SERTIFIKAT KOMPETENSI

Certificate Of Competence

Nomor : 4050191430120180069
Number of Certificate : 4050191430120180069

Diberikan Kepada :
This is to Certify that
Nama Lengkap : TRI KURNIA SANDI
Full Name

Tempat, Tanggal Lahir : UTAN, 20 Oktober 1995

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314047

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180070
Number of Certificate : 4050191430120180070

Diberikan Kepada :
This is to Certify that
Nama Lengkap : VEMMI RETNA LINDASARI
Full Name

Tempat, Tanggal Lahir : EMBUK, 20 November 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314048

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180071
Number of Certificate : 4050191430120180071

Diberikan Kepada :
This is to Certify that
Nama Lengkap : YULIA AGISNI
Full Name

Tempat, Tanggal Lahir : LENEK DAYA, 31 Juli 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314049

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180072
Number of Certificate : 4050191430120180072

Diberikan Kepada :
This is to Certify that
Nama Lengkap : YULIATI ROKMAH
Full Name

Tempat, Tanggal Lahir : LENDANG DAMAI, 02 Juli 1995

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314050

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180073
Number of Certificate : 4050191430120180073

Diberikan Kepada :
This is to Certify that
Nama Lengkap : MARIATI ASTUTI
Full Name

Tempat, Tanggal Lahir : KEMBANG KERANG, 11 Maret 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314026

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180074
Number of Certificate : 4050191430120180074

Diberikan Kepada :
This is to Certify that
Nama Lengkap : NURUL HIDAYANTI
Full Name

Tempat, Tanggal Lahir : MATARAM, 02 Juli 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314034

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180075
Number of Certificate : 4050191430120180075

Diberikan Kepada :
This is to Certify that
Nama Lengkap : MUHAMAD TARMIZI
Full Name

Tempat, Tanggal Lahir : BELEKA, 16 September 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314027

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180076
Number of Certificate : 4050191430120180076

Diberikan Kepada :
This is to Certify that
Nama Lengkap : DINDA LIA AYU FUAN
Full Name

Tempat, Tanggal Lahir : SUMBAWA, 24 November 1995

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314010

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180077
Number of Certificate : 4050191430120180077

Diberikan Kepada :
This is to Certify that
Nama Lengkap : DHANI ADRIAN
Full Name

Tempat, Tanggal Lahir : NARMADA, 11 April 1995

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314008

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180078
Number of Certificate : 4050191430120180078

Diberikan Kepada :
This is to Certify that
Nama Lengkap : AISYIYAH HIDAYATI
Full Name

Tempat, Tanggal Lahir : SABE LENDANG, 20 Januari 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314001

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180079
Number of Certificate : 4050191430120180079

Diberikan Kepada :
This is to Certify that
Nama Lengkap : HARTATI
Full Name

Tempat, Tanggal Lahir : DOMPU, 17 September 1994

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314014

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180080
Number of Certificate : 4050191430120180080

Diberikan Kepada :
This is to Certify that
Nama Lengkap : IRMA SYURIANI
Full Name

Tempat, Tanggal Lahir : BIMA, 15 Januari 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314022

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180081
Number of Certificate : 4050191430120180081

Diberikan Kepada :
This is to Certify that
Nama Lengkap : IDA BAGUS PUTU YOGA PRADNYANA
Full Name

Tempat, Tanggal Lahir : PENYEMBAHAN, 12 Februari 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314018

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180082
Number of Certificate : 4050191430120180082

Diberikan Kepada :
This is to Certify that
Nama Lengkap : PANDIT DESMALA PUTRA SINERU
Full Name

Tempat, Tanggal Lahir : TEBANYAK LENDANG BIL, 22 Desember 1995

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314036

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180083
Number of Certificate : 4050191430120180083

Diberikan Kepada :
This is to Certify that
Nama Lengkap : FIBRIANTI TRIA ASIAM
Full Name

Tempat, Tanggal Lahir : MERCA, 26 Februari 1995

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314013

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180084
Number of Certificate : 4050191430120180084

Diberikan Kepada :
This is to Certify that
Nama Lengkap : AZWIN
Full Name

Tempat, Tanggal Lahir : BONJERUK, 18 Mei 1995

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314006

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180085
Number of Certificate : 4050191430120180085

Diberikan Kepada :
This is to Certify that
Nama Lengkap : BENY PRADANA AS
Full Name

Tempat, Tanggal Lahir : SELONG, 19 Oktober 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314007

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180086
Number of Certificate : 4050191430120180086

Diberikan Kepada :
This is to Certify that
Nama Lengkap : IDA BAGUS KETUT NATHA PARINA JMD
Full Name

Tempat, Tanggal Lahir : PRAYA, 02 Mei 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314017

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180087
Number of Certificate : 4050191430120180087

Diberikan Kepada :
This is to Certify that
Nama Lengkap : KADEK DIKA SURYADINATA
Full Name

Tempat, Tanggal Lahir : MATARAM, 29 Februari 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314070

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180088
Number of Certificate : 4050191430120180088

Diberikan Kepada :
This is to Certify that
Nama Lengkap : AULIA OKTAVIANTI
Full Name

Tempat, Tanggal Lahir : JEMBE, 06 Oktober 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314005

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180089
Number of Certificate : 4050191430120180089

Diberikan Kepada :
This is to Certify that
Nama Lengkap : KADEQ TITA ARDHANARI
Full Name

Tempat, Tanggal Lahir : MATARAM, 27 November 1995

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314071

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180090
Number of Certificate : 4050191430120180090

Diberikan Kepada :
This is to Certify that
Nama Lengkap : DIAN ARFIANI
Full Name

Tempat, Tanggal Lahir : PANCOR, 26 April 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314009

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180091
Number of Certificate : 4050191430120180091

Diberikan Kepada :
This is to Certify that
Nama Lengkap : NI KADEK RIMA WIDYA AS
Full Name

Tempat, Tanggal Lahir : TANJUNG, 27 Maret 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314077

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180092
Number of Certificate : 4050191430120180092

Diberikan Kepada :
This is to Certify that
Nama Lengkap : NI WAYAN NENENG ERMIKA
Full Name

Tempat, Tanggal Lahir : MATARAM, 09 Maret 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314079

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes

 SERTIFIKAT KOMPETENSI
Certificate Of Competence

Nomor : 4050191430120180093
Number of Certificate : 4050191430120180093

Diberikan Kepada :
This is to Certify that
Nama Lengkap : RIYANDHIKA ARI P
Full Name

Tempat, Tanggal Lahir : MATARAM, 29 Desember 1996

Place, Date of Birth

Nomor Induk Mahasiswa : 40501914301P07120314088

Student ID Number

Nama Perguruan Tinggi : Poltekkes Kemenkes Mataram

Name of Institution

Jenis dan No. Keputusan Pendirian Perguruan Tinggi : Poltekkes Kemenkes

Mataram dan 355/E/O/2012
Under the law of Vocational School in Higher Education 355/E/O/2012

Program Studi : D4 Keperawatan

Major : Diploma IV in Nursing

Dinyatakan telah LULUS UJI KOMPETENSI PROGRAM STUDI DIPLOMA IV

KEPERAWATAN MATARAM
Has passed the Competency Test of Diploma IV Nurses Program

Berdasarkan Keputusan Panitia Uji Kompetensi Nasional Program Diploma III

Kebidanan, Diploma III Keperawatan, dan Profesi Ners Nomor
653/PUK-Nas/XII/2018
Based on the decision of the National Committee for the Competency Test of Diploma III in
Midwifery, Diploma III in Nursing Program, and Professional Nursing Program, Number
653/PUK-Nas/XII/2018

Diterbitkan di Mataram, 26 Desember 2018

Issued in Mataram, 26 (Date) 12 (Month) 2018 (Year)

Pengurus Pusat Persatuan Perawat Nasional Indonesia Pimpinan Perguruan Tinggi

Indonesian National Nurses Association - Central Board (Head of Higher Education Institution)
Ketua Umum
President

Foto

Harif Fadhillah Awan Dramawan, S.Pd.,M.Kes