Daily Fit To Work RS Pertamina Balongan

Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 laundry TD: 110/80 N/S:72/36,6 - 1
4 dapur TD: 110/70 N/S:80/36,9 - 1
5 security TD: 100/70 N/S:74/36,2 - 1
6 Driver TD: 120/80 N/S:84/36,6 - 1
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 15 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 120/70 N/S:80/36 - 1
2 cs TD: 100/70 N/S:74/37 - 1
3 cs TD: 120/80 N/S:76/36,2 - 1
4 cs TD: 110/70 N/S:86/36 - 1
5 cs TD: 120/80 N/S:84/36,4 - 1
6 cs TD: 110/70 N/S:86/36,5 - 1
7 cs TD: 110/70 N/S:82/36,6 - 1
8 cs TD: 120/80 N/S:76/36,8 - 1
9 cs TD: 110/80 N/S:72/36,6 - 1
10 cs TD: 110/70 N/S:80/36,9 - 1
11 cs TD: 100/70 N/S:74/36,2 - 1
12 laundry TD: 110/70 N/S:86/36,5 - 1
13 dapur TD: 90/70 N/S:72/36 - 1
14 security TD: 130/90 N/S:84/36,6 - 1
15 Driver TD: 110/80 N/S:84/36,2 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 Driver TD: 110/80 N/S:72/36,6 - 1
4 security TD: 110/70 N/S:80/36,9 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:86/36 - 1
2 cs TD: 120/80 N/S:84/36,4 - 1
3 cs TD: 110/70 N/S:86/36,5 - 1
4 cs TD: 110/70 N/S:82/36,6 - 1
5 cs TD: 120/80 N/S:76/36,8 - 1
6 cs TD: 110/80 N/S:72/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:82/36,6 - 1
11 cs TD: 120/80 N/S:76/36,8 - 1
12 laundry TD: 110/80 N/S:72/36,6 - 1
13 dapur TD: 110/70 N/S:80/36,9 - 1
14 security TD: 110/80 N/S:84/36,2 - 1
15 Driver TD: 120/70 N/S:80/36 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 1
2 cs TD: 100/80 N/S:76/36,6 1
3 Driver TD: 110/70 N/S:80/36,9 1
4 security TD: 130/80 N/S:74/36,2 1
5 Dapur TD: 110/70 N/S:86/36 1
6
7
8
9
10
Shift Malam
1 cs TD: 120/80 N/S:88/36,2 1
2 cs TD: 120/80 N/S:76/36,8 1
3 security TD: 110/80 N/S:72/36,6 1
4 Driver TD: 110/70 N/S:80/36,9 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 120/70 N/S:80/36 - 1
2 cs TD: 100/70 N/S:74/37 - 1
3 cs TD: 120/80 N/S:76/36,2 - 1
4 cs TD: 110/70 N/S:86/36 - 1
5 cs TD: 120/80 N/S:84/36,4 - 1
6 laundry TD: 110/70 N/S:86/36,5 - 1
7 dapur TD: 110/70 N/S:82/36,6 - 1
8 security TD: 120/80 N/S:76/36,8 - 1
9 Driver TD: 110/80 N/S:72/36,6 - 1
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 100/70 N/S:74/36,2 - 1
2 cs TD: 110/70 N/S:86/36 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 120/80 N/S:76/36,8 - 1
5 Dapur TD: 110/80 N/S:72/36,6 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/80 N/S:72/36,6 - 1
2 cs TD: 110/70 N/S:80/36,9 - 1
3 security TD: 110/70 N/S:82/36,6 - 1
4 Driver TD: 120/80 N/S:76/36,8 - 1
5
6
7
8
 Jumlah 18 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 120/70 N/S:80/36 - 1
2 cs TD: 100/70 N/S:74/37 - 1
3 dapur TD: 100/70 N/S:82/36,3 - 1
4 security TD: 120/80 N/S:76/36,6 - 1
5 Driver TD: 110/80 N/S:84/36,2 - 1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,2 - 1
2 cs TD: 110/70 N/S:86/36 - 1
3 Driver TD: 120/80 N/S:84/36,4 - 1
4 security TD: 110/70 N/S:86/36,5 - 1
5 Dapur TD: 110/70 N/S:82/36,6 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 14 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 100/70 N/S:74/37 - 1
2 cs TD: 120/80 N/S:76/36,2 - 1
3 Driver TD: 110/70 N/S:86/36 - 1
4 security TD: 120/80 N/S:84/36,4 - 1
5 Dapur TD: 110/70 N/S:86/36,5 - 1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 14 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 cs TD: 110/80 N/S:72/36,6 - 1
4 cs TD: 110/70 N/S:80/36,9 - 1
5 cs TD: 100/70 N/S:74/36,2 - 1
6 cs TD: 120/80 N/S:84/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:86/36 - 1
11 cs TD: 120/80 N/S:84/36,4 - 1
12 laundry TD: 110/70 N/S:86/36,5 - 1
13 dapur TD: 90/70 N/S:72/36 - 1
14 security TD: 130/90 N/S:84/36,6 - 1
15 Driver TD: 110/80 N/S:84/36,2 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 1
2 cs TD: 110/80 N/S:72/36,6 1
3 Driver TD: 110/70 N/S:80/36,9 1
4 security TD: 100/70 N/S:74/36,2 1
5 Dapur TD: 110/70 N/S:86/36 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 1
2 cs TD: 120/80 N/S:76/36,8 1
3 security TD: 110/80 N/S:72/36,6 1
4 Driver TD: 110/70 N/S:80/36,9 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 120/70 N/S:80/36 - 1
2 cs TD: 100/70 N/S:74/37 - 1
3 cs TD: 120/80 N/S:76/36,2 - 1
4 cs TD: 110/70 N/S:86/36 - 1
5 cs TD: 120/80 N/S:84/36,4 - 1
6 cs TD: 110/70 N/S:86/36,5 - 1
7 cs TD: 110/70 N/S:82/36,6 - 1
8 cs TD: 120/80 N/S:76/36,8 - 1
9 cs TD: 110/80 N/S:72/36,6 - 1
10 cs TD: 110/70 N/S:80/36,9 - 1
11 cs TD: 100/70 N/S:74/36,2 - 1
12 laundry TD: 110/70 N/S:86/36,5 - 1
13 dapur TD: 100/70 N/S:82/36,3 - 1
14 security TD: 120/80 N/S:76/36,6 - 1
15 Driver TD: 110/80 N/S:84/36,2 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/80 N/S:72/36,6 - 1
2 cs TD: 110/70 N/S:80/36,9 - 1
3 security TD: 110/70 N/S:82/36,6 - 1
4 Driver TD: 120/80 N/S:76/36,8 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 120/70 N/S:80/36 - 1
2 cs TD: 100/70 N/S:74/37 - 1
3 cs TD: 120/80 N/S:76/36,2 - 1
4 cs TD: 110/70 N/S:86/36 - 1
5 cs TD: 120/80 N/S:84/36,4 - 1
6 cs TD: 110/70 N/S:86/36,5 - 1
7 cs TD: 110/70 N/S:82/36,6 - 1
8 cs TD: 120/80 N/S:76/36,8 - 1
9 cs TD: 110/80 N/S:72/36,6 - 1
10 cs TD: 110/70 N/S:80/36,9 - 1
11 cs TD: 100/70 N/S:74/36,2 - 1
12 laundry TD: 110/70 N/S:86/36,5 - 1
13 dapur TD: 90/70 N/S:72/36 - 1
14 security TD: 130/90 N/S:84/36,6 - 1
15 Driver TD: 110/80 N/S:84/36,2 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:86/36 - 1
2 cs TD: 120/80 N/S:84/36,4 - 1
3 cs TD: 110/70 N/S:86/36,5 - 1
4 cs TD: 110/70 N/S:82/36,6 - 1
5 cs TD: 120/80 N/S:76/36,8 - 1
6 cs TD: 110/80 N/S:72/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:82/36,6 - 1
11 cs TD: 120/80 N/S:76/36,8 - 1
12 laundry TD: 110/80 N/S:72/36,6 - 1
13 dapur TD: 110/70 N/S:80/36,9 - 1
14 security TD: 110/80 N/S:84/36,2 - 1
15 Driver TD: 120/70 N/S:80/36 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 1
2 cs TD: 110/80 N/S:72/36,6 1
3 Driver TD: 110/70 N/S:80/36,9 1
4 security TD: 100/70 N/S:74/36,2 1
5 Dapur TD: 110/70 N/S:86/36 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 1
2 cs TD: 120/80 N/S:76/36,8 1
3 security TD: 110/80 N/S:72/36,6 1
4 Driver TD: 110/70 N/S:80/36,9 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimb
Fit Fit With Note Unfit
angan
Shift Pagi
1 cs TD: 120/70 N/S:80/36 - 1
2 cs TD: 100/70 N/S:74/37 - 1
3 cs TD: 120/80 N/S:76/36,2 - 1
4 cs TD: 110/70 N/S:86/36 - 1
5 cs TD: 120/80 N/S:84/36,4 - 1
6 laundry TD: 110/70 N/S:86/36,5 - 1
7 dapur TD: 110/70 N/S:82/36,6 - 1
8 security TD: 120/80 N/S:76/36,8 - 1
9 Driver TD: 110/80 N/S:72/36,6 - 1
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 18 0 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 120/70 N/S:80/36 - 1
2 cs TD: 100/70 N/S:74/37 - 1
3 dapur TD: 120/80 N/S:76/36,2 - 1
4 security TD: 110/70 N/S:86/36 - 1
5 Driver TD: 120/80 N/S:84/36,4 - 1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 100/80 N/S:76/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 130/80 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 14 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 100/70 N/S:74/37 - 1
2 cs TD: 120/80 N/S:76/36,2 - 1
3 Driver TD: 110/70 N/S:86/36 - 1
4 security TD: 120/80 N/S:84/36,4 - 1
5 Dapur TD: 110/70 N/S:86/36,5 - 1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 14 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 120/70 N/S:80/36 - 1
2 cs TD: 120/80 N/S:70/36,2 - 1
3 cs TD: 110/80 N/S:78/35,7 - 1
4 cs TD: 110/70 N/S:80/36,9 - 1
5 cs TD: 100/70 N/S:74/36,2 - 1
6 cs TD: 120/90 N/S:81/36,4 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:86/36 - 1
11 cs TD: 120/80 N/S:84/36,4 - 1
12 laundry TD: 110/70 N/S:86/36,5 - 1
13 dapur TD: 100/70 N/S:78/36,6 - 1
14 security TD: 130/80 N/S:87/37 - 1
15 Driver TD: 100/80 N/S:74/36 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/70 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 100/70 N/S:86/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:72/36,8 - 1
3 security TD: 130/80 N/S:82/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 cs TD: 110/80 N/S:72/36,6 - 1
4 cs TD: 110/70 N/S:80/36,9 - 1
5 cs TD: 100/70 N/S:74/36,2 - 1
6 cs TD: 120/80 N/S:84/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:86/36 - 1
11 cs TD: 120/80 N/S:76/36,8 - 1
12 laundry TD: 110/80 N/S:72/36,6 - 1
13 dapur TD: 110/70 N/S:80/36,9 - 1
14 security TD: 100/70 N/S:74/36,2 - 1
15 Driver TD: 110/70 N/S:86/36 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 Driver TD: 110/80 N/S:72/36,6 - 1
4 security TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:86/36 - 1
2 cs TD: 120/80 N/S:84/36,4 - 1
3 cs TD: 110/70 N/S:86/36,5 - 1
4 cs TD: 110/70 N/S:82/36,6 - 1
5 cs TD: 120/80 N/S:76/36,8 - 1
6 cs TD: 110/80 N/S:72/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:82/36,6 - 1
11 cs TD: 120/80 N/S:76/36,8 - 1
12 laundry TD: 110/80 N/S:72/36,6 - 1
13 dapur TD: 110/70 N/S:80/36,9 - 1
14 security TD: 110/80 N/S:84/36,2 - 1
15 Driver TD: 120/70 N/S:80/36 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 100/70 N/S:74/37 - 1
2 cs TD: 120/80 N/S:76/36,2 - 1
3 Driver TD: 110/70 N/S:86/36 - 1
4 security TD: 120/80 N/S:84/36,4 - 1
5 Dapur TD: 110/70 N/S:86/36,5 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:86/36 - 1
2 cs TD: 120/80 N/S:84/36,4 - 1
3 cs TD: 110/70 N/S:86/36,5 - 1
4 cs TD: 110/70 N/S:82/36,6 - 1
5 cs TD: 120/80 N/S:76/36,8 - 1
6 cs TD: 110/80 N/S:72/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:82/36,6 - 1
11 cs TD: 120/80 N/S:76/36,8 - 1
12 laundry TD: 110/80 N/S:72/36,6 - 1
13 dapur TD: 110/70 N/S:80/36,9 - 1
14 security TD: 110/80 N/S:84/36,2 - 1
15 Driver TD: 120/70 N/S:80/36 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:86/36 - 1
2 cs TD: 120/80 N/S:84/36,4 - 1
3 cs TD: 110/70 N/S:86/36,5 - 1
4 cs TD: 110/70 N/S:82/36,6 - 1
5 cs TD: 120/80 N/S:76/36,8 - 1
6 laundry TD: 110/80 N/S:72/36,6 - 1
7 dapur TD: 120/70 N/S:80/36 - 1
8 security TD: 100/70 N/S:74/37 - 1
9 Driver TD: 120/80 N/S:76/36,2 - 1
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 1
2 cs TD: 110/80 N/S:72/36,6 1
3 Driver TD: 110/70 N/S:80/36,9 1
4 security TD: 100/70 N/S:74/36,2 1
5 Dapur TD: 110/70 N/S:86/36 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 1
2 cs TD: 120/80 N/S:76/36,8 1
3 security TD: 110/80 N/S:72/36,6 1
4 Driver TD: 110/70 N/S:80/36,9 1
5
6
7
8
 Jumlah 18 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 120/70 N/S:80/36 - 1
2 cs TD: 100/70 N/S:74/37 - 1
3 dapur TD: 100/70 N/S:82/36,3 - 1
4 security TD: 120/80 N/S:76/36,6 - 1
5 Driver TD: 110/80 N/S:84/36,2 - 1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 14 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 100/70 N/S:74/37 - 1
2 cs TD: 120/80 N/S:76/36,2 - 1
3 Driver TD: 110/70 N/S:86/36 - 1
4 security TD: 120/80 N/S:84/36,4 - 1
5 Dapur TD: 110/70 N/S:86/36,5 - 1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 1
2 cs TD: 110/80 N/S:72/36,6 1
3 Driver TD: 110/70 N/S:80/36,9 1
4 security TD: 100/70 N/S:74/36,2 1
5 Dapur TD: 110/70 N/S:86/36 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 1
2 cs TD: 120/80 N/S:76/36,8 1
3 security TD: 110/80 N/S:72/36,6 1
4 Driver TD: 110/70 N/S:80/36,9 1
5
6
7
8
 Jumlah 14 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 cs TD: 110/80 N/S:72/36,6 - 1
4 cs TD: 110/70 N/S:80/36,9 - 1
5 cs TD: 100/70 N/S:74/36,2 - 1
6 cs TD: 120/80 N/S:84/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:86/36 - 1
11 cs TD: 120/80 N/S:76/36,8 - 1
12 laundry TD: 110/80 N/S:72/36,6 - 1
13 dapur TD: 110/70 N/S:80/36,9 - 1
14 security TD: 100/70 N/S:74/36,2 - 1
15 Driver TD: 110/70 N/S:86/36 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 100/70 N/S:74/37 - 1
2 cs TD: 120/80 N/S:76/36,2 - 1
3 Driver TD: 110/70 N/S:86/36 - 1
4 security TD: 120/80 N/S:84/36,4 - 1
5 Dapur TD: 110/70 N/S:86/36,5 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/80 N/S:72/36,6 - 1
2 cs TD: 120/80 N/S:84/36,8 - 1
3 Driver TD: 120/90 N/S:76/36,6 - 1
4 security TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:86/36 - 1
2 cs TD: 120/80 N/S:84/36,4 - 1
3 cs TD: 110/70 N/S:86/36,5 - 1
4 cs TD: 110/70 N/S:82/36,6 - 1
5 cs TD: 120/80 N/S:76/36,8 - 1
6 cs TD: 110/80 N/S:72/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:82/36,6 - 1
11 cs TD: 120/80 N/S:76/36,8 - 1
12 laundry TD: 110/80 N/S:72/36,6 - 1
13 dapur TD: 110/70 N/S:80/36,9 - 1
14 security TD: 110/80 N/S:84/36,2 - 1
15 Driver TD: 120/70 N/S:80/36 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/70 N/S:82/36,6 - 1
3 Driver TD: 120/80 N/S:76/36,8 - 1
4 security TD: 110/80 N/S:72/36,6 - 1
5 Dapur TD: 110/70 N/S:80/36,9 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 Driver TD: 110/80 N/S:72/36,6 - 1
4 security TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:86/36 - 1
2 cs TD: 120/80 N/S:84/36,4 - 1
3 cs TD: 110/70 N/S:86/36,5 - 1
4 cs TD: 110/70 N/S:82/36,6 - 1
5 cs TD: 120/80 N/S:76/36,8 - 1
6 cs TD: 110/80 N/S:72/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:82/36,6 - 1
11 cs TD: 120/80 N/S:76/36,8 - 1
12 laundry TD: 110/80 N/S:72/36,6 - 1
13 dapur TD: 110/70 N/S:80/36,9 - 1
14 security TD: 110/80 N/S:84/36,2 - 1
15 Driver TD: 120/70 N/S:80/36 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 100/80 N/S:76/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 130/80 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 120/80 N/S:88/36,2 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 cs TD: 110/80 N/S:72/36,6 - 1
4 cs TD: 110/70 N/S:80/36,9 - 1
5 cs TD: 100/70 N/S:74/36,2 - 1
6 cs TD: 120/80 N/S:84/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:86/36 - 1
11 cs TD: 120/80 N/S:84/36,4 - 1
12 laundry TD: 110/70 N/S:86/36,5 - 1
13 dapur TD: 90/70 N/S:86/36,8 - 1
14 security TD: 130/80 N/S:78/36,2 - 1
15 Driver TD: 110/80 N/S:84/36,2 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:86/36 - 1
2 cs TD: 120/80 N/S:84/36,4 - 1
3 cs TD: 110/70 N/S:86/36,5 - 1
4 cs TD: 110/70 N/S:82/36,6 - 1
5 cs TD: 120/80 N/S:76/36,8 - 1
6 laundry TD: 110/80 N/S:72/36,6 - 1
7 dapur TD: 120/70 N/S:80/36 - 1
8 security TD: 100/70 N/S:74/37 - 1
9 Driver TD: 120/80 N/S:76/36,2 - 1
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 1
2 cs TD: 120/80 N/S:76/36,8 1
3 security TD: 110/80 N/S:72/36,6 1
4 Driver TD: 110/70 N/S:80/36,9 1
5
6
7
8
 Jumlah 18 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 100/80 N/S:76/36,6 - 1
3 dapur TD: 110/70 N/S:80/36,9 - 1
4 security TD: 130/80 N/S:74/36,2 - 1
5 Driver TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/80 N/S:72/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 100/70 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/80 N/S:72/36,6 - 1
2 cs TD: 120/80 N/S:84/36,8 - 1
3 Driver TD: 120/90 N/S:76/36,6 - 1
4 security TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 14 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 Driver TD: 110/80 N/S:72/36,6 - 1
4 security TD: 110/70 N/S:80/36,9 - 1
5 Dapur TD: 120/80 N/S:76/36,2 - 1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 100/70 N/S:82/36,3 - 1
2 cs TD: 120/80 N/S:76/36,6 - 1
3 Driver TD: 110/80 N/S:84/36,2 - 1
4 security TD: 110/80 N/S:72/36,6 - 1
5 Dapur TD: 110/70 N/S:80/36,9 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/70 N/S:82/36,6 - 1
3 Driver TD: 120/80 N/S:76/36,8 - 1
4 security TD: 110/80 N/S:72/36,6 - 1
5
6
7
8
 Jumlah 14 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 cs TD: 110/80 N/S:72/36,6 - 1
4 cs TD: 110/70 N/S:80/36,9 - 1
5 cs TD: 100/70 N/S:74/36,2 - 1
6 cs TD: 100/70 N/S:80/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:86/36 - 1
11 cs TD: 120/80 N/S:84/36,4 - 1
12 laundry TD: 110/70 N/S:86/36,5 - 1
13 dapur TD: 110/70 N/S:78/36 - 1
14 security TD: 110/70 N/S:86/36 - 1
15 Driver TD: 120/80 N/S:76/36,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 110/70 N/S:82/36,6 - 1
3 Driver TD: 120/80 N/S:76/36,8 - 1
4 security TD: 110/80 N/S:72/36,6 - 1
5 Dapur TD: 110/70 N/S:80/36,9 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 120/80 N/S:84/36,6 - 1
2 cs TD: 120/70 N/S:80/36 - 1
3 Driver TD: 100/70 N/S:74/37 - 1
4 security TD: 120/80 N/S:76/36,2 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 cs TD: 110/80 N/S:72/36,6 - 1
4 cs TD: 110/70 N/S:80/36,9 - 1
5 cs TD: 100/70 N/S:74/36,2 - 1
6 cs TD: 120/80 N/S:84/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:86/36 - 1
11 cs TD: 120/80 N/S:84/36,4 - 1
12 laundry TD: 110/70 N/S:86/36,5 - 1
13 dapur TD: 90/70 N/S:72/36 - 1
14 security TD: 130/90 N/S:84/36,6 - 1
15 Driver TD: 110/80 N/S:84/36,2 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 100/80 N/S:76/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 130/80 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/80 N/S:72/36,6 - 1
2 cs TD: 120/80 N/S:84/36,8 - 1
3 Driver TD: 120/90 N/S:76/36,6 - 1
4 security TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 laundry TD: 110/80 N/S:72/36,6 - 1
4 dapur TD: 110/70 N/S:80/36,9 - 1
5 security TD: 100/70 N/S:74/36,2 - 1
6 Driver TD: 120/80 N/S:84/36,6 - 1
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD: 120/70 N/S:80/36 - 1
2 cs TD: 100/70 N/S:74/37 - 1
3 Driver TD: 120/80 N/S:76/36,2 - 1
4 security TD: 110/70 N/S:86/36 - 1
5 Dapur TD: 120/80 N/S:84/36,4 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 Driver TD: 110/80 N/S:72/36,6 - 1
4 security TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 15 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 05/05/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD: 110/70 N/S:82/36,6 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 cs TD: 110/80 N/S:72/36,6 - 1
4 cs TD: 110/70 N/S:80/36,9 - 1
5 cs TD: 100/70 N/S:74/36,2 - 1
6 cs TD: 120/80 N/S:84/36,6 - 1
7 cs TD: 120/70 N/S:80/36 - 1
8 cs TD: 100/70 N/S:74/37 - 1
9 cs TD: 120/80 N/S:76/36,2 - 1
10 cs TD: 110/70 N/S:86/36 - 1
11 cs TD: 120/80 N/S:84/36,4 - 1
12 laundry TD: 110/70 N/S:86/36,5 - 1
13 dapur TD: 90/70 N/S:86/36,8 - 1
14 security TD: 130/80 N/S:78/36,2 - 1
15 Driver TD: 110/80 N/S:84/36,2 - 1
16
17
18
19
20
Shift Sore
1 cs TD: 120/80 N/S:76/36,8 - 1
2 cs TD: 100/80 N/S:76/36,6 - 1
3 Driver TD: 110/70 N/S:80/36,9 - 1
4 security TD: 130/80 N/S:74/36,2 - 1
5 Dapur TD: 110/70 N/S:86/36 - 1
6
7
8
9
10
Shift Malam
1 cs TD: 120/80 N/S:88/36,2 - 1
2 cs TD: 120/80 N/S:76/36,8 - 1
3 security TD: 110/80 N/S:72/36,6 - 1
4 Driver TD: 110/70 N/S:80/36,9 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama