Daftar Dinas Icu 2021 Okay

RUMAH SAKIT ISLAM IBNU SINA
JL. MELATI NO. 60 PEKANBARU

DAFTAR DINAS INTENSIVE CARE
RUANGAN/UNIT : ICU
No
NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 YESI SULASTRI, Skep 2000015 KR R S1 Mar-02 Jul-00 P P P P L P P P P L P L P P P
2 JERITA 2002076 KO I D3 Sep-09 Mar-11 S M M L L P P S Sm M M L L P P/s

3 RAHMAT HIDAYAT 2014057 PLK I D3 Aug-16 Jul-03 S M M Lm L P P S/p S M M L L P P
4 Ns.SYAHRIANI, Skep 2013029 PLK I S1 Aug-18 Dec-13 S/p M M L L P P/s S S M M L L P P
5 ENI ERMAWATI 2009009 PLK I D3 Jan-16 Oct-03 S M M L Lp P P S S M M Lm L P P
6 SUSILA FITRI 2002012 KO O D3 Mar-02 M

Jan-02 Lm L P P S/p S M M L L P P/s S S
7 ASNIYARINI 2009027 PLK O D3 Feb-09 M
Feb-09 L L P/s P S S M M L Lp P P S S
8 HARDIB BIANTO 2003058 PLK O D3 Jan-10 Mar-03 M L L P P/s S S M M L L P/s P S S
13 ASTRI YULIANI 2003023 PLK O D3 NOV-2008 Jul-03 L P P/s L P S S M M Lm L P P S Sm
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 L P/s P S S M M L L P P/s S S M M

11 YUSI WARNI 2002068 PLK F D3 Aug-09 Oct-04 M L P S/p S M M Lm L P C C S/p M M
12 Ns.DESRI SAPUTRA S Kep 2014010 PLK F S1 Aug-14 Aug-14 L Lp P S S M M L Lp P P S Sm M M
DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 L P P S Sm M M L L P/s P S S M M
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 P L S/p M M L L P P S Sm M M L L

15 TAPIARA 2009011 PLK E D3 Feb-09 Feb-09 P/s S L M M L L P/s P S S M M Lm L
16 JAKA SAPUTERA,Skep 2010009 PLK E Jan-20 Aug-14 P S S L M Lm L P P S/p S M M L Lp
17 WERDA NINGSIH 2003060 PLK E D3 Jan-16 Oct-03 Pm S L M M L Lp P P S S M M L L
18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 M L L P P S Sm M M L L S/p S S M

19 NASRUL 2011017 PLK T D3 Mar-10 Mar-10 L P Sm M M L L P P/s P M M L Lp P
20 ZULFITRI 2014042 PLK T D3 Jun-10 Apr-09 S S S S L P/s P P S S P L P P/s S
21 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P L P P P P L P L P P P

R KEPALA RUANGAN NB TIM MUTU PMKP
O TJ OBAT TIM PPI

I TJ INVENTARIS RENC RAPAT RUANGAN
F TJ FURNITUR TJ ALAT
E TJ ELEKTRO MEDIS PENGGANTI KARU
T TJ TENUN PENGGANTI KOORDINATOR
RE
BULAN :APRIL 2020 Total

KET
16 17 18 19 20 21 22 23 24 25 L 27 28 29 30 Jam
P P P L P P P P P P L P P P P
S S M M Lm L P P S S/p M M L L P
S/p S M M L Ls P P S S M M Lm L P
S Sm M M L L P P/s S S M M L Lp P
S S Mp M L L P P S Sm M M L L P/s
M M L Lp P P S S M M L L P/s P S
M M Lm L P P S S M M Lm L P P S
M M L L P P S Sm M M L L P P/s S
M M L L P/s P S S M M L Lp P P S
Lm L P P S S/p M M L Ls P P S S M
L L P P/s S S M M Lm L P P S/p S M
L L P P S Sm M M L L P/s P S S M
L Lp P P S S Mp M L L P P S S Mp
P/s P S S M M L Lp P P S S M M L
P P S S Mp M L L P P S Sm M M L
P P S S M M L L P/s P S S M M Lm
P P/s S S M M Lm L P P S/p S M M L
M L Ls P P S S M M L L P S Sm M
P S S M M L Ls P P S S Ms M L L
S M M Lm L P P S S/p P P L P P P
P P P L P P P P P P L P P P P
Disetujui oleh, Dibuat oleh
Dr. Yasri Yunus, Sp.An Yesi Sulastri, S Kep

Diketahui oleh,
Ns. Ul Ahdazumar, S.Kep

RUANGAN/UNIT : ICU BUL

No
NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
1 YESI SULASTRI, Skep 2000015 KR R S1 Mar-02 Jul-00 P P P P L P P P P L P L P P P P P
2 JERITA 2002076 KO I D3 Sep-09 Mar-11 S M M L L P P S Sm M M L L P P/s S S

3 RAHMAT HIDAYAT 2014057 PLK I D3 Aug-16 Jul-03 S M M Lm L P P S/p S M M L L P P S/p S
4 Ns.SYAHRIANI, Skep 2013029 PLK I S1 Aug-18 Dec-13 S/p M M L L P P/s S S M M L L P P S Sm
5 ENI ERMAWATI 2009009 PLK I D3 Jan-16 Oct-03 S M M L Lp P P S S M M Lm L P P S S
6 SUSILA FITRI 2002012 KO O D3 Mar-02 M

Jan-02 Lm L P P S/p S M M L L P P/s S S M M
7 ASNIYARINI 2009027 PLK O D3 Feb-09 M
Feb-09 L L P/s P S S M M L Lp P P S S M M
8 HARDIB BIANTO 2003058 PLK O D3 Jan-10 Mar-03 M L L P P/s S S M M L L P/s P S S M M
13 ASTRI YULIANI 2003023 PLK O D3 NOV-2008 Jul-03 L P P/s L P S S M M Lm L P P S Sm M M
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 L P/s P S S M M L L P P/s S S M M Lm L

11 YUSI WARNI 2002068 PLK F D3 Aug-09 Oct-04 M L P S/p S M M Lm L P C C S/p M M L L
12 Ns.DESRI SAPUTRA S Kep 2014010 PLK F S1 Aug-14 Aug-14 L Lp P S S M M L Lp P P S Sm M M L L
DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 L P P S Sm M M L L P/s P S S M M L Lp
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 P L S/p M M L L P P S Sm M M L L P/s P

15 TAPIARA 2009011 PLK E D3 Feb-09 Feb-09 P/s S L M M L L P/s P S S M M Lm L P P
16 JAKA SAPUTERA,Skep 2010009 PLK E Jan-20 Aug-14 P S S L M Lm L P P S/p S M M L Lp P P
17 WERDA NINGSIH 2003060 PLK E D3 Jan-16 Oct-03 Pm S L M M L Lp P P S S M M L L P P/s
18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 M L L P P S Sm M M L L S/p S S M M L

19 NASRUL 2011017 PLK T D3 Mar-10 Mar-10 L P Sm M M L L P P/s P M M L Lp P P S
20 ZULFITRI 2014042 PLK T D3 Jun-10 Apr-09 S S S S L P/s P P S S P L P P/s S S M
21 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P L P P P P L P L P P P P P

O TJ OBAT TIM PPI

BULAN :APRIL 2020 Total
KET
18 19 20 21 22 23 24 25 L 27 28 29 30 Jam
P L P P P P P P L P P P P
M M Lm L P P S S/p M M L L P
M M L Ls P P S S M M Lm L P
M M L L P P/s S S M M L Lp P
Mp M L L P P S Sm M M L L P/s
L Lp P P S S M M L L P/s P S
Lm L P P S S M M Lm L P P S/p
L L P P S Sm M M L L P P/s S
L L P/s P S S M M L Lp P P S
P P S S/p M M L Ls P P S S M
P P/s S S M M Lm L P P S S M
P P S Sm M M L L P/s P S S M
P P S S Mp M L L P P S Sm M
S S M M L Lp CUTI
S S Mp M L L C C S Sm M M L
S S M M L L P/s P S S M M Lm
S S M M Lm L P P S/p S M M L
Ls P P S S M M L L S Mp M L
S M M L Ls P P P S Ms M L L
M Lm L P P S P P P L P P P
P L P P P P P P L P P P P
Dr. Yasri Yunus, Sp.An Yesi Sulastri, S Kep

Diketahui oleh,

DAFTAR DINAS
RUANGAN/UNIT : ICU
No
NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3 4
1 YESI SULASTRI, Skep 2000015 KR R S1 Mar-02 Jul-00 L P L P
2 JERITA 2002076 KO I D3 Sep-09 Mar-11 P/s S S M

3 RAHMAT HIDAYAT 2014057 PLK I D3 Aug-16 Jul-03 P S/p S M
4 Ns.SYAHRIANI, Skep 2013029 PLK I S1 Aug-18 Dec-13 P S Sm M
5 ENI ERMAWATI 2009009 PLK I D3 Jan-16 Oct-03 P S S M
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 S Ms M L

7 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 S M M L
8 HARDIB BIANTO 2003058 PLK O D3 Jan-10 Mar-03 S M M Lm
13 ASTRI YULIANI 2003023 PLK O D3 NOV-2008 Jul-03 Sm M M L
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 M Lm L P

11 YUSI WARNI 2002068 PLK F D3 Aug-09 Oct-04 M L L P/s
12 Ns.DESRI SAPUTRA S Kep 2014010 PLK F S1 Aug-14 Aug-14 M L L P
DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 M L L P
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 M L P/s S

15 TAPIARA 2009011 PLK E D3 Feb-09 Feb-09 Lp P P S
16 JAKA SAPUTERA,Skep 2010009 PLK E Jan-20 Aug-14 L P P S
17 WERDA NINGSIH 2003060 PLK E D3 Jan-16 Oct-03 L P P S/p
18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 L P P S

19 ZULFITRI 2014042 PLK T D3 Jun-10 Apr-09 P S S/p L
20 NASRUL 2011017 PLK T D3 Mar-10 Mar-10
21 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 L P L P

R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
BULAN :MAI 2020

5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
P P L P P L P P P P P P L P P P L P P L L P
M L Ls P P S S Mp M L L P P S Sm M M L L P P/s S
M L L P P S Sm M M L L P/s P S S M M Lm L P P S/p
M L L P/s P S S M M Lm L P P S/p S M M L L P P S
M Lm L P P S/p S M M L Lp P P S S M M L L P/s P S
L P P S Sm M M L L P P/s S S M M L L P/s P S S M
Lp P P S S M M L Lp P P S Sm M M L L P P/s S S M
L P P S/p S M M L L P/s P S S M M Lm L P P S Sm M
L P/s P S S M M Lm L CUTI P S/p M M L L P/s
P S/p S M M L L P/s P S S M M L Lp P P S Sm M M L
P S S M M Lm L P P S/p S M M L L P/s P S S M M Lm
P/s S S M M L Lp P P S Sm M M L L P P/s S S M M L
P S Sm M M L Ls P P S S M M Lm L P P S S Mp M L
S M M L Lp P P S S M M L Ls P P S S M M Lm L P
S M M L Ls P P S S M M Lm L P P/s S S CUTI
Sm M M L L P/s P S S M M L Lp P P S Sm M M L Lp P
CUTI Sm M M L L P/s P S S M M L L P
S M M Lm L P P S M M L Lp S P M M L Lp P S S M
P P S/p S M M L L P/s P P S M M L Lp P P P M M L
COVID
N NB TIM MUTU PMKP Disetujui oleh,
TIM PPI
RENC RAPAT RUANGAN Dr. Yasri Yunus, Sp.An
TJ ALAT Diketahui oleh,
PENGGANTI KARU
PENGGANTI KOORDINATOR Ns. Ul Ahdazumar, S.Kep
Total
KET
27 28 29 30 31 Jam
P P P P P
S M M L L
S M M L Lp
Sm M M L L
S M M Lm L
M L Ls P P
M Lm L P P
M L L P P
P S L P/s P
L P P S S
L P P S S
L P/s P S Sm
L P P S/p S
P/s S S M M
CUTI S/p M M
P S S M M
P S Sm M M
M Lm L P P/s
Lp P P S M
P P P P P
Dibuat oleh
Yesi Sulastri, S Kep

Diketahui oleh,

DAFTAR DINAS
RUANGAN/UNIT : ICU
No
1 YESI SULASTRI, Skep 2000015 KR R S1 Mar-02 Jul-00 L P L P
2 JERITA 2002076 KO I D3 Sep-09 Mar-11 P/s S S M

3 RAHMAT HIDAYAT 2014057 PLK I D3 Aug-16 Jul-03 P S/p S M
4 Ns.SYAHRIANI, Skep 2013029 PLK I S1 Aug-18 Dec-13 P S Sm M
5 ENI ERMAWATI 2009009 PLK I D3 Jan-16 Oct-03 P S S M
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 S Ms M L

7 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 S M M L
8 HARDIB BIANTO 2003058 PLK O D3 Jan-10 Mar-03 S M M Lm
13 ASTRI YULIANI 2003023 PLK O D3 NOV-2008 Jul-03 Sm M M L
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 M Lm L P

11 YUSI WARNI 2002068 PLK F D3 Aug-09 Oct-04 M L L P/s
12 Ns.DESRI SAPUTRA S Kep 2014010 PLK F S1 Aug-14 Aug-14 M L L P
13 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 M L L P
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 M L P/s S

15 TAPIARA 2009011 PLK E D3 Feb-09 Feb-09 Lp P P S
16 JAKA SAPUTERA,Skep 2010009 PLK E Jan-20 Aug-14 L P P S
17 WERDA NINGSIH 2003060 PLK E D3 Jan-16 Oct-03 L P P S/p
18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 L P P S
20 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 L P L P

R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
BULAN :MAI 2020

5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
M L Ls P P S S Mp M L L P P S Sm M M L L P P/s S
M L L P P S Sm M M L L P/s P S S M M Lm L P P S/p
M L L P/s P S S M M Lm L S P S/p S M M L L P P S
M Lm L P P S/p S M M L Lp P P S S M M L L P/s P S
L P P S Sm M M L L P P/s S S M M L L P/s P S S M
Lp P P S S M M L Lp P P S Sm M M L L P P/s S S M
L P P S/p S M M L L P/s P S S M M Lm L P P S Sm M
L P/s P S S M M Lm L CUTI P S/p M M L L P/s
P S/p S M M L L P/s P S S M M L Lp P P S Sm M M L
P S S M M Lm L P P S/p S M M L L P/s P S S M M Lm
P/s S S M M L Lp P P S Sm M M L L P P S/p S M M L
P S Sm M M L Ls P P S S M M Lm L P P S S Mp M L
S M M L Lp P P S S M M L Ls P P S S M M Lm L P
S M M L Ls P P S S M M Lm L P P/s S S CUTI
Sm M M L L P/s P S S M M L Lp P P S Sm M M L Lp P
CUTI Sm M M L L P/s P S S M M L L P
S M M Lm L P P S P P P/s L S M M L Ls P P S S M
COVID
TIM PPI
PENGGANTI KARU
Total
KET
27 28 29 30 31 Jam
P P P P L
S M M L L
S M M L Lp
Sm M M L L
S M M Lm L
M L Ls P P
M Lm L P P
M L L P P
P S L P/s P NM
L P P S S
L P P S S
L P/s P S Sm
L P P S/p S
P/s S S M M
CUTI S/p M M
P S S M M
P S Sm M M
M Lm L P P/s
P P P P P
Dibuat oleh

Diketahui oleh,

DAFTAR DINAS
RUANGAN/UNIT : ICU
No
1 YESI SULASTRI, Skep 2000015 KR R S1 Mar-02 Jul-00 L P P P
2 JERITA 2002076 KO I D3 Sep-09 Mar-11 P/s P S S

3 RAHMAT HIDAYAT 2014057 PLK I D3 Aug-16 Jul-03 P P S Sm
4 Ns.SYAHRIANI, Skep 2013029 PLK I S1 Aug-18 Dec-13 P P/s S S
5 ENI ERMAWATI 2009009 PLK I D3 Jan-16 Oct-03 P P S S
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 S S M M

7 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 S/p S M M
8 HARDIB BIANTO 2003058 PLK O D3 Jan-10 Mar-03 S Sm M M
13 ASTRI YULIANI 2003023 PLK O D3 NOV-2008 Jul-03 S S M M
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 M M Lm L

11 YUSI WARNI 2002068 PLK F D3 Aug-09 Oct-04 M M L Lp
12 Ns.DESRI SAPUTRA S Kep 2014010 PLK F S1 Aug-14 Aug-14 M M L L
13 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 M M L L
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 L Lp P P

15 TAPIARA 2009011 PLK E D3 Feb-09 Feb-09 L L P/s P
16 JAKA SAPUTERA,Skep 2010009 PLK E Jan-20 Aug-14 Lm L P P
17 WERDA NINGSIH 2003060 PLK E D3 Jan-16 Oct-03 L L P P/s
18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 P P S/p S
20 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P

R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
BULAN :JUNI 2020

5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
P P L P P P P P P L P P P P P P L P P P P P
M M L Ls P P S S Mp M L L P P S Sm M M L L P/s P
M M L L P P/s S S M M L Ls P P S S M M L Ls P P
M M L L P/s P S S M M Lm L P P S S M M Lm L P P
M M Lm L P P S/p S M M L L P/s P S S Ms M L L P P
Lm L P P S S/p M M L L P/s P S S Mp M L L P P S Sm
L L C P S/P S M M Lm L P P S S M M Lm L P P S/p S
L L P/S P S S M M L Ls P P S Sm M M L L P/s P S S
L Lp P P S Sm M M L Lp CUTI M L Lp P P S S
P/s P S S M M L L P/s P S S M M L Ls P P S S M M
P P S Sm M M L L P P S Sm M M L L P P S S/p M M
IZIN S/p S M M Lm L P P S S/p M M L Lp P P S S M M
P P/s S S M M L Lp P P S S M M Lm L P P S Sm M M
S Sm M M L L P P S Sm M M L Lp P P S S M M L Ls
S S M M Lm L P P S S M M Lm L P P S/p S M M L Lp
S/p S M M L L P P/s S S M M L Ls P P S Sm M M L L
S S M M L L P/s P S S Mp M L L P/s P S S M M Lm L
L P P S/p S M M Lm L P P P S/p S M L L P/s P S S M
COVID
P P L P P P P P P L P P P P P P L P P P P P
TIM PPI
PENGGANTI KARU
Total
KET
27 28 29 30 31 Jam
P L P P
S S M M
S S/p M M
S/p S M M
S Sm M M
M M L L
M M L L
M M L Lp
M M Lm L
L Ls P P/s
L Ls P P
Lm L P P
L L P/s P
P P S S
P P S S
P/s P S S
P P S Sm
M L Lp P
P L P P
Dibuat oleh

Diketahui oleh,

DAFTAR DINA
RUANGAN/UNIT : ICU
No
1 YESI SULASTRI, S kep 2000015 KR R S1 Mar-02 Jul-00 P P P P
2 JERITA 2002076 KO I D3 Sep-09 Mar-11 LM L P P

3 RAHMAT HIDAYAT 2014057 PLK I D3 Aug-16 Jul-03 L L P P
4 Ns.SYAHRIANI, Skep 2013029 PLK I S1 Aug-18 Dec-13 L L P P
5 ENI ERMAWATI 2009009 PLK I D3 Jan-16 Oct-03 L L P P
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 P P S S

7 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 P/S P S S
8 HARDIB BIANTO 2003058 PLK O D3 Jan-10 Mar-03 P P S S
13 ASTRI YULIANI 2003023 PLK O D3 NOV-2008 Jul-03 P P S S
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 S S M M

11 YUSI WARNI 2002068 PLK F D3 Aug-09 Oct-04 S S M M
12 Ns.DESRI SAPUTRA S Kep 2014010 PLK F S1 Aug-14 Aug-14 S/P S M M
13 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 S S M M
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 M M L L

15 TAPIARA 2009011 PLK E D3 Feb-09 Feb-09 M M L L
16 JAKA SAPUTERA,Skep 2010009 PLK E Jan-20 Aug-14 M M L L
17 WERDA NINGSIH 2003060 PLK E D3 Jan-16 Oct-03 M M L L
18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 P M M L

R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
AFTAR DINAS INTENSIVE CARE
BULAN :JULI 2020

5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
L P P P P P P L P P P P P P L P P P P P P L
S S M M L L P P S S M M L L P P S S M M L L
M M L L P P S S M M L L P P S S M M L L P P
L L P P S S M M L L P P S S M M L L P P S S
P P S S M M L L P P S S M M L L P P S S M M
L P P M M L L P P S S M M L L P P S M M L L
COVID
TIM PPI
PENGGANTI KARU
Total
KET
27 28 29 30 31 Jam
P P P P L
P P S S M
P P S S M
P P S S M
P P S S M
S S M M L
S S M M L
S S M M L
S S M M L
M M L L P
M M L L P
M M L L P
M M L L P
L L P P S
L L P P S
L L P P S
L L P P S
P P S S S
P P P P L
Dibuat oleh

Diketahui oleh,

DAFTAR DINAS
RUANGAN/UNIT : ICU
No
1 YESI SULASTRI, S kep 2000015 KR R S1 Mar-02 Jul-00 L L P P
2 JERITA 2002076 KO I D3 Sep-09 Mar-11 M L L P

3 RAHMAT HIDAYAT 2014057 PLK I D3 Aug-16 Jul-03 M L L P
4 Ns.SYAHRIANI, Skep 2013029 PLK I S1 Aug-18 Dec-13 M L L P
5 ENI ERMAWATI 2009009 PLK I D3 Jan-16 Oct-03 M L L P
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 L P P S

7 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 L P P S
8 HARDIB BIANTO 2003058 PLK O D3 Jan-10 Mar-03 L P P S
13 ASTRI YULIANI 2003023 PLK O D3 NOV-2008 Jul-03 L P P S
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 P S S M

11 YUSI WARNI 2002068 PLK F D3 Aug-09 Oct-04 CUTI
12 Ns.DESRI SAPUTRA S Kep 2014010 PLK F S1 Aug-14 Aug-14 P S S M
13 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 P S S M
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 S M M L

15 TAPIARA 2009011 PLK E D3 Feb-09 Feb-09 S M M L
16 JAKA SAPUTERA,Skep 2010009 PLK E Jan-20 Aug-14 S M M L
17 WERDA NINGSIH 2003060 PLK E D3 Jan-16 Oct-03 S M M L
18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 L S S M
20 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P L P P

R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
BULAN :AGUSTUS 2020

5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
P P P P L P P P P P P L P P P P P P L P P P
P S S M M L L P P S S M M L L P P S S M M L
S M M L L P P S S M M L L P P S S M M L L P
M L L P P S S M M L L S S P P M M L L P P S
CUTI P P S S M M L L S S P P M M L L P P S
L P P S S M M L L P P S S M M L L P P S S M
M L L P P S S M M L L
TIM PPI
PENGGANTI KARU
Total
KET
27 28 29 30 31 Jam
P P P L P
L P P S S M
L P P S S M
L P P S S M
L P P S S M
P S S M M L
P S S M M L
P S S M M L
P S S M M L
S M M L L P
S M M L L P
S M M L L P
S M M L L P
M L L P P S
M L L P P S
M L L P P S
M L L P P S
P P P L P
Dibuat oleh

Diketahui oleh,

RUANGAN/UNIT : ICU BU
No
NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3 4 5 6 7 8 9 10 11 12 13 14
1 Ns. YESI SULASTRI, S kep 2000015 KR R S1 Mar-02 Jul-00 P P P P L P P P P P P P P P
2 JERITA 2002076 KO I D3 Sep-09 Mar-11 Lm L P P S/p S M M L L P P/s S S

3 RAHMAT HIDAYAT 2014057 PLK I D3 Aug-16 Jul-03 L L C S S M M Lm L P P S/p S
4 Ns.SYAHRIANI, Skep 2013029 PLK I S1 Aug-18 Dec-13 L Lp P P S S M M L Ls P P S Sm
5 ENI ERMAWATI 2009009 PLK I D3 Jan-16 Oct-03 L L P P S Sm M M L L P/s P S S
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 P P/s S S M M L Lp P P S S M M

7 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 P/s P S S M M Lm L P P S S M M
8 HARDIB BIANTO 2003058 PLK O D3 Jan-10 Mar-03 P P S Sm M M L L P/s P S S M M
9 ASTRI YULIANI 2003023 PLK O D3 NOV-2008 Jul-03 P P S/p S M M L Ls P P S Sm M M
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 S S M M L Lp P P S S M M L Ls

11 YUSI WARNI 2002068 PLK F D3 Aug-09 Oct-04 S Sm M M L L P/s P S S M M L L
12 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 S S M M Lm L P P S S M M Lm L
13 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 S S Ms M L L P P S Sm M M L Lp
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 Mp M L L P/s P S S M M L L P P

15 TAPIARA 2009011 PLK E D3 Feb-09 Feb-09 M M Lm L P P S/p S M M L Lp P P
16 Ns. JAKA SAPUTERA,Skep 2010009 PLK E Jan-20 Aug-14 M M L L P P/s S S M M Lm L P P
17 WERDA NINGSIH 2003060 PLK E D3 Jan-16 Oct-03 M M L Lp P P S Sm M M L L P/s P
18 Ns. Sari Ratina Y, S Kep 2015030 PLK F S1 Jul-20 Jun-15 Cuti P P P S/p S S L P P
18 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P L P P P P P P L P P

O TJ OBAT TIM PPI

VE CARE
BULAN :JULI 2020 Total

KET
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jam
P P P P L P P P P P P L P P P P L
M M L L P P/s S S M M L Ls P P S Sm M
M M L Ls P P S Sm M M L L P/s P S S M
M M L L P/s P S S M M Lm L P P S S M
M M Lm L P P S S Mp M L L P P S/p S M
Lm L P P S/p S M M L L P P S Sm M M L
L L P/s P S S M M L Ls P P S S M M Lm
L Ls P P S S M M Lm L P P S S/p M M L
L L P P S Sm M M L L P/s P S S M M L
P P S Sm M M L Lp P P S S M M Lm L P
P/s P S S M M L L P P S Sm M M L L P/s
P P S/p S M M L L P/s P S S M M L Ls P
P P S S M M Lm L P P S S/p M M L L P
S Sm M M L L P P/s S S M M L Ls P P S
S S M M Lm L P P S S/p M M L L P/s P S
S/p S M M L L P/s P S S M M Lm L P P S
S S M M L Lp P P S Sm M M L L P P S/p
S S/p M M L L P P P S S/p S L P P S S
P P P P L P P P P P P L P P P P L
Dr. Yasri Yunus, Sp.An Ns. Yesi Sulastri, S Kep

Diketahui oleh,
OORDINATOR Ns. Ul Ahdazumar, S.Kep

DAFTAR DINA
RUANGAN/UNIT : ICU
No
1 Ns. YESI SULASTRI, S kep 2000015 KR R S1 Mar-02 Jul-00 P P P P
2 JERITA 2002076 KO I D3 Sep-09 Mar-11 Lm L P P

3 RAHMAT HIDAYAT 2014057 PLK I D3 Aug-16 Jul-03 L L C
4 Ns.SYAHRIANI, Skep 2013029 PLK I S1 Aug-18 Dec-13 L Lp P P
5 ENI ERMAWATI 2009009 PLK I D3 Jan-16 Oct-03 L L P P
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 P P/s S S

7 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 P/s P S S
8 HARDIB BIANTO 2003058 PLK O D3 Jan-10 Mar-03 P P S Sm
9 ASTRI YULIANI 2003023 PLK O D3 NOV-2008 Jul-03 P P S/p S
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 S S M M

11 YUSI WARNI 2002068 PLK F D3 Aug-09 Oct-04 S Sm M M
12 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 S S M M
13 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 S S Ms M
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 Mp M L L

15 TAPIARA 2009011 PLK E D3 Feb-09 Feb-09 M M Lm L
16 Ns. JAKA SAPUTERA,Skep 2010009 PLK E Jan-20 Aug-14 M M L L
17 WERDA NINGSIH 2003060 PLK E D3 Jan-16 Oct-03 M M L Lp
18 Ns. Sari Ratina Y, S Kep 2015030 PLK F S1 Jul-20 Jun-15 Cuti
R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
AFTAR DINAS INTENSIVE CARE
BULAN :JULI 2020

5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
L P P P P P P P P P P P P P L P P P P P P L
S/p S M M L L P P/s S S M M L L P P/s S S M M L Ls

S S M M Lm L P P S/p S M M L Ls P P S Sm M M L L
S S M M L Ls P P S Sm M M L L P/s P S S M M Lm L
S Sm M M L L P/s P S S M M Lm L P P S S Mp M L L
M M L Lp P P S S M M Lm L P P S/p S M M L L P P
M M Lm L P P S S M M L L P/s P S S M M L Ls P P
M M L L P/s P S S M M L Ls P P S S M M Lm L P P
M M L Ls P P S Sm M M L L P P S Sm M M L L P/s P
L Lp P P S S M M L Ls P P S Sm M M L Lp P P S S
L L P/s P S S M M L L P/s P S S M M L L P P S Sm
Lm L P P S S M M Lm L P P S/p S M M L L P/s P S S
L L P P S Sm M M L Lp P P S S M M Lm L P P S S/p
P/s P S S M M L L P P S Sm M M L L P P/s S S M M
P P S/p S M M L Lp P P S S M M Lm L P P S S/p M M
P P/s S S M M Lm L P P S/p S M M L L P/s P S S M M
P P S Sm M M L L P/s P S S M M L Lp P P S Sm M M
Cuti P P P S/p S S L P P S S/p M M L L P P P S S/p S

TIM PPI
PENGGANTI KARU
Total
KET
27 28 29 30 31 Jam
P P P P L
P P S Sm M
P/s P S S M
P P S S M
P P S/p S M
S Sm M M L
S S M M Lm
S S/p M M L
S S M M L
M M Lm L P
M M L L P/s
M M L Ls P
M M L L P
L Ls P P S
L L P/s P S
Lm L P P S
L L P P S/p
L P P S S
P P P P L
Dibuat oleh
Ns. Yesi Sulastri, S Kep

Diketahui oleh,

RUANGAN/UNIT : ICU BULAN :AGUSTUS 2

No
NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
1 Ns. YESI SULASTRI, S kep 2000015 KR R S1 Mar-02 Jul-00 P L P P P P P P L P P P P P P L L L P L P
2 JERITA 2002076 KO I D3 Sep-09 M

Mar-11 L L P/s P S S M M Lm L P P S S Ms M L L P P
3 HARDIB BIANTO 2003058 PLK I D3 Jan-10 L
Mar-03 M M L P S S Ms M L Lp P P S S M M L Lp P P
4 ASTRI YULIANI 2003023 PLK I D3 NOV-2008 Jul-03 L P/s P M L S Sm M M L L P P S Sm M M L L P P/s
5 WERDA NINGSIH 2003060 PLK I D3 Jan-16 Oct-03 S M M Lm L S S M M L L P/s P S S M M Lm L P P
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 L P P/s S S M M L L P/s P S S M M L L P P S Sm

7 Ns. JAKA SAPUTERA,S kep 2010009 PLK O Jan-20 Aug-14 S S L S/p S M M Lm L P P S Sm M M L L P P/s S S
8 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 L P P S Sm M M L L S P/s S S M M L L P/s P S S
9 Ns. SYAHRIANI, S kep 2013029 PLK O S1 Aug-18 Dec-13 M Lm L S S CUTI M M Lm L P P S S/p
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 P S/p S M M L L P/s P S S M M Lm L P P S S M M

11 RAHMAT HIDAYAT 2014057 PLK F D3 Aug-16 Jul-03 M L L P P/s P L P P S/p S M M L Lp P P S S M M
12 TAPIARA 2009011 PLK F D3 Feb-09 Feb-09 S/p M M L L P P/s P P L Sm M M L L P P S Sm M M
13 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 P/s S S M M Lm L S P S S Mp M L L P P/s S S M M
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 Sm M M L L P P S/p S M M L Lp P P S Sm M M L L

15 TRY SURYA TRESNA 2009014 PLK E D3 Aug-09 Feb-13 P S Sm M M L P L S/p M M L P/s P L S S M M L P
16 ENI ERMAWATI 2009009 PLK E D3 Jan-16 Oct-03 M L L P P P/s P C S M M Lm L P P S/p S M M L L
17 YUSI WARNI 2002068 PLK E D3 Aug-09 Oct-04 CUTI S Sm M M L L P/s P S S M M Lm L
18 Ns. SARI RATINA Y , S Kep 2015030 PLK T S1 Jul-20 Jun-15 P P S/p L P M M L Ls P P S S P P/s L P P P S/p S
18 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P L P P P P P P L P P P P P P L P P
R KEPALA RUANGAN NB TIM MUTU PMKP Diset

O TJ OBAT TIM PPI
I TJ INVENTARIS RENC RAPAT RUANGAN Dr. Yasri

USTUS 2020 Total
KET
22 23 24 25 26 27 28 29 30 31 Jam
P L P P P P P P L P
S/p S M M Lm L P P S S
S Sm M M L L P P S Sm
S S M M L Ls P P S S
S S M M L L P/s P S S/p
M M L Lp P P S S Ms M
M M L Ls P P S S M M
M M Lm L P P S/p S M M
M M L L P/s P S S M M
L Lp P P S S/p M M L L
Lm L P P S S M M Lm L
L L P/s P S S M M L Ls
L L P P S Sm M M L L
P P/s S S M M L Lp P P
L P S/p S M M Lm L P P
P/s P S S M M L Ls P P
P P S Sm M M L L P P
P L P S S M M Lm L P
P P P P L P P P P L

Diketahui oleh,

DAFTAR DIN
RUANGAN/UNIT : ICU
No
NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3
1 Ns. YESI SULASTRI, S kep 2000015 KR R S1 Mar-02 Jul-00 P L P
2 JERITA 2002076 KO I D3 Sep-09 M

Mar-11 L L
3 HARDIB BIANTO 2003058 PLK I D3 Jan-10 Mar-03 L M M
4 ASTRI YULIANI 2003023 PLK I D3 NOV-2008 Jul-03 L P/s P
5 WERDA NINGSIH 2003060 PLK I D3 Jan-16 Oct-03 S M M
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 L P P/s

7 Ns. JAKA SAPUTERA,S kep 2010009 PLK O Jan-20 Aug-14 S S L
8 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 L P P
9 Ns. SYAHRIANI, S kep 2013029 PLK O S1 Aug-18 Dec-13 M Lm L
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 P S/p S

11 TRY SURYA TRESNA 2009014 PLK E D3 Aug-09 Feb-13 P S Sm
12 TAPIARA 2009011 PLK F D3 Feb-09 Feb-09 S/p M M
13 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 P/s S S
RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 Sm M M

RAHMAT HIDAYAT 2014057 PLK F D3 Aug-16 Jul-03 M L L
14 ENI ERMAWATI 2009009 PLK E D3 Jan-16 Oct-03 M L L
15 YUSI WARNI 2002068 PLK E D3 Aug-09 Oct-04 CUTI
16
17 Ns. SARI RATINA Y , S Kep 2015030 PLK T S1 Jul-20 Jun-15 P P S/p
KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P
18 R KEPALA RUANGAN
O TJ OBAT
18 I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
BULAN :AGUSTUS 2020

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
P P P P P L P P P P P P L L L P L P P L P P
P/s P S S M M Lm L P P S S/p M M L L P/s P S/p S M M

L P S S Ms M L Lp P P S S M M L Lp P P S Sm M M
M L S Sm M M L L P P S Sm M M L L P P/s S S M M
Lm L S S M M L L P/s P S S M M Lm L P P S S M M
S S M M L L P/s P S S M M L L P P S Sm M M L Lp
S/p S M M Lm L P P S Sm M M L L P P/s S S M M L Ls
S Sm M M L L S P/s S S M M L L P/s P S S M M Lm L
S S CUTI M M Lm L P P S S/p M M L L
M M L L P/s P S S M M Lm L P P S S M M Lm L P P
M M L P L P S/p S M M L L P/s P S S M M L Lp P P
L L P P/s P P L Sm M M L L P P S Sm M M L L P/s P
M M Lm L S P S S Mp M L L P P/s S S M M L L P P
L L P P S/p S M M L Lp P P S Sm M M L L P P/s S S
P P/s P L P S/p M M L Ls P P S S M M L L P P S/p S
P P P/s P C S M M Lm L P P S/p S M M L L P/s P S S
CUTI S Sm M M L L P/s P S S M M Lm L P P S Sm
L P M M L Ls P P S S P P/s L P P P S/p S P L P S
P L P P P P P P L P P P P P P L P P P P P P
NGAN NB TIM MUTU PMKP Disetujui oleh,

TIM PPI
IS RENC RAPAT RUANGAN Dr. Yasri Yunus, Sp.An
PENGGANTI KARU
PENGGANTI KOORDINATOR Ns. Ul Ahdazumar, S.Ke
Total
KET
26 27 28 29 30 31 Jam
P P P P P P
Lm L P P S S
L L P P S Sm
L L P/s P S S
L Ls P P S/p S
P P S S Ms M
P P S S M M
P P S/p S M M
P/s P S S M M
S S/p M M L L
S Sm M M L L
S S M M L Ls
P S M M Lm L
M M L Lp P P
M M Lm L P P
M M L Ls P P
M M L L P P
S M M Lm L P
L P P P P L
leh, Dibuat oleh
s, Sp.An Ns. Yesi Sulastri, S Kep

Diketahui oleh,

RUANGAN/UNIT : ICU BULA

No
NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
1 Ns. YESI SULASTRI, S kep 2000015 KR R S1 Mar-02 Jul-00 P P P P P L P P P P P P L P P P
2 JERITA 2002076 KO I D3 Sep-09 Mar-11 M M L L P P S Sm M M L L P/s P S S

3 HARDIB BIANTO 2003058 PLK I D3 Jan-10 Mar-03 M M L L P/s P S S M M Lm L P P S/p S
4 ASTRI YULIANI 2003023 PLK I D3 NOV-2008 Jul-03 M M Lm L P P/s S S M M L L P P/s S S
5 WERDA NINGSIH 2003060 PLK I D3 Jan-16 Oct-03 M M L Lp P P S S M M L Ls P P S Sm
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 L L P P/s S S M M L Lp P P S Sm M M

7 Ns. JAKA SAPUTERA,S kep 2010009 PLK O Jan-20 Aug-14 Lm L P P S S/p M M L L P S/p S S M M
8 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 L L P/s CUTI M L P/s P S S M M
9 Ns. SYAHRIANI, S kep 2013029 PLK O S1 Aug-18 Dec-13 L Lp P P S S M M Lm L P P S/p S M M
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 P P/s S S M M L Lp P P S Sm M M L L

11 TRY SURYA TRESNA 2009014 PLK F D3 Aug-09 Feb-13 P/s P S S M M Lm L P P S/p P M M L P
12 TAPIARA 2009011 PLK F D3 Feb-09 Feb-09 P P S S Mp M L L P P/s S S M M L Lp
13 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 C S Sm M M L L P/s P S S M M Lm L
RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 S Sm M M L L P/s P S S M M L Lp P P

RAHMAT HIDAYAT 2014057 PLK E D3 Aug-16 Jul-03 S/p S M M L L P P/s S S M M Lm L P P
14 ENI ERMAWATI 2009009 PLK E D3 Jan-16 Oct-03 S S M M Lm L P P S/p S M M L L P/s P
15 YUSI WARNI 2002068 PLK E D3 Aug-09 Oct-04 S S Mp M L L P P S Sm M M L L P P/s
16
17 Ns. SARI RATINA Y , S Kep 2015030 PLK T S1 Jul-20 Jun-15 P P L P S Sm M M L L CUTI
KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P P L P P P P P P L P P P

O TJ OBAT TIM PPI
BULAN :SEPTEMBER 2020 Total
KET
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jam
P P P L P P P P P P L P P P
M M L Ls P P S CUTI P/s P
M M L L P P S/p S M M L Ls P P
M M Lm L P P S S/p M M L L P P
M M L L P/s P S S M M Lm L P P
L L P P S Sm M M L L P/s P S S
L Lp P P S S M M Lm L P P S S
Lm L P P S/p S M M L L P P S Sm
L L P/s P S S M M L Lp P P S S
P C S Sm M M L Ls P P S S M M
P/s P L S M M L S P/s L S S M M
P P S S M M Lm L P P S Sm M M
P P S/p S M M L L P P/s S S M M
S S M M L Lp P P S S M M Lm L
S Sm M M L L P/s P S S M M L Ls
S S M M Lm L P P S S Mp M L L
S S M M L Ls P P S Sm M M L L
P/s S P S L P Pm M M L Lp P P

Diketahui oleh,

RUANGAN/UNIT : ICU BULAN

No
1 Ns. YESI SULASTRI, S kep 2000015 KR R S1 Mar-02 Jul-00 P P P P P L P P P P P P L P P P
2 JERITA 2002076 KO I D3 Sep-09 Mar-11 M M L L P P S Sm M M L L P/s P S S

3 HARDIB BIANTO 2003058 PLK I D3 Jan-10 Mar-03 M M L L P/s P S S M M Lm L P P S/p S
4 ASTRI YULIANI 2003023 PLK I D3 NOV-2008 Jul-03 M M Lm L P P/s S S M M L L P P/s S S
5 WERDA NINGSIH 2003060 PLK I D3 Jan-16 Oct-03 M M L Lp P P S S M M L Ls P P S Sm
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 L L P P/s S S M M L Lp P P S Sm M M

7 Ns. JAKA SAPUTERA,S kep 2010009 PLK O Jan-20 Aug-14 Lm L P P S S/p M M L L P S/p S S M M
8 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 L L P/s CUTI M L P/s P S S M M
9 Ns. SYAHRIANI, S kep 2013029 PLK O S1 Aug-18 Dec-13 L Lp P P S S M M Lm L P P S/p S M M
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 P P/s S S M M L Lp P P S Sm M M L L

11 TRY SURYA TRESNA 2009014 PLK F D3 Aug-09 Feb-13 P/s P S S M M Lm L P P S/p P M M L P
12 TAPIARA 2009011 PLK F D3 Feb-09 Feb-09 P P S S Mp M L L P P/s S S M M L Lp
13 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 C S Sm M M L L P/s P S S M M Lm L
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 S Sm M M L L P/s P S S M M L Lp P P

15 RAHMAT HIDAYAT 2014057 PLK E D3 Aug-16 Jul-03 S/p S M M L L P P/s S S M M Lm L P P
16 ENI ERMAWATI 2009009 PLK E D3 Jan-16 Oct-03 S S M M Lm L P P S/p S M M L L P/s P
17 YUSI WARNI 2002068 PLK E D3 Aug-09 Oct-04 S S Mp M L L P P S Sm M M L L P P/s
18 Ns. SARI RATINA Y , S Kep 2015030 PLK T S1 Jul-20 Jun-15 P P L P S Sm M M L L CUTI
19 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P P L P P P P P P L P P P

O TJ OBAT TIM PPI
BULAN :SEPTEMBER 2020 Total
KET
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jam
M M L Ls P P S CUTI P/s P
M M L L P P S/p S M M L Ls P P
M M Lm L P P S S/p M M L L P P
M M L L P/s P S S M M Lm L P P
L L P P S Sm M M L L P/s P S S
L Lp P P S S M M Lm L P P S S
Lm L P P S/p S M M L L P P S Sm
L L P/s P S S M M L Lp P P S S
P C S Sm M M L Ls P P S S M M
P/s P L S M M L S P/s L S S M M
P P S S M M Lm L P P S Sm M M
P P S/p S M M L L P P/s S S M M
S Sm M M L L P/s P S S M M L Ls
S S M M Lm L P P S S Mp M L L
S S M M L Ls P P S Sm M M L L
P/s S P S L P Pm M M L Lp P P
M M L L

Diketahui oleh,

DAFTAR DIN
RUANGAN/UNIT : ICU
No
1 Ns. YESI SULASTRI, S kep 2000015 KR R S1 Mar-02 Jul-00 P P P
2 JERITA 2002076 KO I D3 Sep-09 S

Mar-11 S M
3 HARDIB BIANTO 2003058 PLK I D3 Jan-10 Mar-03 S S MS
4 ASTRI YULIANI 2003023 PLK I D3 NOV-2008 Jul-03 S Sm M
5 WERDA NINGSIH 2003060 PLK I D3 Jan-16 Oct-03 S/p S M
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 M M L

7 Ns. JAKA SAPUTERA,S kep 2010009 PLK O Jan-20 Aug-14 M M L
8 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 M M L
9 Ns. SYAHRIANI, S kep 2013029 PLK O S1 Aug-18 Dec-13 M M Lm
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 Lm L P

11 TRY SURYA TRESNA 2009014 PLK F D3 Aug-09 Feb-13 L P/s L
12 TAPIARA 2009011 PLK F D3 Feb-09 Feb-09 L L P/s
13 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 L Lp P
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 P P S/p

15 RAHMAT HIDAYAT 2014057 PLK E D3 Aug-16 Jul-03 CUTI
16 ENI ERMAWATI 2009009 PLK E D3 Jan-16 Oct-03 P P S
17 YUSI WARNI 2002068 PLK E D3 Aug-09 Oct-04 P/s P S
18 Ns. SARI RATINA Y , S Kep 2015030 PLK T S1 Jul-20 Jun-15 S L P
19 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P
R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
BULAN :OKTOBER 2020

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
M Lm L P P S/p S M M L L P P/s S S M M Lm L P P S
M L L P P S Sm M M L L P/s P S S M M L Lp P P S
M L Lp P P S S M M L Lp P P S Sm M M L L P/s P S
M L L P/s P S S M M Lm L cuti S Mp M L L P P S
Ls P P S Sm M M L L P/s P S S Ms M L L P P S Sm M
L P/s P S S M M Lm L P P S/p S M M L L P/s P S S M
L P P/s S S M M L Ls P P S Sm M M L L P P/s S S M
L P P S/p S M M L L P P/s S S M M L Lp P P S S Mp
P S/p S M M L L P/s P S S M M Lm L P P S S M M L
P S Sm M M L L P S/p S S M M L L S S S Sm M M L
P S S M M L Lp P P S Sm M M L L P/s P S S M M Lm
P S S M M Lm L P P S/p S M M L L P P/s S S M M L
S M M L Ls P P S Sm M M L L P P S Sm M M L L P/s
CUTI M L P P/s S L M M Lm L P P P P M M Lm L P
S/p M M L Lp P P S S M M L Lp P P S S Mp M L L P
S M M Lm L P P S/p S M M L L P P/s S S M M L Ls P
Sm M M L L P/s P P P P L P P S P Pm M M L Lp P P

TIM PPI
PENGGANTI KARU
Total
KET
26 27 28 29 30 31 Jam
P P P L P P
S Ms M L L P
S M M Lm L P
S M M L Lp P
Sm M M L L P/s
M L L P P/s S
M Lm L P P S/p
M L Ls P P S
M L L P P S
Lp P P S S M
L S/p S S S M
L P P S/p S M
Ls P P S S M
P S S M M L
P P P Ms M L
P S Sm M M L
P S S M M Lm
S S M M Lm L
P P P L P P
leh, Dibuat oleh

Diketahui oleh,

DAFTAR DINAS INTENSIVE CARE REVISI 4
RUANGAN/UNIT : ICU BULAN :NOVEMBE

No
NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
1 Ns. YESI SULASTRI, S kep 2000015 KR R S1 Mar-02 Jul-00 L ISOLASI
2 TRY SURYA TRESNA 2009014 PLK F D3 Aug-09 Feb-13 SKT L P L M M L S P/S M L L C L L S P P/M L
3 Ns. JAKA SAPUTERA,S kep 2010009 PLK O Jan-20 Aug-14 ISOLASI
4 YUSI WARNI 2002068 PLK E D3 Aug-09 Oct-04 L L L P P S S M M L L P P S L M M L L
5 Ns. SARI RATINA Y , S Kep 2015030 PLK T S1 Jul-20 Jun-15 ISOLASI
6 RITA SORAYA SKT M L S S S M L S P S/M M M L L C S L M

7 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 SKT L P L P P P L P P P P P P L S P M M
8 ENI ERMAWATI 2009009 PLK E D3 Jan-16 Oct-03 ISOLASI C S S S
9 RAHMAT HIDAYAT 2014057 PLK E D3 Aug-16 Jul-03 SKT L M L S M M L P P P M M L L M M L L/P
\
10 JERITA 2002076 KO I D3 Sep-09 Mar-11 ISOLASI
11 Ns. SYAHRIANI, S kep 2013029 PLK O S1 Aug-18 Dec-13 ISOLASI
12 TAPIARA 2009011 PLK F D3 Feb-09 Feb-09 SKT L S L P P P P L S S S S L L M M L L
13 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 ISOLASI
14 HARDIB BIANTO 2003058 PLK I D3 Jan-10 Mar-03 SKT L L L SKT SKT S S L S L S S L L C P S S

15 ASTRI YULIANI 1996008 KO E D3 Oct-08 Aug-96 ISOLASI SAKIT P P
16 WERDA NINGSIH 2003060 PLK I D3 Jan-16 Oct-03 P P L M L C C P P M M L L SAKIT SAKIT
17 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 ISOLASI

18 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 SKT P L M L P P M M L L P IS
19 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P P L P P P P P P L P P P P P P
O TJ OBAT TIM PPI
I TJ INVENTARIS RENC RAPAT RUANGAN N

:NOVEMBER 2020 Total
KET
20 21 22 23 24 25 26 27 28 29 30 1 Jam
PELATIHAN P P
P Isolasi Swb P P P L S S
P S P L S
S Isolasi Swb S S S L S S
S P P L P S S
L/M Isolasi Swb M M L L P P

L Isolasi Swb P M M L L P S
sakit L S M M L L P P
P Isolasi Swb P M M L L P
M L P P S M M
M L P P S M M
P Isolasi Swb S S S P M M
L L C S S M M L L
S Isolasi Swb S S M M L L
AKIT SAKIT L P P S M M L L
ISOLASI
L L C P L P P P
Ns. Dewi Eriani, S.Kep Ns. Yesi Sulastri, S Kep
Diketahui oleh,

DAFTAR DIN
RUANGAN/UNIT : ICU
No
2 JERITA 2002076 KO I D3 Sep-09 L

Mar-11 P P
3 HARDIB BIANTO 2003058 PLK I D3 Jan-10 Mar-03 L P P
4 ASTRI YULIANI 2003023 PLK I D3 NOV-2008 Jul-03 L P P
5 WERDA NINGSIH 2003060 PLK I D3 Jan-16 Oct-03 L P P
6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 P S S

7 Ns. JAKA SAPUTERA,S kep 2010009 PLK O Jan-20 Aug-14 P S S
8 ASNIYARINI 2009027 PLK O D3 Feb-09 Feb-09 P S S
9 Ns. SYAHRIANI, S kep 2013029 PLK O S1 Aug-18 Dec-13 P S S
10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 S M M

11 TRY SURYA TRESNA 2009014 PLK F D3 Aug-09 Feb-13 S M M
12 TAPIARA 2009011 PLK F D3 Feb-09 Feb-09 S M M
13 DESI SASWITA 2003036 PLK F D3 Mar-03 Jul-17 S M M
14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 M L L

15 RAHMAT HIDAYAT 2014057 PLK E D3 Aug-16 Jul-03 M L L
17 YUSI WARNI 2002068 PLK E D3 Aug-09 Oct-04 M L L
18 Ns. SARI RATINA Y , S Kep 2015030 PLK T S1 Jul-20 Jun-15
R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN

DAFTAR DIN
RUANGAN/UNIT : ICU
No
No NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3

Mar-11 P P



R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
BULAN :DESEMBER 2020

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
P P L P P P P P P L P P P P P P L P P P P L
M M L L P P S S M M L L P P S S M M L L CUTI

TIM PPI
PENGGANTI KARU

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

TIM PPI
PENGGANTI KARU
0 Total
KET
26 27 28 29 30 31 Jam
P L P P P P
P P S S M M
P P S S M M
P P S S M M
P P S S M M
CUTI
S S M M L L
S S M M L L
S S M M L L
M M L L P P
M M L L P P
M M L L P P
M M L L P P
L L P P S S
L L P P S S
L L P P S S
L L P P S S
P P/s S
P L P P P P
leh, Dibuat oleh

Diketahui oleh,
0 Total
KET
Jam
Total
KET
26 27 28 29 30 31 Jam
P L P P P P
P P S S M M
P P S S M M
P P S S M M
P P S S M M
CUTI
S S M M L L
S S M M L L
S S M M L L
M M L L P P
M M L L P P
M M L L P P
M M L L P P
L L P P S S
L L P P S S
L L P P S S
L L P P S S
P P/s S
P L P P P P
leh, Dibuat oleh

Diketahui oleh,

DAFTAR DI
RUANGAN/UNIT : ICU
No

Mar-11 P P



R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN

DAFTAR DI
RUANGAN/UNIT : ICU
No

Mar-11 P P



R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
BULAN :FEBRUARI 2020

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
P P P L P P P P L P L P P P P P P L P P P P

TIM PPI
PENGGANTI KARU

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

TIM PPI
PENGGANTI KARU
PENGGANTI KOORDINATOR Ns. Ul Ahdazumar, S
Total Jam KET
26 27 28
P P L
P P S
P P S
P P S
P P S
CUTI
S S M
S S M
S S M
M M L
M M L
M M L
M M L
L L P
L L P
L L P
L L P
P L P
Dibuat oleh

Diketahui oleh,
020 Total
KET
Jam
Total
KET
26 27 28 29 30 31 Jam
P L P P P P
P P S S M M
P P S S M M
P P S S M M
P P S S M M
CUTI
S S M M L L
S S M M L L
S S M M L L
M M L L P P
M M L L P P
M M L L P P
M M L L P P
L L P P S S
L L P P S S
L L P P S S
L L P P S S
P P/s S
P L P P P P
leh, Dibuat oleh

Diketahui oleh,

DAFTAR D
RUANGAN/UNIT : ICU
No
2 JERITA, AMK 2002076 KO I D3 Sep-09 S

Mar-11 M M
3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 S M M
4 ASTRI YULIANI, AMK 2003023 PLK I D3 NOV-2008 Jul-03 S M M
5 NASRUL. AMK 2011017 PLK I D3 Mar-10 Mar-10 S M M
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 isolasi

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 L P P
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 L P P
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 L P P
KARTIKA CANDRA , AMK
10
11 SUSILA FITRI, AMK 2002012 KO O D3 Mar-02 Jan-02 P S
13 ASNIYARINI, AMK 2009027 PLK O D3 Feb-09 Feb-09 P S S
ELVIYONITA, AMK
14
15 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 M L L
16 TRY SURYA TRESNA 2009014 PLK F D3 Aug-09 Feb-13 M L P
WERDA NINGSIH 2003060 PLK I D3 Jan-16 Oct-03 M L L
Ns. SYAHRIANI, S kep 2013029 PLK O S1 Aug-18 Dec-13 P S S

18 Ns.AMAR HUSNI, S Kep PLK
R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN

DAFTAR D
RUANGAN/UNIT : ICU

Mar-11 P P



R KEPALA RUANGAN
O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
BULAN :FEBRUARI 2020

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
P P P L P P P P L P P L P P C SAKIT L P P P P
L L P P S S M M L L P P S S M M L L P/s P S S
L L P P S S M M L L P P S S M M L L P P S Sm
L L P P S S M M L L P P S S M M L L P P/s S S
L L P P S S M M L L P P S S CUTI S
isolasi P S S S S M M L L S P S S M M L L
P P M M L L P P S S M M L L P P S S M M Lm L
S S M M L L P P S S M M L L P P S S M M L Ls
COVID MARWA P P P P M M
SAKIT P P
M M L L P P S S M M L L P P S S M M Lm L P P
COVID MARWA M M L L P/s P
P P S L M M L L P P S S M M L L P P S Sm CUTI
CUTI L S M M L L P P S S M M L L P P S/p S M M
P P S S M M L L CUTI L L P P S S M M
M M L L P P S S M M L L P P S S P L Vaksinator
COVID MARWA S M M L L S/p P
P P P L P P P P L P L P P P P P P L P P P P

TIM PPI
PENGGANTI KARU

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
M M L L P P S S M M L L P P S S M M L L CUT

TIM PPI
TJ ALAT Diketahui oleh
PENGGANTI KARU
PENGGANTI KOORDINATOR Ns. Ul Ahdazumar,
Total Jam KET
26 27 28
P P L
M M Lm
M M L
M M L
M M L
P/s P S
P P S/p
P P S
S S M
L Ls P
S S M
S Sm M
S S M
S S M
CUTI
L L P
L L P/s
Lm L P
P Vak L
P P S
P P L
Dibuat oleh

Diketahui oleh,

2020 Total
KET
26 27 28 29 30 31 Jam
P L P P P P
P P S S M M
P P S S M M
P P S S M M
P P S S M M
CUTI
S S M M L L
S S M M L L
S S M M L L
M M L L P P
M M L L P P
M M L L P P
M M L L P P
L L P P S S
L L P P S S
L L P P S S
L L P P S S
P P/s S
P L P P P P
leh, Dibuat oleh

Diketahui oleh,

RUMAH SAKIT ISLAM IBNU SINA DAFTAR DINAS
RUANGAN/UNIT : INTENSIF CARE BULAN : MA

No
NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 P P P P P P L P P P P P P L P P P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 L P P S S M M Lm L P P S S M M L L P

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 L P P S Sm M M L L P P/s S S M M L L P
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 L P P/s S S M M L L P/s P S S M M Lm L P
5 NASRUL. AMK 2011017 PLK I D3 Mar-10 Mar-10 L P/s S S S M M L L P P S Sm M M L L P
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 Sm M M L L P P/s S S M M L L P P/s S S M

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 S M M L L P/s P S S M M Lm L P P S S M
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P M M Lm L P P P P M M L L P/s P P P M
9 KARTIKA CANDRA , AMK S M M L L P C S Sm M M L L P P S Sm M
10 SUSILA FITRI, AMK 2002012 KO O D3 Mar-02 Jan-02 sakit P P P L P P P S/p S S L P P S S

11 ASNIYARINI, AMK 2009027 PLK O D3 Feb-09 Feb-09 M L L P/s P S S M M L L P/s P S S M M L
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O Jan-20 Aug-14 M L L P P S S M M Lm L P P S S M M Lm
13 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 M L L CUTI S Sm M M L L P P/s S S M M L
14 ELVIYONITA, AMK M Lm L P P S S/p M M L L P P S Sm M M L
15 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 C S Sm M M L L P P/s S S M M L L P/s P S

16 TRY SURYA TRESNA, AMK 2009014 PLK F D3 Aug-09 Feb-13 S S S M M Lm L S S S S M M Lm L S S S
17 YUSI WARNI, AMK 2002068 PLK E D3 Aug-09 Oct-04 P S S M M L L P/s P S S M M L L P P/s S
18 WERDA NINGSIH, AMK 2003060 PLK I D3 Jan-16 Oct-03 sakit P P S S M M L L P P S
19 Ns. SYAHRIANI, S Kep 2013029 PLK O S1 Aug-18 Dec-13 P S P (VAK) P/s L P S S P (VAK) P L L S P P (VAK)
20 Ns.AMAR HUSNI, S Kep PLK S/p L P M M L L P P S Sm M M L L S P M
21 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P CUTI L P P P L P P L P P P P

KETERANGAN : O TJ OBAT TIM PPI
I TJ INVENTARIS RENCANA RAPAT RUANGAN

009/FM DD/02-01/07
N0. Revisi : 03
AFTAR DINAS
BULAN : MARET 2021 Total

KET
Jam
19 20 21 22 23 24 25 26 27 28 29 30 31
P P L P P P P P P L P P P
P/s S S M M L L P/s P S S M M
P S Sm M M L L P P/s S S M M
P S S M M Lm L P P S S M M
P S S/p M M L L P P S Sm M M
M L L P P S Sm M M L L P P
M Lm L P P S S M M L L P/s P
M L L P P/s P P M M Lm L P P
M L L P P S S M M L L P P/s
P P L P/s P S S S S L P P P
L CUTI M M L P P S Sm
L P P S S M M L L P/s P S S
L P P S Sm M M L L P P S S
L P P S S M M Lm L P P S S
S M M L L P P S Sm M M L L
S M M L S P P/s S L M M L L
S M M Lm L P P S S M M Lm L
Sm M M L L S S S S M M L L
S L P S S P/s P (VAK) L S P/s P P(V)

M L Ls S P M M L Lp P S S M
Diketahui oleh Dibuat oleh

Disetujui oleh

RUMAH SAKIT ISLAM IBNU SINA DAFTAR DINAS
No
RUANGAN/UNIT : INTENSIF CARE BULAN : MARET 2021 , REVISI ( 4 ) Total
KET
Jam
NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 P P P P P P L P P P P P P L P P P P P P L P P P P P P L P P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 L P P S S M M Lm L P P S S M M L L P P/s S S M M L L P/s P S S M M

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 L P P S Sm M M L L P P/s S S M M L L P P S Sm M M L L P P/s S S M M
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 L P P/s S S M M L L P/s P S S M M Lm L P P S S M M Lm L P P S S M M
5 NASRUL. AMK 2011017 PLK I D3 Mar-10 Mar-10 L P/s S S S M M L L P P S Sm M M L L P P S S/p M M L L P P S Sm M M
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 Sm M M L L P P/s S S M M L L P P/s S S M M L L P P S Sm M M L L P P

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 S M M L L P/s P S S M M Lm L P P S S M M Lm L P P S S M M L L P/s P
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P M M Lm L P P P P M M L L P/s P P P M M L L P P/s P P M M Lm L P P
9 KARTIKA CANDRA , AMK S M M L L P C S Sm M M L L P P S Sm M M L L P/s P S S M M L L P P/s
10 SUSILA FITRI, AMK 2002012 KO O D3 Mar-02 Jan-02 sakit P P S S M M L L P P S S M M L L P/s P S S M M L L P P S S

11 ASNIYARINI, AMK 2009027 PLK O D3 Feb-09 Feb-09 M L L P/s P SAKIT P CUTI M M L P P S Sm
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O Jan-20 Aug-14 M L L P P S S M M Lm L P P S S M M Lm L P P S S M M L L P/s P S S
13 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 M L L CUTI S Sm M M L L P P/s S S M M L L P P S Sm M M L L P P S S
14 ELVIYONITA, AMK M Lm L P P S S/p M M L L P P P Sm M M L L P P S S M M Lm L P S S S
15 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 C S Sm M M L L P P/s S S M M L L P/s P S S M M L L P P S Sm M M L L

16 TRY SURYA TRESNA, AMK 2009014 PLK F D3 Aug-09 Feb-13 S S S M M Lm L S S S S M M Lm L S S S S M M L S P P/s S L M M L L
17 YUSI WARNI, AMK 2002068 PLK E D3 Aug-09 Oct-04 P S S M M L L P/s P S S M M L L P P/s S Sm M M L L P P S S M M Lm L
18 WERDA NINGSIH, AMK 2003060 PLK I D3 Jan-16 Oct-03 sakit P S S S P S L P P P S S S L S S M M L L
19 Ns. SYAHRIANI, S Kep 2013029 PLK O S1 Aug-18 Dec-13 P S P (VAK) P/s L P S S P (VAK) S L L P P P (VAK) S L P P P S P (VAK) L S P/s P P(V)
20 Ns.AMAR HUSNI, S Kep PLK S/p L P M M L L P P S Sm M M L L S P S S M M L L P/s S S S M M L Lp
21 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P CUTI L P P P L P P L P P P P P P L P P P P P P L P P P
R KEPALA RUANGAN NB TIM MUTU PMKP Diketahui oleh Dibuat oleh

I TJ INVENTARIS RENCANA RAPAT RUANGAN Ns. Dewi Eriani, S.Kep Ns. Yesi Sulastri, S Kep
F TJ FURNITUR TJ ALAT Disetujui oleh
T TJ TENUN PENGGANTI KOORDINATOR Ns. Ul Ahdazumar, S.Kep

009/FM DD/02-01/07
N0. Revisi : 03
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR
No RUANGAN/UNIT : INTENSIF CARE

NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3 4 5 6
1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 P L P L P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 L L P P S S

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 Lm L P P S S
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 L L P P S S
5 ELVIYONITA, AMK PLK I D3 Feb-21 L S P P S CUTI
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 S S M M L L

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 S S M M L L
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 S S M M L L
9 KARTIKA CANDRA , AMK 2009005 PLK E D3 Feb-21 Jun-08 S S M M L L
10 SUSILA FITRI, AMK 2002012 KO O D3 Mar-02 Jan-02 M M L L P P

11 ASNIYARINI, AMK 2009027 PLK O D3 Feb-09 Feb-09 M M L L P P
12 DESI SASWITA, AMK 2003036 PLK O D3 Mar-03 Jul-17 M M L L P P
13 Ns.AMAR HUSNI, S Kep PLK O S1 Feb-21 Jan-19 P P M M L L
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 P P S S M M

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 P P S S M M
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 P P S S M M
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 L L S S M M
18 TRY SURYA TRESNA, AMK 2009014 PLK T D3 Aug-09 Feb-13 P P P S M M

19 Ns. JAKA SAPUTERA,S Kep 2010009 PLK T S1 Jan-20 Aug-14 M M L L P P
20 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S L S P S S
21 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P L P L P P

R KEPALA RUANGAN
KETERANGAN : O TJ OBAT
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
BULAN : APRIL 2021

7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
P P L C L P P P P P P L P P P P P P L P P P P
M M L L P P C S M M L L P P S S M M L L P P S
M M L L P P S S M M L L P P S S M M L L P P S
CUTI M M L L P S S M M L L P P S S M M L L P P S
P P S S M M L L P P S S M M L L P P S S M M L
P P P S M M L L P P S S M M L L P P S P M M L
S S M M L L P P S S M M L L P P S S M M L L P
S S M M L L C C S S M M L L P P S S M M L L P
L L P P S S M M L L P P S S M M L L P P S S M
L L P P S S M M L L CUTI M L P S S M
L L S P S S M M L L P P S S M M L L P P S S M
L L CUTI P M M L L P P P S M M L L P P S S S S
P M M L L S P P P M M L L P P S S S S L P P P
S S L L P P S S S S L P S S S M M L L S S M M
P P P P L P P P P P P L P P P P P P L P P P P
NB TIM MUTU PMKP Diketahui oleh Dibuat oleh
TIM PPI
RENCANA RAPAT RUANGAN Ns. Dewi Eriani, S.Kep Ns. Yesi Sulastri, S
TJ ALAT Disetujui oleh
PENGGANTI KARU
Total
KET
30 Jam
P
S
S
S
S
L
L
L
L
P
P
P
P
M
M
M
M
L
S
L
P
Dibuat oleh

oleh
mar, S.Kep
L
DAFTAR

2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 L L P P S Sm

4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 L L P/s P S S
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 S Sm M M L L

8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 S S M M Lm L
10 SUSILA FITRI, AMK 2002012 KO O D3 Mar-02 Jan-02 M M L L P P/s

11 ASNIYARINI, AMK 2009027 PLK O D3 Feb-09 Feb-09 M M L L P/s P
12 DESI SASWITA, AMK 2003036 PLK O D3 Mar-03 Jul-17 M M Lm L P P
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 P P S Sm M M

16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 P P/s S S M M
18 TRY SURYA TRESNA, AMK 2009014 PLK T D3 Aug-09 Feb-13 P/s P P S M M

20 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S L S P/s S S

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
BULAN : APRIL 2021

7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
M M L L P P/s C S M M L Ls P P S S M M L L P P S
M M L L P/s P S S M M Lm L P P S S M M L L P P/s S
M M Lm L P P S S Mp M L L P P S Sm M M L L P P S
CUTI M M L L P S Sm M M L L P/s P S S M M Lm L P P S
P P S/p S M M L L P P S Sm M M L L P P S/p S M M L
P P/s S S M M Lm L P P S/p S M M L L P/s P S S M M L
P P P S/p M M L L P P S S M M Lm L P P S P M M Lm
P P S Sm M M L L P/s P S S M M L L P P S Sm M M L
S S M M L L P P S Sm M M L L P P/s S S M M L L P/s
S S M M Lm L P P S S M M Lm L P P S/p S M M L L P
S S M M L L P/s P S S M M L Lp P P S S M M Lm L P
S Sm M M L L CUTI 2020 S P/s P S S M M L L P
L L P P S/p S M M L Ls P P S S M M L
L P P S Sm M
L L P/s P S S M M Lm L P P S Sm M M L
L P/s P S S M
L L P P S Sm M M L L CUTI M L P/s S S M
Lm L S P S S Mp M L L P/s P S S M M Lm L P P S S M
L L CUTI P M M Lm L P P P/s S M M L L P/s P S S S S

Ms M L L P S P P/s L S M M L Ls P S S S S L P/s P P
S S L Ls P P S S S S L P S/p S S M M Lm L S S M M
NB TIM MUTU PMKP CODE BLUE Diketahui oleh Dibuat oleh
TIM PPI
PENGGANTI KARU
Total
KET
30 Jam
P
Sm
S
S
S/p
L
L
L
L
P
P
P
P/s
M
M
M
M
L
S
L
P
Dibuat oleh

oleh
mar, S.Kep
L
DAFTAR DINAS
No RUANGAN/UNIT : INTENSIF CARE BUL

NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 P L P L P P P P L C L P P P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 L L P P S Sm M M L L P P/s C S M

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 Lm L P P S S M M L L P/s P S S M
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 L L P/s P S S M M Lm L P P S S Mp
5 ELVIYONITA, AMK PLK I D3 Feb-21 L S P P S CUTI M M L L P S Sm M
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 S Sm M M L L P P S/p S M M L L P

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 S S M M L L P P/s S S M M Lm L P
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 S S M M Lm L P P P S/p M M L L P
9 KARTIKA CANDRA , AMK 2009005 PLK E D3 Feb-21 Jun-08 S S M M L L P P S Sm M M L L P/s
10 SUSILA FITRI, AMK 2002012 KO O D3 Mar-02 Jan-02 M M L L P P/s S S M M L L P P S

11 ASNIYARINI, AMK 2009027 PLK O D3 Feb-09 Feb-09 M M L L P/s P S S M M Lm L P P S
12 DESI SASWITA, AMK 2003036 PLK O D3 Mar-03 Jul-17 M M Lm L P P S S M M L L P/s P S
13 Ns.AMAR HUSNI, S Kep PLK O S1 Feb-21 Jan-19 P P M M L L S Sm M M L L CUTI 2020
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 P P S Sm M M L L P P S/p S M M L

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 P P S S M M L L P/s P S S M M Lm
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 P P/s S S M M L L P P S Sm M M L
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 L L S S M M Lm L S P S S Mp M L
18 TRY SURYA TRESNA, AMK 2009014 PLK T D3 Aug-09 Feb-13 P/s P P P M M L L CUTI P P P P L
19 Ns. JAKA SAPUTERA,S Kep 2010009 PLK T S1 Jan-20 Aug-14 M M L L P P Ms M L L P S P P/s L
20 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S L S P/s S S S S L Ls P P S S S
21 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P L P L P P P P P P L P P P P

R KEPALA RUANGAN NB TIM MUTU PMKP CODE BLUE
009/FM DD/02-01/07
N0. Revisi : 03
BULAN : APRIL 2021 Total
KET
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Jam
P P L P P P P P P L P P P P P
M L Ls P P S S M M L L P P S Sm
M Lm L P P S S M M L L P P/s S S
M L L P P S Sm M M L L P P S S
M L L P/s P S S M M Lm L P P S S/p
P S Sm M M L L P P S/p S M M L L
P S/p S M M L L P/s P S S M M L L
P S S M M Lm L P P S P M M Lm L
P S S M M L L P P S Sm M M L L
Sm M M L L P P/s S S M M L L P/s P
S M M Lm L P P S/p S M M L L P P
S M M L Lp P P S S M M Lm L P P
CUTI 2020 S P P S Sm M M L L P P/s
Ls P P S S Ms M L L P P S Sm M M
L P P S Sm M M L L P/s P S S M M
L CUTI M L P/s S S M M
L P/s P S S M M Lm L P S S S M M
P P P/s P P P L P P/s P P P P L P
S M M L Ls P S S S S L P/s P P S
S L P S/p S M M L L P S S M M L
P P L P P P P P P L P P P P P
CODE BLUE Diketahui oleh Dibuat oleh

Disetujui oleh
L
DAFTAR





18 TRY SURYA TRESNA, AMK 2009014 PLK T D3 Aug-09 Feb-13 P/s P P P M M

20 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S L S P/s S S

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
BULAN : APRIL 2021

7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
M M L L P P/s C S M M L Ls P P S S M M L L P P S
M M L L P/s P S S M M Lm L P P S S M M L L P P/s S
M M Lm L P P S S Mp M L L P P S Sm M M L L P P S
CUTI M M L L P S Sm M M L L P/s P S S M M Lm L P P S
P P S/p S M M L L P P S Sm M M L L P P S/p S M M L
P P/s S S M M Lm L P PS/p S M M L L P/s P S S M M L
P P P S/p M M L L P P S S M M Lm L P P S P M M Lm
P P S Sm M M L L P/s P S S M M L L P P S Sm M M L
M M L L
S S M M L L P P S Sm M M L L P P/s S S M M L L P/s
S S M M Lm L P P S S M M Lm L P P S/p S M M L L P
S S M M L L P/s P S S M M L Lp P P S S M M Lm L P
S Sm M M L L CUTI 2020 S P P S Sm M M L L P
L L P P S/p S M M L Ls P P S S Ms M L
L P P S Sm M
L P/s P S S M
L L P P S Sm M M L L CUTI M L P/s S S M
Lm L S P S S Mp M L L P/s P S S M M Lm L P S S S M
L L CUTI P P P P L P P P/s P P P L P P/s P P P P L

Ms M L L P S P P/s L S M M L Ls P S S S S L P/s P P
S S L Ls P P S S S S L P S/p S M M L L P S S M M
TIM PPI
PENGGANTI KARU
Total
KET
30 Jam
P
Sm
S
S
S/p
L
L
L
L
P
P
P
P/s
M
M
M
M
P
S
L
P
Dibuat oleh

oleh
mar, S.Kep
L
DAFTA

NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2 3 4 5
1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 L L P P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 M M L L P

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 M M L L P
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 M M L L P
5 ELVIYONITA, AMK PLK I D3 Feb-21 M M L L P
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 P P S S M

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 P P S S M
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P P S S M
9 KARTIKA CANDRA , AMK 2009005 PLK E D3 Feb-21 Jun-08 P P S S M
10 SUSILA FITRI, AMK 2002012 KO O D3 Mar-02 Jan-02 S S M M L

11 ASNIYARINI, AMK 2009027 PLK O D3 Feb-09 Feb-09 S S M M L
12 DESI SASWITA, AMK 2003036 PLK O D3 Mar-03 Jul-17 S S M M L
13 Ns.AMAR HUSNI, S Kep PLK O S1 Feb-21 Jan-19 S S M M L
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 L L P P S

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 L L P P S
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 L L P P S
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 L L P P S
18 TRY SURYA TRESNA, AMK 2009014 PLK T D3 Aug-09 Feb-13 L P P S S

19 Ns. JAKA SAPUTERA,S Kep 2010009 PLK T S1 Jan-20 Aug-14 S L S S P
20 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 P S L P P
21 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 L L P P P

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
BULAN : MAI 2021

6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
P P P L P P P L L L L P P P P CUTI
P S S M M L L CUTI L L P P S S M M L
CUTI S M M L L P P S S M M L
M L L P P S S M M L L P P S S M M L L P P S
S M M L L P P S S M M L L P CUTI M M L L P
L S S M M L L P P S S M M L L P P P P
P M M L L S S S S P P L P P P S S S L
P S S S L P P P P S S L S P P S M M L L
P P P L P P P L L P L P P P P P P L P P L P
NB TIM MUTU PMKP CODE BLUE Diketahui oleh Dib
TIM PPI
RENCANA RAPAT RUANGAN Ns. Dewi Eriani, S.Kep Ns. Yesi S
PENGGANTI KARU
Total
KET
28 29 30 31 Jam
P P L P
L P P S
L P P S
L P P S
L P P S
S M M L
S M M L
S M M L
S M M L
M L L P
M L L P
M L L P
M L L P
P S S M
P S S M
P S S M
P S S M
P P L P
Dibuat oleh

Disetujui oleh
l Ahdazumar, S.Kep
L
DAFTAR

1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 L L P P P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 M M L L P P

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 M M L L P P
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 M M L L P P
5 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 M M L L P P
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 P P S S M M

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 P P S S M M
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P P S S M M
9 Ns. JAKA SAPUTERA,S Kep 2010009 PLK T S1 Jan-20 Aug-14 L P S S M M
10 SUSILA FITRI, AMK 2002012 KO O D3 Mar-02 Jan-02 S S M M L L

11 ASNIYARINI, AMK 2009027 PLK O D3 Feb-09 Feb-09 S S M M L L
12 DESI SASWITA, AMK 2003036 PLK O D3 Mar-03 Jul-17 S S M M L L
13 TRY SURYA TRESNA, AMK 2009014 PLK T D3 Aug-09 Feb-13 S S M M L L
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 L L P P S S

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 L L P P S S
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 L L P P S S
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 L L P P S S
18 ELVIYONITA, AMK PLK I D3 Feb-21 S S L S S CU

19 KARTIKA CANDRA , AMK 2009005 PLK E D3 Feb-21 Jun-08 P P S M M L
20 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 L L P P P P

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
BULAN : MAI 2021

7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
P P L P P CUTI P P P
S S M M L L CUTI LEBARAN L L P P S S M M L L P
S S M M L L P P S/P S M M L L P P S S M M L L P
L L P P S S M M L L P P S S/P M M L L P P S S M
L L P P S S M M L LS P P S S M M L L P P S S M
P P S S M M L L P P S SM M M L L P P S S M M L
M M L L P P S S M M L L P CUTI M M L L P P S
M M L L P P S S M M LM L P P S S M M L L P P S
CUTI LEBARAN
L P
P P L P P P L L P L P P P P P P L P P L P P P
TIM PPI
PENGGANTI KARU
Total
KET
30 31 Jam
L P
P S
P S
P S
P S
M L
M L
M L
M L
L P
L P
L P
L P
S M
S M
S M
S M
L P
Dibuat oleh

oleh
mar, S.Kep
L
DAFTAR



7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 C S M M L L


18 TRY SURYA TRESNA, AMK 2009014 PLK T D3 Aug-09 Feb-13 MAGANG RSUD
20 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S L L P S S

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
BULAN : APRIL 2021

7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
P P L C L P P P P P P L P P S P P P L P P P
M M L L P P/s C S M M L Ls P P S S M M L L P P
M M L L P/s P S S M M Lm L SKT S SKT M M L L P P/s
M M Lm L P P S S Mp M L L P P S Sm M M L L P P
CUTI M M L L P S Sm M M L L P/s P S S M M Lm L P P
P P S/p S M M L L P P S Sm SKT M L L P P S/p S M M

P P/s S S M M Lm L P P S/p SKT M Lm L P/s P S S M M
P P P S/p M M L L P P S S M M Lm L P S S P M M
P P S Sm M M L L P/s C S SKT M M L L P P S Sm M M
S S M M L L P P S Sm M M L L P P/s S S M M L L
S S M M Lm L P P S S M M Lm L P P S/p S M M L L
S S M M L L P/s P S S M M L Lp P P S Sm M M L L
S Sm M M L L CUTI 2020 S P PINDAH COVID RAUDAH
L L P P S/p C M M L Ls P P S S Ms M L
L P P S Sm
L P/s P S S
L L P P S Sm M M L L CUTI M L P/s S S
Lm L S P S S SKT C L L P/s P S S M M Lm L P S S S
MAGANG RSUD L C P P P P P L P P P P L P M M Lm L
S M M L L MAGANG RSUD S P/s S
VAKS P L P P S VAKS L M M L S VAKS S P/s P L S VAKS
TIM PPI
PENGGANTI KARU
Total
KET
29 30 Jam
P P
S Sm
S S
S S
S S/p
L L
L L
Lm L
L L
P/s P
P P
P P
ID RAUDAH
M M
M M
M M
M M
P P
S S
VAKS S
P P
Dibuat oleh

ujui oleh
azumar, S.Kep
L
DAFTAR DINAS
No RUANGAN/UNIT : INTENSIF CARE BUL

1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 L L P P P P* P P L P P P* L L C L P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 M M* L L P/s P S S M M* Lm L CUTI LEBARAN

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 M M L Ls P* P S P Mp M L L P P* S Sm M*
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 M* M Lm L P P S/p* S M M L Ls P P S* S* M
5 KARTIKA CANDRA , AMK 2009005 PLK E D3 Feb-21 Jun-08 P S M M L L S Sm M M L L P/s P S S* M
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 P P S S/p M M* L L P P S* Sm M M L L P/s

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 P/s P S* S M M L Ls P* P S S M* M L LS P
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P* P P Pm M M L L P/s P* P P M M* Lm L P
9 Ns. JAKA SAPUTERA,S Kep 2010009 PLK T S1 Jan-20 Aug-14 L P* S S M* M Lm L P P S/p S* M M L Lp P*
10 SUSILA FITRI, AMK 2002012 KO O D3 Mar-02 Jan-02 S S M M L Lp P* P S S M M* L Ls P P S*

11 ASNIYARINI, AMK 2009027 PLK O D3 Feb-09 Feb-09 S Sm* M M L L P/s P* S S* M M L L P/s P S
12 DESI SASWITA, AMK 2003036 PLK O D3 Mar-03 Jul-17 S/p S M* M L Ls P P S* S M M Lm L P* P S/p
13 TRY SURYA TRESNA, AMK 2009014 PLK T D3 Aug-09 Feb-13 S* S M M* Lm L P S* S S/p M* M L L P P* S
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 L L P/s P* S* S M M* L Ls P P S* S/p M M L

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 Lm L P P S/p S M M L L P P S Sm M* M L
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 L L P* P S Sm M* M L L P/s* P S S* M M* Lm
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 L Lp S S* S S* M M Lm L S P* S/p S M M L
18 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S P/s L P VAKSIN M M* Lm L S P P S/p M M*
20 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 L P P P P P P P L P P P L L P L P

009/FM DD/02-01/07
N0. Revisi : 03
BULAN : MAI 2021 Total Jam KET
18 19 20 21 22 23 24 25 26 27 28 29 30 31
P P P P P L P P* L P P P* L P
ARAN L L P* P S Sm M* M L L P P* S/p
M L LP P P* S S M M* L Lp P P S*
M* L Ls P P S* S M M Lm L P P S
M Lm L P P S/p S* M M L L P/s* P S
P S* S Ms M L L P P S/P S M* M L
P* S S M* M Lm L P P S* S M M Lm
P P P* M M L Lp P P* P Pm M M L
P S Sm M M* L L P/s P S S M M* L
S Mp M L L P P/s S S* M M L Ls P
S M* M Lm L P P S* S/p M M* L L P/s
S* M M L Ls P* P S Sm M M L L P*
SM M M* L L P/s P S S M* M Lm L P
L P/s P S* S M M* L L P/s P S S* M
Lp P CUTI M M Lm L P* P S S M
L S S* S/p S CUTI P/s S* S M
Ls P* P S S* M M L L S S* S Sm M*
L VAKS S Sm M* M L Ls VAK P* P S/p S
P P P P P L P P L P P P L P
BLUE Diketahui oleh Dibuat oleh

Disetujui oleh
L
D

1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 L P P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 S M M L

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 Sm M M L
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 S M M Lm
5 JUSMIATI I Mai 2021 S M M L
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 L P/s P S

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 L P P/s S
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 L P P P
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 P/s P L S
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 P S Sm M

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 P S S/p M
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 Lp S S M
13 TRY SURYA TRESNA, AMK 2009014 PLK O D3 Aug-09 Feb-13 P S/p S M
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 M Lm L P

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 M L L P/s
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 M L L P
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 M L L S/p
18 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S L CUTI 2021
20 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 L P P P

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
BULAN : JUNI 2021

5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
P L P P P P P P L P P P P P P L P P P P
L P/s P S S Mp M L L P P S Sm M M L L P P S
L P P/s S S M M Lm L P P S S M M L L P P/s S
L P P S/p S M M L L CUTI 2021 P/s P S
Lp P P S Sm M M L L P/s P S S M M Lm L P P S
S M M L L P P/s S S M M L Lp P P S S M M Lm
S M M L Lp P P S Sm M M L L P P S Sm M M L
Sm M M L L P/s P S S M M Lm L P S S/p P M M L
S M M Lm L P P S S/p M M L L P/s P S S M M L
M L L P P/s S S M M Lm L P P S S M M L L P
M L L P/s P S S M M L L P P/s S S M M L L P
M Lm L P P S S M M L L P/s P S S M M Lm L P
M MAGANG SURABAYA P P/s L S S Pm M M L L P/s
P S/p S M M L L P P/s S S M M L Ls P P S S M
P S S M M Lm L P P S Sm M M L L P P/s S S M
P/s S S M M L L P/s P S S M M Lm L P P S Sm M
P S Sm M M L L P P S/p S M M L L P/s S S S M
CUTI 2021 VAK Sm M M L L S/p VAK M M L L P P VAK
P L P P P P P P L P P P P P P L P P P P
N NB TIM MUTU PMKP CODE BLUE Diketahui oleh
TIM PPI
RENCANA RAPAT RUANGAN Ns. Dewi Eriani, S.Kep
TJ ALAT Disetuju
PENGGANTI KARU
PENGGANTI KOORDINATOR Ns. Ul Ahdazu
21 Total Jam KET
25 26 27 28 29 30
P P L P P P
Sm M M L L P
S M M L L P/s
S M M Lm L P
S M M L L P
L P P S Sm M
L P P/s S S M
L S/p P P P M
L P/s P S S M
P/s S S M M L
P S Sm M M L
P S S/p M M L
P P S M M Lm
M Lm L P P S
M L L P/s P S
M L L S/p S S
M L L P P/s S
S/p S P L P S/p
P P L P P P
hui oleh Dibuat oleh
riani, S.Kep Ns. Yesi Sulastri, S Kep

Disetujui oleh

L
DAFTAR DINAS
No RUANGAN/UNIT : INTENSIF CARE BULA

1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 L P P P P L P P P P P P L P P P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 S M M L L P/s P S S Mp M L L P P S Sm

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 Sm M M L L P P/s S S M M Lm L P P S S/P
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 S M M Lm L P P S/p S M M L L CUTI 2021
5 Ns. JUSMIATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 S M M L Lp P P S Sm M M L L P/s P S S
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 L P/s P S S/P M M L L P P/s S S M M L Lp

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 L P P/s S S M M L Lp P P S Sm M M L L
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 L P P P Lm M M L L P/s P S S M M Lm L
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 P/s P L S S M M Lm L P P S S/p M M L L
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 P S Sm M M LL P P/s S S M M Lm L P P

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 P S S/p M sakit S S M M L L P P/s
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 Lp S S M M Lm L P P S S M M L L P/s S
13 TRY SURYA TRESNA, AMK 2009014 PLK O D3 Aug-09 Feb-13 P S/p S M M L L P/s P S S P MAGANG CATLAB
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 M Lm L P P S/p S M M L L P P/s S S M M

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 M L L P/s P S S M M Lm L P P S Sm M M
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 M L L P P/s S S M M L L P/s P S S M M
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 M L L S/p S S Sm M M L L P P S/p S M M
18 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S L CUTI 2021 L Sm M M L Ls S P
20 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 L P P P P L P P P P P P L P P P P

009/FM DD/02-01/07
N0. Revisi : 03
REVISI 2
BULAN : JUNI 2021 Total Jam KET

18 19 20 21 22 23 24 25 26 27 28 29 30
M M L L P P S Sm M M L L P
M M L L P P/s S S M M L L P/s
CUTI 2021 P/s P S S M M Lm L P
M M Lm L P P S S M M L L P
P P S S M M Lm L P P S Sm M
S P S Sm M M L L P P/s S S M
P S S/p P M M L L S/p P P P M
P/s P S S M M L L P/s P S S M
S Sm M M L L P P/s S S M M L
S S M M L L P P S Sm M M L
S S M M Lm L P P S S/p M M L
CATLAB M L L P/s P P S M M Lm
L Ls P P S S M M Lm L P P S
L L P P/s S S M M L L P/s P S
Lm L P P S Sm M M L L S/p S S
L L P/s S S S M M L L P P/s S
M M L L P P VAK S/p S P L P S/p
UE Diketahui oleh Dibuat oleh

Disetujui oleh
L
DAFTAR DINAS

1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 P P P L P P P P P L L P P P P P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 P/s S C M M L L P P S Sm M M L L P P/s

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 P S P M M Lm L P P S/P S M* M L Lp P P
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 P S* S/p M M* L L P/s P S S* M M Lm L P P
5 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 P S Sm M* M L L P P S/p* S M M* L L P P
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 M L LS P P S Sm M M L L P/s P S S M M

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 M L L P P/s S* S M M* L L P P S Sm* M M
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 M* Lm L P P P P M* M L L P P/s P P M* M
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 M L L P/s* P S S* M M Lm L P P S/p* S M M*
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 L P P/s S S M M L L P/s P S S M M Lm L

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 L P/s P S* S M M* L Ls P P* S S M* M L Lp
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 L P P S S* M M Lm L P P Sp* S M M* L L
13 TRY SURYA TRESNA, AMK 2009014 PLK O D3 Aug-09 Feb-13 L P S* S/p S M* M L S L P S Sm* M M L L
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 Sm M M L L P P/s S S M M L L P P/s S S

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 S* M M Lm L P P S* S M M* L Lp P P S Sm
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 S M* M L L P/s L S S* M M Lm L P S S* S
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 S M M* L L S/p S S Sm M* M L L P/s P S S*
18 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 P S M M Lm L P P P P P/s S L S P P/s S
20 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P L P P P P P P L P P P P P P

R KEPALA RUANGAN TIM MUTU PMKP CODE BLUE
KETERANGAN : O TJ OBAT TIM PPI SISMADAK DAN PPI
I TJ INVENTARIS RENCANA RAPAT RUANGAN * TJ ALAT
009/FM DD/02-01/07
N0. Revisi : 03
REVISI 2
BULAN : JULI 2021 Total Jam KET

18 19 20 21 22 23 24 25 26 27 28 29 30 31
L P L P P P P P P P P P P P
S* S M M Lm L P P S* S Mp M* L L
S S M M* L Ls P P S Sm* M M L L
S Sm M* M L L P/s P* S S M* M L L
L L P/s P S S M M Lm L P P S Sm
L LP P* P S Sm M* M L L P/s P S S*
Lm L P P P P Mp M* L L P P/s P S
L L P P/s S S* M M L Lp P P S S
P P S S M M L L P/s P S S M M
P CUTI 2021 P/s S S M M*
P/s P* S S M* M Lm L P P S* S M* M
P* P/s S S* M M L Lp P P S Sm* M M
M M L Lp P P S Sm M M L L P P
M M* L L P/s P S* S M M* L L P/s P
M* M L Lm P P S S* M M Lm L P P/s
M M Lm L S* S S S Mp* M L L P P
P L S/p* S M M* L Ls P S S P S* P
L P L P P P P L P P P P P P
PI
Disetujui oleh
L

NAMA KARYAWAN Nik Jab TJ Pdd TMT Ru TMT-RSI 1 2
1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 L P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 P P

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 P* P
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 P/s P
5 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 P P
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 M M

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 M* M
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 M M*
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 M M
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 Lm L

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 L Ls
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 L L
13 TRY SURYA TRESNA, AMK 2009014 PLK O D3 Aug-09 Feb-13 L L
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 S/p S

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 S* S
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 S S*
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 S Sm
18 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 L P
19 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 L P

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
ARE BULAN : AGUSTU

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
P P P P P L P P P P P P L P L P
S/p S M M L L P P S Sm M M L L P P/s
S Sm M* M L L P/s P S* S M M* L Lp P* P
S* S M M* L Lp P P S S* M M Lm L P P
S S* M M Lm L P P* S/p S M* M L L P/s P
L L P P S Sm M M L L P/s P S S M M
L L P P/s S S* M M L L P P S/p* S M M
Lm L P P S S M* M L L P P S Pm M* M
L L P P S/p* S M M* Lm L P P/s S S M M*
P P S S M M L Ls P P S S M M Lm L
P P S* Sm M M L L P P/s S* S M M* L L
P/s P S S* M M Lm L P P S Sm* M M L L
P P/s S S M M* L L P/s P S S M* M L S/p*
M M L L P P/s S S M M L L P/s P S S
M M* L L P P S S/p* M M L L P* P/s S S
M M L L P/s P S* S M M* Lm L P P S* Sm
M* M L L P P S Sm M* M L L P S* S/p S
S S Sm M M* L L P S CUTI
P P P P P L P L P P P P L P L P
TIM MUTU PMKP CODE BLUE
TIM PPI SISMADAK DAN PPI
RENCANA RAPAT RUANGAN * TJ ALAT
TJ ALAT
PENGGANTI KARU
PENGGANTI KOORDINATOR
BULAN : AGUSTUS 2021 Total Jam KET
19 20 21 22 23 24 25 26 27 28 29 30 31
P P P L P P P P P P L P P
S S M M L L P P S Sm M M L
S Sm M* M L L P/s P S* S M M* L
S* S M M* L Ls P P S S* M M Lm
S S* M M Lm L P P S S/p M* M L
L L P P/s S S M M Lm L P P S
L L P P* S Sm M M* L L P P/s S*
L L P/s P P P M* M L Ls P P P
Lm L S P S* S M M L L P/s* P S
P P S S M M L Lp P P S S M
P/s P S* S M M* L L P/s P S S* M
P P/s S S* M M L Ls P P S* S M
P P L Sm M* M L S P L S Sm M*
M M Lm L P P S S M M L L P
M M* L Lp P P S* S M M Lm L P
M M L L P/s P S S* M M L L S/p
M* M L L S S* S Sm M M* L L P/s
S P S/p L P P Sm M M* L L P S

Disetujui oleh

L
DAFTAR DINAS
No RUANGAN/UNIT : INTENSIF CARE BULAN

1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 P P P L P P P P P L L P P P P P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 P/s S C M M L L P P S Sm M M L L P P/s

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 IZIN P M M Lm L P P S/P S M* M L L P/s P
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 P S* S/p M M* L L P/s P S S* M M Lm L P P
5 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 P VAK Sm M* M L L P P S/p* S M M* L L P P
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 M L LS P P S Sm M M L L P/s P S S M M

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 M L L P P/s S* S M M* L L P P S Sm* M M
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 M* Lm L P P P P M* M L L P P/s P P M* M
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 SKT C C P/s* P S S* M M Lm L P P S/p* S M M*
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 L P P S Sm M M L L P/s P S S M M Lm L

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 L P/s P S* S M M* L Ls P P* S S M* M L Lp
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 L P P S S* M M Lm L P P/s S* S M M* L L
13 TRY SURYA TRESNA, AMK 2009014 PLK O D3 Aug-09 Feb-13 L SKT S* S/p S M* M L S L P S Sm* M M L L
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 Sm M M L L P P/s S S M M L L P P/s S S

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 S* M M Lm L P P S* S M M* L Lp P P S Sm
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 S M* M L L P/s P S L* M M Lm L S S S* S
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 S M M* L L S/p S S Sm M* M L L P/s P S S*
18 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 P S SEMENTARA PINDAH RUANG
20 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P L P P P P P P L P P P P P P

I TJ INVENTARIS
009/FM DD/02-01/07
N0. Revisi : 03
REVISI 2
BULAN : JULI 2021 Total Jam KET

18 19 20 21 22 23 24 25 26 27 28 29 30 31
L P L P P P P P P P P P P P
S* S M M Lm L P P S* S Mp M* L L
S S M M* L Ls P P S Sm* M M L L
S Sm M* M L L P/s P* S S M* M L L
L L P/s P S S M M Lm L P P S Sm
L LP P* P S Sm M* M L L P/s P S S*
Lm L P P P P Mp M* L L P P/s P S
L L P P/s S S* M M L Lp P P S S
P P S/p S M M L L P/s P S S M M
P CUTI 2021 P/s S S M M*
P P/s* S S M* M Lm L P P S* S M* M
P* P S Sm* M M L Ls P P S Sm* M M
M M L Lp P P S Sm M M L L P P
M M* L L P/s P S* S M M* L L P/s P
Ms* M L L P P S S* M M Lm L P P/s
M M Lm L S* S S S Mp* M L L S P
PINDAH RUANGAN HD
L P L P P P P L P P P P P P
PPI
Disetujui oleh
L
DAFTAR DINAS

1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 L P P P P P P L P P P P P P L P L
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 P P S/p S M M L L P P S Sm M M L L P

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 P* P S Sm M* M L L P/s P S* S M M* L Lp P*
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 P/s P S* S M M* L Lp P P S S* M M Lm L P
5 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 P P/s S S* P P L L P P* S/p S M* M L L P/s
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 M M L L P P S Sm M M L L P/s P S S M

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 M* M L L P P/s S S* M M L L P P S/p* S M
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 M M* Lm L P P S S M* M L L P P S Pm M*
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 M M L L P S S/p* S M M* Lm L P P/s S S M
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 L L P P S Sm M M L Ls P P S S M M Lm

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 Lm L P P S* C M* M L L P P/s S* S M M* L
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 L L P/s P S S* M M Lm L P P S Sm* M M L
13 TRY SURYA TRESNA, AMK 2009014 PLK O D3 Aug-09 Feb-13 L L P P/s S S M M* L L P/s P S S M* M L
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 S/p S M M L L P P/s S S M M L L P/s P S
15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 S* S M M* Lm L P P S S/p* M M L L P* P/s S
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 S S* M M L L P/s P S* S M M* Lm L P P S*
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 S Sm M* M L L P P S Sm M* M L L P S* S/p
18 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 L P P S M M Lm L P P S CUTI
19 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 L P P P P P P L P L P P P P L P L

I TJ INVENTARIS
009/FM DD/02-01/07
N0. Revisi : 03
18 19 20 21 22 23 24 25 26 27 28 29 30 31
P P P P L P P P P P P L P P
P/s S S M M L L P P S Sm M M L
P S Sm M* M L L P/s P S* S M M* L
P S* S M M* L Ls P P S S* M M Lm
P S S* M M Lm L P P S S/p M* M L
M L L P P/s S S M M Lm L P P S
M L L P P* S Sm M M* L L P P/s S*
M L L P/s P P P M* M L Ls P P P
M* Lm L S P S* S M M L L P/s* P S
L P P S S M M L Lp P P S S M
L P/s P S* S M M* L L P/s P S S* M
L P P/s S S* M M L Ls P P S* S M
S/p* P P L Sm M* M L S P L S Sm M*
S M M Lm L P P S S M M L L P
S M M* L Lp P P S* S M M Lm L P
Sm M M L L P/s P S S* M M L L S/p
S M* M L L S S* S Sm M M* L L P/s
S P S/p L P P Sm M M* L L P S
P P P P L P P P P P P L P P

Disetujui oleh
L

1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 L P

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 L P/s
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 L P
5 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 L P
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 Sm M

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 S* M
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P M*
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 S M
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 M L

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 M L
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 M Lm
13 TRY SURYA TRESNA, AMK 2009014 PLK O D3 Aug-09 Feb-13 M* L
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 P/s S

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 P S
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 P S
18 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 S P
19 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
ARE BULAN : AGUSTU

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
P P L P P P C P P L P P P P P P
P S Sm M M L L P P/s S S M M L L P
P S* S M M* L Lp P* P S Sm M* M L L P/s
P S S* M M Lm L P P S* S M M* L Ls P
P* S/p S M* M L L P/s P S S* M M Lm L P
M L L P/s P S S M M L L P P/s S S M
M Lm L P P S/p* S M M L L P P* S Sm M
M L L P P P Pm M* M L L P/s P P P M*
M* L L P P/s S S M M* Lm L S P S* S M
Ls P P S S M M Lm L P P S S M M L
L P P/s S* S M M* L L P/s P S* S M M* L
L P P S Sm* M M L L P P/s S S* M M L
L P/s P S S M* M L S/p* P P L Sm M* M L
S M M L L P/s P S S M M Lm L P P S
S/p* M M L L P* P/s S S M M* L Lp P P S*
S M M* Lm L P P S* Sm M M L L P/s P S
Sm M* M L L S S* S/p S M* M L L S S* S
M M L L P P P S M M L L P S S S
P P L P P P P P P L P P P P P P
TJ ALAT
PENGGANTI KARU
19 20 21 22 23 24 25 26 27 28 29 30 31
L P P P P P P L P P P P
P S Sm M M L Lp P P S S M
P S* S M M* L L P P S Sm M
P S S* M M Lm L P P S S M
P S S/p M* M L L P/s P S S M
M Lm L P P S S M M L Ls P
M* L L P P/s S* S M M L L P/s
M L Ls P P P Sm M M L L P
M L L P/s* P S S M M Lm L P
Lp P P S S M M Lm L P P S
L P/s P S S* M M L L P P S
Ls P P S* S M M L Ls P P S
S P L S Sm M* M L L P/s P S
S M M L L P P/s S S M M Lm
S M M Lm L P P S Sm M M L
S* M M L L S/p P S S M M L
Sm M M* L L P/s P S S M M L
P P L P S S M M L L
L P P P P P P L P P P P

Disetujui oleh

L
DAFTAR DINAS

1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 P P P P L P P P C P P L P P P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 L P P S Sm M M L L P P/s S S M M L

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 L P/s P S* S M M* L Lp P* P S Sm M* M L
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 L P P S S* M M Lm L P P S* S M M* L
5 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 S P P* L S M* M L L P/s P S S* M M Lm
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 Sm M M L L P/s P S S M M L L P P/s S

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 S* M M Lm L P P S/p* S M M L L P P* S
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P M* M L L P P P Pm M* M L L P/s P P
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 S M M* L L P P/s S S M M* Lm L P P S*
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 M L Ls P P S S M M Lm L P P S S M

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 M L L P P/s S* S M M* L L P/s P S* S M
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 M Lm L P P S Sm* M M L L P P/s S S* M
13 TRY SURYA TRESNA, AMK 2009014 PLK O D3 Aug-09 Feb-13 M* L L P/s P S S M* M L LP P P S Sm M*
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 P/s S S M M L L P/s P S S M M Lm L P

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 P S S/p* M M L L P* P S S M M* L Lp P
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 S S* S M M* Lm L P P S* Sm M M L L P/s
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 P S Sm M* M L L S S* S/p S M* M L L S
18 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 L P P* S S/p S S L P/s P P S S S L P
19 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P L P P P P P P L P P P P

I TJ INVENTARIS
009/FM DD/02-01/07
N0. Revisi : 03
BULAN : SEPTEMBER 2021 Total Jam KET
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
P P L P P P C P P L P P P P
L P P S Sm M M L Lp P P S S M
L P/s P S* S M M* L L P P S* Sm M
Ls P P S S* M M Lm L P* P S/p S* M
L P P S S/p M* M L L P/s P* S S M*
S M M Lm L P P S S M M L Ls P
Sm M M* L Ls P P S* S M M* L L P/s
P M* M L L P P/s P Sm M* M L L P
S M M L L P/s* P S S* M M Lm L P
M L Lp P P S S M M Lm L P P S
M* Lm L P P S S* M M L L P P S
M L Ls P P S* S M M* L Ls P P S*
M L L P P S Sm M* M L L P/s P S
P S S M M L L P P/s S S M M Lm
P S* S M M Lm L P P S* Sm M M* L
P S S* M M L L S/p P S S* M M L
S* S Sm M M* L L P/s P S S M* M L
P P S S/p S L P P P S/p S S L P
P P L P P P P P P L P P P P
E Diketahui oleh Dibuat oleh
DAN PPI
Disetujui oleh
L

2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 L P

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 L P/s
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 L P
5 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 S P
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 Sm M

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 S* M
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P M*
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 S M
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 M L

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 M L
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 M Lm
13 TRY SURYA TRESNA, AMK 2009014 PLK O D3 Aug-09 Feb-13 M* L
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 P/s S

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 P S
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 P S
18 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 L P

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
ARE BULAN : SEPTEMBER

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
P P L P P P C P P L P P P P P P L
P S Sm M M L L P P/s S S M M L L P P
P S* S M M* L Ls P* P S Sm M* M L L P/s P
P S S* M M Lm L P P S* S M M* L Ls P P
P* L S M* M L L P/s P S S* M M Lm L P P
M L L P/s P S CUTI P P/s S S M M

M Lm L P P S/p* S M M L L P P* S Sm M M*
M L L C P P Pm M* M L L P/s P P P M* M
M* L L P P/s S S M M* Lm L P P S* S M M
Ls P P S S M M Lm L P P S S M M L L
L P P/s S* S M M* L L P/s P S* S M M* Lm L
L P P S Sm* M M L L P P/s S S* M M L Ls
L P/s P S S M* M L LP P P S Sm M* M L L
S M M L L P/s P S S M M Lm L P P S S
S/p* M M L L P* P S S M M* L Lp P P S* S
S M M* Lm L P P S* Sm M M L L P/s P S S*
Sm M* M L L S S* S/p S M* M L L S S* S Sm
P* S S/p P L P S/p M M L L P P P S S S/p
P P L P P P P P P L P P P P P P L
TIM MUTU PMKP CODE BLUE Di
RENCANA RAPAT RUANGAN * TJ ALAT Ns. De
TJ ALAT
PENGGANTI KARU
LAN : SEPTEMBER 2021 Total Jam KET
20 21 22 23 24 25 26 27 28 29 30 31
P P P C P P P P P P P
S Sm M M L Lp P P S S M
S* S M M* L L P P S* Sm M
S S* M M Lm L P* P S/p S* M
S S/p M* M L L P/s P* S S M*
Lm L P P S S M M L Ls P
L Ls P P S* S M M* L L P/s
L L P P/s P Sm M* M L L C
L L P/s* P S S* M M Lm L P
P/s P S S M M Lm L P P S
P P S S* M M L L P P S
P P S* S M M* L Ls P P S*
P P S Sm M* M L L P/s P S
M M L L P P/s S S M M Lm
M M Lm L P P S* Sm M M* L
M M L L S/p P S S* M M L
M M* L L P/s P S S M* M L
L P P P S S S/p L P P P
P P P P P P L P P P P

Disetujui oleh

L

2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 M L

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 M* L
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 M Lm
5 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 M L
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 P S

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 P S*
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P S
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 P/s S
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 S M

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 S M
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 Sm* M
13 TRY SURYA TRESNA, AMK 2009014 PLK O D3 Aug-09 Feb-13 S M*
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 L P

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 L P/s*
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 L P
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 L P
18 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S S/p

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
ARE BULAN : OKTOBER 2

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
L P P P P P P L P P P P P P L P L
L P P/s S S M M L L P P S Sm M M L Lp
Ls P* P S Sm M* M L L P/s P S* S M M* L L
L P P S* S M M* L Ls P P S S* M M Lm L
L P/s P S S* M M Lm L P P S S/p M* M L L
S M M L L P P/s S S M M Lm L P P S S
S/p M M L L P P* S Sm M M* L Ls P P S* S
Sm M* M L L P/s P S P M* M L L P/s P* P Sm
S M M* Lm L P P S* S M M L L P P/s S S*
M Lm L P P S S M M L L P/s P S S M M
M* L L P/s P S* S M M* Lm L P P S S* M M
M L L P P/s S S* M M L Ls P P S* S M M*
M L LP P P S Sm M* M L L P P S Sm M* M
P S/p S M M Lm L P P S S M M L L P P/s
P S S M M* L Lp P P S* S M M Lm L P P
P S* Sm M M L L P/s* P S S* M M L L S/p P
P* S S M* M L L P S* S Sm M M* L L P/s P*
S L P P P S S S/p L P P P S S S/p L P
L P P P P P P L P P P P P P L P L
TIM MUTU PMKP CODE BLUE Di
RENCANA RAPAT RUANGAN * TJ ALAT Ns. De
TJ ALAT
PENGGANTI KARU
ULAN : OKTOBER 2021 Total Jam KET
20 21 22 23 24 25 26 27 28 29 30 31
P P P P L P P P P P P L
P P S S M M Lm L P P S S 4
P P S* Sm M M* L L P P S/p S 5
P* P S/p S* M M L L P P S Sm* 5
P/s P* S S M* M L L P P/s S* S 5
M M L Ls P P S Sm M M L L 4
M M* L L P/s P S* S M M* L L 4
M* M L L P* P P P M* M Lm L 6
M M Lm L P P* S S* M M L Lp 5
Lm L P P S S M M Lm L P P 4
L Ls P P S S/p* M M L L P P* 4
L L P P S* Sm M M* L L P P/s 5
L L P/s P S S M* M L L P/s P 5
S S M M Lm L P P S S M M 4
S* Sm M M* L L P P/s S S M M* 5
S S* M M L L P/s* P S S M* M 4
S S M* M L Ls S S S* Sm M M 5
P P S S S/p L P P P/s S* S S 5
P P P P L P P P P P P L

Disetujui oleh

L

2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 M L

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 M* L
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 M Lm
5 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 M L
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 P S/p

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 P S*
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P CUTI
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 P/s S
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 S M

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 S M
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 Sm* M
13 TRY SURYA TRESNA, AMK 2009014 PLK O D3 Aug-09 Feb-13 S M*
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 L P

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 L P/s*
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 Lp P
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 L P
18 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 L S

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
ARE BULAN : OKTOBE

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
L P P P P P P L P P P P P P L P
L P P/s S S M M L L P P S Sm M M L
Ls P* P S Sm M* M L L P/s P S* S M M* L
L P P S* S M M* L Ls P P S S* M M Lm
L P/s P S S* M M Lm L P P S S/p M* M L
S M M L L P P/s S S M M Lm L P P S
S/pM M L Lp P P* S Sm M M* L L C IZIN
CUTI 2021 P/s P S P M* M L L P/s P* P
S M M* Lm L P P S* S M M L L P P/s S
M Lm L P P S S M M L L P/s P S S M
M* L L P/s P S* S M M* Lm L P P S S* M
M L L P P/s S S* M M L Ls P P S/p* S M
M L LP P P S Sm M* M L L P P S Sm M*
P S/p S M M Lm L P P S S M M L L P
P S S M M* L Lp P P S* S M M Lm L P
P S* Sm M M L L P/s* P S S* M M L Lp S
P* S S Mp* M L L P S* S Sm M M* L L P/s
Sm M* M L L P P P S S S L P/s P P S/p
L P P P P P P L P P P P P P L P
TJ ALAT
PENGGANTI KARU
BULAN : OKTOBER 2021 Total Jam KET
19 20 21 22 23 24 25 26 27 28 29 30 31
L P P P P L P P P P P P L
Lp P P S S M M Lm L P P S S 4
L P P S* Sm M M* L L P P S/p S 5
L P* P S/p S* M M L L P P S Sm* 5
L P/s P* S S M* M L L P/s P S* S 5
S M M L Ls P P S Sm M M L L 5
S M M* L L P/s P S* S M M* L L 4
Sm M* M L L P CUTI 2021 M M Lm L 4
S* M M Lm L P P* S S* M M L Lp 5
M Lm L P P S S M M Lm L P P 4
M L Ls P P S S/p* M M L L P P* 4
M* L L P P S* Sm M M* L L P P/s 5
M L L P/s P S S M* M L Ls P P 5
P/s S S M M Lm L P P S S M M 4
P S* Sm M M* L L P P/s S S M M* 5
P S S* M M L L P/s* P S S M* M 5
P* S S M* M L Ls P P S* Sm M M 5
S S L P P P* P S/p S L P P/s P 5
L P P P P L P P P P P P L

Disetujui oleh

L
DAFTAR DINAS

1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 P P L P P P P P P L P P P P P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 M L L P P/s S S M M L L P P C Sm M

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 M* L Ls P* P S Sm M* M L L P/s P P/S* S M
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 M Lm L P P S* S M M* L Ls P P S S* M
5 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 M L L P/s P S C M M Lm L P P S S/p M*
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 P S/p S M M L L P P/s S S M M Lm L P

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 P S* S/p M M L LS P P* S Sm M M* L L C
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P CUTI 2021 P/s P S P M* M L L P/s
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 P/s S S M M* Lm L P P S* S M M L L P
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 S M M Lm L P P S S M M L L P/s P S

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 S M M* L L P/s P S* S M M* Lm L P P S
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 Sm* M M L L P P/s S S* M M L Ls S P S/p*
13 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S M* M L LP P P S Sm M* M L L P P S
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 L P P S/p S M M Lm L P P S S M M L

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 L P/s* P S S M M* L Lp P P S* S M M Lm
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 Lp P P S* Sm M M L L P/s* P S S* M M L
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 L S S* S S Mp* M L L P S* S Sm M M* L
18 TRY SURYA TRESNA, AMK 2009014 PLK O D3 Aug-09 Feb-13 L P Pm M* M L L P P P P P P L P/s C
19 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P L P P P P P P L P P P P P P

I TJ INVENTARIS
009/FM DD/02-01/07
N0. Revisi : 03
BULAN : OKTOBER 2021 Total Jam KET
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
L P L P P P P L P P P P P P L
M L Lp P P S S M M Lm L P P S S
M* L L P P S* Sm M M* L L P P S/p S
M Lm L P* P S/p S* M M L L P P S Sm*
M L L P/s P* S S M* M L L P/s P S* S
P S S M M L Ls P P S Sm M M L L
IZIN S M M* L L P/s P S* S M M* L L
P* P Sm M* M L L P CUTI 2021 M M Lm L
P/s S S* M M Lm L P P* S S* M M L Lp
S M M Lm L P P S S M M Lm L P P
S* M M L Ls P P S S/p* M M L L P P*
S M aq L L P P S* Sm M M* L L P P/s
Sm M* L L P/s P S S M* M L Ls P P
L P P/s S S M M Lm L P P S S M M
L P P S* Sm M M* L L P P/s S S M M*
Lp S P S S* M M L L P/s* P S S M* M
L P/s P* S S M* M L Ls P P S* Sm M M
P S/p S S L P P P* P S/p S L P P/s P
L P L P P P P L P P P P P P L
UE Diketahui oleh Dibuat oleh
K DAN PPI
Disetujui oleh
L

2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 M M

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 M* M
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 M M*
5 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 M M
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 P P/s

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 P P
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P/s P
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 P P
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 S S

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 S* S
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 S S*
13 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S Sm
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 Lm L

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 L L
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 L L
17 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 L Lp

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03

2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 M M

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 M* M
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 M M*
5 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 M M
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 P P/s

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 P P
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P/s P
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 P P
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 S S

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 S* S
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 S S*
13 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S Sm
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 Lm L

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 L L
16 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 L Lp
17 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 L L

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
ARE BULAN : NOVEMBE
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
P P P P L P P P P P P L P P P P
L L P P S Sm M M L Lp P P S S M M
L Ls P P S* S M M* L L P P S* Sm M M*
L L P/s P S S* M M Lm L P P S/p S* M M
Lm L P P S S/p M* M L L P/s P* S S M* M
S S M M Lm L P P S S M M L Ls P P
S Sm M M* L L P P S* S M M* L L P/s P
P P M* M L L P/s P P Pm M* M L L P P
S S* M M L L P P/s S S* M M Lm L P P
M M L L P/s P S S M M Lm L P P S S
M M* L Ls P P S S* M M L Ls P P S S/p*
M M Lm L P P S/p* S M M* L L P P S* Sm
M* M L L P* P S Sm M* M L L P/s P S S
P P S S M M L L P P/s S S M M Lm L
P/s P S* S M* M Lm L P P S* Sm M M* L L
CUTI S Sm* M M L Lp S S S S* M M L L
S* S S S M M* L L P/s P S S M* M L Ls
TJ ALAT
PENGGANTI KARU
ARE BULAN : NOVEMBE

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
L L P P S Sm M M L Lp P P S S M M
L Ls P P S* S M M* L L P P S* Sm M M*
L L P/s P S S* M M Lm L P P S/p S* M M
Lm L P P S S/p M* M L L P/s P* S S M* M
S S M M Lm L P P S S M M L Ls P P
S Sm M M* L L P P S* S M M* L L P/s P
P P M* M L L P/s P P Pm M* M L L P P
S S* M M L L P P/s S S* M M Lm L P P
M M L L P/s P S S M M Lm L P P S S
M M* L Ls P P S S* M M L Ls P P S S/p*
M M Lm L P P S/p* S M M* L L P P S* Sm
M* M L L P* P S Sm M* M L L P/s P S S
P P S S M M L L P P/s S S M M Lm L
P/s P S* S M* M Lm L P P S* Sm M M* L Ls
S* S S S M M* L L P/s P S S M* M L L
CUTI S Sm* M M L Lp S S S S* M M L L
TJ ALAT
PENGGANTI KARU
BULAN : NOVEMBER 2021 Total Jam KET
19 20 21 22 23 24 25 26 27 28 29 30 31
P P L P P P P P P L P P
Lm L P P/s S S M M L L P P/s
L L P P S/p S M* M LM L P P
L L P* P S Sm* M M L L P/s P
L L P/s S* M M Lm L S S S* S
S Sm M M L L P P S S/P M M
S* S/p M M* L L P/s S S* S MS M*
P S M* M Lm L P P S/p S* M M
Ms M L L S* S S P/s M M* L Lp
CUTI 2021
M M L Lp P P S Sm M* M L L
M M* L L P/s P S S* M M Lm L
M* M Lm L P P M M* L L S/p S
P P S/p S M M L L P/s P S S
S/p S* S S M M* L L CUTI Sm*
P P/s M M L Ls S* S P PM M* M
S P S* Sm M* M L L P P/s* S S

Disetujui oleh

19 20 21 22 23 24 25 26 27 28 29 30 31
Lm L P P/s S S M M L L P P/s
L L P P S/p S M* M LM L P P
L Ls P* P S Sm* M M L L P/s P
L L P/s P S* S M M* L L S* P
S Sm M M L L P P S S/P M M
S* S/p M M* L L P/s S S* S/P M M*
P S M* M Lm L P P S Sm* M M
S S* M M L Lp P P S/p M M* L
M M L L P P/s S CUTI 2021

M M L Lp P P S Sm M* M L L
M M* L L P/s P S S* M M Lm L
M* M Lm L P P S* S/p M M L L
P P S/p S M M L L P/s P S S
P P S S M M* Lm L CUTI Sm*
S/p P S* Sm M* M L L P P/s* S S
P/s P S S* M M L Ls P S* S SM

Disetujui oleh


2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 S S

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 S S
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 S S
5 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 L L

6 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 L L
7 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 L L
8 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 P P

9 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 P P
10 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 P P
11 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 M M

12 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 M M
13 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 M M
14 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 CUTI 20

15 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 L P
16 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 M M
17 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 S S

R KEPALA RUANGAN
I TJ INVENTARIS
F TJ FURNITUR
E TJ ELEKTRO MEDIS
T TJ TENUN
009/FM DD/02-01/07
N0. Revisi : 03
DAFTAR DINAS
ARE BULAN : DESEMBE

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
M M L L P P S S M M L L P P S S
P P S S M M L L P P S S M M L L
S S M M L L P P S S M M L L P P
L L P P S S M M L L P P S S M M
CUTI 2021 CUTI NIKAH L L

S S M M L L
L L S S M M L L
M M L L S S M M L L
TJ ALAT
PENGGANTI KARU
BULAN : DESEMBER 2021 Total Jam KET
19 20 21 22 23 24 25 26 27 28 29 30 31
L P P P P P L L P P P P P
M M L L P P S S M M L L P
P P S S M M L L P P S S M
S S M M L L P P S S M M L
L L P P S S M M L L P P S
L P P P P P L L P P P P P

Disetujui oleh

JADWAL DINAS RUANGAN INTENSIVE CARE

1 Ns. YESI SULASTRI, S Kep 2000015 KR R S1 Mar-02 Jul-00 L P P P P P L P P P P P P L P P P
2 JERITA, AMK 2002076 KO I D3 Sep-09 Mar-11 M M L L P P S Sm M M L Ls P P S S M

3 HARDIB BIANTO, AMK 2003058 PLK I D3 Jan-10 Mar-03 M* M L Ls P P S* S M M* L Lp P P S* Sm M
4 ASTRI YULIANI, AMK 2003023 PLK I D3 Nov-08 Jul-03 M M* L L P/s P S S* M M Lm L P P S/p S* M
5 Ns. JUSMIYATI, S Kep 2014046 PLK I S1 Mai 2021 Aug-14 M M Lm L P P S S/p M* M L L P/s P* S S M*
6 RITA SORAYA, AMK 1996008 KO E D3 Oct-08 Aug-96 P P/s S S M M Lm L P P S S M M L Ls P

7 TAPIARA, AMK 2009011 PLK E D3 Feb-09 Feb-09 P P S Sm M M* L L P P S* S M M* L L P/s
8 RAHMAT HIDAYAT, AMK 2014057 PLK E D3 Aug-16 Jul-03 P/s P P P M* M L L P/s P P Pm M* M L L P
9 DESI SASWITA, AMK 2003036 PLK E D3 Mar-03 Jul-17 P P S S* M M L L P P/s S S* M M Lm L P
10 ASNIYARINI, AMK 2009027 KO O D3 Feb-09 Feb-09 S S M M L L P/s P S S M M Lm L P P S

11 SUSILA FITRI, AMK 2002012 PLK O D3 Mar-02 Jan-02 S* S M M* L Ls P P S S* M M L Ls P P S
12 Ns. JAKA SAPUTERA,S Kep 2010009 PLK O S1 Jan-20 Aug-14 S S* M M Lm L P P S/p* S M M* L L P P S*
13 Ns. SYAHRIANI, S Kep 2013029 PLK T S1 Aug-18 Dec-13 S Sm M* M L L P* P S Sm M* M L L P/s P S
14 FITRI SRI LESTARI, AMK 2010004 KO F D3 Feb-10 Feb-10 Lm L P P S S M M L L P/s P S S M M Lm

15 YUSI WARNI, AMK 2002068 PLK F D3 Aug-09 Oct-04 L L P/s P S* S M* M Lm L P P S* S M M* L
16 NASRUL. AMK 2011017 PLK F D3 Mar-10 Mar-10 L Lp S* S S S M M* L L P P S Sm M* M L
17 WERDA NINGSIH, AMK 2003060 PLK F D3 Jan-16 Oct-03 L L CUTI S Sm* M M L Lp S S S S* M M L
18 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P P P L P P P P P P L P P P

I TJ INVENTARIS
009/FM DD/02-01/07 N0.

Revisi : 03
ARE

18 19 20 21 22 23 24 25 26 27 28 29 30 31
P P P P P P P P P P L P P
M Lm L P P/s S S M M L L P P/s
M* L L P P S/p S M* M LM L P P
M L Ls P* P S Sm* M M L L P/s P
M L L P/s P S* S M M* L L Sp* P
P S Sm M M L L P P S S/P M M
P S* S/p M M* L L P/s S S* S/P M M*
P P S M* M Lm L P P S Sm* M M
P S S* M M L Lp P P S/p M M* L
S M M L L P P/s S CUTI 2021

S/p* M M L Lp P P S Sm M* M L L
Sm M M* L L P/s P S S* M M Lm L
S M* M Lm L P P S* S/p M M L L
L P P S/p S M M L L P/s P S S
Ls P P S S M M* Lm L CUTI Sm*
L S/p P S* Sm M* M L L P P/s* S S
L P/s P S S* M M L Ls P S* S SM
PI
Ns. Ul Ahdazumar, S.Kep Ns. Yesi Sulastri, S Kep
Disetujui oleh
dr .Hj .Rifa Rosanti

Daftar Dinas Icu 2021 Okay

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RUMAH SAKIT ISLAM IBNU SINA

JL. MELATI NO. 60 PEKANBARU

2 JERITA 2002076 KO I D3 Sep-09 Mar-11 S M M L L P P S Sm M M L L P P/s

6 SUSILA FITRI 2002012 KO O D3 Mar-02 M

10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 L P/s P S S M M L L P P/s S S M M

14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 P L S/p M M L L P P S Sm M M L L

18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 M L L P P S Sm M M L L S/p S S M

21 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P L P P P P L P L P P P

O TJ OBAT TIM PPI

BULAN :APRIL 2020 Total

Dr. Yasri Yunus, Sp.An Yesi Sulastri, S Kep

Ns. Ul Ahdazumar, S.Kep

RUANGAN/UNIT : ICU BUL

2 JERITA 2002076 KO I D3 Sep-09 Mar-11 S M M L L P P S Sm M M L L P P/s S S

6 SUSILA FITRI 2002012 KO O D3 Mar-02 M

10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 L P/s P S S M M L L P P/s S S M M Lm L

14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 P L S/p M M L L P P S Sm M M L L P/s P

18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 M L L P P S Sm M M L L S/p S S M M L

21 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P L P P P P L P L P P P P P

O TJ OBAT TIM PPI

Dr. Yasri Yunus, Sp.An Yesi Sulastri, S Kep

Ns. Ul Ahdazumar, S.Kep

2 JERITA 2002076 KO I D3 Sep-09 Mar-11 P/s S S M

6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 S Ms M L

10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 M Lm L P

14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 M L P/s S

18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 L P P S

21 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 L P L P

BULAN :MAI 2020

Yesi Sulastri, S Kep

Ns. Ul Ahdazumar, S.Kep

2 JERITA 2002076 KO I D3 Sep-09 Mar-11 P/s S S M

6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 S Ms M L

10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 M Lm L P

14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 M L P/s S

18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 L P P S

19 NASRUL 2011017 PLK T D3 Mar-10 Mar-10

20 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 L P L P

BULAN :MAI 2020

Yesi Sulastri, S Kep

Ns. Ul Ahdazumar, S.Kep

2 JERITA 2002076 KO I D3 Sep-09 Mar-11 P/s P S S

6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 S S M M

10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 M M Lm L

14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 L Lp P P

18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 P P S/p S

19 NASRUL 2011017 PLK T D3 Mar-10 Mar-10

20 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P

BULAN :JUNI 2020

L P P S/p S M M Lm L P P P S/p S M L L P/s P S S M

Yesi Sulastri, S Kep

Ns. Ul Ahdazumar, S.Kep

2 JERITA 2002076 KO I D3 Sep-09 Mar-11 LM L P P

6 SUSILA FITRI 2002012 KO O D3 Mar-02 Jan-02 P P S S

10 FITRI SRI LESTARI 2010004 KO F D3 Feb-10 Feb-10 S S M M

14 RITA SORAYA 1996008 KO E D3 Oct-08 Aug-96 M M L L

18 TRY SURYA TRESNA 2009014 PLK T D3 Aug-09 Feb-13 P M M L

19 NASRUL 2011017 PLK T D3 Mar-10 Mar-10

20 KARDENSI 1998010 PRD T SPK Jul-15 Jul-91 P P P P

BULAN :JULI 2020

Yesi Sulastri, S Kep

Ns. Ul Ahdazumar, S.Kep