Puspitasari TK / 0 D III Bidan 0056789707100
8 Tuti Kristanti TK / 0 D III Bidan 0056787704100
9 Susi Rosita TK / 0 D III Bidan 0056789995100
10 Heni Safitri TK / 0 D III Bidan 0056799362100
11 Dewi Ayu Lestari Wijaya TK / 0 D III Bidan 0056791051100
12 Dessy Ria Sylviani TK / 0 D III Bidan 0068651468100
13 Arlin Apriyanto TK / 0 D III Perawat 0056777040100
14 Novi Rachmawati TK / 0 D III Perawat 0056790756100
15 Catur Pamungkas Sari TK / 0 D III Perawat 0062770678100
16 Achmad Fitroh TK / 0 D III Perawat 0056783725100
17 Nur Istikomah TK / 0 D III Perawat 0027587542100

18 Farida Larasati TK / 0 D III Sanitarian 0058238791100
19 Ayu Nurul Asriyanti TK / 0 Rekam Medis 0072476808100
20 Andi Fauzi TK / 0 Asisten Apoteker 0074075487100
21 Maryati TK/0 Juru Masak 0065657066100
22 Suryati TK/0 Juru Masak 0056790306100
23 Sumiyati - Admin Perkantoran 0057448210100
24 Farida Salam - Admin Perkantoran 0057448075100
25 Rifkoh Azizah - Admin Perkantoran 0057447885100
26 Mohamad Dali - Pengemudi Ambulans 0057448423100
27 Ari Supriatna - Pengemudi Ambulans 0065230410100
28 Deddy Permana - Pengaman Kantor 0008779910101
29 Indra Jaya - Pengaman Kantor 0056838260100
30 Firman Mustaqim - Pengaman Kantor 0056904999100
31 M. Jum'an - Pengaman Kantor 0056862595100
32 Muhamad Ubaidillah - Cleaning Service 0056880501100
33 Karlina - Cleaning Service 0056870830100
34 Rochman Firmansyah - Cleaning Service 0056857265100
35 Bahrudin - Cleaning Service 0056881271100
36 Imas Kurniasari - Bidan PTT 0062273895100
Total :
Terbilang : Delapan Puluh Empat Juta Seratus Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 74.273.518.6-453.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 08.902.088.7-523.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 70.558.885.3-416.000
Rp 2,500,000 Rp - Rp 2,500,000 76.508.682.2-411.000
Rp 2,250,000 Rp - Rp 2,250,000 45.885.402.3-411.000
Rp 2,500,000 Rp - Rp 2,500,000 46.575.002.4-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.896.277.6-402.000
Rp 2,500,000 Rp - Rp 2,500,000 45.885.542.6-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.885.454.4-411.000
Rp 2,500,000 Rp - Rp 2,500,000 46.226.521.6-528.000
Rp 2,500,000 Rp - Rp 2,500,000 34.227.935.3-411.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 45.885.581.4-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.885.616.8-411.000
Rp 2,500,000 Rp - Rp 2,500,000 71.689.660.0-416.000
Rp 2,500,000 Rp - Rp 2,500,000 36.703.944.3-416.000
Rp 2,500,000 Rp - Rp 2,500,000 44.022.443.4-416.000

Rp 2,250,000 Rp - Rp 2,250,000
Rp 2,500,000 Rp - Rp 2,500,000 97.022.213.9.421.000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,500,000 Rp - Rp 1,500,000
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 750,000 Rp - Rp 750,000
Rp 84,100,000 Rp 300,000 Rp 83,800,000


Purwanto Amd, Kep Syahlan King Syahnan Siregar, SE.

P. 19780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
Tanda Tangan
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
Tanda Tangan
n, Januari 2017
ksana Kegiatan
PPTK)

20 201001 1 009
52000000
26600000
Rp 23,600,000
TANDA TERIMA HONORAR
KEGIATAN PENYEDIAAN DAN PEM
KODE R
TAHU
Puskesmas : Paku Alam
1 drg. Dhita Hanedyawuri TK / 0 Dokter Gigi 0056787631100
2 dr. Sri Ernawati TK / 0 Dokter Umum 0056793887100
3 dr. Nuke Nurmaya Santi TK / 0 Dokter Umum 0058212245100
4 dr Kurnia Tejawati TK / 0 Dokter Umum 007238557100
5 Baytul Izzah, S.Farm.,Apt TK / 0 Apoteker 0056787305100
6 Erytharina Julianti TK / 0 NERS 0068679486100
7 Dede Yuningsih,Amd Kep TK / 0 D III Perawat 0056782478100
8 Rachma Apresiana TK / 0 D III Perawat 0056781668100
9 Hevi Hermawan,Amd Kep TK / 0 D III Perawat 0056774572100
10 Suci Lestari TK / 0 D III Perawat 0073999111100
11 Arih Candraningsih,Amd Analis TK / 0 D III Analis 0056784659100
12 Elsa Wantigarsika,Amd Keb TK / 0 D III Bidan 0056787518100
13 Hari Buntari Catur Y.Amd,Keb TK / 0 D III Bidan 0056784616100
14 Winda Rusnilayani TK / 0 D III Bidan 0068692520100
15 Ifah Latifah TK / 0 D IV Bidan 0073995000100
16 Sovi Mila TK / 0 D III Sanitarian 0065579952100
17 Yayuk Sri Rahayu TK/0 Juru Masak 0058243604100
18 Wiwin Wiarsih TK/0 Juru Masak 0056785531100
19 Maryati - Admin Perkantoran 0057441046100

20 Parida - Admin Perkantoran 0033885121100
21 Den Jaza Kurniawan - Admin Perkantoran 0063232408100
22 Desy Laras Rahmawati - Admin Perkantoran 0073871141100
23 Murdan - Pengemudi Ambulans 0057502762100
24 Debih Masyanto - Pengemudi Ambulans 0057461853101
25 Ade Rahmat - Pengaman Kantor 0056874089100
26 Nana Junaedi - Pengaman Kantor 0057503718100
27 Hendra Gunawan - Pengaman Kantor 0056833595100
28 Amir Hamzah - Pengaman Kantor 0056855483100
29 Abdul Majid - Cleaning Service 0057445750100
30 Nur Muhammad Azis - Cleaning Service 0068692938100
31 Epah Rahayu - Cleaning Service 0056839569100
32 Maryani - Cleaning Service 0059642855100
33 Afifah Ali - Bidan PTT 0075659296101
34 Eva Listiana - Bidan PTT 0064792318100
35 Lita Eka Puspita - Bidan PTT 0064792032100
Total :
Terbilang : Delapan Puluh Enam Juta Delapan Ratus Lima Puluh Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 006
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 35.526.937.4-416.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 45.938.186.9-033.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 24.145.659.9-402.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 46.106.511.2-416.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 74.912.513.4-453.000
Rp 2,500,000 Rp - Rp 2,500,000 35.656.477.3-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.892.780.3-411.000
Rp 2,500,000 Rp - Rp 2,500,000 46.095.665.9-451.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 35.656.477.3-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.877.522.8-418.000
Rp 2,500,000 Rp - Rp 2,500,000 70.004.831.7-085.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 1,500,000 Rp - Rp 1,500,000 66.861.163.5-411.000
Rp 1,500,000 Rp - Rp 1,500,000 45.893.573.1-411.000
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,900,000 Rp - Rp 1,900,000 -
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 2,150,000 Rp - Rp 2,150,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 750,000 Rp - Rp 750,000
Rp 86,850,000 Rp 600,000 Rp 86,250,000

Purwanto Amd, Kep Syahlan King Syahnan Siregar, SE.,MA

P. 19780521 201001 1 006 NIP. 19840520 201001 1 009

Tanda Tangan
10
11
12
13
14
15
16
17
18
19
Tanda Tangan
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
n, Januari 2017
aksana Kegiatan
PPTK)
ahnan Siregar, SE.,MA

Tanda Tangan
520 201001 1 009

Rp 50,000,000
29850000
Rp 50,000,000
Rp 50,000,000
TANDA TERIMA HONORARI
KODE RE
TAHUN
Puskesmas : Pondok Jagung
1 dr Dicky Hermansyah TK / 0 Dokter Umum 0058223204100
2 dr Fajar Rizkiansyah TK / 0 Dokter Umum 0059218174100
dr Ephifani Budi Ekowati Erna

3 TK / 0 Dokter Umum 0056801863100
Santosa
4 dr Reno Ar Razaq TK / 0 Dokter Umum 0075286201100
5 drg Shalfiah rahmawati putri TK / 0 Dokter Gigi 0068646405100
6 Bunga Ayudia TK / 0 Apoteker 0070712512100
7 Helmy Ridha TK / 0 NERS 0063423076100
8 Irma Samratun Najah TK / 0 SKM 0071904555100
9 Agustin Dwi Hartini TK / 0 Rekam Medis 0059901125100
10 Julaeha TK / 0 D III Perawat 0056786120100
11 Ray Evander Saragih TK / 0 D III Perawat 0056789529100
12 Melda Selvia TK / 0 D III Perawat 0068643244100
13 Uun Kumalasari TK / 0 D III Bidan 0056792538102
14 Munawati TK / 0 D III Bidan 0056779787100
15 Sri Rahmawati TK / 0 D III Bidan 0056777326100
16 Annissa Usaidah Hasyim TK / 0 D III Bidan 0056780599100
17 Ficka Indah Pratiwi TK / 0 D III Bidan 0062994843100
18 Choiru Anisa Hidayati TK / 0 D III Bidan 0073294711100

19 Dwi Agustina TK / 0 D III Bidan 0065167506100
20 Liana Putri Wulandari TK / 0 D III Gizi 0058368751100
21 Indra Septiana. Amd, Ak TK / 0 D III Sanitarian 0056776125100
22 Rimot TK/0 Juru Masak 0056789741100
23 Andy Raynaldi - Admin Perkantoran 0058520691100
24 Maya Puspita - Admin Perkantoran 0057510617100
25 Ria Andreanti - Admin Perkantoran 0063779237100
26 Ali Akbar Setiawan - Admin Perkantoran 0068705665100
27 Ayi Febriani - Admin Perkantoran 0074061095100
28 Rendi Efendi - Pengemudi Ambulans 0056790721100
29 Ryan Alhadi Fajar - Pengemudi Ambulans 0072766271100
30 Syahadi - Pengaman Kantor 0056872922100
31 Yuliantoro - Pengaman Kantor 0056876561100
32 Heri - Pengaman Kantor 0056876340100
33 M. Marjuki - Pengaman Kantor 0056875409100
34 Sri Komala - Cleaning Service 0056869344100
35 Ahmad Hidayat - Cleaning Service 0056874704100
36 Asep - Cleaning Service 0056878335100
37 Nana Suryana - Cleaning Service 0071640728100
38 Leni Maryanti - Bidan PTT 0075632010100
Total :
Terbilang : Seratus Juta Seratus Lima Puluh Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 006
ANDA TERIMA HONORARIUM PEGAWAI HONORER/TIDAK TETAP
PENYEDIAAN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Rp 5,500,000 Rp 125,000 Rp 5,375,000 66.861.749.1-418.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 54.558.447.6-402.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 54.601.849.0-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 72.539.998.4-411.000
Rp 5,500,000 Rp 125,000 Rp 5,375,000 70.544.974.2-0856.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 76.059.956.3-448.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 72.194.644.0.402.000
Rp 2,500,000 Rp - Rp 2,500,000 73.399.648.2-411.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 68.894.521.1-451.999
Rp 2,500,000 Rp - Rp 2,500,000 45.897.916.8-418.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 45.884.477.6-402.000
Rp 2,500,000 Rp - Rp 2,500,000 45.881.686.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 34.700.282.6-411.000
Rp 2,500,000 Rp - Rp 2,500,000 45.881.686.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 72.219.865.2.416.000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000 73.206.450.6-411.000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 2,250,000 Rp - Rp 2,250,000 45.882.197.2-421.000
Rp 1,500,000 Rp - Rp 1,500,000 66.897.848.9.411.000
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,150,000 Rp - Rp 2,150,000
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000
Rp 750,000 Rp - Rp 750,000
Rp 100,150,000 Rp 725,000 Rp 99,425,000


rwanto Amd, Kep Syahlan King Syahnan Siregar, SE.,MA

9780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
18
Tanda Tangan
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
Tanda Tangan
Januari 2017
a Kegiatan
)
n Siregar, SE.,MA
01001 1 009
Rp 63,000,000
29400000
Rp 63,000,000
Rp 63,000,000
TAHUN ANGGARAN 2017
Puskesmas : Jurang Mangu
No Nama Status Profesi No Rekening Honor Pph 21 Terima NPWP
1 dr.Meiriyana Dauries F TK / 0 Dokter Umum 0056791930100 Rp 5,500,000 Rp 125,000 Rp 5,375,000 45.892.504.7-411.000
2 dr. Helmi Dwi Kurniawan TK / 0 Dokter Umum 0056788433100 Rp 5,500,000 Rp 125,000 Rp 5,375,000 46.069.708.9-516.000
3 dr Yunita Pangestuti TK / 0 Dokter Umum 0065530287100 Rp 5,500,000 Rp 125,000 Rp 5,375,000 64.110.532.5-411.000
4 Ita Melda Santi TK / 0 NERS 0068643473100 Rp 4,000,000 Rp 50,000 Rp 3,950,000 45.891.067.6-416.000
5 Nurhasanah,A.Md.Kep TK / 0 D III Perawat 0056793305100 Rp 2,500,000 Rp - Rp 2,500,000 45.932.846.4-416.000
6 Tri Yuliyanto.Amd.Kep TK / 0 D III Perawat 0056793658100 Rp 2,500,000 Rp - Rp 2,500,000 45.894.926.0-411.000
7 Anggi Dewi A TK / 0 D III Perawat 0068710146100 Rp 2,500,000 Rp - Rp 2,500,000 14.367.720.1-439.000
8 Siti Nurholifah TK / 0 D III Bidan 0056789162100 Rp 2,500,000 Rp - Rp 2,500,000 54.056.949.8-418.000
9 Fitri Afriyanti,A.Md.Keb TK / 0 D III Bidan 0056792058100 Rp 2,500,000 Rp - Rp 2,500,000 44.970.647.2-401.000
10 Lisna Andriyani TK / 0 D III Bidan 0065051702100 Rp 2,500,000 Rp - Rp 2,500,000 73.135.121.9-416.000
11 Dyna Fairuz Maharani TK / 0 D III Sanitarian 0069976451100 Rp 2,250,000 Rp - Rp 2,250,000 45.460.680.7.411.000
12 Teguh Setyo Nugroho TK / 0 D III Analis 0064642340100 Rp 2,500,000 Rp - Rp 2,500,000 54.570.709.3.432.000
13 Sudarini TK/0 Juru masak 0056790225100 Rp 1,500,000 Rp - Rp 1,500,000
14 Ely Setiawati TK/0 Juru masak 0058204986100 Rp 1,500,000 Rp - Rp 1,500,000

15 Dhandy Mahendra, SE - Admin Perkantoran 0057424281100 Rp 2,150,000 Rp - Rp 2,150,000 -
16 Triyas Sakdiah - Admin Perkantoran 0062301635100 Rp 1,700,000 Rp - Rp 1,700,000 -
17 Octriana Kemala Sari - Admin Perkantoran 0057434521100 Rp 1,700,000 Rp - Rp 1,700,000 -
18 M. Ajim Jamhari - Admin Perkantoran 0057487038100 Rp 1,900,000 Rp - Rp 1,900,000 -
19 Sabarudin - Pengemudi Ambulans 0057487623100 Rp 1,750,000 Rp - Rp 1,750,000 -
20 Hari Rochimat - Pengemudi Ambulans 0057435003100 Rp 1,750,000 Rp - Rp 1,750,000 -
21 Sarwani - Pengaman Kantor 0056952454100 Rp 2,000,000 Rp - Rp 2,000,000 -
22 Abdillah - Pengaman Kantor 0056936076100 Rp 2,000,000 Rp - Rp 2,000,000 -
23 Miskat - Pengaman Kantor 0056952810100 Rp 2,000,000 Rp - Rp 2,000,000 -
24 Resnawati - Cleaning Service 0056952985100 Rp 1,750,000 Rp - Rp 1,750,000 -
25 Jasir - Cleaning Service 0056949690100 Rp 1,750,000 Rp - Rp 1,750,000 -
26 Nurmansyah - Cleaning Service 0061778268100 Rp 1,750,000 Rp - Rp 1,750,000 -
27 Adiman - Cleaning Service 0071410668100 Rp 1,750,000 Rp - Rp 1,750,000 -

28 Novi Gunanti - Bidan PTT 0075650604100 Rp 750,000 Rp - Rp 750,000
29 Trinawang Wulan - Bidan PTT 0075682301100 Rp 750,000 Rp - Rp 750,000
Total : Rp 68,700,000 Rp 425,000 Rp 68,275,000
Terbilang : Enam Puluh Delapan Juta Tujuh Ratus Ribu Rupiah
Mengetahui Lunas dibayar Pejabat Pelaksana Kegiatan

Pengguna Anggaran Bendahara Pengeluaran (PPTK)
Hj. Listya Windyarti, S. Sos., M. KM Purwanto Amd, Kep Syahlan King Syahnan Siregar, SE.,MA
NIP. 196001021980032001
NIP. 19780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
2
40250000
3
26950000
10
11
12
13
14
Tanda Tangan
15
16
17
18
19
Rp 22,200,000
20
21
22
23
24
25
26
27
Tanda Tangan
28
29
latan, Januari 2017
Pelaksana Kegiatan
(PPTK)
Syahnan Siregar, SE.,MA

40520 201001 1 009
TANDA TERIMA HONORA
KODE
TAH
Puskesmas : Sawah Baru
1 dr. Lies Chusnul Imamah TK / 0 Dokter Umum 0058204994101
2 dr Wiwit Afrimil TK / 0 Dokter Umum 0068157366100
3 drg. Citra Vedi Marchia TK / 0 Dokter Gigi 0058307505100
4 drg Riska Yuliana TK / 0 Dokter Gigi 0071676021100
5 Rinal Gafur TK / 0 D III Perawat 0068642371100
6 Sri Ulfah TK / 0 D III Perawat 0061623868100
7 Khalida Handayani TK / 0 SI Asisten Apoteker 0065527529100
8 Oggy Antarini TK / 0 SI Gizi 0065527308100
9 Ayu Nilam Sari TK / 0 D IV Bidan 0056799044100
10 Kundari TK / 0 D III Bidan 0068651581100
11 Mella Tri Afianty TK / 0 D III Bidan 0068645735100
12 Nina Nurhayani TK / 0 D III Bidan 0068666694101
13 M.Oetomo Amd Ak TK / 0 Analis 0074191770100
D III Kesehatan
14 Yusnita Agustini TK / 0 0058667315100
Lingkungan
15 Juliana Artha Panjaitan - Tenaga Administrasi 0068657954100
16 Delia Noviyanti - Tenaga Administrasi 0068661358100
17 Tri Hapsari Puspaningrum, S.Pd - Tenaga Administrasi 0057467258100
18 Adit Oky Ipsal Supir Ambulans 0073763649100

19 Sulaiman - Pengaman Kantor 0068740320100
20 Supriatna - Pengaman Kantor 0068993709100
21 Dawam - Pengaman Kantor 0069616186100
22 Asya Muhayar - Pengaman Kantor 0069990940100
23 Nur Arifin - Cleaning Service 0068939811100
24 Rosliah - Cleaning Service 0068751128100
Total :
Terbilang : Enam Puluh Lima Juta Tujuh Ratus Lima Puluh Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 006
AN PENYEDIAAN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Honor Pph 21 Terima
Rp 5,500,000 Rp 125,000 Rp 5,375,000
Rp 5,500,000 Rp 125,000 Rp 5,375,000
Rp 5,500,000 Rp 125,000 Rp 5,375,000
Rp 5,500,000 Rp 125,000 Rp 5,375,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,500,000 Rp - Rp 2,500,000
Rp 2,250,000 Rp - Rp 2,250,000
Rp 2,150,000 Rp - Rp 2,150,000
Rp 1,700,000 Rp - Rp 1,700,000
Rp 2,150,000 Rp - Rp 2,150,000
Rp 1,750,000 Rp - Rp 1,750,000
Honor Pph 21 Terima
Rp 2,000,000 Rp - Rp 2,000,000
Rp 2,000,000 Rp - Rp 2,000,000
Rp 2,000,000 Rp - Rp 2,000,000
Rp 2,000,000 Rp - Rp 2,000,000
Rp 1,750,000 Rp - Rp 1,750,000
Rp 1,750,000 Rp - Rp 1,750,000
Rp 65,750,000 Rp 500,000 Rp 65,250,000

dahara Pengeluaran (PPTK)
urwanto Amd, Kep Syahlan King Syahnan Siregar, SE.,

19780521 201001 1 006 NIP. 19840520 201001 1 009
NPWP Tanda Tangan
58.468.375.9-411.001 1
73.372.377.9-2004.000 2
44.972.853.4-017.000 3
35.645.657.4-439.000 4
46.595.999.7.325.000 5
73.379.209.7-411.000 7
73.378.324.5-411.000 8
45.892.403.2-411.000 9
74.898.703.9-453.000 10
11
74.894.120.0.406.000 12
13
14
- 15
- 16
- 17
18
NPWP Tanda Tangan
- 19
20
21
22
23
- 24

(PPTK)

NIP. 19840520 201001 1 009
44250000
19250000
TAHUN ANGGARAN 2017
Puskesmas : Bambu Apus
1 Robby Irlando - Pengaman Kantor 0075217031100 Rp 2,000,000 Rp -
2 Ade Abdullah - Pengaman Kantor 0075299419100 Rp 2,000,000 Rp -
3 Rizki Aditiya - Pengaman Kantor 0075618816100 Rp 2,000,000 Rp -
4 Muhamad Sofyan - Pengaman Kantor 0075626703100 Rp 2,000,000 Rp -
Total : Rp 8,000,000 Rp -
Terbilang : Delapan Juta Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 006
RER/TIDAK TETAP
DAN JASA PERKANTORAN
2
Rp 2,000,000 1
Rp 2,000,000 2
Rp 2,000,000 3
Rp 2,000,000 4
Rp 8,000,000

(PPTK)

NIP. 19840520 201001 1 009
TAHUN ANGGARAN 2017
Puskesmas : Pondok Cabe Ilir
1 Suryadi - Pengaman Kantor 0074820298100 Rp 2,000,000 Rp -
2 Ma'mun - Pengaman Kantor 0074820484100 Rp 2,000,000 Rp -
3 Jaelani - Pengaman Kantor 0075324103100 Rp 2,000,000 Rp -
4 Bahtiar - Pengaman Kantor 0075324448100 Rp 2,000,000 Rp -
Total : Rp 8,000,000 Rp -


NIP. 196001021980032001
NIP. 19780521 201001 1 006
RER/TIDAK TETAP
2
Rp 2,000,000
Rp 2,000,000
Rp 2,000,000
Rp 2,000,000
Rp 8,000,000

(PPTK)

NIP. 19840520 201001 1 009
TAHUN ANGGARAN 2017
Puskesmas : Lengkong Wetan
1 Subur - Pengaman Kantor 0074710530100 Rp 2,000,000 Rp -
2 Budian - Pengaman Kantor 0074984649100 Rp 2,000,000 Rp -
3 Muhammad Yusup Bo'ing - Pengaman Kantor 0014622187100 Rp 2,000,000 Rp -
4 Aditya Ramadhan - Pengaman Kantor 0074711456100 Rp 2,000,000 Rp -
Total : Rp 8,000,000 Rp -


NIP. 196001021980032001
NIP. 19780521 201001 1 006
RER/TIDAK TETAP
2
Rp 2,000,000
Rp 2,000,000
Rp 2,000,000
Rp 2,000,000
Rp 8,000,000

(PPTK)

NIP. 19840520 201001 1 009
TANDA TERIMA HONORA
KODE R
TAHU
UPT Farmasi
1 Fitriyani S Farm Apt TK / 0 Apoteker 0068673895100
SI Farmasi (Asisten
2 Subur Rosmawati TK / 0 0058218871100
Apoteker)
SI Farmasi (Asisten
3 Sheta Erfiandari TK / 0 0065545438100
Apoteker)
4 Yeyen Suryani, S.T - Admin Perkantoran 0057469188100
5 Heri Hidayat - Admin Perkantoran 0063210560100
6 Jhon Wills Mailano - Admin Perkantoran 0057495561100
7 Kamaludin - Admin Perkantoran 0057494840100
8 Sutrisno - Admin Perkantoran 0063051462100
9 SYIFA FAUZIYAH - Admin Perkantoran 0068653436100
10 Badarudin - Sopir Mobil Operasional 0063059536100
11 Burhanudin - Pengaman Kantor 0057499915100
12 Dedi Susanto - Pengaman Kantor 0069022316100
13 Ismail - Pengaman Kantor 0069332374100
14 Farid Adam - Pengaman Kantor 0069369421100
15 Kamaliah - Cleaning Service 0057493429100
16 Mustopa - Cleaning Service 0056944699100
Total :
Terbilang : Tiga Puluh Dua Juta Enam Ratus Lima Puluh Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 006
TAN PENYEDIAAN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Rp 4,000,000 Rp 50,000 Rp 3,950,000 25.065.152.8-411.000
Rp 2,250,000 Rp - Rp 2,250,000 55.894.805.5-402.000
Rp 2,250,000 Rp - Rp 2,250,000 49.681.459.1-036.000
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 32,650,000 Rp 50,000 Rp 32,600,000



P. 19780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
1
6250000
2
24150000
10
11
12
13
14
15
16
Tanda Tangan
Januari 2017
na Kegiatan
K)
n Siregar, SE.,MA
01001 1 009
Rp 22,400,000
TANDA TERIMA HONORA
KODE R
TAHU
UPT Labkesda
dr. Veronica Nunuk Dokter Dengan Keahlian

1 TK / 0 0057560681100
Kartika Dewi, M. Biomed Khusus
2 dr. Johannis Jacob Kalay K/5 Dokter Umum 0057560452100
Guntur Lidaroni,
3 TK / 0 NERS 0056786147100
S.Kep,.Ns.
4 Nasti Susanti TK / 0 Analis Mikrobiologi 0056780823100
5 Unthi Sari Dwiastuti TK / 0 Analis Mikrobiologi 0056780769100
Waode Syafitri Mariani,

6 TK / 0 Analis Kesmas 0056779841100
S.Si
7 Fadil Ramadhan TK / 0 Analis Kesehatan 0062800151100
8 Entus Sutisna - Admin Perkantoran 0057439629100
9 Riki Ramdani - Admin Perkantoran 0057439904100
10 Redha Nurul Huda - Admin Perkantoran 0057500034100
11 Tiara Sundari - Admin Perkantoran 0063154458100
12 Murtalih - Pengaman Kantor 0056905294100
13 Achmad Yadi - Pengaman Kantor 0056874283100
14 Rendy Noviandy - Pengaman Kantor 0056876960100
15 Nurhidayat - Pengaman Kantor 0056881379100
16 Nenih - Cleaning Service 0056863532100
17 Darwis - Cleaning Service 0056862862100
Total :
Terbilang : Empat Puluh Empat Juta Dua Ratus Lima Puluh Ribu Rupiah


NIP. 196001021980032001
NIP. 19780521 201001 1 006
TAN PENYEDIAAN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN
TAHUN ANGGARAN 2017
Rp 6,000,000 Rp 150,000 Rp 5,850,000 59.495.616.1-407.000
Rp 5,500,000 Rp 75,000 Rp 5,425,000 59.495.616.1-407.000
Rp 4,000,000 Rp 50,000 Rp 3,950,000 66.754.132.0-411.000
Rp 2,500,000 Rp - Rp 2,500,000 54.085.329.8-411.000
Rp 2,500,000 Rp - Rp 2,500,000 36.957.143.5-411.000
Rp 2,500,000 Rp - Rp 2,500,000 35.057.504.9-416.000
Rp 2,500,000 Rp - Rp 2,500,000 97.382.809.8-425.000
Rp 2,150,000 Rp - Rp 2,150,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 1,700,000 Rp - Rp 1,700,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 2,000,000 Rp - Rp 2,000,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 1,750,000 Rp - Rp 1,750,000 -
Rp 44,250,000 Rp 275,000 Rp 43,975,000



P. 19780521 201001 1 006 NIP. 19840520 201001 1 009
Tanda Tangan
10
11
12
13
14
15
16
17
Tanda Tangan
Januari 2017
na Kegiatan
K)
n Siregar, SE.,MA
01001 1 009
Rp 25,500,000
Rp 18,750,000
Rp 18,750,000

1.Ttd Honor TKS Januari 2017

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TANDA TERIMA HONORARIUM PEGAWAI HONORER/TIDAK TETAP

KEGIATAN PENYEDIAAN DAN PEMELIHARAAN BARANG DAN JASA PERKANTORAN

No Nama Status Profesi No Rekening Honor Pph 21

1 dr. Tanty Riyanti TK / 0 Dokter Umum 0056782176101 Rp 5,500,000 Rp 125,000

2 dr. Edna Fauziah. S TK / 0 Dokter Umum 0062662425100 Rp 5,500,000 Rp 125,000

3 dr. Anniesha Friezshia TK / 0 Dokter Umum 0056783644100 Rp 5,500,000 Rp 125,000

4 dr. Heru Indrawan K/0 Dokter Umum 0060479895100 Rp 5,500,000 Rp 112,500

5 dr. Sandra TK / 0 Dokter Umum 0062677546100 Rp 5,500,000 Rp 125,000

6 Marni Susanti, S.Si, Apt TK / 0 Apoteker 0014871713100 Rp 4,000,000 Rp 50,000

7 David Adam TK / 0 NERS 0064626957100 Rp 4,000,000 Rp 50,000

8 Firmansyah TK / 0 NERS 0069566189100 Rp 4,000,000 Rp 60,000

9 Ria Syukriawati,SKM TK / 0 SKM 0056787208100 Rp 2,500,000 Rp -

10 Nur Indah Pratiwi,SKM TK / 0 SKM 0064689266100 Rp 2,500,000 Rp -

11 Apriyani,SKM TK / 0 SKM 0065527847100 Rp 2,500,000 Rp -

12 Darozatun Nisa,SKM TK / 0 SKM 0065659441100 Rp 2,500,000 Rp -

13 Sarani, SKM K/2 SKM 0056774696100 Rp 2,500,000 Rp -

Siti Pipit Nurzeha Puspa

15 Andini Hendrawati, SKM TK / 0 SKM 0057443340100 Rp 2,500,000 Rp -

16 Yusi Syamisa Cassandra, SKM TK / 0 SKM 0056783709100 Rp 2,500,000 Rp -

17 Putry Septy Lestary, SKM TK / 0 SKM 0056783946100 Rp 2,500,000 Rp -

Julyta Nurlenawati Sari Sinta Uli

19 Laila Romlah TK / 0 SKM 0069572571100 Rp 2,500,000 Rp -

20 Laila Masturina TK / 0 SKM 0071671941100 Rp 2,500,000 Rp -

21 Raenanda Rifani,Amd Keb TK / 0 D III Bidan 0063422002100 Rp 2,500,000 Rp -

22 Anisa Maharani,Amd Keb TK / 0 D III Bidan 0060697620100 Rp 2,500,000 Rp -

23 Uswatun Hasanah,Amd Keb TK / 0 D III Bidan 0068669375100 Rp 2,500,000 Rp -

24 Elviyani,Amd Keb TK / 0 D III Bidan 0063836214100 Rp 2,500,000 Rp -

25 Atikah TK / 0 D III Bidan 0056773525100 Rp 2,500,000 Rp -

26 Eva Lestari TK / 0 D III Bidan 0063531782100 Rp 2,500,000 Rp -

27 Wayan Winasari TK / 0 D III Bidan 0072337883100 Rp 2,500,000 Rp -

28 Amalia Yuniarti TK / 0 SI Perawat 0068711789100 Rp 2,500,000 Rp -

29 Erwin Herdian Firmansyah S, kep TK / 0 SI Perawat 0056792831100 Rp 2,500,000 Rp -

30 Veliddita Rustianingrum TK / 0 SI Perawat 0059220284100 Rp 2,500,000 Rp -

31 Ricka Sulistiani TK / 0 SI Perawat 0025374010100 Rp 2,500,000 Rp -

32 Hendra Hartini TK / 0 D III Perawat 0062667591100 Rp 2,500,000 Rp -

33 Dendy Dwi Prawira TK / 0 D III Perawat 0063267961100 Rp 2,500,000 Rp -

34 Muhammad Rizal TK / 0 D III Perawat 0056791590100 Rp 2,500,000 Rp -

35 Supriyadi, Amd. Kep TK / 0 D III Perawat 0056111883101 Rp 2,500,000 Rp -

36 Fian Yusti Prsara, Amd. Kep TK / 0 D III Perawat 0056785116100 Rp 2,500,000 Rp -

37 Siti Nurkhairani,A.Md.Kep TK / 0 D III Perawat 0009851704100 Rp 2,500,000 Rp -

38 Hendra Saputra K/2 SPK Perawat 0021810800100 Rp 2,250,000 Rp -

39 Dian Nurlina TK / 0 SPK Perawat 0056785167100 Rp 2,250,000 Rp -

40 Tasman K/2 SPK Perawat 0056789936100 Rp 2,250,000 Rp -

41 M. Sirojudin TK / 0 D III Sanitarian 0056795510100 Rp 2,250,000 Rp -

42 Ikhsan Gustiana TK / 0 D III Sanitarian 0064722689100 Rp 2,250,000 Rp -

43 Saeful Nazar TK / 0 D III Sanitarian 0056792155100 Rp 2,250,000 Rp -

44 Rudy, S.Sos.I - Tenaga Administrasi 0009112146100 Rp 2,150,000 Rp -

45 Muhamad Irsad, SE - Tenaga Administrasi 0057442581100 Rp 2,150,000 Rp -

46 R. Yoga Premadha - Tenaga Administrasi 0057420766100 Rp 2,150,000 Rp -

47 Ajat Sudrajat, S.Kom - Tenaga Administrasi 0027316621100 Rp 2,150,000 Rp -

48 Iwan Haryanto - Tenaga Administrasi 0057012811100 Rp 2,150,000 Rp -

49 Listya Rahmadian, S. Ikom - Tenaga Administrasi 0066376613100 Rp 2,150,000 Rp -

50 Iin Pardilla, SE - Tenaga Administrasi 0057420138102 Rp 2,150,000 Rp -

51 Kristiyanti Hadiwiguno, S. Kom - Tenaga Administrasi 0057430605100 Rp 2,150,000 Rp -

52 Agus Sutiyanto, SE - Tenaga Administrasi 0056807160100 Rp 2,150,000 Rp -

53 Putra Satria Hardika - Tenaga Administrasi 0069376894100 Rp 2,150,000 Rp -

54 Andika Kusuma Putra, ST - Tenaga Administrasi 0070493683100 Rp 2,150,000 Rp -

55 Winda Oktarina Putri, SE - Tenaga Administrasi 0068879299100 Rp 2,150,000 Rp -

56 Saffana Profita Destian, S. Kom - Tenaga Administrasi 0068679621100 Rp 2,150,000 Rp -

57 Dina Handayani - Tenaga Administrasi 0068666708100 Rp 2,150,000 Rp -

58 Rima Safria Tuhulaula, S. Sy - Tenaga Administrasi 0068632323100 Rp 2,150,000 Rp -

59 Grevia Anggesti Putri - Tenaga Administrasi 0068920787100 Rp 2,150,000 Rp -

60 Dita Triastuti, SE - Tenaga Administrasi 0070148161100 Rp 2,150,000 Rp -

61 Muhamad Kiromi - Tenaga Administrasi 0057428740100 Rp 2,150,000 Rp -