LAPORAN RETRIBUSI UPTD PUSKESMAS CIMANGGIS

BULAN JANUARI 2021

URAIAN
TGL SETORAN MAGANG/PKL/PE TOTAL TGL SETOR BJB
PAGI SORE MALAM/UGD PONED R. INAP TIND. UMUM TIND.GIGI
TIND.KEBIDANAN KIA/KB
DIAGNOSTIK SKS LEGALISIR HAJI NELITIAN
1 90,000 135,000 30,000 - - - - - - - - - - 255,000
2 38,000 120,000 15,000 - - - - 40,000 356,000 10,000 - - - 579,000 1/4/2021
3 60,000 165,000 30,000 - - - - - 12,000 - - - - 267,000
4 86,000 190,000 - - - 30,000 72,000 423,000 40,000 - - - 841,000
1/6/2021
5 74,000 100,000 - - - - - 75,000 693,000 70,000 - - - 1,012,000
6 84,000 170,000 - - - 67,000 - 30,000 293,000 60,000 - - - 704,000 1/7/2021
7 56,000 180,000 - - - - - 76,000 483,000 60,000 - - - 855,000 1/8/2021
8 38,000 160,000 15,000 - - 25,000 - 70,000 396,000 40,000 - - - 744,000
9 30,000 80,000 30,000 - - 42,000 - - 331,000 50,000 - - - 563,000 1/11/2021
10 30,000 150,000 15,000 - - - - - 50,000 - - - - 245,000
11 50,000 250,000 - - - - - 42,000 404,000 80,000 - - - 826,000
12 52,000 220,000 15,000 - - 25,000 - 16,000 864,000 90,000 - - - 1,282,000 1/14/2021
13 20,000 180,000 - 886,000 - 82,000 - - 149,000 40,000 - - - 1,357,000
14 34,000 90,000 45,000 - - - - 24,000 162,000 50,000 - - - 405,000 1/15/2021
15 38,000 200,000 45,000 - - 149,000 - 55,000 394,000 40,000 - - - 921,000
16 38,000 150,000 15,000 - - - 20,000 45,000 404,000 10,000 - - - 682,000 1/18/2021
17 75,000 180,000 15,000 24,000 - 25,000 - - 189,000 - - - - 508,000
18 54,000 140,000 60,000 - - 129,000 - 54,000 622,000 10,000 - - - 1,069,000 1/19/2021
19 60,000 160,000 - 16,000 - 25,000 - 24,000 870,000 40,000 - - - 1,195,000
1/21/2021
20 90,000 210,000 30,000 21,000 - - - 30,000 118,000 30,000 - - - 529,000
21 58,000 100,000 45,000 4,000 - 67,000 - 54,000 720,000 40,000 - - 1,088,000 1/22/2021
22 34,000 190,000 - 621,000 - 15,000 - 75,000 248,000 10,000 - - 1,193,000
23 32,000 100,000 15,000 - - - - 55,000 208,000 10,000 - - - 420,000 1/25/2021
24 90,000 150,000 15,000 12,000 - 85,000 - - 84,000 - - - - 436,000
25 54,000 160,000 15,000 - - 137,000 15,000 72,000 519,000 40,000 - - - 1,012,000
1/27/2021
26 40,000 160,000 15,000 - - 150,000 - 12,000 164,000 10,000 - - - 551,000
27 56,000 170,000 15,000 - - 35,000 - - 48,000 80,000 20,000 - 424,000
28 56,000 160,000 45,000 83,000 - 40,000 - 88,000 709,000 40,000 - - 1,221,000
29 52,000 180,000 15,000 - - - - 100,000 1,120,000 10,000 - - - 1,477,000 2/1/2021
30 28,000 60,000 30,000 628,000 - 15,000 - 60,000 75,000 - - - - 896,000
31 45,000 135,000 15,000 - - 20,000 - - 43,000 - - - - 258,000
JUMLAH 1,642,000 4,795,000 585,000 2,295,000 - 1,133,000 65,000 1,169,000 11,151,000 960,000 20,000 - - 23,815,000
 LAPORAN RETRIBUSI UPTD PUSKESM
BULAN FEBRUARI 202

URA

TGL SETORAN
PAGI SORE MALAM/UGD PONED R. INAP TIND. UMUM

1 56,000 170,000 15,000 611,000 - 80,000

2 70,000 180,000 - - - 5,000
3 66,000 140,000 30,000 - - 5,000
4 54,000 100,000 - - - 72,000
5 30,000 180,000 30,000 - - 5,000
6 14,000 140,000 30,000 - - 5,000
7 15,000 180,000 15,000 12,000 - 5,000
8 58,000 130,000 - - - 5,000
9 44,000 140,000 30,000 31,000 - 5,000
10 70,000 130,000 - - - 30,000
11 40,000 180,000 30,000 916,000 - 5,000
12 60,000 210,000 - 12,000 - 30,000
13 30,000 110,000 15,000 - - 55,000
14 60,000 135,000 15,000 - - 5,000
15 72,000 250,000 15,000 - - 30,000
16 32,000 210,000 30,000 672,000 - 75,000
17 70,000 120,000 15,000 566,000 - 75,000
18 56,000 80,000 - - - 25,000
19 38,000 220,000 - - - 30,000
20 28,000 110,000 - 4,000 - 75,000
21 30,000 165,000 45,000 - - 25,000
22 64,000 130,000 - - - 25,000
23 74,000 170,000 - - - 17,000
24 68,000 120,000 15,000 74,000 - 34,000
25 56,000 80,000 15,000 14,000 - 25,000
26 28,000 210,000 - - - 25,000
27 40,000 150,000 - - - 75,000
28 60,000 60,000 15,000 808,000 - -
JUMLAH 1,383,000 4,200,000 360,000 3,720,000 - 848,000
AN RETRIBUSI UPTD PUSKESMAS CIMANGGIS
BULAN FEBRUARI 2021

URAIAN

TIND.GIGI TIND.KEBIDANAN KIA/KBDIAGNOSTIK SKS LEGALISIR HAJI AMBULANCE

- 20,000 776,000 30,000 - -

30,000 62,000 782,000 - - -
- 90,000 220,000 10,000 - -
15,000 20,000 615,000 50,000 - -
- 65,000 100,000 30,000 - -
- 35,000 229,000 20,000 - -
- - - 10,000 - -
- 84,000 284,000 30,000 - -
- 68,000 288,000 30,000 - -
5,000 60,000 90,000 30,000 - -
- 50,000 369,000 10,000 - -
- - 50,000 10,000 - -
- 60,000 141,000 30,000 - -
- - 12,000 - - -
- 40,000 795,000 20,000 - -
- 20,000 483,000 40,000 - -
- - 530,000 70,000 - -
- 32,000 586,000 10,000 - -
15,000 65,000 781,000 20,000 -
- 85,000 246,000 20,000 - -
- - 63,000 10,000 - -
- 114,000 366,000 40,000 - -
15,000 28,000 599,000 60,000 20,000 -
15,000 60,000 307,000 - - - 5,000
- 28,000 313,000 20,000 - -
15,000 - 143,000 40,000 - -
- 100,000 341,000 10,000 - -
- - 191,000 10,000 - - 5,000
110,000 1,186,000 9,700,000 660,000 20,000 - 10,000
MAGANG/PKL/ TOTAL TGL SETOR BJB
PENELITIAN

- 1,758,000
2/3/2021
- 1,129,000
- 561,000 2/4/2021
- 926,000
- 440,000
2/8/2021
- 473,000
- 237,000
- 591,000
2/10/2021
- 636,000
- 415,000
- 1,600,000
- 372,000 2/15/2021
- 441,000
- 227,000
- 1,222,000 2/16/2021
- 1,562,000
2/18/2021
- 1,446,000
- 789,000
- 1,169,000
2/22/2021
- 568,000
- 338,000
- 739,000
- 983,000 2/25/2021
- 698,000
- 551,000
- 461,000
3/1/2021
- 716,000
- 1,149,000
- 22,197,000
 LAPORAN RETRIBUSI UPTD PUSK
BULAN MARET 2

U
TGL SETORAN
PAGI SORE MALAM/UGD PONED R. INAP TIND. UMUM

1 80,000 150,000 - - - 10,000

2 52,000 160,000 15,000 - - 25,000
3 80,000 140,000 15,000 - - 25,000
4 84,000 190,000 - 828,000 - 25,000
5 24,000 130,000 - - - 92,000
6 52,000 110,000 - - - 84,000
7 60,000 120,000 - - - -
8 78,000 140,000 15,000 - - 50,000
9 76,000 160,000 - - - 50,000
10 70,000 150,000 30,000 12,000 - 34,000
11 60,000 135,000 - 12,000 - -
12 46,000 130,000 - - - -
13 24,000 190,000 60,000 59,000 - 114,000
14 60,000 135,000 - 703,000 - -
15 72,000 190,000 - 16,000 - 25,000
16 74,000 130,000 15,000 - - 25,000
17 76,000 160,000 15,000 - - 109,000
18 82,000 120,000 30,000 - - 34,000
19 64,000 260,000 45,000 - - -
20 44,000 190,000 15,000 638,000 - 34,000
21 75,000 210,000 - - - -
22 112,000 170,000 - - - 142,000
23 120,000 160,000 15,000 - - 67,000
24 92,000 150,000 - - - 100,000
25 130,000 200,000 15,000 16,000 - 75,000
26 74,000 190,000 45,000 - - 42,000
27 48,000 70,000 15,000 - - 149,000
28 45,000 135,000 45,000 - - -
29 124,000 240,000 60,000 910,000 - 176,000
30 72,000 190,000 15,000 - - -
31 112,000 110,000 - 66,000 - 25,000
JUMLAH 2,262,000 4,915,000 465,000 3,260,000 - 1,512,000
APORAN RETRIBUSI UPTD PUSKESMAS CIMANGGIS
BULAN MARET 2021

URAIAN

TIND.GIGI
TIND.KEBIDANAN KIA/KBDIAGNOSTIK SKS LEGALISIR AMBULANCE

- 16,000 864,000 30,000 - -

40,000 36,000 567,000 30,000 - -
15,000 30,000 70,000 20,000 - -
30,000 74,000 863,000 130,000 - -
- - 155,000 10,000 - -
- 135,000 908,000 20,000 - -
- - 72,000 10,000 - -
- 58,000 686,000 30,000 - -
- 16,000 435,000 50,000 20,000 -
- 30,000 594,000 10,000 - -
- - 23,000 - - -
30,000 10,000 418,000 50,000 - -
- - 278,000 30,000 - -
- - 43,000 - - -
30,000 66,000 544,000 80,000 - -
- 40,000 619,000 40,000 - -
- 30,000 127,000 50,000 - -
- 58,000 698,000 40,000 - -
- 65,000 832,000 90,000 20,000 -
- 105,000 266,000 40,000 20,000 -
- - - - - -
- 86,000 629,000 110,000 90,000 -
15,000 100,000 1,330,000 140,000 180,000 -
- 30,000 12,000 130,000 150,000 -
- 58,000 743,000 150,000 150,000 -
- 55,000 805,000 130,000 170,000 -
- 20,000 503,000 80,000 130,000 -
- - 66,000 10,000 20,000 -
- 20,000 568,000 170,000 70,000 5,000
30,000 42,000 771,000 100,000 40,000 -
- 30,000 347,000 50,000 30,000 -
190,000 1,210,000 14,836,000 1,830,000 1,090,000 5,000
 MAGANG/PKL/P TOTAL TGL SETOR BJB
HAJI
ENELITIAN
- - 1,150,000
3/3/2021
- - 925,000
- - 395,000
- - 2,224,000 3/6/2021
- - 411,000
- - 1,309,000
- - 262,000
3/10/2021
- - 1,057,000
- - 807,000
- - 930,000
- - 230,000
- - 684,000 3/15/2021
- - 755,000
- - 941,000
- - 1,023,000 3/16/2021
- - 943,000
3/18/2021
- - 567,000
- - 1,062,000
- - 1,376,000
3/22/2021
- - 1,352,000
- - 285,000
- - 1,339,000
40,000 - 2,167,000 3/25/2021
- - 664,000
520,000 - 2,057,000
- - 1,511,000
3/29/2021
- - 1,015,000
- - 321,000
440,000 - 2,783,000
3/31/2021
- - 1,260,000
340,000 - 1,110,000 4/5/2021
1,340,000 - 32,915,000
 LAPORAN RETRIBUSI UPTD PUSKESMAS CIMANGGIS
BULAN APRIL 2021

URAIAN
TGL SETORAN MAGANG/PKL/ TOTAL TGL SETOR BJB
PAGI SORE MALAM/UGD PONED R. INAP TIND. UMUM TIND.GIGI
TIND.KEBIDANAN KIA/KB
DIAGNOSTIK SKS AMBULANCE LEGALISIR HAJI
PENELITIAN
1 126,000 140,000 - - - 77,000 30,000 54,000 573,000 30,000 - 10,000 380,000 - 1,420,000
2 165,000 255,000 15,000 - - 81,000 - - 68,000 - - - - - 584,000
4/5/2021
3 36,000 190,000 - 74,000 - 50,000 - 110,000 386,000 30,000 5,000 10,000 - - 891,000
4 90,000 135,000 45,000 70,000 - 57,000 - - 83,000 - 5,000 - - - 485,000
5 154,000 290,000 15,000 12,000 - 75,000 - 96,000 1,258,000 90,000 - 20,000 400,000 - 2,410,000 4/6/2021
6 66,000 180,000 30,000 186,000 - 92,000 - 42,000 1,066,000 60,000 10,000 - - - 1,732,000 4/7/2021
7 98,000 230,000 30,000 816,000 - 34,000 - - 889,000 80,000 10,000 30,000 - - 2,217,000 4/8/2021
8 118,000 150,000 30,000 - - 157,000 15,000 50,000 771,000 60,000 - - 340,000 - 1,691,000
9 72,000 180,000 45,000 - - - 40,000 120,000 958,000 50,000 - - - - 1,465,000
4/12/2021
10 130,000 170,000 30,000 - - 70,000 - 70,000 707,000 50,000 - 10,000 620,000 - 1,857,000
11 30,000 90,000 30,000 824,000 - 5,000 - - - - - - - - 979,000
12 134,000 110,000 15,000 894,000 - 90,000 - 32,000 1,177,000 20,000 - - 420,000 - 2,892,000 4/13/2021
13 54,000 270,000 30,000 156,000 - 55,000 - 28,000 1,373,000 40,000 20,000 - 20,000 - 2,046,000
4/15/2021
14 58,000 90,000 45,000 24,000 - 51,000 - 60,000 176,000 10,000 - - - - 514,000
15 72,000 180,000 15,000 12,000 - 125,000 - 40,000 941,000 30,000 - - - - 1,415,000
16 30,000 180,000 - 124,000 - - 15,000 10,000 83,000 20,000 10,000 - - - 472,000
4/19/2021
17 42,000 140,000 30,000 7,000 - 62,000 - 50,000 260,000 40,000 - - - - 631,000
18 90,000 180,000 - 832,000 - 5,000 - - 23,000 - - - - - 1,130,000
19 92,000 160,000 - 802,000 - 200,000 - 110,000 584,000 - - - - 100,000 2,048,000 4/20/2021
20 78,000 120,000 15,000 - - 25,000 - 62,000 844,000 30,000 - - - - 1,174,000
4/22/2021
21 60,000 120,000 45,000 - - 84,000 - 95,000 48,000 20,000 - - - - 472,000
22 64,000 180,000 30,000 848,000 - 150,000 - 20,000 457,000 20,000 - - - 1,769,000 4/23/2021
23 40,000 130,000 15,000 - - - - 10,000 202,000 20,000 - - - - 417,000
24 34,000 160,000 15,000 - - 87,000 - 30,000 134,000 20,000 - - - - 480,000 4/26/2021
25 225,000 225,000 15,000 12,000 - 5,000 - - 342,000 - - - - - 824,000
26 60,000 250,000 15,000 - - 182,000 - 38,000 649,000 50,000 - - - - 1,244,000
4/28/2021
27 42,000 180,000 15,000 - - 42,000 - 12,000 102,000 20,000 - - - - 413,000
28 52,000 170,000 - - - 75,000 - 60,000 158,000 60,000 - - - - 575,000 4/29/2021
29 62,000 130,000 30,000 66,000 - 75,000 - 54,000 410,000 40,000 - - - - 867,000
5/3/2021
30 58,000 140,000 - - - 27,000 - 55,000 387,000 40,000 - - 707,000
JUMLAH 2,432,000 5,125,000 600,000 5,759,000 - 2,038,000 100,000 1,308,000 15,109,000 930,000 60,000 80,000 2,180,000 100,000 35,821,000
 LAPORAN RETRIBUSI UPTD PUSKESMAS CIMANGGIS
BULAN MEI 2021

URAIAN

TGL SETORAN MAGANG/PKL TOTAL TGL SETOR BJB

PAGI SORE MALAM/UGD PONED R. INAP TIND. UMUM TIND.GIGITIND.KEBIDANAN KIA/KB
DIAGNOSTIK SKS AMBULANCE LEGALISIR HAJI
/PENELITIAN

1 210,000 195,000 - 7,000 - 10,000 - - 66,000 - - - - - 488,000

5/3/2021
2 120,000 180,000 45,000 1,006,000 - 5,000 - - 197,000 - - - - - 1,553,000
3 86,000 200,000 15,000 - - 114,000 - 80,000 410,000 50,000 - - - - 955,000
5/5/2021
4 56,000 110,000 - - - 50,000 - 42,000 287,000 40,000 - - - - 585,000
5 70,000 110,000 15,000 78,000 - - - 30,000 146,000 40,000 - - - 489,000
6 58,000 70,000 - 624,000 - 75,000 - 46,000 228,000 - - - - - 1,101,000
7 60,000 90,000 - 928,000 - - - 110,000 217,000 40,000 - - - - 1,445,000 5/10/2021
8 70,000 150,000 45,000 150,000 - - - 100,000 379,000 10,000 - - - - 904,000
9 45,000 165,000 - - - 5,000 - - 46,000 - - - - - 261,000
10 104,000 30,000 45,000 - - 69,000 30,000 241,000 610,000 20,000 - - - - 1,149,000 5/11/2021
11 54,000 120,000 15,000 - - - - 50,000 374,000 30,000 - - - - 643,000
12 14,000 70,000 - 78,000 - - - - 166,000 - 10,000 - - - 338,000
13 75,000 60,000 - - - 60,000 - - - - - - - - 195,000
5/17/2021
14 135,000 165,000 - - - 5,000 - - 167,000 - - - - - 472,000
15 26,000 240,000 30,000 - - 72,000 - 30,000 103,000 - - - - - 501,000
16 120,000 120,000 60,000 - - 5,000 - - 60,000 - - - - - 365,000
17 86,000 240,000 15,000 - - 92,000 - 150,000 424,000 90,000 - - - - 1,097,000
5/19/2021
18 84,000 250,000 30,000 34,000 - 47,000 - 66,000 729,000 70,000 15,000 - - - 1,325,000
19 82,000 170,000 15,000 862,000 - - - 60,000 250,000 40,000 - - - - 1,479,000 5/20/2021
20 62,000 110,000 15,000 - - 150,000 - 42,000 192,000 40,000 - - - - 611,000
21 62,000 120,000 30,000 82,000 - - 15,000 170,000 595,000 30,000 10,000 - - - 1,114,000
5/24/2021
22 56,000 140,000 15,000 - - 47,000 - 50,000 363,000 80,000 - - - - 751,000
23 135,000 345,000 - 1,073,000 - 30,000 - - 114,000 20,000 25,000 - - - 1,742,000
24 94,000 190,000 15,000 - - 150,000 - 126,000 1,071,000 60,000 - - - 200,000 1,906,000 5/25/2021
25 76,000 150,000 60,000 12,000 - 50,000 - 54,000 464,000 30,000 15,000 - - - 911,000
26 330,000 195,000 45,000 882,000 - 5,000 - - 299,000 - - - - - 1,756,000 5/28/2021
27 104,000 230,000 30,000 - - 55,000 - 145,000 756,000 70,000 - 10,000 - 1,400,000
28 94,000 170,000 - 7,000 - 50,000 - 150,000 725,000 80,000 - - - - 1,276,000
29 34,000 90,000 15,000 - - 52,000 - 25,000 340,000 30,000 - - - 90,000 676,000 5/31/2021
30 135,000 195,000 15,000 - - 25,000 - - 106,000 - - - - - 476,000
31 90,000 240,000 15,000 - - 67,000 - 84,000 750,000 100,000 - - - - 1,346,000 6/2/2021
JUMLAH 2,827,000 4,910,000 585,000 5,823,000 - 1,290,000 45,000 1,851,000 10,634,000 970,000 75,000 10,000 - 290,000 29,310,000
 LAPORAN RETRIBUSI UPTD PUS
BULAN JUNI 2

TGL SETORAN
PAGI SORE MALAM/UGD PONED R. INAP

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 - -
JUMLAH - - - - -
LAPORAN RETRIBUSI UPTD PUSKESMAS CIMANGGIS
BULAN JUNI 2021

URAIAN

TIND. UMUM TIND.GIGI

TIND.KEBIDANAN KIA/KB
DIAGNOSTIK SKS AMBULANCE LEGALISIR HAJI

- - - - - -
- - - - -
- - - - -
- - - -
- - -
- - - - -
- - - -
- - -
- - - -
- - -
- - - - -
- - - -
- - - - - -
- - - - - -
- - - - -
- - - -
- - - -
- - - -
- - -
- - - -
- - - - - -
-
- -
- - - -
- - -
- -
- -
- - - - - -
- -
- -
- - - - - - -
MAGANG/ TOTAL TGL SETOR BJB
PKL/PENEL
ITIAN

- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
-
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
-
- -
- -
- -
 LAPORAN RETRIBUSI UPTD PUSKESMAS CIMAN
BULAN JULI 2020

URAIAN
TGL SETORAN
PAGI SORE MALAM/UGD PONED R. INAP TIND. UMUM

1 60,000 180,000 - - - -
2 82,000 30,000 - - - -
3 36,000 150,000 - - - 30,000
4 30,000 150,000 30,000 956,000 - -
5 105,000 120,000 - - - -
6 102,000 140,000 - - - -
7 50,000 140,000 - - - 75,000
8 98,000 130,000 30,000 976,000 - -
9 46,000 280,000 15,000 - - 60,000
10 50,000 140,000 - - - 25,000
11 44,000 130,000 - - - -
12 45,000 90,000 15,000 - - -
13 84,000 130,000 15,000 - - 17,000
14 60,000 130,000 30,000 - - 30,000
15 76,000 160,000 30,000 - - 130,000
16 72,000 100,000 15,000 - - -
17 38,000 190,000 15,000 - - 65,000
18 44,000 160,000 15,000 - - 20,000
19 90,000 165,000 - - - 37,000
20 66,000 160,000 - - - 92,000
21 70,000 200,000 15,000 - - 60,000
22 98,000 150,000 15,000 - - -
23 76,000 140,000 - - - -
24 30,000 130,000 15,000 - - -
25 32,000 180,000 - - - -
26 60,000 150,000 - - - -
27 70,000 110,000 45,000 758,000 - -
28 76,000 110,000 - - - 10,000
29 92,000 80,000 30,000 - - 50,000
30 52,000 110,000 - - - 17,000
31 60,000 120,000 - 673,000 - 25,000
JUMLAH 1,994,000 4,355,000 330,000 3,363,000 - 743,000
BUSI UPTD PUSKESMAS CIMANGGIS
BULAN JULI 2020

URAIAN
MAGANG/PKL/
TIND.GIGI
TIND.KEBIDANAN KIA/KB
DIAGNOSTIK SKS LEGALISIR HAJI
PENELITIAN
- - 135,000 20,000 - - -
- 42,000 868,000 90,000 - - -
- 10,000 255,000 50,000 - -
- 15,000 320,000 10,000 - - -
- - 180,000 - - - -
- 38,000 1,301,000 90,000 - - -
- - 340,000 30,000 - - -
15,000 - 257,000 70,000 - - -
- 8,000 129,000 50,000 - - -
- 65,000 348,000 90,000 - - -
- 120,000 331,000 60,000 - - -
- - 180,000 - - - -
- 72,000 668,000 20,000 - - -
- - 546,000 50,000 - - -
- - 157,000 60,000 - - -
- 46,000 482,000 50,000 - - -
- 30,000 222,000 40,000 - - -
- 80,000 222,000 70,000 - - -
- - 66,000 - - - -
- 86,000 734,000 20,000 - - -
- 84,000 517,000 20,000 - - -
- 30,000 - 50,000 - - -
- 138,000 997,000 30,000 - - -
- 54,000 - 20,000 - - -
- 25,000 104,000 20,000 - - -
- - - - - - -
- 28,000 519,000 70,000 - - -
- 12,000 354,000 50,000 - - -
- - 114,000 120,000 - - -
- 44,000 619,000 20,000 - - -
- - - - - - -
15,000 1,027,000 10,965,000 1,270,000 - - -
TOTAL TGL SETOR BJB

395,000
1,112,000
531,000 7/6/2020
1,511,000
405,000
1,671,000
7/8/2020
635,000
1,576,000
588,000
718,000 7/13/2020
685,000
330,000
1,006,000
7/15/2020
846,000
613,000
765,000
600,000 7/20/2020
611,000
358,000
1,158,000
966,000 7/23/2020
343,000
1,381,000
249,000
7/27/2020
361,000
210,000
1,600,000 7/28/2020
612,000 7/29/2020
486,000
862,000 8/3/2020
878,000
24,062,000
 LAPORAN RETRIBUSI UPTD PUSKESMAS CIMAN
BULAN AGUSTUS 2020

URAIAN

TGL SETORAN
PAGI SORE MALAM/UGD PONED R. INAP TIND. UMUM

1 46,000 100,000 15,000 - - -

2 135,000 135,000 45,000 911,000 - -
3 66,000 230,000 15,000 - - 25,000
4 76,000 120,000 15,000 - - 25,000
5 88,000 170,000 15,000 - - 25,000
6 50,000 110,000 - - - -
7 60,000 160,000 75,000 633,000 - 25,000
8 44,000 110,000 15,000 - - 20,000
9 120,000 75,000 - - - -
10 110,000 150,000 15,000 - - 92,000
11 42,000 70,000 - - - 42,000
12 102,000 210,000 - - - 25,000
13 82,000 120,000 30,000 873,000 - 20,000
14 42,000 190,000 15,000 - - 17,000
15 56,000 90,000 60,000 - - -
16 30,000 165,000 - - - -
17 105,000 150,000 - - - 10,000
18 94,000 140,000 30,000 - - -
19 80,000 190,000 - - - -
20 75,000 135,000 - - - 5,000
21 56,000 210,000 15,000 - - -
22 34,000 160,000 30,000 - - 20,000
23 105,000 210,000 - - - -
24 94,000 270,000 - - - -
25 58,000 100,000 - - - -
26 120,000 140,000 - - - 27,000
27 78,000 130,000 - - - -
28 42,000 150,000 15,000 - - -
29 34,000 150,000 30,000 - - -
30 75,000 165,000 30,000 - - -
31 62,000 100,000 30,000 - - 25,000
JUMLAH 2,261,000 4,605,000 495,000 2,417,000 - 403,000
UPTD PUSKESMAS CIMANGGIS
AGUSTUS 2020

URAIAN
MAGANG/P TOTAL
TIND.GIGI
TIND.KEBIDANAN KIA/KB
DIAGNOSTIK SKS LEGALISIR HAJI KL/PENELITI
AN
- 40,000 454,000 20,000 - - - 675,000
- - - - - - - 1,226,000
- 88,000 672,000 20,000 - - - 1,116,000
- 28,000 846,000 50,000 - 60,000 - 1,220,000
- 30,000 350,000 40,000 - 20,000 - 738,000
- 98,000 124,000 60,000 - - - 442,000
- 100,000 711,000 20,000 - - - 1,784,000
- 135,000 52,000 40,000 - - - 416,000
- - - - - - - 195,000
- 78,000 1,398,000 50,000 - - - 1,893,000
- 16,000 469,000 - - - - 639,000
- 30,000 71,000 90,000 20,000 - 548,000
- 86,000 893,000 50,000 - - - 2,154,000
- 75,000 920,000 30,000 - - - 1,289,000
- 55,000 154,000 110,000 - - 525,000
- - 24,000 - - - - 219,000
- - 101,000 - - - - 366,000
- 32,000 789,000 50,000 - - - 1,135,000
- 30,000 89,000 30,000 - - - 419,000
- - 53,000 - - - - 268,000
- 30,000 46,000 - - - - 357,000
15,000 120,000 197,000 10,000 - - - 586,000
- - 115,000 - - - - 430,000
15,000 72,000 1,229,000 80,000 - - - 1,760,000
- 46,000 188,000 100,000 - - - 492,000
15,000 60,000 345,000 90,000 - - - 797,000
15,000 112,000 387,000 60,000 - - - 782,000
- 15,000 433,000 50,000 - - - 705,000
- 80,000 222,000 40,000 - 20,000 - 576,000
- - 27,000 - - - - 297,000
- 28,000 568,000 40,000 - - - 853,000
60,000 1,484,000 11,927,000 1,130,000 - 120,000 - 24,902,000
TGL SETOR BJB

8/3/2020

8/6/2020

8/10/2020

8/12/2020

8/18/2020

8/19/2020

8/24/2020

8/26/2020

8/29/2020

8/31/2020

9/1/2020
 LAPORAN RETRIBUSI UPTD PUSKESMAS CIMAN
BULAN SEPTEMBER 2020

URAIAN

TGL SETORAN
PAGI SORE MALAM/UGD PONED R. INAP TIND. UMUM

1 72,000 120,000 - - - -
2 74,000 100,000 15,000 - - -
3 46,000 80,000 - - -
4 56,000 120,000 15,000 - - -
5 36,000 60,000 - - - -
6 75,000 135,000 - - - -
7 64,000 190,000 - - - -
8 76,000 150,000 - - - -
9 76,000 150,000 15,000 - - -
10 58,000 120,000 15,000 753,000 - 17,000
11 30,000 150,000 30,000 - - 20,000
12 44,000 120,000 - - - 80,000
13 30,000 90,000 15,000 - - -
14 62,000 140,000 60,000 - - 82,000
15 64,000 90,000 - - - -
16 78,000 170,000 - - - -
17 58,000 130,000 - - - 92,000
18 48,000 110,000 - - - 42,000
19 40,000 40,000 45,000 - - 60,000
20 30,000 105,000 - - - 17,000
21 76,000 150,000 30,000 - - 30,000
22 36,000 90,000 45,000 728,000 - 10,000
23 32,000 30,000 - - - 10,000
24 56,000 170,000 15,000 - - 60,000
25 44,000 150,000 15,000 - - 25,000
26 34,000 90,000 - - - -
27 45,000 60,000 15,000 - - -
28 - - - - - -
29 66,000 120,000 - - - -
30 64,000 100,000 75,000 - - -
JUMLAH 1,570,000 3,330,000 405,000 1,481,000 - 545,000
 I UPTD PUSKESMAS CIMANGGIS
N SEPTEMBER 2020

URAIAN
MAGANG/PK TOTAL
TIND.GIGI
TIND.KEBIDANAN KIA/KB
DIAGNOSTIK SKS LEGALISIR HAJI L/PENELITIA
N
- 54,000 563,000 80,000 - - - 889,000
- - 172,000 20,000 - - - 381,000
- 36,000 699,000 40,000 - - - 901,000
- 75,000 495,000 50,000 - - - 811,000
- 130,000 419,000 40,000 - - - 685,000
- - 222,000 - - - - 432,000
- 32,000 720,000 60,000 - - - 1,066,000
- 16,000 60,000 100,000 - - - 402,000
- - 354,000 50,000 - - - 645,000
- 32,000 577,000 40,000 - - - 1,612,000
- 32,000 645,000 - - - - 907,000
- 10,000 517,000 20,000 - - - 791,000
- - 33,000 - - - - 168,000
- 50,000 465,000 30,000 - - - 889,000
- 118,000 472,000 50,000 - - 794,000
- - 505,000 40,000 - - - 793,000
- 46,000 659,000 20,000 - - - 1,005,000
- 10,000 355,000 30,000 - - - 595,000
- 35,000 219,000 - - - - 439,000
- - 76,000 - - - - 228,000
- 58,000 596,000 60,000 - - - 1,000,000
- 24,000 583,000 70,000 - - - 1,586,000
- - - - - - - 72,000
- 50,000 377,000 50,000 - - - 778,000
- 90,000 634,000 40,000 - - - 998,000
- 50,000 107,000 10,000 - - - 291,000
- - 43,000 - - - - 163,000
- - - - - - - -
- 23,000 236,000 110,000 - - - 555,000
- - 75,000 - - 120,000 - 434,000
971,000 10,878,000 1,010,000 - 120,000 - 20,310,000
TGL SETOR BJB

9/3/2020

9/4/2020

9/7/2020

9/9/2020

9/14/2020

9/17/2020

9/21/2020

9/23/2020

9/28/2020

NIHIL

10/1/2020
 LAPORAN RETRIBUSI UPTD PUSKESMAS CIMANG
BULAN OKTOBER 2020

URAIAN

TGL SETORAN
PAGI SORE MALAM/UGD PONED R. INAP TIND. UMUM

1 46,000 80,000 15,000 - - 137,000

2 34,000 70,000 - - - -
3 42,000 40,000 - - - -
4 105,000 105,000 - - - -
5 66,000 100,000 15,000 - - -
6 46,000 60,000 30,000 886,000 - 50,000
7 54,000 110,000 - - - 30,000
8 44,000 120,000 - - - -
9 40,000 80,000 - - - 10,000
10 26,000 60,000 - - - -
11 45,000 105,000 - - - -
12 156,000 240,000 15,000 - - 47,000
13 112,000 100,000 15,000 - - 30,000
14 104,000 130,000 - 611,000 - 10,000
15 68,000 100,000 30,000 - - 112,000
16 116,000 90,000 - - - -
17 168,000 80,000 - - - 25,000
18 90,000 285,000 15,000 678,000 - 57,000
19 90,000 60,000 - - - 95,000
20 152,000 60,000 15,000 - - -
21 66,000 60,000 - - - 67,000
22 92,000 150,000 - - - 25,000
23 54,000 150,000 15,000 - - -
24 68,000 100,000 15,000 - - 10,000
25 120,000 60,000 - - - -
26 54,000 70,000 - - - 190,000
27 124,000 60,000 15,000 - - -
28 88,000 60,000 15,000 - - 57,000
29 105,000 135,000 - - - -
30 68,000 120,000 - - - 25,000
31 32,000 70,000 - - - 17,000
JUMLAH 2,475,000 3,110,000 210,000 2,175,000 - 994,000
RIBUSI UPTD PUSKESMAS CIMANGGIS
BULAN OKTOBER 2020

URAIAN

MAGANG/PKL
TIND.GIGI
TIND.KEBIDANAN KIA/KB
DIAGNOSTIK SKS LEGALISIR HAJI
/PENELITIAN

- 12,000 206,000 40,000 - 20,000 -

- 60,000 169,000 20,000 - - -
- 70,000 159,000 40,000 - - -
- - 43,000 - - -
- 59,000 399,000 60,000 - - -
- 12,000 628,000 20,000 - - -
- - 98,000 50,000 - - -
- 38,000 309,000 20,000 - - -
- 100,000 337,000 10,000 - - -
- - 33,000 20,000 - - -
- - 33,000 - - - -
- 8,000 211,000 90,000 10,000 - -
- 32,000 678,000 90,000 70,000 - -
- - 424,000 20,000 20,000 - -
- 84,000 561,000 20,000 - -
- 55,000 466,000 - - - -
- 90,000 428,000 40,000 - - -
- - 60,000 - - - -
- 24,000 291,000 20,000 - - -
15,000 28,000 321,000 50,000 - - -
30,000 - 218,000 30,000 - - -
- 20,000 681,000 20,000 - - -
15,000 10,000 364,000 - - - -
- 50,000 164,000 30,000 - - -
- - - - - - -
- 20,000 273,000 60,000 - - -
15,000 24,000 679,000 100,000 - - -
- 60,000 261,000 30,000 - - -
- - - - - - -
- 55,000 108,000 - - - -
- 60,000 154,000 10,000 10,000 - -
75,000 971,000 8,756,000 890,000 110,000 20,000 -
TOTAL TGL SETOR BJB

556,000
353,000
10/5/2020
351,000
253,000
699,000
1,732,000 10/8/2020
342,000
531,000
577,000
10/12/2020
139,000
183,000
777,000
14/10/2020
1,127,000
1,319,000
16/10/2020
975,000
727,000
831,000 19/10/2020
1,185,000
580,000
641,000 22/10/2020
471,000
988,000 23/10/2020
608,000
437,000 26/10/2020
180,000
667,000 27/10/2020
1,017,000
571,000
240,000 11/1/2020
376,000
353,000
19,786,000
 LAPORAN RETRIBUSI UPTD PUSKESMAS CIMANG
BULAN NOVEMBER 2020

URAIAN

TGL SETORAN
PAGI SORE MALAM/UGD PONED R. INAP TIND. UMUM

1 45,000 165,000 - - - 30,000

2 72,000 180,000 15,000 - - -
3 46,000 60,000 15,000 - - -
4 90,000 130,000 30,000 - - -
5 40,000 150,000 - - - 97,000
6 32,000 60,000 30,000 - - -
7 26,000 130,000 - - -
8 60,000 45,000 45,000 - - -
9 68,000 100,000 15,000 - - 50,000
10 68,000 150,000 - - - -
11 76,000 160,000 15,000 - - -
12 82,000 160,000 15,000 976,000 - 20,000
13 30,000 180,000 60,000 - - 20,000
14 28,000 120,000 15,000 - - -
15 90,000 105,000 - - - -
16 74,000 220,000 15,000 - - 35,000
17 62,000 160,000 30,000 - - 72,000
18 84,000 110,000 - - - 25,000
19 78,000 240,000 15,000 - - 17,000
20 46,000 110,000 15,000 - - 17,000
21 36,000 170,000 - - - -
22 90,000 165,000 - 686,000 - 25,000
23 76,000 80,000 - - - 42,000
24 66,000 120,000 - - - 17,000
25 72,000 120,000 30,000 - - 72,000
26 72,000 120,000 15,000 - - 20,000
27 152,000 70,000 15,000 - - -
28 38,000 110,000 - - - 27,000
29 60,000 180,000 - - - 114,000
30 56,000 140,000 15,000 - - -
JUMLAH 1,915,000 4,010,000 405,000 1,662,000 - 700,000
IBUSI UPTD PUSKESMAS CIMANGGIS
ULAN NOVEMBER 2020

URAIAN
MAGANG/PK
TIND.GIGI
TIND.KEBIDANAN KIA/KB
DIAGNOSTIK SKS LEGALISIR HAJI L/PENELITIA
N
- - 84,000 - - - -
- 52,000 1,221,000 80,000 - - -
- 12,000 157,000 20,000 - - -
- 45,000 177,000 60,000 - - -
- 58,000 563,000 10,000 - - -
- 10,000 338,000 30,000 - - -
- 45,000 247,000 10,000 - - -
- - 53,000 - - - -
- 58,000 623,000 20,000 - - -
- 100,000 871,000 30,000 - - -
15,000 30,000 - 40,000 - - -
- 48,000 824,000 120,000 - - -
- 40,000 546,000 50,000 - - -
- 29,000 228,000 20,000 - - -
- - 23,000 - - -
- 150,000 803,000 60,000 - - -
- 32,000 997,000 10,000 - - -
- 60,000 197,000 50,000 - - -
- 50,000 732,000 60,000 - - -
15,000 45,000 468,000 10,000 - - -
- 15,000 387,000 30,000 - - -
- - 179,000 - - - -
- 114,000 337,000 20,000 - - -
30,000 78,000 609,000 20,000 - - -
- 60,000 182,000 130,000 - - -
- 46,000 511,000 60,000 - - -
- 130,000 5,186,000 360,000 - - -
- 75,000 471,000 20,000 - - -
- - 100,000 - - - -
- 16,000 240,000 40,000 - - -
60,000 1,398,000 17,354,000 1,360,000 - - -
 TOTAL TGL SETOR BJB

324,000 11/2/2020
1,620,000 11/3/2020
310,000
532,000 11/6/2020
918,000
500,000
458,000 11/9/2020
203,000
934,000
11/11/2020
1,219,000
336,000 11/12/2020
2,245,000
926,000
11/16/2020
440,000
218,000
1,357,000
11/18/2020
1,363,000
526,000
1,192,000
726,000 11/23/2020
638,000
1,145,000
669,000 11/24/2020
940,000 11/25/2020
666,000 11/26/2020
844,000
5,913,000
11/30/2020
741,000
454,000
507,000 12/1/2020
28,864,000
 LAPORAN RETRIBUSI UPTD PUSKESMAS CIMANGGIS
BULAN DESEMBER 2020

URAIAN

TGL SETORAN
PAGI SORE MALAM/UGD PONED R. INAP TIND. UMUM

1 54,000 160,000 15,000 - - 50,000

2 68,000 170,000 15,000 - - 64,000
3 32,000 140,000 45,000 12,000 - 40,000
4 36,000 150,000 - 686,000 - 34,000
5 40,000 140,000 15,000 - - 17,000
6 105,000 135,000 - 863,000 - -
7 46,000 100,000 90,000 21,000 - 62,000
8 54,000 120,000 45,000 - - 109,000
9 135,000 225,000 - 640,000 - -
10 58,000 120,000 15,000 - - 25,000
11 52,000 130,000 30,000 12,000 - 109,000
12 42,000 150,000 30,000 330,000 - -
13 60,000 105,000 - - - 5,000
14 62,000 170,000 - - - 20,000
15 64,000 240,000 30,000 - - 72,000
16 98,000 200,000 - 19,000 - -
17 48,000 90,000 30,000 - - -
18 32,000 150,000 15,000 - 44,000
19 26,000 80,000 30,000 34,000 - -
20 45,000 165,000 15,000 - - 99,000
21 64,000 230,000 15,000 - - 119,000
22 78,000 260,000 15,000 - - 125,000
23 84,000 190,000 15,000 - - 51,000
24 64,000 90,000 45,000 - - 20,000
25 90,000 165,000 - - - 17,000
26 32,000 130,000 - - - 25,000
27 120,000 135,000 - - - 5,000
28 58,000 250,000 75,000 - - 25,000
29 84,000 180,000 30,000 - - 50,000
30 52,000 190,000 - - - -
31 28,000 90,000 30,000 - - 100,000
JUMLAH 1,911,000 4,850,000 645,000 2,617,000 - 1,287,000
I UPTD PUSKESMAS CIMANGGIS
N DESEMBER 2020

URAIAN
MAGANG/P TOTAL
TIND.GIGI
TIND.KEBIDANAN KIA/KB
DIAGNOSTIK SKS LEGALISIR HAJI KL/PENELITI
AN
- 28,000 665,000 10,000 - - - 982,000
- 4,000 12,000 30,000 - - - 363,000
- 4,000 382,000 10,000 - - - 665,000
- 55,000 308,000 10,000 - - - 1,279,000
- 30,000 156,000 10,000 - - - 408,000
- - 121,000 - - - - 1,224,000
- 16,000 307,000 - - - - 642,000
- 50,000 391,000 30,000 - - - 799,000
- - 68,000 - - - - 1,068,000
- 20,000 407,000 70,000 - - - 715,000
- 40,000 416,000 20,000 - - - 809,000
- 110,000 181,000 40,000 - - 883,000
- - 23,000 - - - 193,000
20,000 54,000 457,000 40,000 - - 823,000
15,000 66,000 519,000 60,000 - - 1,066,000
- 60,000 234,000 60,000 - - - 671,000
- 16,000 402,000 20,000 - - - 606,000
- 65,000 383,000 50,000 - - - 739,000
- - 103,000 30,000 - - - 303,000
- - 40,000 - - - - 364,000
28,000 669,000 90,000 - - - 1,215,000
- 48,000 1,101,000 100,000 10,000 - - 1,737,000
90,000 211,000 50,000 - - - 691,000
30,000 84,000 163,000 30,000 - - - 526,000
- - 83,000 - - - - 355,000
- 30,000 346,000 40,000 - - - 603,000
- - 129,000 - - - - 389,000
15,000 61,000 708,000 30,000 - - - 1,222,000
15,000 36,000 857,000 40,000 - - - 1,292,000
- - 197,000 20,000 - - - 459,000
15,000 8,000 240,000 10,000 - - - 521,000
110,000 1,003,000 10,279,000 900,000 10,000 - - 23,612,000
TGL SETOR BJB

12/7/2020

12/10/2020

12/14/2020

12/15/2020

12/17/2020

12/21/2020

12/23/2020

12/30/2020
LAMPIRAN PERATURAN WALIKOTA DEPOK
TENTANG TARIF PELAYANAN KESEHATAN PUSKESMAS PADA DINAS KESEHATAN KOTA DEPOK
NOMOR 61 TAHUN 2016

Pelayanan Pagi 2000

Pelayanan Sore 10000
Hari Libur 15000
Pelayanan Gawat Darurat 15000
Pelayanan Kesehatan Khusus 5000
Puskesmas Rawat Inap/Hari 50000
Konsultasi Dan Pemeriksaan Visite Dokter Umum/Hari 5000
Asuhan Keperawatan/Hari 3000
Asuhan Kebidanan/Hari 3000
Bilas Lambung 35000
Buka Jahitan 10000
Chalazion 75000
Ekstirpasi Lipoma, Kista Ateroma 50000
Ekstraksi Satu Kuku 25000
Ekstraksi Batu Uretra 35000
Ekstraksi Benda Asing 20000
Ekstraksi Corpus Alineum Tanpa Komplikasi 20000
Ekstraksi Serumen/Irigasi Telinga 20000
Ganti Balutan 10000
Imunisasi Calon Pengantin 10000
Insisi Abses 20000
Injeksi 5000
Pasang Oksigen Per Jam 5000
Penggunaan Nebulizer 25000
Perawatan Luka Bakar <10% 25000
Perawatan Luka Bakar >10% 75000
Perawatan Luka Dengan Jahitan > 10, Setiap Satu Jahitan 5000
Perawatan Luka Dengan Jahitan 1 S/D 5 25000
Perawatan Luka Dengan Jahitan 6 S/D 10 50000
Perawatan Luka Tanpa Jahitan 7000
Probing Ductus Nasolacrimalis 35000
Surat Keterangan Sehat (termasuk Tes Ichihara)/Orang 10000
Tindakan Bedah Minor (ektirpasi Granuloma, Lipoma, Clavus, 50000
Kista Atheroma)
Tindik 15000
Tindik 15000
Incisi Abses 10000
Perawatan Luka Dengan Jahitan 1 S/D 3 25000
Perawatan Luka Dengan Jahitan > 3, Penambahan Setiap Satu
5000
Jahitan
Buka Jahitan 5000
Eritrosit 3000
Golongan Darah + Rhesus 8000
Hb 5000
Hematokrit 3000
Hematologi Lengkap 40000
Hematologi Rutin 25000
Hitung Jenis Leukosit 4000
Laju Endap Darah 5000
Leukosit 3000
Malaria/Fillaria 5000
Masa Pembekuan 2000
Masa Pendarahan 2000
Retikulosit 3000
Trombosit 5000
Gula Darah Per Test 12000
Albumin 10000
Alkali Phosphatase 15000
Asam Urat 15000
Bilirubin Direct 10000
Bilirubin Indirect 10000
Bilirubin Total 10000
Cholesterol Total 11000
Gamma Gt 15000
Globulin 10000
Hdl 11000
Kreatinin 11000
Ldl 11000
Pemeriksaan Hbsag 20000
Protein 10000
Sgot 12500
Sgpt 12500
Trigliserida 15000
Ureum 11000
Batang Tahan Asam Per Spesimen 5000
Neisseria 8000
Benzidin 10000
Darah Samar 5000
Lengkap 25000
Rutin (Maskroskopis, Miskroskopis 5000
Widal 20000
Anti Hbs 40000
Asto 30000
Ureum 11000
Batang Tahan Asam Per Spesimen 5000
Sedimen 5000
Tes Kehamilan 10000
Urine Rutin 10000
Urobilin 3000
Urobilinogen 3000
Pewarna Gram 8000
Secret Jamur 5000
Sekret Neissaria Gonorrhoe 8000
Sekret Trichomonas 5000
Ekg 25000