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Absensi Jasa Suntik Pasien TB Resistan Obat

Di Fasilitas Pelayanan Kesehatan Satelit


Kab/Kota : Kab. Tangerang
Puskesmas : Gunung Kaler
Bulan : Juli-Agustus-September (Triwulan 3)
Nama Pasien : Jani

No. Tanggal Uraian Nama Petugas Tanda Tangan


1 3/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
2 4/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
3 5/7/2017 inj. Kanamisin 500 mg Baehaki, Amd.Kep
4 6/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
5 7/7/2017 inj. Kanamisin 500 mg Baehaki, Amd.Kep
6 10/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
7 11/7/2017 inj. Kanamisin 500 mg Baehaki, Amd.Kep
8 12/7/2017 inj. Kanamisin 500 mg Baehaki, Amd.Kep
9 13/7/2017 inj. Kanamisin 500 mg Baehaki, Amd.Kep
10 14/7/2017 inj. Kanamisin 500 mg Kurdi, Amd.Kep
11 17/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
12 18/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
13 19/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
14 20/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
15 21/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
16 24/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
17 25/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
18 26/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
19 27/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
20 28/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
21 31/7/2017 inj. Kanamisin 500 mg dr. Supriyanto
22 1/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
23 2/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
24 3/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
25 4/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
Absensi Jasa Suntik Pasien TB Resistan Obat
Di Fasilitas Pelayanan Kesehatan Satelit
Kab/Kota : Kab. Tangerang
Puskesmas : Gunung Kaler
Bulan : Juli-Agustus-September (Triwulan 3)
Nama Pasien : Jani

No. Tanggal Uraian Nama Petugas Tanda Tangan


26 7/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
27 8/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
28 9/8/2017 inj. Kanamisin 500 mg Daman H, Amd. Kep
29 10/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
30 11/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
31 14/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
32 15/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
33 16/8/2017 inj. Kanamisin 500 mg Baehaki, Amd.Kep
34 17/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
35 18/8/2017 inj. Kanamisin 500 mg Baehaki, Amd.Kep
36 21/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
37 22/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
38 23/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
39 24/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
40 25/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
41 28/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
42 29/8/2017 inj. Kanamisin 500 mg Daman H, Amd. Kep
43 30/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
44 31/8/2017 inj. Kanamisin 500 mg dr. Supriyanto
45 1/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
46 4/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
47 5/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
48 6/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
49 7/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
50 8/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
Absensi Jasa Suntik Pasien TB Resistan Obat
Di Fasilitas Pelayanan Kesehatan Satelit
Kab/Kota : Kab. Tangerang

Puskesmas : Gunung Kaler

Bulan : Juli-Agustus-September (Triwulan 3)

Nama Pasien : Jani

No. Tanggal Uraian Nama Petugas Tanda Tangan


51 11/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
52 12/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
53 13/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
54 14/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
55 15/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
56 18/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
57 19/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
58 20/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
59 21/9/2017 inj. Kanamisin 500 mg Kurdi, Amd.Kep
60 22/9/2017 inj. Kanamisin 500 mg Daman H, Amd.Kep
61 25/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
62 26/9/2017 inj. Kanamisin 500 mg Kurdi, Amd.Kep
63 27/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
64 28/9/2017 inj. Kanamisin 500 mg Baehaki, Amd.Kep
65 29/9/2017 inj. Kanamisin 500 mg dr. Supriyanto
66
67
68
69
70
71

Tangerang, ………2017
Mengetahui
Kepala UPT Puskesmas Gunung Kaler Wasor TB Kab/Kota

dr. Hj. T U T I Nining Mularsih, M.Epid


NIP. 197507142008012009 NIP. 19780822 200003 2 002

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