PEMERINTAH KABUPATEN KULON PROGO

DINAS KESEHATAN
PUSKESMAS TEMON II

Alamat : Dusun Kragon II, Palihan, Temon, Kulon Progo 55654 Telp. 081225262755

Email : temonduapuskesmas.kp@gmail.com

DAFTAR HADIR
Hari dan Tanggal :
Tempat :
Acara :
NO NAMA JABATAN ALAMAT TANDA TANGAN
1 1
2 2
3 3
4 4
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40 40

Mengetahui
Kepala UPT Puskesmas Temon II

drg. Viera Juniver Thenu

Pembina Tk I, IV/b
NIP. 19690609 200212 2 004
 PEMERINTAH KABUPATEN KULON PROGO
DINAS KESEHATAN
PUSKESMAS TEMON II

Alamat : Dusun Kragon II, Palihan, Temon, Kulon Progo 55654 Telp. 081225262755

Email : temonduapuskesmas.kp@gmail.com

DAFTAR PENERIMAAN TRANSPORT PESERTA

Hari dan Tanggal :
Tempat :
Acara :

NO NAMA ALAMAT JUMLAH PAJAK (6%) DITERIMA TANDA TANGAN

1 Rp 50,000 Rp 3,000 Rp 47,000 1
2 Rp 50,000 Rp 3,000 Rp 47,000 2
3 Rp 50,000 Rp 3,000 Rp 47,000 3
4 Rp 50,000 Rp 3,000 Rp 47,000 4
5 Rp 50,000 Rp 3,000 Rp 47,000 5
6 Rp 50,000 Rp 3,000 Rp 47,000 6
7 Rp 50,000 Rp 3,000 Rp 47,000 7
8 Rp 50,000 Rp 3,000 Rp 47,000 8
9 Rp 50,000 Rp 3,000 Rp 47,000 9
10 Rp 50,000 Rp 3,000 Rp 47,000 10
11 Rp 50,000 Rp 3,000 Rp 47,000 11
12 Rp 50,000 Rp 3,000 Rp 47,000 12
13 Rp 50,000 Rp 3,000 Rp 47,000 13
14 Rp 50,000 Rp 3,000 Rp 47,000 14
15 Rp 50,000 Rp 3,000 Rp 47,000 15
16 Rp 50,000 Rp 3,000 Rp 47,000 16
17 Rp 50,000 Rp 3,000 Rp 47,000 17
18 Rp 50,000 Rp 3,000 Rp 47,000 18
19 Rp 50,000 Rp 3,000 Rp 47,000 19
20 Rp 50,000 Rp 3,000 Rp 47,000 20
21 Rp 50,000 Rp 3,000 Rp 47,000 21
22 Rp 50,000 Rp 3,000 Rp 47,000 22
23 Rp 50,000 Rp 3,000 Rp 47,000 23
24 Rp 50,000 Rp 3,000 Rp 47,000 24
25 Rp 50,000 Rp 3,000 Rp 47,000 25
26 Rp 50,000 Rp 3,000 Rp 47,000 26
27 Rp 50,000 Rp 3,000 Rp 47,000 27
28 Rp 50,000 Rp 3,000 Rp 47,000 28
29 Rp 50,000 Rp 3,000 Rp 47,000 29
30 Rp 50,000 Rp 3,000 Rp 47,000 30
31 Rp 50,000 Rp 3,000 Rp 47,000 31
32 Rp 50,000 Rp 3,000 Rp 47,000 32
33 Rp 50,000 Rp 3,000 Rp 47,000 33
34 Rp 50,000 Rp 3,000 Rp 47,000 34
35 Rp 50,000 Rp 3,000 Rp 47,000 35
36 Rp 50,000 Rp 3,000 Rp 47,000 36
37 Rp 50,000 Rp 3,000 Rp 47,000 37
38 Rp 50,000 Rp 3,000 Rp 47,000 38
39 Rp 50,000 Rp 3,000 Rp 47,000 39
40 Rp 50,000 Rp 3,000 Rp 47,000 40
JUMLAH Rp 2,000,000 Rp 120,000 Rp 1,880,000

Mengetahui
Kepala UPT Puskesmas Temon II Penerima,

drg. Viera Juniver Thenu _______________

Pembina Tk I, IV/b
NIP. 19690609 200212 2 004