KAPITASI 10,000

SUSULAN
NON KAPITASI
TOTAL PENDAPATAN BLUD 10,000
JASPEL 60% 6,000 -

MASA BEBAN
NO NAMA JABATAN PENDIDIKAN JABATAN STATUS
KERJA KERJA
1 HANI HARIRI, S.Kep.Ners.MM.Kes 100 150 10 350
2 ENGKOS KOSWARA 50 60 20 350
3 Dr. SRI NURHAYATI 150 25 5 350
4 Dr. EVA NURSANTY 150 0 0 350
5 H. DEDI SWARDIMAN, S.Kep 80 25 25 350
6 NURHAYATI, S.Kep. 80 0 25 350
7 Hj. YOYOH ROKAYAH, AMKeb. 60 0 25 350
8 Hj.N.SITI NURYAMAH, AM.Keb. 60 0 25 350
9 Hj. NINA TURNANINGSIH, SKM.STrKeb 60 0 25 350
10 N. ERNI NURLIZA, S.ST 80 0 20 350
11 EUIS AISYAH MARGO 50 0 25 350
12 EMMA WAHYUNI, AMG 60 0 20 350
13 PEPPI ZULFIAN Y, Sfarm.Apt. 100 50 5 350
14 ELIS SULASTRI, AM.Keb 60 0 20 350
15 IIP SUMIYATI, SKM 80 0 5 350
16 JAJANG SUPYADIN.N 25 0 25 350
17 NINA KUSUFIAWATI, AM.Keb 60 0 10 350
18 RENI INAYATI, AMKG 60 0 15 350
19 ELIS MULYATI, AMKeb. 60 0 10 350
20 Hj. MIMIN ST. SUMINAR, AMKeb. 80 0 10 350
21 EUIS TRIYANI M., AMKeb. 60 0 10 350
22 H. YUSUP MULYANA, S.Kep.Ners. 100 0 5 350
23 ENENG RENI MARLIANI, S.Kep.Ners. 100 0 5 350
24 TATANG, S.Kep.Ners 100 50 5 350
25 HASTUTI NURHAENI, AMK. 60 0 5 350
26 TITA HERLINA, AM.Keb 60 0 10 350
27 CAHYA HASBUNA, AMK 60 25 5 350
28 SHELMA NABYILA, AM.Keb 60 0 0 350
29 NENENG NURLELA, AM.Keb 60 0 0 350
30 WITRI, AM.Keb 60 0 0 350
31 REGINA PURNAMA, AM.Keb 60 25 0 350
 MASA BEBAN
NO NAMA JABATAN PENDIDIKAN JABATAN STATUS
KERJA KERJA
1 Drg. ERLIN CHARSELINA 150 0 0 250
2 DONI ROMDONI, A.Md.Kep. 60 0 0 50
3 BEBEN BAHTIAR, S.Kep 80 0 0 50
4 ASEP JAYA SARKOSIH, S.Kep.Ners 80 0 0 50
5 RIZAL AMANATI, S.Kep 80 0 0 50
6 KRIMAR ARDIAN, Amd.Kep 80 0 0 50
7 AGUNG MUHARAM, S.Kep.Ners 80 0 0 50
8 JENAL MUTTAKIN, S.Kep.Ners 80 0 0 50
9 HEDI TEJA, AMK 60 0 0 50
10 ISMA ABDULLAH, S.Kep 80 0 0 50
11 SITI NURFAJAR, S.Kep 80 0 0 50
12 MUTIA SIFA FAUZIAH, S.Kep 80 0 0 50
13 RISMA NOVALIA, AMK 60 0 0 50
14 ERINA SW, AM.Keb 60 0 0 50
15 DIAN PANDINI, AM.Keb 60 0 0 50
16 HANI ROHIMAH, AM.Keb 60 0 0 50
17 RINA HERLINA, AM.Keb 60 0 0 50
18 SRI WULAN R, AMKeb. 60 0 0 50
19 DIAN KAMILAH, AM.Keb 60 0 0 50
20 EUIS HERAWATI, AM.Keb 60 0 0 50
21 SARAH SRI DAMAYANTI, AM.Keb 60 0 0 50
22 AI RINA ROSDIANA, AM.Keb 60 0 0 50
23 HESTINA ZANUARASWATI 50 0 0 50
24 CHINTIYA FEBRIYANI, AM.Keb 60 0 0 50
25 AMALIA, AM.Keb 60 0 0 50
26 CITRA AULIYA, AM.Keb 60 0 0 50
27 CINDY LESTARI, AMKG 60 0 0 50
28 DELIS HANA NURMULYANI 60 0 0 50
29 EVA SOFIAH 50 0 0 50
30 ANISAH IMANIARTI, AMKeb. 60 0 0 50
31 NURAENI SAFITRI 25 0 0 50
32 RINI 25 0 0 50
33 YANA 25 0 0 50
34 ASEP SARIPUDIN 25 0 0 50
35 DEMON 25 0 0 50
TOTAL % KEHADIRAN TOTAL JASPEL
POIN HADIR H. KERJA POIN POIN DITERIMA
610 26 26 1.0 610 232
480 26 26 1.0 480 182
530 26 26 1.0 530 201
500 26 26 1.0 500 190
480 26 26 1.0 480 182
455 26 26 1.0 455 173
435 20 26 0.8 335 127
435 20 26 0.8 335 127
435 26 26 1.0 435 165
450 26 26 1.0 450 171
425 26 26 1.0 425 162
430 26 26 1.0 430 163
505 26 26 1.0 505 192
430 20 26 0.8 331 126
435 2 26 0.1 33 13
400 26 26 1.0 400 152
420 2 26 0.1 32 12
425 26 26 1.0 425 162
420 20 26 0.8 323 123
440 26 26 1.0 440 167
420 20 26 0.8 323 123
455 26 26 1.0 455 173
455 26 26 1.0 455 173
505 26 26 1.0 505 192
415 26 26 1.0 415 158
420 20 26 0.8 323 123
440 26 26 1.0 440 167
410 26 26 1.0 410 156
410 26 26 1.0 410 156
410 20 26 0.8 315 120
435 26 26 1.0 435 165
4,728
TOTAL % KEHADIRAN TOTAL JASPEL
POIN HADIR H. KERJA POIN POIN DITERIMA
400 14 26 0.5 215 82
110 20 26 0.8 85 32
130 20 26 0.8 100 38
130 20 26 0.8 100 38
130 20 26 0.8 100 38
130 20 26 0.8 100 38
130 20 26 0.8 100 38
130 20 26 0.8 100 38
110 20 26 0.8 85 32
130 20 26 0.8 100 38
130 20 26 0.8 100 38
130 20 26 0.8 100 38
110 20 26 0.8 85 32
110 20 26 0.8 85 32
110 20 26 0.8 85 32
110 20 26 0.8 85 32
110 20 26 0.8 85 32
110 20 26 0.8 85 32
110 20 26 0.8 85 32
110 20 26 0.8 85 32
110 20 26 0.8 85 32
110 20 26 0.8 85 32
100 26 26 1.0 100 38
110 26 26 1.0 110 42
110 26 26 1.0 110 42
110 26 26 1.0 110 42
110 26 26 1.0 110 42
110 26 26 1.0 110 42
100 26 26 1.0 100 38
110 24 26 0.9 102 39
75 22 26 0.8 63 24
75 26 26 1.0 75 29
75 26 26 1.0 75 29
75 26 26 1.0 75 29
75 26 26 1.0 75 29
18,040 15,786 1,272

4,728
1,272
6,000
 PENDAPATAN 14,985,100 DOKTER 25 1,461,047 1,995,000
KOP 5,994,040 GIZI 5 292,209 798,000
Jaspel 8,991,060 FARMASI 5 292,209 1,197,000
Manajemen 1,798,212 LAB - - 239,400
Penyeimbang 1,348,659 DAFTAR 3 175,326 179,550
Pelaksana 5,844,189 KOOR 2 116,884 778,050
PERUJUK - -
PERAWAT 60 4,793,708

100 7,131,384

DTP
NO NAMA JABATAN
Manaj Imbang Pelaksana Manaj
1 HANI HARIRI, S.Kep.Ners.MM.Kes 539,464 20,749 71,820
2 ENGKOS KOSWARA 359,642 20,749 47,880
3 Dr. SRI NURHAYATI 89,911 20,749 50 847,407 11,970
4 Dr. EVA NURSANTY 20,749 50 730,524
5 H. DEDI SWARDIMAN, S.Kep 89,911 20,749 11,970
6 NURHAYATI, S.Kep. 20,749 16 274,908
7 Hj. YOYOH ROKAYAH, AMKeb. 20,749
8 Hj.N.SITI NURYAMAH, AM.Keb. 20,749
9 NINA TURNANINGSIH, SKM.STrKeb 20,749
10 N. ERNI NURLIZA, S.ST 20,749
11 EUIS AISYAH MARGO 20,749 30 87,663
12 EMMA WAHYUNI, AMG 20,749 75 219,157
13 PEPPI ZULFIAN Y, Sfarm.Apt. 179,821 20,749 40 116,884 23,940
14 ELIS SULASTRI, AM.Keb 20,749
15 IIP SUMIYATI, SKM
16 JAJANG SUPYADIN.N 20,749
17 NINA KUSUFIAWATI, AM.Keb
18 RENI INAYATI, AMKG 20,749
19 ELIS MULYATI, AMKeb. 20,749
20 Hj. MIMIN ST. SUMINAR, AMKeb. 20,749
21 EUIS TRIYANI M., AMKeb. 20,749
22 H. YUSUP MULYANA, S.Kep.Ners. 20,749 4 68,727
23 ENENG RENI MARLIANI, S.Kep.Ners. 20,749 17 292,090
24 TATANG, S.Kep.Ners 269,732 20,749 5 85,909 35,910
25 HASTUTI NURHAENI, AMK. 20,749 15 257,726
26 TITA HERLINA, AM.Keb 20,749
27 CAHYA HASBUNA, AMK 89,911 20,749 5 85,909 11,970
28 SHELMA NABYILA, AM.Keb 20,749
29 NENENG NURLELA, AM.Keb 20,749 15 26,299
30 WITRI, AM.Keb 20,749
31 REGINA PURNAMA, AM.Keb 179,821 20,749 23,940
32 Drg. ERLIN CHARSELINA 20,749
33 DONI ROMDONI, A.Md.Kep. 20,749 4 68,727
34 BEBEN BAHTIAR, S.Kep 20,749 4 68,727
35 ASEP JAYA SARKOSIH, S.Kep.Ners 20,749 21 360,817
36 RIZAL AMANATI, S.Kep 20,749 21 360,817
37 KRIMAR ARDIAN, Amd.Kep 20,749 21 360,817
38 AGUNG MUHARAM, S.Kep.Ners 20,749 20 343,635
39 JENAL MUTTAKIN, S.Kep.Ners 20,749 20 343,635
40 HEDI TEJA, AMK 20,749 21 360,817
41 ISMA ABDULLAH, S.Kep 20,749 19 326,453
42 SITI NURFAJAR, S.Kep 20,749 22 474,428
43 MUTIA SIFA FAUZIAH, S.Kep 20,749 22 377,999
44 RISMA NOVALIA, AMK 20,749 22 377,999
45 ERINA SW, AM.Keb 20,749
46 DIAN PANDINI, AM.Keb 20,749
47 HANI ROHIMAH, AM.Keb 20,749
48 RINA HERLINA, AM.Keb 20,749
49 SRI WULAN R, AMKeb. 20,749
50 DIAN KAMILAH, AM.Keb 20,749
51 EUIS HERAWATI, AM.Keb 20,749
52 SARAH SRI DAMAYANTI, AM.Keb 20,749
53 AI RINA ROSDIANA, AM.Keb 20,749
54 HESTINA ZANUARASWATI 20,749
55 CHINTIYA FEBRIYANI, AM.Keb 20,749
56 AMALIA, AM.Keb 20,749 15 26,299
57 CITRA AULIYA, AM.Keb 20,749
58 CINDY LESTARI, AMKG 20,749
59 DELIS HANA NURMULYANI 20,749
60 EVA SOFIAH 20,749 30 87,663
61 ANISAH IMANIARTI, AMKeb. 20,749
62 NURAENI SAFITRI 20,749 15 26,299
63 AGUN 20,749
64 RINI ROAENI 20,749 25 73,052
65 YANA 20,749
66 ASEP SARIPUDIN 20,749
67 DEMON 20,749
1,798,212 1,348,659 7,131,384 239,400
OPR 50 389,025 6,102,000 DOKTER 50 1,189,890 700,000 DOKTER 50
ASS 40 311,220 2,440,800 FARMASI 10 237,978 280,000 PERAWAT 35
FARMASI 5 38,903 3,661,200 DAFTAR 3 71,393 420,000 FARMASI 10
LAB 0 - 732,240 KOORD 2 47,596 84,000 DAFTAR 3
KOOR 2 15,561 549,180 KESLING - - 63,000 KOORD 2
KESLING 0 - 2,379,780 PERAWAT 35 832,923 273,000 KESLING -
DAFTAR 3 23,342 BP 40 333,169 100
100 TB 7 58,305
MTBS 20 166,585
778,050 Konseling 33 274,865
2,379,780
IGD BP Umum GIGI
Imbang Pelaksana Manaj Imbang Pelaksana Manaj Imbang Pelaksana
2,762 219,672 8,449 25,200 969
2,762 146,448 8,449 16,800 969
2,762 36,612 8,449 50 594,945 4,200 969
2,762 8,449 50 642,541 969
2,762 36,612 8,449 30 82,459 4,200 969
2,762 8,449 969
2,762 8,449 969
2,762 8,449 969
2,762 8,449 969
2,762 8,449 969
2,762 30 11,671 8,449 30 71,393 969 30
2,762 8,449 20 54,973 969
2,762 40 15,561 73,224 8,449 40 95,191 8,400 969 40
2,762 8,449 969

2,762 8,449 969

2,762 8,449 969 60

2,762 8,449 969
2,762 8,449 969
2,762 8,449 969
2,762 100 15,561 8,449 100 58,305 969
2,762 8,449 969
2,762 109,836 8,449 12,600 969
2,762 8,449 20 54,973 969
2,762 8,449 969
2,762 36,612 8,449 30 82,459 4,200 969
2,762 8,449 969
2,762 8,449 3 23,798 969 3
2,762 8,449 969
2,762 73,224 8,449 8,400 969
2,762 8,449 969 100
2,762 8,449 969
2,762 8,449 969
2,762 8,449 969
2,762 8,449 969
 2,762 8,449 969
2,762 8,449 969
2,762 8,449 969
2,762 8,449 969
2,762 8,449 969
2,762 100 23,342 8,449 969
2,762 8,449 969
2,762 8,449 969
2,762 8,449 8 20,823 969
2,762 8,449 969
2,762 8,449 8 20,823 969
2,762 8,449 8 20,823 969
2,762 8,449 8 20,823 969
2,762 8,449 8 20,823 969
2,762 8,449 8 20,823 969
2,762 8,449 8 20,823 969
2,762 8,449 8 20,823 969
2,762 8,449 969
2,762 8,449 969
2,762 8,449 3 23,798 969 3
2,762 8,449 50 166,585 969
2,762 8,449 969 40
2,762 8,449 969
2,762 30 11,671 8,449 30 71,393 969 30
2,762 8,449 969
2,762 8,449 3 23,798 969 3
2,762 8,449 50 166,585 969
2,762 8,449 969
2,762 8,449 969
2,762 8,449 969
2,762 8,449 969
179,550 77,805 732,240 549,180 2,379,780 84,000 63,000
 136,500 420,000 DOKTER 10 16,380 3,295,000 OP LAB 60 771,030 2,150,000
95,550 168,000 BIDAN 80 131,040 1,318,000 ASS 35 449,768 860,000
27,300 252,000 FARMASI 5 8,190 1,977,000 KOORD 2 25,701 1,290,000
8,190 50,400 KOOR 2 3,276 395,400 DAFTAR 3 38,552 258,000
5,460 37,800 DAFTAR 3 4,914 296,550 PERUJUK 0 - 193,500
- 163,800 LAB - 1,285,050 KESLING 0 - 838,500
KESLING 0 - 100
PERUJUK -
100
273,000 163,800 1,285,050

KIA LAB A
Pelaksana Manaj Imbang Pelaksana Manaj Imbang Pelaksana Manaj
15,120 582 118,620 4,562 77,400
10,080 582 79,080 4,562 51,600
2,520 582 100 16,380 19,770 4,562 12,900
582 4,562
2,520 582 19,770 4,562 12,900
582 4,562
582 4,562
582 4,562
582 100 16,380 4,562
582 4,562 100 796,731
8,190 582 30 2,457 4,562
582 4,562
10,920 5,040 582 40 3,276 39,540 4,562 25,800
582 4,562

582 4,562

57,330 582 4,562

582 4,562
582 4,562
582 4,562
582 4,562
582 4,562
7,560 582 59,310 4,562 38,700
582 4,562
582 4,562
2,520 582 19,770 4,562 12,900
582 10 13,104 4,562
2,730 582 3 1,638 4,562 3 12,851
582 4,562
5,040 582 39,540 4,562 25,800
141,960 582 4,562
582 4,562
582 4,562
582 4,562
582 4,562
 582 4,562
582 4,562
582 4,562
582 4,562
582 4,562
582 4,562
582 4,562
582 4,562
582 10 13,104 4,562
582 4,562
582 10 13,104 4,562
582 10 13,104 4,562
582 10 13,104 4,562
582 10 13,104 4,562
582 10 13,104 4,562
582 10 13,104 4,562
582 10 13,104 4,562
582 4,562
582 4,562
2,730 582 3 1,638 4,562 3 12,851
582 4,562
38,220 582 4,562
582 4,562 100 449,768
8,190 582 30 2,457 4,562
582 4,562
2,730 582 3 1,638 4,562 3 12,851
582 4,562
582 4,562
582 4,562
582 4,562
582 4,562
273,000 50,400 37,800 163,800 395,400 296,550 1,285,050 258,000
OPR 70 586,950 - opr 50 - - Bides -
SOPIR 25 209,625 - bikor 5 - - Bikor -
DAFTAR 3 25,155 - gizi 5 - -
KOORD 2 16,770 - farm 5 -
- koor 2 -
- daf 3 -
rujuk 25 -
Lab 5 -
100
838,500

Ambulan Persalinan Persalinan Di Desa

Imbang Pelaksana Manaj Imbang Pelaksana Bides Bidkor
2,977 - -
2,977 - -
2,977 - -
2,977 -
2,977 - -
2,977 -
2,977 - -
2,977 -
2,977 - -
2,977 -
2,977 - -
2,977 - -
2,977 - - -
2,977 -
-
2,977 -
-
2,977 -
2,977 - -
2,977 -
2,977 -
2,977 -
2,977 -
2,977 - -
2,977 -
2,977 -
2,977 - -
2,977 -
2,977 3 8,385 - -
2,977 -
2,977 - -
2,977 -
2,977 -
2,977 -
2,977 -
2,977 -
 2,977 -
2,977 -
2,977 100 16,770 -
2,977 -
2,977 -
2,977 -
2,977 -
2,977 -
2,977 -
2,977 -
2,977 -
2,977 -
2,977 -
2,977 - -
2,977 - -
2,977 -
2,977 -
2,977 -
2,977 -
2,977 3 8,385 - -
2,977 -
2,977 -
2,977 -
2,977 - -
2,977 -
2,977 3 8,385 - -
2,977 -
2,977 -
2,977 -
2,977 -
2,977 100 209,625 -
193,500 251,550 - - -
 29,647,100
- 17,788,260
-

Pustu

1,108,345
752,580
1,677,665
1,414,114
301,392
315,958
41,050
41,050
57,430
837,781
222,424
315,180
638,647
41,050
-
41,050
-
98,380
41,050
41,050
41,050
183,642
333,140
660,606
353,749
41,050
387,301
54,154
116,750
41,050
396,815
183,010
109,777
109,777
401,867
401,867
401,867
384,685
401,455
401,867
367,503
538,819
419,048
419,048
74,977
41,050
74,977
74,977
74,977
74,977
74,977
74,977
74,977
41,050
41,050
116,750
207,634
79,270
490,817
222,424
41,050
116,750
207,634
114,102
41,050
41,050
250,675
17,788,260
 PEMBAGIAN JASA PELAYANAN PPK-BLUD UPT PUSKESMAS JAMANIS KABUPATEN TA
BULAN JANUARI TAHUN 2019
Jumlah Uang PPK-BLUD
Uang Jasa Pelayanan
Jasa Jasa Jasa Pelayanan
NO NAMA JABATAN PENDIDIKAN GOL Kapitasi Non Kapitasi Kotor ( 1 + 2 )
1 2 3
1 HANI HARIRI, S.Kep.Ners.MM.Kes 3 232 1,108,345 1,108,577

2 ENGKOS KOSWARA 3 182 752,580 752,763

3 Dr. SRI NURHAYATI 3 201 1,677,665 1,677,866

4 Dr. EVA NURSANTY 3 190 1,414,114 1,414,304

5 H. DEDI SWARDIMAN, S.Kep 4 182 301,392 301,574

6 NURHAYATI, S.Kep. 4 173 315,958 316,131

7 Hj. YOYOH ROKAYAH, AMKeb. 3 127 41,050 41,177

8 Hj.N.SITI NURYAMAH, AM.Keb. 3 127 41,050 41,177

9 Hj. NINA TURNANINGSIH, SKM.STrKeb 4 165 57,430 57,595

10 N. ERNI NURLIZA, S.ST 4 171 837,781 837,952

11 EUIS AISYAH MARGO 3 162 222,424 222,585

12 EMMA WAHYUNI, AMG 3 163 315,180 315,343

13 PEPPI ZULFIAN Y, Sfarm.Apt. 3 192 638,647 638,839

14 ELIS SULASTRI, AM.Keb 3 126 41,050 41,176

15 IIP SUMIYATI, SKM 3 13 - 13

16 JAJANG SUPYADIN.N 3 152 41,050 41,202

17 NINA KUSUFIAWATI, AM.Keb 3 12 - 12

18 RENI INAYATI, AMKG 3 162 98,380 98,541

19 ELIS MULYATI, AMKeb. 3 123 41,050 41,173

20 Hj. MIMIN ST. SUMINAR, AMKeb. 3 167 41,050 41,217

21 EUIS TRIYANI M., AMKeb. 3 123 41,050 41,173

22 H. YUSUP MULYANA, S.Kep.Ners. 3 173 183,642 183,815

23 ENENG RENI MARLIANI, S.Kep.Ners. 3 173 333,140 333,313

24 TATANG, S.Kep.Ners 3 192 660,606 660,798

25 HASTUTI NURHAENI, AMK. 3 158 353,749 353,907

26 TITA HERLINA, AM.Keb 3 123 41,050 41,173

27 CAHYA HASBUNA, AMK 2 167 387,301 387,468

28 SHELMA NABYILA, AM.Keb 2 156 54,154 54,310

29 NENENG NURLELA, AM.Keb 2 156 116,750 116,906

30 WITRI, AM.Keb 2 120 41,050 41,170

31 REGINA PURNAMA, AM.Keb 2 165 396,815 396,980

32 Drg. ERLIN CHARSELINA 82 183,010 183,092

33 DONI ROMDONI, A.Md.Kep. 32 109,777 109,809

34 BEBEN BAHTIAR, S.Kep 38 109,777 109,815

35 ASEP JAYA SARKOSIH, S.Kep.Ners 38 401,867 401,905

36 RIZAL AMANATI, S.Kep 38 401,867 401,905

37 KRIMAR ARDIAN, Amd.Kep 38 401,867 401,905

38 AGUNG MUHARAM, S.Kep.Ners 38 384,685 384,723

39 JENAL MUTTAKIN, S.Kep.Ners 38 401,455 401,493

40 HEDI TEJA, AMK 32 401,867 401,899

41 ISMA ABDULLAH, S.Kep 38 367,503 367,541

42 SITI NURFAJAR, S.Kep 38 538,819 538,857

43 MUTIA SIFA FAUZIAH, S.Kep 38 419,048 419,086

44 RISMA NOVALIA, AMK 32 419,048 419,081

45 ERINA SW, AM.Keb 32 74,977 75,009

46 DIAN PANDINI, AM.Keb 32 41,050 41,082

47 HANI ROHIMAH, AM.Keb 32 74,977 75,009

48 RINA HERLINA, AM.Keb 32 74,977 75,009

49 SRI WULAN R, AMKeb. 32 74,977 75,009

50 DIAN KAMILAH, AM.Keb 32 74,977 75,009

51 EUIS HERAWATI, AM.Keb 32 74,977 75,009

52 SARAH SRI DAMAYANTI, AM.Keb 32 74,977 75,009

53 AI RINA ROSDIANA, AM.Keb 32 74,977 75,009

54 HESTINA ZANUARASWATI 38 41,050 41,088

55 CHINTIYA FEBRIYANI, AM.Keb 42 41,050 41,092

56 AMALIA, AM.Keb 42 116,750 116,792

57 CITRA AULIYA, AM.Keb 42 207,634 207,676

58 CINDY LESTARI, AMKG 42 79,270 79,312

59 DELIS HANA NURMULYANI 42 490,817 490,859

60 EVA SOFIAH 38 222,424 222,462

61 ANISAH IMANIARTI, AMKeb. 39 41,050 41,088

62 NURAENI SAFITRI 24 116,750 116,774

63 AGUN 207,634 207,634

64 RINI ROAENI 29 114,102 114,131

65 YANA 29 41,050 41,078

66 ASEP SARIPUDIN 29 41,050 41,078

67 DEMON 29 250,675 250,703

JUMLAH 6,000 17,788,260 17,794,260

TERBILANG SEMBILAN PULUH SATU JUTA TIGA RATUS ENAM PUUN ENAM RIBU LIMA RATUS ENAM PULU

Setuju Bayar, .................................. Pejabat Pelaksana Lunas Bayar, ...........................

Kuasa Pengguna Anggaran Teknis Kegiatan Bendahara Pengeluaran
ATEN TASIKMALAYA

5.2.1.01.09

Potongan Jasa Pelayanan

TANDA TANGAN
Pajak Bersih ( 3 - 4 )
4 5 6
55,429 1,053,148 1 ...................

37,638 715,125 2 ...................

83,893 1,593,973 3 ...................

70,715 1,343,589 4 ...................

45,236 256,338 5 ...................

47,420 268,711 6 ...................

2,059 39,118 7 ...................

2,059 39,118 8 ...................

8,639 48,956 9 ...................

125,693 712,259 10 ...................

11,129 211,456 11 ...................

15,767 299,576 12 ...................

31,942 606,897 13 ...................

2,059 39,117 14 ...................

1 12 15 ...................

2,060 39,142 16 ...................

1 12 17 ...................

4,927 93,614 18 ...................

2,059 39,114 19 ...................

2,061 39,156 20 ...................

2,059 39,114 21 ...................

9,191 174,625 22 ...................

16,666 316,647 23 ...................

33,040 627,758 24 ...................

17,695 336,211 25 ...................

2,059 39,114 26 ...................

19,373 368,094 27 ...................

2,715 51,594 28 ...................

5,845 111,061 29 ...................

2,058 39,111 30 ...................

19,849 377,131 31 ...................

9,155 173,937 32 ...................

5,490 104,319 33 ...................

5,491 104,324 34 ...................

20,095 381,809 35 ...................

20,095 381,809 36 ...................

20,095 381,809 37 ...................

19,236 365,487 38 ...................

20,075 381,418 39 ...................

20,095 381,804 40 ...................

18,377 349,164 41 ...................

26,943 511,914 42 ...................

20,954 398,132 43 ...................

20,954 398,126 44 ...................

3,750 71,259 45 ...................

2,054 39,028 46 ...................

3,750 71,259 47 ...................

3,750 71,259 48 ...................

3,750 71,259 49 ...................

3,750 71,259 50 ...................

 3,750 71,259 51 ...................

3,750 71,259 52 ...................

3,750 71,259 53 ...................

2,054 39,033 54 ...................

2,055 39,037 55 ...................

5,840 110,952 56 ...................

10,384 197,292 57 ...................

3,966 75,346 58 ...................

24,543 466,316 59 ...................

11,123 211,339 60 ...................

2,054 39,034 61 ...................

5,839 110,935 62 ...................

10,382 197,253 63 ...................

5,707 108,424 64 ...................

2,054 39,024 65 ...................

2,054 39,024 66 ...................

12,535 238,168 67 ...................

1,041,038 16,753,222
AM PULUH RUPIAH

Tasikmalaya, 31 Januari 2019

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