PEMERINTAH KABUPATEN SITUBONDO

BUKU KAS UMUM (BKU)

BENDAHARA PENERIMAAN TAHUN 2022
PUSKESMAS WIDOROPAYUNG
JANUARI
SKPD. DINAS KESEHATAN / UPT PUSKESMAS WIDOROPAYUNG………
PENDAPATAN
NO TANGGAL PENERIMAAN
SALDO BULAN LALU
1. 1/3/2022 Retribusi Loket/KARCIS Rp 36,000.00
Retribusi Loket/RM Rp 8,000.00
Retribusi P. BP Rp 10,000.00
Retribusi KARCIS UGD Rp 28,000.00
Retribusi RM UGD Rp 14,000.00
Retribusi TINDAKAN UGD Rp 50,000.00

2. 1/4/2022 Retribusi Loket/KARCIS Rp 12,000.00

Retribusi Loket/RM Rp 4,000.00
SALDO
3. 1/5/2022 Retribusi Loket/karcis Rp 12,000.00
Retribusi Loket/RM Rp 4,000.00
Retribusi LABORAT Rp 55,000.00
SALDO
4. 1/6/2022 Retribusi Loket/karcis Rp 20,000.00
Retribusi LOKET/RM Rp 6,000.00
Retribusi LABORAT Rp 5,000.00
Retribusi P. KIA Rp 17,500.00
SALDO
5. 1/7/2022 Retribusi Loket/karcis Rp 12,000.00
Retribusi LOKET/RM Rp 2,000.00
Retribusi LABORAT Rp 5,000.00
Retribusi P. KIA Rp 10,000.00
SALDO
6. 1/8/2022 Retribusi Loket/karcis Rp 4,000.00
Retribusi LOKET/RM Rp 2,000.00
Retribusi P. BP Rp 10,000.00
SALDO
7. 1/10/2022 Retribusi Loket/karcis Rp 24,000.00
Retribusi LOKET/RM Rp 10,000.00
Retribusi LABORAT Rp 15,000.00
Retribusi P. KIA Rp 10,000.00
Retribusi P. BLIMBING Rp 60,000.00
Retribusi P. SUMBEREJO Rp 20,000.00
Retribusi P. JETIS Rp 60,000.00
SALDO
 Setor ke rek Bendahara Penerimaan Dinkes 1-10 JANUARI
9. 1/11/2022 Retribusi Loket/karcis Rp 28,000.00
Retribusi LOKET/RM Rp 2,000.00
Retribusi P. BP Rp 10,000.00
SALDO
10. 1/12/2022 Retribusi Loket/karcis Rp 28,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi LABORAT Rp 45,000.00
SALDO
11. 1/13/2022 Retribusi Loket/karcis Rp 28,000.00
Retribusi LOKET/RM -
Retribusi P. BP Rp 10,000.00
Retribusi LABORAT Rp 30,000.00
Retribusi P. KIA Rp 12,000.00
SALDO
12. 1/14/2022 Retribusi Loket/karcis Rp 12,000.00
Retribusi LOKET/RM Rp 2,000.00
SALDO
13. 1/15/2022 Retribusi Loket/karcis Rp 4,000.00
Retribusi Loket/RM -
SALDO
14. 1/17/2022 Retribusi Loket/karcis Rp 8,000.00
Retribusi LOKET/RM -
SALDO
15. 1/18/2022 Retribusi Loket/karcis Rp 20,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi P. BP Rp 10,000.00
SALDO
16. 1/19/2022 Retribusi Loket/karcis Rp 52,000.00
Retribusi LOKET/RM Rp 14,000.00
Retribusi P. BP Rp 10,000.00
Retribusi LABORAT Rp 110,000.00
SALDO
17. 1/20/2022 Retribusi Loket/karcis Rp 16,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi P. BLIMBING Rp 100,000.00
Retribusi P. SUMBEREJO Rp 60,000.00
Retribusi P. JETIS Rp 20,000.00
SALDO
Setor ke rek Bendahara Penerimaan Dinkes 11-20 JANUARI
18. 1/21/2022 Retribusi Loket/karcis Rp 4,000.00
Retribusi LOKET/RM Rp 2,000.00
SALDO
19. 1/22/2022 Retribusi Loket/karcis Rp 24,000.00
Retribusi LOKET/RM Rp 2,000.00
 SALDO
20. 1/24/2022 Retribusi Loket/karcis Rp 20,000.00
Retribusi LOKET/RM Rp 2,000.00
Retribusi P. KIA Rp 7,500.00
SALDO
21. 1/25/2022 Retribusi Loket/karcis Rp 8,000.00
Retribusi LOKET/RM Rp 2,000.00
SALDO
22. 1/26/2022 Retribusi Loket/karcis Rp 56,000.00
Retribusi LOKET/RM Rp 20,000.00
Retribusi LABORAT Rp 157,500.00
SALDO
23. 1/27/2022 Retribusi Loket/karcis Rp 16,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi P. BP Rp 10,000.00
SALDO
24. 1/28/2022 Retribusi Loket/karcis Rp 8,000.00
Retribusi LOKET/RM Rp 2,000.00
Retribusi LABORAT Rp 22,500.00
Retribusi P. KIA Rp 10,000.00
SALDO
25. 1/29/2022 NIHIL
SALDO
26. 1/31/2022 Retribusi Loket/karcis Rp 20,000.00
Retribusi LOKET/RM -
Retribusi P. BLIMBING Rp 100,000.00
Retribusi P. SUMBEREJO Rp 20,000.00
Retribusi P. JETIS Rp 60,000.00
SALDO
Setor ke rek Bendahara Penerimaan Dinkes 22-31 JANUARI
Total Penerimaan Bulan JANUARI 2022
Setor ke rek Bendahara Penerimaan Dinkes

Mengetahui Disetor
Kepala Puskesmas Widoropayung Bendahara Peneri

SULISTYO BUDIWIYONO,S.KEP.NERS YULI HARTINING T

NIP. 19670525 199103 1 009 NIP. 197405
BONDO

UN 2022

PENGELUARAN SALDO

Rp 146,000.00

Rp 16,000.00

Rp 71,000.00

Rp 48,500.00

Rp 29,000.00

Rp 16,000.00

Rp 199,000.00
Rp 525,500.00

Rp 40,000.00

Rp 77,000.00

Rp 80,000.00

Rp 14,000.00

Rp 4,000.00

Rp 8,000.00

Rp 34,000.00

Rp 186,000.00

Rp 200,000.00
Rp 643,000.00

Rp 6,000.00
 Rp 26,000.00

Rp 29,500.00

Rp 10,000.00

Rp 233,500.00

Rp 30,000.00

Rp 42,500.00

Rp 200,000.00
Rp 577,500.00
Rp 1,746,000.00
Rp 1,746,000.00

Disetor oleh
Bendahara Penerimaan Pembantu

YULI HARTINING TIYASWARI, Amd.Keb

NIP. 197405081993 01 2002
 PEMERINTAH KABUPATEN SITUBONDO
BUKU KAS UMUM (BKU)
BENDAHARA PENERIMAAN TAHUN 2022
PUSKESMAS WIDOROPAYUNG
FEBRUARI
SKPD. DINAS KESEHATAN / UPT PUSKESMAS WIDOROPAYUNG………
PENDAPATAN
NO TANGGAL PENERIMAAN
SALDO BULAN LALU
1. 2/2/2022 Retribusi Loket/KARCIS Rp 80,000.00
Retribusi Loket/RM Rp 22,000.00
Retribusi LABORAT Rp 270,500.00

2. 2/3/2022 Retribusi Loket/KARCIS Rp 24,000.00

Retribusi Loket/RM Rp 4,000.00
Retribusi LABORAT Rp 5,000.00
Retribusi KIA Rp 17,500.00
Retribusi P. BP Rp 10,000.00
SALDO
3. 2/4/2022 Retribusi Loket/karcis Rp 8,000.00
Retribusi Loket/RM Rp 2,000.00
SALDO
4. 2/5/2022 Retribusi Loket/karcis NIHIL
Retribusi P.JETIS Rp 40,000.00
Retribusi P.BLIMBING Rp 100,000.00
Retribusi P.SUMBEREJO Rp 12,000.00
SALDO
Setor ke rek Bendahara Penerimaan Dinkes 02-05 FEBRUARI
5. 2/7/2022 Retribusi Loket/karcis Rp 24,000.00
Retribusi Loket/RM Rp 4,000.00
SALDO
6. 2/8/2022 Retribusi Loket/karcis Rp 16,000.00
Retribusi LOKET/RM Rp 2,000.00
SALDO
7. 2/9/2022 Retribusi Loket/karcis Rp 56,000.00
Retribusi LOKET/RM Rp 20,000.00
Retribusi LABORAT Rp 212,500.00
SALDO
8. 2/10/2022 Retribusi Loket/karcis Rp 20,000.00
Retribusi LOKET/RM Rp 6,000.00
Retribusi P.JETIS Rp 20,000.00
Retribusi P.SUMBEREJO Rp 12,000.00
SALDO
Setor ke rek Bendahara Penerimaan Dinkes 07-10 februari
9. 2/11/2022 Retribusi Loket/karcis Rp 8,000.00
 Retribusi LOKET/RM Rp 2,000.00
Retribusi P. BP Rp 10,000.00
SALDO
10. 2/12/2022 Retribusi Loket/karcis Rp 8,000.00
Retribusi P. BP Rp 10,000.00
SALDO
11. 2/14/2022 Retribusi Loket/karcis Rp 32,000.00
Retribusi LOKET/RM Rp 6,000.00
SALDO
12. 2/15/2022 Retribusi Loket/karcis Rp 12,000.00
Retribusi P. BP Rp 10,000.00
SALDO
13. 2/16/2022 Retribusi Loket/karcis Rp 68,000.00
Retribusi Loket/RM Rp 18,000.00
Retribusi LABORAT Rp 122,000.00
Retribusi KIA Rp 7,500.00
SALDO
14. 2/17/2022 Retribusi Loket/karcis Rp 4,000.00
Retribusi LOKET/RM Rp 2,000.00
SALDO
15. 2/18/2022 Retribusi Loket/karcis Rp 4,000.00
Retribusi Loket/RM Rp 2,000.00
Retribusi LABORAT Rp 5,000.00
Retribusi KIA Rp 17,500.00
SALDO
16. 2/19/2022 Retribusi Loket/karcis Rp 8,000.00
SALDO
17 2/21/2022 Retribusi Loket/karcis Rp 28,000.00
Retribusi Loket/RM Rp 6,000.00
Retribusi P. BP Rp 10,000.00
Retribusi P.JETIS Rp 60,000.00
Retribusi P.BLIMBING Rp 100,000.00
Retribusi P.SUMBEREJO Rp 20,000.00

Setor ke rek Bendahara Penerimaan Dinkes 11-21 FEBRUARI

18 2/22/2022 Retribusi Loket/karcis Rp 16,000.00
Retribusi Loket/RM Rp 6,000.00
SALDO
19 2/23/2022 Retribusi Loket/karcis Rp 20,000.00
Retribusi Loket/RM Rp 6,000.00
Retribusi LABORAT Rp 35,500.00
SALDO
20 2/24/2022 Retribusi Loket/karcis Rp 24,000.00
Retribusi LOKET/RM Rp 8,000.00
Retribusi P. BP Rp 20,000.00
 Retribusi KIA Rp 37,500.00
SALDO
Retribusi Loket/karcis Rp 20,000.00
Retribusi Loket/RM Rp 6,000.00
21 2/25/2022 Retribusi LABORAT Rp 15,000.00
SALDO
22 2/26/2022 Retribusi Loket/karcis Rp 8,000.00
SALDO
23 3/1/2022 Retribusi Loket/karcis Rp 32,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi LABORAT Rp 12,500.00
Retribusi P.JETIS Rp 100,000.00
Retribusi P.BLIMBING Rp 100,000.00
Retribusi P.SUMBEREJO Rp 32,000.00
SALDO
Setor ke rek Bendahara Penerimaan Dinkes 22 FEB - 01 MAR
Total Penerimaan Bulan februari 2022
Setor ke rek Bendahara Penerimaan Dinkes

Mengetahui Disetor oleh

Kepala Puskesmas Widoropayung Bendahara Penerimaan Pembantu

MOCHAMAD MAQFUR,S.KEP.NERS YULI HARTINING TIYASWARI, Amd.Ke

NIP. 19720515 1999803 1 012 NIP. 197405081993 01 2002
SITUBONDO
BKU)
TAHUN 2022
YUNG

PENGELUARAN SALDO

Rp 372,500.00

Rp 60,500.00

Rp 10,000.00

Rp 152,000.00
Rp 595,000.00

Rp 28,000.00

Rp 18,000.00

Rp 288,500.00

Rp 58,000.00
Rp 392,500.00
 Rp 20,000.00

Rp 18,000.00

Rp 38,000.00

Rp 22,000.00

Rp 215,500.00

Rp 6,000.00

Rp 28,500.00

Rp 8,000.00

Rp 224,000.00
Rp 580,000.00

Rp 22,000.00

Rp 61,500.00
 Rp 89,500.00

Rp 41,000.00

Rp 8,000.00

Rp 280,500.00
Rp 502,500.00
Rp 2,070,000.00
Rp 2,070,000.00

Disetor oleh
Bendahara Penerimaan Pembantu

YULI HARTINING TIYASWARI, Amd.Keb

NIP. 197405081993 01 2002
 PEMERINTAH KABUPATEN SITUBONDO
BUKU KAS UMUM (BKU)
BENDAHARA PENERIMAAN TAHUN 2022
PUSKESMAS WIDOROPAYUNG
MARET
SKPD. DINAS KESEHATAN / UPT PUSKESMAS WIDOROPAYUNG………
PENDAPATAN
NO TANGGAL PENERIMAAN PENGELUARAN SALDO
SALDO BULAN LALU
1. 3/2/2022 Retribusi Loket/KARCIS Rp 56,000.00
Retribusi Loket/RM Rp 8,000.00
Retribusi LABORAT Rp 124,000.00
Retribusi KIA Rp 17,500.00
Rp 205,500.00
2. 3/4/2022 Retribusi Loket/KARCIS Rp 12,000.00
SALDO Rp 12,000.00
3. 3/5/2022 Retribusi Loket/karcis Rp 12,000.00
Retribusi Loket/RM Rp 6,000.00
SALDO Rp 18,000.00
4. 3/7/2022 Retribusi Loket/karcis Rp 12,000.00
SALDO Rp 12,000.00
5. 3/8/2022 Retribusi Loket/karcis Rp 16,000.00
SALDO Rp 16,000.00
6. 3/9/2022 Retribusi Loket/karcis Rp 40,000.00
Retribusi LOKET/RM Rp 10,000.00
Retribusi LABORAT Rp 45,500.00
Retribusi KIA Rp 10,000.00
SALDO Rp 105,500.00
7. 3/10/2022 Retribusi Loket/karcis Rp 24,000.00
Retribusi LOKET/RM Rp 8,000.00
Retribusi P.JETIS Rp 100,000.00
Retribusi P.BLIMBING Rp 100,000.00
Retribusi P.SUMBEREJO Rp 24,000.00
Retribusi Tindakan Wilayah SUMBEREJO Rp 10,000.00
SALDO Rp 266,000.00
Setor ke rek Bendahara Penerimaan Dinkes 02-10 MARET Rp 635,000.00
8. 3/11/2022 Retribusi Loket/karcis Rp 24,000.00
Retribusi LOKET/RM Rp 2,000.00
Retribusi P. BP Rp 20,000.00
SALDO Rp 46,000.00
9. 3/12/2022 Retribusi Loket/karcis Rp 28,000.00
Retribusi LOKET/RM Rp 14,000.00
Retribusi KIA Rp 10,000.00
SALDO Rp 52,000.00
10. 3/14/2022 Retribusi Loket/karcis Rp 48,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi LABORAT Rp 12,500.00
Retribusi KIA Rp 17,500.00
Retribusi P. BP Rp 10,000.00
SALDO Rp 92,000.00
11. 3/15/2022 Retribusi Loket/karcis Rp 32,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi LABORAT Rp 20,000.00
Retribusi KIA Rp 27,500.00
Retribusi P. BP Rp 10,000.00
SALDO Rp 93,500.00
12. 3/16/2022 Retribusi Loket/karcis Rp 64,000.00
Retribusi Loket/RM Rp 18,000.00
Retribusi LABORAT Rp 50,500.00
Retribusi P. BP Rp 20,000.00
SALDO Rp 152,500.00
13. 3/17/2022 Retribusi Loket/karcis Rp 32,000.00
Retribusi LOKET/RM Rp 12,000.00
 Retribusi KIA Rp 50,000.00
Retribusi LABORAT Rp 12,500.00
SALDO Rp 106,500.00
14. 3/18/2022 Retribusi Loket/karcis Rp 32,000.00
Retribusi Loket/RM Rp 4,000.00
Retribusi LABORAT Rp 7,500.00
Retribusi KIA Rp 10,000.00
Retribusi P. BP Rp 10,000.00
SALDO Rp 63,500.00
15. 3/19/2022 Retribusi Loket/karcis Rp 8,000.00
Retribusi Loket/RM Rp 2,000.00
SALDO Rp 10,000.00
16. 3/21/2022 Retribusi Loket/karcis Rp 16,000.00
Retribusi P.JETIS Rp 100,000.00
Retribusi P.BLIMBING Rp 64,000.00
Retribusi P.SUMBEREJO Rp 20,000.00
Retribusi Tindakan Wilayah BLIMBING Rp 60,000.00
Rp 260,000.00
Setor ke rek Bendahara Penerimaan Dinkes 11-21 MARET Rp 876,000.00
17. 3/22/2022 Retribusi Loket/karcis Rp 12,000.00
Retribusi Loket/RM Rp 2,000.00
Retribusi LABORAT Rp 27,500.00
Retribusi P. BP Rp 10,000.00
Retribusi KIA Rp 17,500.00
SALDO Rp 69,000.00
18. 3/23/2022 Retribusi Loket/karcis Rp 60,000.00
Retribusi Loket/RM Rp 8,000.00
Retribusi LABORAT Rp 55,500.00
Retribusi P. BP Rp 10,000.00
Retribusi KIA Rp 27,500.00
SALDO Rp 161,000.00
19. 3/24/2022 Retribusi Loket/karcis Rp 8,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi KIA Rp 30,000.00
SALDO Rp 42,000.00
20. 3/25/2022 Retribusi Loket/karcis Rp 4,000.00
SALDO Rp 4,000.00
21 3/26/2022 Retribusi Loket/karcis Rp 12,000.00
Retribusi Loket/RM Rp 2,000.00
Retribusi LABORAT Rp 5,000.00
Retribusi KIA Rp 17,500.00
SALDO Rp 36,500.00
22 3/28/2022 Retribusi Loket/karcis Rp 16,000.00
SALDO Rp 16,000.00
23 3/29/2022 Retribusi Loket/karcis Rp 8,000.00
Retribusi Loket/RM Rp 2,000.00
Retribusi P. BP Rp 10,000.00
SALDO Rp 20,000.00
24 3/30/2022 Retribusi Loket/karcis Rp 64,000.00
Retribusi Loket/RM Rp 16,000.00
Retribusi LABORAT Rp 152,000.00
SALDO Rp 232,000.00
25 3/31/2022 Retribusi Loket/karcis Rp 24,000.00
Retribusi LOKET/RM Rp 6,000.00
Retribusi P.JETIS Rp 100,000.00
Retribusi P.BLIMBING Rp 64,000.00
Retribusi P.SUMBEREJO Rp 40,000.00
Retribusi Tindakan Wilayah JETIS Rp 30,000.00
Retribusi Tindakan Wilayah BLIMBING Rp 60,000.00
Retribusi Tindakan Wilayah SUMBEREJO Rp 10,000.00
Retribusi KARCIS UGD Rp 28,000.00
Retribusi RM UGD Rp 14,000.00
Retribusi TINDAKAN UGD Rp 20,000.00
SALDO Rp 396,000.00
Setor ke rek Bendahara Penerimaan Dinkes 22-31 MAR Rp 976,500.00
Total Penerimaan Bulan Maret 2022 Rp 2,487,500.00
Setor ke rek Bendahara Penerimaan Dinkes Rp 2,487,500.00

Mengetahui Disetor oleh

Kepala Puskesmas Widoropayung Bendahara Penerimaan Pembantu
MOCHAMAD MAQFUR,S.KEP.NERS YULI HARTINING TIYASWARI, Amd.Keb
NIP. 19720515 1999803 1 012 NIP. 197405081993 01 2002
 PEMERINTAH KABUPATEN SITUBONDO
BUKU KAS UMUM (BKU)
BENDAHARA PENERIMAAN TAHUN 2022
PUSKESMAS WIDOROPAYUNG
APRIL
SKPD. DINAS KESEHATAN / UPT PUSKESMAS WIDOROPAYUNG………
PENDAPATAN
NO TANGGAL PENERIMAAN PENGELUARAN SALDO
SALDO BULAN LALU
1. 4/1/2022 Retribusi Loket/KARCIS Rp 4,000.00
Retribusi LABORAT Rp 30,000.00
Rp 34,000.00
2. 4/2/2022 Retribusi Loket/KARCIS Rp 12,000.00
Retribusi Loket/RM Rp 4,000.00
Retribusi LABORAT Rp 52,500.00
Retribusi KIA Rp 17,500.00
Retribusi P. BP Rp 10,000.00
SALDO Rp 96,000.00
3. 4/4/2022 Retribusi Loket/karcis Rp 16,000.00
Retribusi Loket/RM Rp 4,000.00
Retribusi P. BP Rp 10,000.00
SALDO Rp 30,000.00
4. 4/5/2022 Retribusi Loket/karcis Rp 24,000.00
Retribusi Loket/RM Rp 6,000.00
Retribusi LABORAT Rp 12,500.00
Retribusi KIA Rp 27,500.00
SALDO Rp 70,000.00
5. 4/6/2022 Retribusi Loket/karcis Rp 44,000.00
Retribusi Loket/RM Rp 10,000.00
Retribusi LABORAT Rp 66,000.00
Retribusi KIA Rp 15,000.00
SALDO Rp 135,000.00
6. 4/7/2022 Retribusi Loket/karcis Rp 8,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi LABORAT Rp 5,000.00
Retribusi KIA Rp 17,500.00
SALDO Rp 34,500.00
7. 4/8/2022 Retribusi Loket/karcis Rp 12,000.00
Retribusi LOKET/RM Rp 2,000.00
SALDO Rp 14,000.00
8 4/9/2022 Retribusi Loket/karcis Rp 8,000.00
SALDO Rp 8,000.00
9 4/11/2022 Retribusi Loket/karcis Rp 36,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi P. BP Rp 20,000.00
Retribusi P.JETIS Rp 100,000.00
Retribusi P.BLIMBING Rp 64,000.00
Retribusi P.SUMBEREJO Rp 32,000.00
Retribusi Tindakan Wilayah BLIMBING Rp 60,000.00
SALDO Rp 316,000.00
Setor ke rek Bendahara Penerimaan Dinkes 01-11 APRIL Rp 737,500.00
10. 4/12/2022 Retribusi Loket/karcis Rp 28,000.00
Retribusi LOKET/RM Rp 8,000.00
Retribusi KIA Rp 60,000.00
SALDO Rp 96,000.00
11 4/13/2022 Retribusi Loket/karcis Rp 32,000.00
Retribusi LOKET/RM Rp 8,000.00
Retribusi LABORAT Rp 69,000.00
Retribusi P. BP Rp 20,000.00
SALDO Rp 129,000.00
12 4/14/2022 Retribusi Loket/karcis Rp 4,000.00
SALDO Rp 4,000.00
13 4/16/2022 Retribusi Loket/karcis Rp 8,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi P. BP Rp 10,000.00
SALDO Rp 22,000.00
14 4/18/2022 Retribusi Loket/karcis Rp 20,000.00
Retribusi Loket/RM Rp 6,000.00
Retribusi P. BP Rp 10,000.00
SALDO Rp 36,000.00
15 4/19/2022 Retribusi Loket/karcis Rp 16,000.00
Retribusi LOKET/RM Rp 4,000.00
SALDO Rp 20,000.00
16 4/20/2022 Retribusi Loket/karcis Rp 44,000.00
Retribusi LOKET/RM Rp 10,000.00
Retribusi LABORAT Rp 35,500.00
Retribusi KIA Rp 10,000.00
Retribusi P.JETIS Rp 100,000.00
Retribusi P.BLIMBING Rp 64,000.00
Retribusi P.SUMBEREJO Rp 32,000.00
Retribusi Tindakan Wilayah BLIMBING Rp 60,000.00
Retribusi Tindakan Wilayah JETIS Rp 30,000.00
Rp 385,500.00
Setor ke rek Bendahara Penerimaan Dinkes 11-20 APRIL Rp 692,500.00
17. 4/21/2022 Retribusi Loket/karcis Rp 20,000.00
Retribusi Loket/RM Rp 10,000.00
SALDO Rp 30,000.00
18. 4/22/2022 Retribusi Loket/karcis Rp 8,000.00
SALDO Rp 8,000.00
19. 4/23/2022 Retribusi Loket/karcis Rp 8,000.00
Retribusi LOKET/RM Rp 4,000.00
SALDO Rp 12,000.00
20. 4/25/2022 Retribusi Loket/karcis Rp 28,000.00
Retribusi LOKET/RM Rp 4,000.00
SALDO Rp 32,000.00
21 4/26/2022 Retribusi Loket/karcis Rp 16,000.00
Retribusi Loket/RM Rp 4,000.00
Retribusi LABORAT Rp 15,000.00
SALDO Rp 35,000.00
22 4/27/2022 Retribusi Loket/karcis Rp 64,000.00
Retribusi Loket/RM Rp 16,000.00
Retribusi LABORAT Rp 18,000.00
SALDO Rp 98,000.00
23 4/28/2022 Retribusi Loket/karcis Rp 12,000.00
Retribusi Loket/RM Rp 2,000.00
Retribusi P. BP Rp 10,000.00
Retribusi P.JETIS Rp 100,000.00
Retribusi P.BLIMBING Rp 100,000.00
Retribusi P.SUMBEREJO Rp 32,000.00
SALDO Rp 256,000.00
Setor ke rek Bendahara Penerimaan Dinkes 22-31 APRIL Rp 471,000.00
Total Penerimaan Bulan APRIL 2022 Rp 1,901,000.00
Setor ke rek Bendahara Penerimaan Dinkes Rp 1,901,000.00

Mengetahui Disetor oleh

Kepala Puskesmas Widoropayung Bendahara Penerimaan Pembantu

MOCHAMAD MAQFUR,S.KEP.NERS YULI HARTINING TIYASWARI, Amd.Keb

NIP. 19720515 1999803 1 012 NIP. 197405081993 01 2002
 PEMERINTAH KABUPATEN SITUBONDO
BUKU KAS UMUM (BKU)
BENDAHARA PENERIMAAN TAHUN 2022
PUSKESMAS WIDOROPAYUNG
MEI
SKPD. DINAS KESEHATAN / UPT PUSKESMAS WIDOROPAYUNG………
PENDAPATAN
NO TANGGAL PENERIMAAN
SALDO BULAN LALU
1. 5/7/2022 Retribusi Loket/karcis Rp 20,000.00
Retribusi Loket/RM Rp 6,000.00
Retribusi P.BP Rp 10,000.00
SALDO
2. 5/9/2022 Retribusi Loket/karcis Rp 44,000.00
Retribusi LOKET/RM Rp 16,000.00
Retribusi LABORAT Rp 57,500.00
Retribusi KIA Rp 17,500.00
Retribusi P.BP Rp 20,000.00
SALDO
3. 5/10/2022 Retribusi Loket/karcis Rp 12,000.00
Retribusi LOKET/RM Rp 2,000.00
Retribusi P.BP Rp 10,000.00
Retribusi LABORAT Rp 22,500.00
Retribusi P. Jetis Rp 52,000.00
Retribusi P.Blimbing Rp 52,000.00
Retribusi P. Sumberejo Rp 32,000.00
SALDO
Setor ke rek Bendahara Penerimaan Dinkes 07-10 MEI
4. 5/11/2022 Retribusi Loket/karcis Rp 60,000.00
Retribusi LOKET/RM Rp 16,000.00
Retribusi KIA Rp 27,500.00
Retribusi LABORAT Rp 170,000.00
Retribusi P. BP Rp 10,000.00
SALDO
5. 5/12/2022 Retribusi Loket/karcis Rp 20,000.00
Retribusi LOKET/RM Rp 2,000.00
Retribusi LABORAT Rp 7,500.00
Retribusi KIA Rp 10,000.00
SALDO
6. 5/13/2022 Retribusi Loket/karcis Rp 16,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi P. BP Rp 20,000.00
SALDO
7. 5/14/2022 Retribusi Loket/karcis Rp 32,000.00
Retribusi LOKET/RM Rp 12,000.00
 Retribusi P. BP Rp 10,000.00
Retribusi LABORAT Rp 40,000.00
Retribusi KIA Rp 47,500.00
SALDO
8. 5/17/2022 Retribusi Loket/karcis Rp 12,000.00
SALDO
9. 5/18/2022 Retribusi Loket/karcis Rp 56,000.00
Retribusi LOKET/RM Rp 12,000.00
Retribusi LABORAT Rp 147,500.00
Retribusi KIA Rp 57,500.00
SALDO
10. 5/19/2022 Retribusi Loket/karcis Rp 12,000.00
Retribusi LOKET/RM Rp 4,000.00
Retribusi KIA Rp 7,500.00

11. 5/20/2022 Retribusi Loket/karcis Rp 4,000.00

Retribusi LOKET/RM Rp 2,000.00
Retribusi P. Sumberejo Rp 32,000.00
Retribusi P. Blimbing Rp 100,000.00
Retribusi P. Jetis Rp 100,000.00

Setor ke rek Bendahara Penerimaan Dinkes 11-20 MEI

12. 5/21/2022 Retribusi Loket/karcis Rp 64,000.00
Retribusi Loket/RM Rp 20,000.00
SALDO
13. 5/23/2022 Retribusi Loket/karcis Rp 120,000.00
Retribusi Loket/RM Rp 44,000.00
Retribusi LABORAT Rp 12,500.00
Retribusi KIA Rp 17,500.00
SALDO
14. 5/24/2022 Retribusi Loket/karcis Rp 20,000.00
Retribusi LOKET/RM Rp 2,000.00
Retribusi LABORAT Rp 12,500.00
Retribusi KIA Rp 27,500.00
SALDO
15. 5/25/2022 Retribusi Loket/karcis Rp 48,000.00
Retribusi LOKET/RM Rp 12,000.00
Retribusi LABORAT Rp 177,000.00
Retribusi KIA Rp 17,500.00
SALDO
16. 5/27/2022 Retribusi Loket/karcis Rp 28,000.00
Retribusi Loket/RM Rp 10,000.00
Retribusi LABORAT Rp 15,000.00
Retribusi P.BP Rp 40,000.00
SALDO
17. 5/28/2022 Retribusi Loket/karcis Rp 32,000.00
Retribusi Loket/RM Rp 4,000.00
Retribusi LABORAT Rp 20,000.00
Retribusi KIA Rp 10,000.00
SALDO
18. 5/30/2022 Retribusi Loket/karcis Rp 4,000.00
Retribusi Loket/RM Rp 2,000.00
Retribusi P. BP Rp 10,000.00
Retribusi KARCIS UGD Rp 20,000.00
Retribusi RM UGD Rp 10,000.00
Retribusi Tindakan UGD Rp 40,000.00

19. 5/31/2022 Retribusi Loket/karcis Rp 40,000.00

Retribusi Loket/RM Rp 10,000.00
Retribusi LABORAT Rp 43,000.00
Retribusi KIA Rp 17,500.00
Retribusi P.JETIS Rp 80,000.00
Retribusi Tindakan P. Jetis Rp 20,000.00
Retribusi P.BLIMBING Rp 80,000.00
Retribusi Tindakan P. Blimbing Rp 20,000.00
Retribusi P.SUMBEREJO Rp 32,000.00
Retribusi Tindakan P. Sumberejo Rp 20,000.00
SALDO
Setor ke rek Bendahara Penerimaan Dinkes 21-31 MEI
Total Penerimaan Bulan MEI 2022
Setor ke rek Bendahara Penerimaan Dinkes

Mengetahui Disetor oleh

Kepala Puskesmas Widoropayung Bendahara Penerimaan Pem

MOCHAMAD MAQFUR,S.KEP.NERS EKA FITRI CAHYANI, S.Kep

NIP. 19720515 1999803 1 012 NIP. 19930501 202012 2
ONDO

N 2022

PENGELUARAN SALDO

Rp 36,000.00

Rp 155,000.00

Rp 182,500.00
Rp 373,500.00

Rp 283,500.00

Rp 39,500.00

Rp 40,000.00
 Rp 141,500.00

Rp 12,000.00

Rp 273,000.00

Rp 23,500.00

Rp 238,000.00
Rp 1,051,000.00

Rp 84,000.00

Rp 194,000.00

Rp 62,000.00

Rp 254,500.00

Rp 93,000.00
 Rp 66,000.00

Rp 86,000.00

Rp 362,500.00
Rp 1,202,000.00
Rp 2,626,500.00
Rp 2,626,500.00

Disetor oleh
Bendahara Penerimaan Pembantu

EKA FITRI CAHYANI, S.Kep., Ners.

NIP. 19930501 202012 2 018