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TMC/FRM/MSS/008, Rev 00

TIRTA MEDICAL CENTER JAKARTA


MS SITE-BASED STAFF TIMESHEET

Attn : Admin MESSTA


Email : medsite@tirta.co.id

Employee Name :
Position : Doctor / Paramedic

Period : 20…….
Description
Day Total
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
2 4 6 8 10 12 14 16 18 20 22 24 26 28 30
Site :
Travel to Site:
Days on : 0
Travel from Site: 0
Days off : 0
Other: 0
Total 0
Note : Use an "X" to mark the row that applies to the day where worked, travelling, days off or other
Note : For Other : this applies to special assignment, sick or special leave days

Employee Signature ___________________ TMC Confirmation by ___________________ Client Site Confirmation by ___________________

Employee Name ___________________ TMC Person Name___________________ Client Person Name___________________

Date ___________________ Date___________________ Date ___________________

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