REPORTE DE SERVICIOS POR TRASLADO APROBADO CERRADO

COMPONENTE: SUBSIDIADO

Periodo Calendario: ABRIL/2016

DISA: 340 DISA UCAYALI

Fecha de Impresion : 15/04/2016 01:35:21p.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

0950 REGION UCAYALI - SALUD

1 340-15-01899875 ALEJO DAZA LETISIA 20 340-2-48604749 28/09/2015 250302A202 250105A101 0.00 0.00 70.20 0.00 70.20
2 340-15-02032252 AREVALO ALEGRIA HILARIO 57 340-2-40365274 05/12/2015 250101A319 250105A101 0.00 140.00 140.40 0.00 280.40
3 340-15-01900321 ARIRUA ARIMUYA CLARA ROCIO 35 340-2-80142524 20/10/2015 250302A202 250105A101 0.00 0.00 70.20 0.00 70.20
4 340-15-01898491 ESPEJO MOZOMBITE CLORINDA 15 340-2-76739459 27/09/2015 250302A202 250105A101 0.00 0.00 70.20 0.00 70.20
5 340-15-00904894 GAGO MILLAN SABINA PAULA 42 340-2-00116718 14/10/2015 250302A202 250105A101 0.00 0.00 70.20 0.00 70.20
6 340-15-00906309 GOMEZ INUMA NESY KENIA 17 340-2-62908174 19/09/2015 250104A313 250101A101 0.00 112.00 1,287.00 0.00 1,399.00
7 340-15-01853298 GUERRA SUAREZ MARCO ANTONIO 48 340-2-09913538 15/10/2015 250101A325 250101A101 0.00 0.00 316.00 0.00 316.00
8 340-15-01899873 HUAMAN CANTARO LIZ ISABEL 16 340-2-77532274 26/10/2015 250302A202 250105A101 0.00 0.00 70.20 0.00 70.20
9 340-15-01808586 HUAMAN REYES SUSANA 25 340-2-48566140 25/09/2015 250106A302 250105A101 0.00 112.00 234.00 0.00 346.00
10 340-15-00904215 LINARES REQUEJO MARIBEL 0 340-E-27462686 14/11/2015 250302A202 250105A101 0.00 0.00 70.20 0.00 70.20
11 340-15-01872504 LOMAS CAUPER LOIDA 34 340-2-42429684 16/10/2015 250104A304 250101A101 0.00 112.00 674.35 0.00 786.35
12 340-15-01805370 MONTES MELENDEZ AYDEE 28 340-2-44342416 10/11/2015 250401A201 250101A101 0.00 320.00 0.00 0.00 320.00
13 340-15-01972433 RIVERA JIPA DORISA 26 340-2-46123343 26/10/2015 250302A202 250105A101 0.00 0.00 70.20 0.00 70.20
14 340-15-01898844 RUEDA LEON LUCITH 23 340-2-47096570 22/10/2015 250302A202 250105A101 0.00 0.00 70.20 0.00 70.20
15 340-15-02062403 SANCHEZ VASQUEZ FLORENTINA 61 340-2-00057287 11/12/2015 250103A201 250101A101 0.00 0.00 962.50 0.00 962.50
16 340-15-01899221 SANDOVAL RAMIREZ ALFONSO 30 340-2-48621994 10/11/2015 250302A202 250105A101 0.00 0.00 70.20 0.00 70.20
17 340-15-00904895 SANTA CRUZ MOLOCHO NELLY ROXANA 22 340-2-48669811 29/09/2015 250302A202 250105A101 0.00 0.00 70.20 0.00 70.20
18 340-15-00906318 TENAZOA CASHU CESAR FRANCISCO 15 340-2-63257907 05/11/2015 250101A325 250101A101 0.00 0.00 316.00 0.00 316.00
19 340-15-00904900 TORRES RESPALDIZA KRISTHY EILEEN 34 340-2-41867571 10/10/2015 250302A202 250105A101 0.00 0.00 70.20 0.00 70.20
20 340-15-01872521 VALDIVIA ZUMBA KEYLA KAYNA 19 340-2-75733199 10/10/2015 250104A320 250101A101 0.00 112.00 195.50 0.00 307.50
21 340-15-01872520 VARGAS MACEDO NIRTA MARIA 24 340-2-61201729 28/10/2015 250101A318 250105A101 0.00 112.00 354.00 0.00 466.00
22 340-15-01852286 VENTURA ROMAINA JHEYSON PATRICIO 1 340-2-80903255 26/11/2015 250103A302 250101A101 0.00 0.00 1,098.08 0.00 1,098.08

7,370.03

Total: general: 0.00 1,020.00 6,350.03 0.00 7,370.03

Elaborado por OIE-SIS Página 1 de 1