TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH

1 8,000 - - - - - - - - 8,000
2 8,000 - - - - - - - - 8,000
3 8,000 - - - - - - - - 8,000
4 8,000 - - - - - - - - 8,000
5 8,000 - - - - - - - - 8,000
6 8,000 - - - - - - - - 8,000
7 8,000 - - - - - - - - 8,000
8 8,000 - - - - - - - - 8,000
9 8,000 - - - - - - - - 8,000
10 8,000 - - - - - - - - 8,000
11 8,000 - - - - - - - - 8,000
12 8,000 - - - - - - - - 8,000
13 8,000 - - - - - - - - 8,000
14 8,000 - - - - - - - - 8,000
15 8,000 - - - - - - - - 8,000
16 8,000 - - - - - - - - 8,000
17 8,000 - - - - - - - - 8,000
18 8,000 - - - - - - - - 8,000
19 8,000 - - - - - - - - 8,000
20 8,000 - - - - - - - - 8,000
21 8,000 - - - - - - - - 8,000
22 8,000 - - - - - - - - 8,000
23 8,000 - - - - - - - - 8,000
24 8,000 - - - - - - - - 8,000
25 8,000 - - - - - - - - 8,000
26 8,000 - - - - - - - - 8,000
27 8,000 - - - - - - - - 8,000
28 8,000 - - - - - - - - 8,000
29 8,000 - - - - - - - - 8,000
30 8,000 - - - - - - - - 8,000
31 8,000 - - - - - - - - 8,000
32 8,000 - - - - - - - - 8,000
33 8,000 - - - - - - - - 8,000
34 8,000 - - - - - - - - 8,000
35 8,000 - - - - - - - - 8,000
36 - - - - - - - - - -
37 - - - - - - - - - -
JUMLAH 280,000 - - - - - - - - 280,000
TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/1/2022 1 JAMAL MEDALSARI 8,000 - - - - - - - - 8,000
2 KOKOM MEDALSARI 8,000 - - - - - - - - 8,000
3 ALBI MEDALSARI 8,000 - - - - - - - - 8,000
4 NONENG LAKSANAMEKAR 8,000 - - - - - - - - 8,000
5 ANWAR BANJARWANGI 8,000 - - - - - - - - 8,000
6 IROH MEKARSARI 8,000 - - - - - - - - 8,000
7 AI RINA KARYAMANDALA 8,000 - - - - - - - - 8,000
8 ASEP LUKMAN KAWITAN 8,000 - - - - - - - - 8,000
9 ROPI RAHMAUDIN CITUNDUN 8,000 - - - - - - - - 8,000
10 AA RATNASARI NANGERANG 8,000 - - - - - - - - 8,000
11 ARKANA M KAWITAN 8,000 - - - - - - - - 8,000
12 DAREEN WAFFA UMUL QURO 8,000 - - - - - - - - 8,000
13 LIA ISMAYA MARINGINAN 8,000 - - 40,000 - - - - - 48,000
14 REGINA LISTIANI POJOK 8,000 - - - - - - - - 8,000
15 SUMARNI HAURKUNING 8,000 - - 35,000 - - - - - 43,000
16 TETI SUMIARTI LAKSANAMEKAR 8,000 - - - - - - - - 8,000
17 EDI DARYANA HAURKUNING 8,000 - - - - - - - - 8,000
18 DODI EKA AFANDI KAWITAN 8,000 - - - - - - - - 8,000
19 MUHAMAD FARHAN TANJUNGSARI 8,000 - - - - - - - - 8,000
20 UTAS MUKOAS UMUL QURO 8,000 - - - - - - - - 8,000
21 ATLAN LAKSANAMEKAR 8,000 - - - - - - - - 8,000
22 AEP SAEPUDIN SINGKUR 8,000 - - - - - - - - 8,000
23 ANISA SAGA 8,000 - - - - - - - - 8,000
24 YULI LAKSANAMEKAR 8,000 - - - - - - - - 8,000
25 ONAH - - - 25,000 - - - - - 25,000
26 SARIPUDIN - 75,000 - - - - - - - 75,000
JUMLAH 192,000 75,000 - 100,000 - - - - - 367,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/2/2022 1 DAFIN BINUANG 8,000 - - - - - - - - 8,000
2 TIA AGUSTIN BOLANG 8,000 - - 25,000 - - - - - 33,000
3 TINA SA'BANI PANGOCOKAN 8,000 - - - - - - - - 8,000
4 ELIN HERLINA KALANGANYAR 8,000 75,000 - - - - - - - 83,000
5 MISNO MANDALAHAYU 8,000 - - 45,000 - - - - - 53,000
6 DODI AGUS SALIM CIBEUNYING 8,000 - - - - - - - - 8,000
7 DAIR NUR MAARIF KERTARAHAYU 8,000 - - - - - - - - 8,000
8 NAZWA AULIA CIKEMBANG 8,000 - - - - - - - - 8,000
9 ARGA MANDALAWANGI 8,000 - - - - - - - - 8,000
10 SARI SUMARNI MULYASARI 8,000 - - - - - - - - 8,000
11 M NIZAM CIBADAK 8,000 - - - - - - - - 8,000
12 ARMAN ABDUL UMUL QURO 8,000 - - - - - - - - 8,000
13 M RAHAL KAWITAN 8,000 - - - - - - - - 8,000
14 ALIF SAPUTRA SAGA 8,000 35,000 - - - - - - - 43,000
15 SITI MARIAH MANDALAWANGI 8,000 - - - - - - - - 8,000
16 ADITIA SALMAN MULYASARI 8,000 - - - - - - - - 8,000
17 AMAIRA SRI JAYAMUKTI 8,000 - - - - - - - - 8,000
18 BELA JAMUPU 8,000 - - 130,000 - - - - - 138,000
19 AMAH MULYASARI 8,000 - - - - - - - - 8,000
20 ERIK MARINGINAN 8,000 - - - - - - - - 8,000
21 ALISA SAHMINA MARINGINAN 8,000 - - - - - - - - 8,000
22 AGAM HOER APANDI MARINGINAN 8,000 - - - - - - - - 8,000
23 KUKUS KUSWANDI SUKASARI 8,000 - - - - - - - - 8,000
24 TUTI - - - 25,000 - - - - - 25,000
JUMLAH 184,000 110,000 - 225,000 - - - - - 519,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/4/2022 1 ROPIAH MANDALAWANGI 8,000 - - - - - - - - 8,000
2 ELSA SINDNAGASIH 8,000 - - - - - - - - 8,000
3 DARA LINGGA ARUM BOJONGRAPIH 8,000 105,000 - - - - - - - 113,000
4 MUSLIMIN WANGUNHARJA 8,000 - - - - - - - - 8,000
5 RAHMAT MANDALAGUNA 8,000 - - - - - - - - 8,000
6 M DAVA UMUL QURO 8,000 - - - - - - - - 8,000
7 ARMILAH CAYUR 8,000 - - - - - - - - 8,000
8 ENTIN ROSTINI CIKEMBANG 8,000 - - 25,000 - - - - - 33,000
9 LULU JAMUPU 8,000 50,000 - - - - - - - 58,000
10 ALTAN SUKASARI 8,000 - - - - - - - - 8,000
11 ASLAM SUKASARI 8,000 - - - - - - - - 8,000
12 IYAH SADIYAH MEKARWANGI 8,000 - - - - - - - - 8,000
13 RONI SAPAAT KARYAMANDALA 8,000 - - - - - - - - 8,000
14 NENG YESI MEKARWANGI 8,000 - - - - - - - - 8,000
15 ADINDA ANJANI MANDALAHAYU 8,000 - - - - - - - - 8,000
16 OPIK HIDAYAT JAMUPU 8,000 - - - - - - - - 8,000
17 MUHAMAD KAFI ANJUNG 8,000 - - - - - - - - 8,000
18 TINI SRIWANTINI ANJUNG 8,000 - - - - - - - - 8,000
19 NADIA RAMADANI KAWITAN 8,000 - - - - - - - - 8,000
20 SATRIA JAMUPU 8,000 - - - - - - - - 8,000
21 ANJANI MANDALAHAYU 8,000 - - - - - - - - 8,000
22 ZAHRA NURHSANASAH UMUL QURO 8,000 - - - - - - - - 8,000
23 TOWI CIKASUNGKA 8,000 - - - - - - - - 8,000
24 RAIFA MULYASARI 8,000 - - - - - - - - 8,000
 25 SITI KHODIJAH SUTALAYA 8,000 - - - - - - - - 8,000
26 DARA LILLAH KARYAMANDALA 8,000 - - - - - - - - 8,000
27 DHENA TRI PUTRA WANGUNHARJA 8,000 - - - - - - - - 8,000
28 ADAM EKA RIYADHI WANGUNHARJA 8,000 - - - - - - - - 8,000
29 GAISAN CITUNDUN 8,000 - - - - - - - - 8,000
30 ZAKI MEKARWANGI 8,000 - - - - - - - - 8,000
31 NAYSHA MEKARWANGI 8,000 - - - - - - - - 8,000
32 IYAH CIKASUNGKA 8,000 - - - - - - - - 8,000
33 MARWAH MULYASARI 8,000 - - - - - - - - 8,000
34 REVAN PAUJI 8,000 - - - - - - - - 8,000
35 RAPA HIJRAH BARENGKOK 8,000 - - - - - - - - 8,000
36 SARIP MANDALAHAYU 8,000 - - - - - - - - 8,000
37 YATI MANDALAHAYU 8,000 - - - - - - - - 8,000
38 NAJIYA FAHRA KARYAMANDALA 8,000 - - - - - - - - 8,000
39 AI HENI KARYAMANDALA 8,000 - - - - - - - - 8,000
40 AGUS KOMARA CIKASUNGKA 8,000 - - - - - - - - 8,000
41 WINDI TAMANSARI 8,000 - - - - - - - - 8,000
42 WILDAN BANJARWARINGIN 8,000 - - - - - - - - 8,000
43 UNANG 8,000 - - 45,000 - - - - - 53,000
44 RIZKY - - - - 25,000 - - - - 25,000
45 IYOH - - - 25,000 - - - - - 25,000
46 SITI AMANAH - - - 55,000 - - - - - 55,000
47 ELIT - - - 35,000 - - - - - 35,000
48 SITI SAROH - - - 25,000 - - - - - 25,000
JUMLAH 344,000 155,000 - 210,000 25,000 - - - - 734,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/5/2022 1 TITIN SUHARTINI CIKEMBANG 2 8,000 - - - - - - - - 8,000
2 AAT CIPICUNG 8,000 - - - - - - - - 8,000
3 UMINI TANJUNG 8,000 - - - - - - - - 8,000
4 MUHAMAD FAJAR JAYAMUKTI 8,000 - - - - - - - - 8,000
5 NADIA CIPASARA 8,000 - - - - - - - - 8,000
6 ENCIN SUPLIAH MEKARWANGI 8,000 - - - - - - - - 8,000
7 CANDRA UMUL QURO 8,000 - - - - - - - - 8,000
8 UUN CIKEMBANG 8,000 - - - - - - - - 8,000
9 SALMAN UMUL QURO 8,000 - - - - - - - - 8,000
10 ALEA PITRI BANGBAYANG 8,000 - - - - - - - - 8,000
11 HASAN UMUL QURO 8,000 - - - - - - - - 8,000
12 GIBRAN NAFIZA TANJUNG 8,000 - - - - - - - - 8,000
13 ARSA PUTRA MEKARSARI 8,000 - - - - - - - - 8,000
14 ENI ROHANI KARYAMANDALA 8,000 - - - - - - - - 8,000
15 MUHAMAD PALIH CIKASUNGKA 8,000 - - - - - - - - 8,000
16 RINI - - - 35,000 - - - - - 35,000
17 ALMA - - - - - - 33,000 - - 33,000
JUMLAH 120,000 - - 35,000 - - 33,000 - - 188,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/6/2022 1 DEDE ELIA SINDANGASIH 8,000 - - 55,000 - - - - - 63,000
2 KUKUS KUSWANDI KAWITAN 8,000 - - - - - - - - 8,000
3 AI SILPA GUNUNG MEDANG 8,000 - - - - - - - - 8,000
4 IIS SUNIABANA 8,000 - - - - - - - - 8,000
5 MAE SINGAYUN 8,000 - - - - - - - - 8,000
6 NAYSHA MEKARWANGI 8,000 - - - - - - - - 8,000
7 ZAKY MEKARWANGI 8,000 - - - - - - - - 8,000
8 FIRA SUTALAYA 8,000 - - - - - - - - 8,000
9 SITI JENAB MANDALAWANGI 8,000 - - - - - - - - 8,000
10 RAMDAN BARENGKOK 8,000 - - - - - - - - 8,000
11 ARDIANSYAH CILEGI 8,000 - - - - - - - - 8,000
12 ASEP JULIANA KARYAMANDALA 8,000 - - - - - - - - 8,000
13 IMAS MASWATI JAKSI 8,000 - - - - - - - - 8,000
14 FAHIRA JAKSI 8,000 - - - - - - - - 8,000
15 SAFIRA KAWITAN 8,000 - - - - - - - - 8,000
16 AI HAYAT BOJONGRAPIH 8,000 - - - - - - - - 8,000
17 PUPI BOJONGRAPIH 8,000 - - - - - - - - 8,000
18 KAIRA JAMUPU 8,000 - - - - - - - - 8,000
19 RINA - - - - 25,000 - - - - 25,000
20 EVA - - - 55,000 - - - - - 55,000
21 DIKI - - - 175,000 - - - - - 175,000
22 RUKOYAH - - - 30,000 - - - - - 30,000
JUMLAH 144,000 - - 315,000 25,000 - - - - 484,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/7/2022 1 SARIPAH DINDINGARI 8,000 - - 25,000 - - - - - 33,000
2 ADILA CILEGI 8,000 - - - - - - - - 8,000
3 YETI CILEGI 8,000 - - - - - - - - 8,000
4 NAIRA MANDALAWANGI 8,000 - - - - - - - - 8,000
5 RIRI PUTRI MANDALAHAYU 8,000 - - - - - - - - 8,000
6 HENI MARYANI SUKAHENING 8,000 - - - - - - - - 8,000
 7 NENENG RISKA HAURKUNING 8,000 - - - - - - - - 8,000
8 INDRI TANJUNGSARI 8,000 - - - - - - - - 8,000
9 ENGKUS JAMUPU 8,000 - - 25,000 - - - - - 33,000
10 ALVARENDRA JAMUPU 8,000 - - - - - - - - 8,000
11 LILIS MAESAROH BANGBAYANG 8,000 - - - - - - - - 8,000
12 TOWI MULYASARI 8,000 - - - - - - - - 8,000
13 RISMAWATI BANJARAN 8,000 - - - - - - - - 8,000
14 AYI KARYAMANDALA 8,000 - - - - - - - - 8,000
15 RATU NAZWA MULYASARI 8,000 - - - - - - - - 8,000
16 TRIA LAZUARDINI JAKSI 8,000 - - 30,000 - - - - - 38,000
17 OOH NURJANAH CISARUA 8,000 - - 65,000 - - - - - 73,000
18 AI MUSAROPAH POJOK 8,000 - - - - - - - - 8,000
19 YASIR JAINI LUTFI POJOK 8,000 - - - - - - - - 8,000
20 IWAN SETIAWAN TANJUNGSARI 8,000 - - - - - - - - 8,000
21 M ALBI SALMAN HAURKUNING 8,000 - - - - - - - - 8,000
22 ENI SUMARNI TANJUNG 8,000 - - - - - - - - 8,000
23 YEDI MARINGINAN 8,000 - - - - - - - - 8,000
24 ADE SOLIHAH BARENGKOK 8,000 - - - - - - - - 8,000
25 ZAHRA FAUZI BARENGKOK 8,000 - - - - - - - - 8,000
26 MUPLIHIN - - - 90,000 - - - - - 90,000
JUMLAH 200,000 - - 235,000 - - - - - 435,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/8/2022 1 MARNASIH MEKARWANGI 8,000 - - - - - - - - 8,000
2 ROHIYAH CIPICUNG 8,000 - - - - - - - - 8,000
3 AGI NURDIANSYAH JAMUPU 8,000 - - - - - - - - 8,000
4 RIFKI TAMANSARI 8,000 - - - - - - - - 8,000
5 IMAS MASITOH HAURKUNING 8,000 - - - - - - - - 8,000
6 AHDIANA HAURKUNING 8,000 - - - - - - - - 8,000
7 SOPYAN JAMUPU 8,000 - - - - - - - - 8,000
8 ANIS PURNAMA CIKOPI 8,000 - - - - - - - - 8,000
9 MIRA ANDINI PENCUT KAWUNG 8,000 - - - - - - - - 8,000
10 TAOPIK HIDAYAT BANJARWARINGIN 8,000 - - - - - - - - 8,000
11 MUHAMAD PARID CIGEDANG 8,000 - - - - - - - - 8,000
12 MUHAMAD ALPIN JAMUPU 8,000 - - - - - - - - 8,000
13 DADAN MISBAH BOJONGRAPIH 8,000 - - - - - - - - 8,000
14 WILDA MAULIDA NANGOH 8,000 - - - - - - - - 8,000
15 SUNEN CITUNDUN 8,000 - - - - - - - - 8,000
16 ZAHRA ALMAIRA SUTALAYA 8,000 - - - - - - - - 8,000
17 DEDE NABILA KAWITAN 8,000 75,000 - - - - - - - 83,000
18 RIFKI KALIMUDIN POJOK 8,000 - - - - - - - - 8,000
19 AHMAD DANI TAMANSARI 8,000 - - - - - - - - 8,000
20 PARHANA MAGUNG 8,000 - - - - - - - - 8,000
21 AGAM CIKEMBANG 8,000 - - - - - - - - 8,000
22 JAHRONAH SILENJANG 8,000 - - 25,000 - - - - - 33,000
23 INA RODATUL JANNAH MULYASARI 8,000 - - - - - - - - 8,000
24 TUTI HARYATI CILEGI 8,000 - - - - - - - - 8,000
25 RISKI CIKASO 8,000 - - - - - - - - 8,000
26 LEA - - - 55,000 - - - - - 55,000
27 MIMIN - - - 25,000 - - - - - 25,000
28 WAWAN - - - 25,000 - - - - - 25,000
29 NURANTI - - - - - - - - 800,000 800,000
JUMLAH 200,000 75,000 - 130,000 - - - - 800,000 1,205,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/9/2022 1 AI DEDE ROHAYATI HAURKUNING 8,000 - - - - - - - - 8,000
2 SINDI MAGUNG 8,000 - - - - - - - - 8,000
3 RIAN SAPAAT CIBALAGBAG 8,000 - - - - - - - - 8,000
4 FARIS RAMDAN ANJUNG 8,000 - - - - - - - - 8,000
5 FAHRI FEBRIANI TANJUNGSARI 8,000 - - - - - - - - 8,000
6 ADYA CIKASUNGKA 8,000 - - - - - - - - 8,000
7 ADE ELI SARTIKA MANDALAWANGI 8,000 - - 35,000 - - - - - 43,000
8 HERDIANSYAH TANJUNG 8,000 - - - - - - - - 8,000
9 HERI FIRMANSYAH SUTALAYA 8,000 - - - - - - - - 8,000
10 BIMA CIPASARA 8,000 - - - - - - - - 8,000
11 NAFISA CIKEMBANG 8,000 - - - - - - - - 8,000
12 NURJANAH SINGKUR 8,000 - - - - - - - - 8,000
13 NADIA SINGKUR 8,000 - - - - - - - - 8,000
14 SUHAROH CIBADAK 8,000 - - - - - - - - 8,000
15 GHAZY UMUL QURO 8,000 - - - - - - - - 8,000
16 SALMANDIA UMUL QURO 8,000 - - - - - - - - 8,000
17 ASLAM GUNAWAN MULYASARI 8,000 - - - - - - - - 8,000
18 ROHMAN MANDALAWANGI 8,000 - - - - - - - - 8,000
19 AI NURHAYATI TAMANSARI 8,000 - - - - - - - - 8,000
20 NINA TAMANSARI 8,000 - - - - - - - - 8,000
21 ENAH SAGA 8,000 - - - - - - - - 8,000
22 ENTIN - - - 25,000 - - - - - 25,000
23 SITI - - - 55,000 - - - - - 55,000
24 DIAN - - - - 15,000 - - - - 15,000
 JUMLAH 168,000 - - 115,000 15,000 - - - - 298,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/11/2022 1 MUSLIMIN WANGUNHARJA 8,000 - - - - - - - - 8,000
2 YAYA LAKSANAMEKAR 8,000 - - - - - - - - 8,000
3 SOPIAH JAMUPU 8,000 - - - - - - - - 8,000
4 RENA BANJARWARINGIN 8,000 - - - - - - - - 8,000
5 IRMA NURMALA CIKASUNGKA 8,000 - - - - - - - - 8,000
6 SANDI EPAN ALKANA CIRANCA 8,000 - - - - - - - - 8,000
7 ARDIANSYAH CILEGI 8,000 - - - - - - - - 8,000
8 AFKANA BARENGKOK 8,000 35,000 - - - - - - - 43,000
9 ARDAN KARYAMANDALA 8,000 - - - - - - - - 8,000
10 ENIN LAKSANAMEKAR 8,000 - - - - - - - - 8,000
11 DEDE FAJAR TALEGONG 8,000 - - - - - - - - 8,000
12 SYAKIRA ALBINA SINGKUR 8,000 - - - - - - - - 8,000
13 YAYA SUNARYA MULYASARI 8,000 - - - - - - - - 8,000
14 ACE SAPARUDIN DINDINGARI 8,000 - - - - - - - - 8,000
15 M ARSYIL CIKEMBANG 8,000 - - - - - - - - 8,000
16 ENUNG NURHAYATI MANDALAWANGI 8,000 - - - - - - - - 8,000
17 JUNJUN CIKIANGIR 8,000 - - - - - - - - 8,000
18 WIWIN LAKSANAMEKAR 8,000 - - - - - - - - 8,000
19 ZULPI M RIZKI CIKASUNGKA 8,000 - - - - - - - - 8,000
20 RANI CIKASUNGKA 8,000 - - - - - - - - 8,000
21 EDAH BARENGKOK 8,000 - - 45,000 - - - - - 53,000
22 ERNA RAHMAWATI WANGUNHARJA 8,000 - - 45,000 - - - - - 53,000
23 ADINDA CILEGI 8,000 - - - - - - - - 8,000
24 DIRA CIKIANGIR 8,000 - - - - - - - - 8,000
25 DESI TARESA MANDALAWANGI 8,000 - - - - - - - - 8,000
26 GUGUN RAHMAT MANDALAWANGI 8,000 - - - - - - - - 8,000
27 M KEMAL JUNIAR MANDALAWANGI 8,000 - - - - - - - - 8,000
28 RINA 8,000 - - - 25,000 - - - - 33,000
29 ILMA 8,000 - - 50,000 - - - - - 58,000
30 ADE 8,000 - - 45,000 - - - - - 53,000
31 EMMY - - - - 25,000 - - - - 25,000
32 UJANG - - - 25,000 - - - - - 25,000
JUMLAH 240,000 35,000 - 210,000 50,000 - - - - 535,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/12/2022 1 ARAFI MAULANA JAMUPU 8,000 - - - - - - - - 8,000
2 BOBI TAMANSARI 8,000 - - - - - - - - 8,000
3 SAHUDIN KARYAWANGI 8,000 - - - - - - - - 8,000
4 MIFTAHUL AZIZ PENCUT KAWUNG 8,000 - - - - - - - - 8,000
5 FAHIM CIKASUNGKA 8,000 35,000 - - - - - - - 43,000
6 SODAH CIKEMBANG 8,000 - - - - - - - - 8,000
7 HANA NABILA MEKARWANGI 8,000 - - - - - - - - 8,000
8 DENI NUGRAHA SUTALAYA 8,000 - - - - - - - - 8,000
9 RESTA MAULANA JAMUPU 8,000 - - - - - - - - 8,000
10 ARYA SATIA WANGUNHARJA 8,000 - - - - - - - - 8,000
11 SALISA MANDALAHAYU 8,000 - - - - - - - - 8,000
12 DIPANI JAMUPU 8,000 - - - - - - - - 8,000
13 ARHA MEKARSARI 8,000 - - - - - - - - 8,000
14 ABDUL GOPAR BARENGKOK 8,000 - - - - - - - - 8,000
15 SISI KAEZILA BANJARWARINGIN 8,000 - - - - - - - - 8,000
16 ADI NUGRAHA TANJUNGSARI 8,000 - - - - - - - - 8,000
17 AI SOLEHATI BANJARAN 8,000 - - - - - - - - 8,000
18 ARPA SUNIABANA 8,000 - - - - - - - - 8,000
19 RENDI MAULANA SUNIABANA 8,000 - - - - - - - - 8,000
20 IWAN SINAGAR 8,000 - - - - - - - - 8,000
21 APILIANSYAH TAMANSARI 8,000 - - - - - - - - 8,000
22 LIA - - - 45,000 - - - - - 45,000
23 NENI - - - 25,000 - - - - - 25,000
24 NAZWA - - - - 15,000 - - - - 15,000
25 MUMUN - - - 45,000 - - - - - 45,000
26 CECEP - - - - 15,000 - - - - 15,000
JUMLAH 168,000 35,000 - 115,000 30,000 - - - - 348,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/13/2022 1 SANIA TANJUNGSARI 8,000 - - - - - - - - 8,000
2 NANI CIKEMBANG 8,000 - - - - - - - - 8,000
3 VIRZA BANJARWARINGIN 8,000 - - - - - - - - 8,000
4 ZIDNI AZAM CUKANGAKAR 8,000 - - - - - - - - 8,000
5 RIDHO LALAN CIKASUNGKA 8,000 - - - - - - - - 8,000
6 AMI AINUR NANGERANG 8,000 - - - - - - - - 8,000
7 ATUN NURJANAH MANDALAHAYU 8,000 - - - - - - - - 8,000
8 ARYA SAPUTRA PETIR 8,000 - - - - - - - - 8,000
9 KEYSA PUTRI CITUNDUN 8,000 105,000 - - - - - - - 113,000
 10 DEVIN ALFATIH KARYAMANDALA 8,000 - - - - - - - - 8,000
11 NARSINAH KARYAMANDALA 8,000 - - - - - - - - 8,000
12 AKOY NEGLASARI 8,000 - - - - - - - - 8,000
13 AAP SETIAWAN 8,000 - - - - - - - - 8,000
14 ALINDO TANJUNGSARI 8,000 - - - - - - - - 8,000
15 HADI MEKARSARI 8,000 - - - - - - - - 8,000
16 FADIL MANDALAHAYU 8,000 - - - - - - - - 8,000
17 DEDI JULIANTO CIPICUNG 8,000 - - - - - - - - 8,000
18 LUTFAH HAURKUNING 8,000 - - - - - - - - 8,000
19 GINANJAR JAKSI 8,000 - - - - - - - - 8,000
JUMLAH Err:522 Err:522 Err:522 Err:522 Err:522 Err:522 Err:522 Err:522 Err:522 257,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/14/2022 1 RAIHAN 8,000 - - - - - - - - 8,000
2 FARDI GUNUNG MEDANG 8,000 - - - - - 25,000 - - 33,000
3 IHAH SOLIHAH BANGBAYANG 8,000 - - - - - - - - 8,000
4 M GHOZI JAYAMUKTI 8,000 - - - - - - - - 8,000
5 ROWAN ARDIANSYAH 8,000 - - - - - - - - 8,000
6 ECIN 8,000 - - - - - - - - 8,000
7 SAIDAH 8,000 - - - - - - - - 8,000
8 NURAENI 8,000 - - - - - - - - 8,000
9 SITI MARIAH 8,000 - - - - - - - - 8,000
10 LINA MARLINA 8,000 - - - - - - - - 8,000
11 M FIKRI 8,000 - - - - - - - - 8,000
12 TEGAR 8,000 - - - - - - - - 8,000
13 AZIZAH 8,000 - - - - - - - - 8,000
14 KAYLA 8,000 - - - - - - - - 8,000
15 AMAS 8,000 - - - - - - - - 8,000
16 MIMI 8,000 - - - - - - - - 8,000
17 8,000 - - - - - - - - 8,000
18 8,000 - - - - - - - - 8,000
19 8,000 - - - - - - - - 8,000
20 8,000 - - - - - - - - 8,000
21 8,000 - - - - - - - - 8,000
22 8,000 - - - - - - - - 8,000
23 8,000 - - - - - - - - 8,000
24 8,000 - - - - - - - - 8,000
25 8,000 - - - - - - - - 8,000
26 8,000 - - - - - - - - 8,000
27 8,000 - - - - - - - - 8,000
28 - - - - - - - - - -
29 - - - - - - - - - -
30 - - - - - - - - - -
31 - - - - - - - - - -
32 - - - - - - - - - -
33 - - - - - - - - - -
34 - - - - - - - - - -
35 - - - - - - - - - -
36 - - - - - - - - - -
37 - - - - - - - - - -
JUMLAH 216,000 - - - - - 25,000 - - 241,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/15/2022 1 8,000 - - - - - - - - 8,000
2 8,000 - - - - - - - - 8,000
3 8,000 - - - - - - - - 8,000
4 8,000 - - - - - - - - 8,000
5 8,000 - - - - - - - - 8,000
6 8,000 - - - - - - - - 8,000
7 8,000 - - - - - - - - 8,000
8 8,000 - - - - - - - - 8,000
9 8,000 - - - - - - - - 8,000
10 8,000 - - - - - - - - 8,000
11 8,000 - - - - - - - - 8,000
12 8,000 - - - - - - - - 8,000
13 8,000 - - - - - - - - 8,000
14 8,000 - - - - - - - - 8,000
15 8,000 - - - - - - - - 8,000
16 8,000 - - - - - - - - 8,000
17 8,000 - - - - - - - - 8,000
18 8,000 - - - - - - - - 8,000
19 8,000 - - - - - - - - 8,000
20 8,000 - - - - - - - - 8,000
21 8,000 - - - - - - - - 8,000
22 8,000 - - - - - - - - 8,000
23 8,000 - - - - - - - - 8,000
24 - - - - - - - - - -
25 - - - - - - - - - -
26 - - - - - - - - - -
27 - - - - - - - - - -
 28 - - - - - - - - - -
29 - - - - - - - - - -
30 - - - - - - - - - -
31 - - - - - - - - - -
32 - - - - - - - - - -
33 - - - - - - - - - -
34 - - - - - - - - - -
35 - - - - - - - - - -
36 - - - - - - - - - -
37 - - - - - - - - - -
JUMLAH 184,000 - - - - - - - - 184,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/16/2022 1 TATA R CIKIANGIR 8,000 - - - - - - - - 8,000
2 ARDAN SALOPA 8,000 - - - - - - - - 8,000
3 MAFAZA ARUMI CIKOPI 8,000 - - - - - - - - 8,000
4 NIZAM TANJUNGSARI 8,000 - - - - - - - - 8,000
5 AI NURI SUKAHURIP 8,000 - - - - - - - - 8,000
6 JUJU JUBAEDAH KALANGANYAR 8,000 - - - - - - - - 8,000
7 HABIBI JAYAN MANDALAHAYU 8,000 - - - - - - - - 8,000
8 AHMAD CIPARIUK 8,000 - - 135,000 - - - - - 143,000
9 ALIKA TANJUNG 8,000 - - - - - - - - 8,000
10 ASTRI SRI PARIHAH KAWALU 8,000 - - - - - - - - 8,000
11 RAFLI MANDALAHAYU 8,000 - - - - - - - - 8,000
12 ANANDAR TANJUNGSARI 8,000 - - - - - - - - 8,000
13 RISKI YANUAR JAMUPU 8,000 - - - - - - - - 8,000
14 ETI MANDALAWANGI 8,000 - - - - - - - - 8,000
15 AZRUMI SABATUL CIKEMBANG 8,000 - - - - - - - - 8,000
16 AZMI CIKEMBANG 8,000 - - - - - - - - 8,000
17 M ZAKI CIKEMBANG 8,000 - - - - - - - - 8,000
18 WARSINAH KARYAMANDALA 8,000 - - - - - - - - 8,000
19 DEWI IRAWATI CIKEMBANG 8,000 - - - - - - - - 8,000
20 ATEP AHMAD CIKEMBANG 8,000 - - - - - - - - 8,000
21 ZIHAN NAHLA TALEGONG 8,000 - - - - - - - - 8,000
22 LILIS KARYAMANDALA 8,000 - - - - - - - - 8,000
23 TEGUH - - - - 25,000 - - - - 25,000
JUMLAH 176,000 - - 135,000 25,000 - - - - 336,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/18/2022 1 REHAN MAULANA GUNUNG MEDANG 8,000 - - - - - - - - 8,000
2 MUPLIHIN CIPICUNG 8,000 - - - - - - - - 8,000
3 DIKSA FAUZI BANJARWARINGIN 8,000 - - - - - - - - 8,000
4 EJA MULYANI CIKEMBANG 8,000 - - - - - - - - 8,000
5 AI DEDE ROHAYATI HAURKUNING 8,000 - - - - - - - - 8,000
6 HERI MANDALAHAYU 8,000 - - - - - - - - 8,000
7 DEDE HAYAT MANDALAHAYU 8,000 - - - - - - - - 8,000
8 SUHERMAN SUKAHURIP 8,000 - - - - - - - - 8,000
9 EDAH SALOPA 8,000 - - - - - - - - 8,000
10 ZAKI HUSNUL SIRNASARI 8,000 - - - - - - - - 8,000
11 WIDA TAMANSARI 8,000 - - - - - - - - 8,000
12 BIMA KAWITAN 8,000 75,000 - - - - - - - 83,000
13 ABDUL ROJAK MEDALSARI 8,000 - - - - - - - - 8,000
14 DEDE SOFA LAKSANAMEKAR 8,000 - - 55,000 - - - - - 63,000
15 IMA HERMAYANTI JAYAMUKTI 8,000 - - - - - - - - 8,000
16 ADE YULIYAMAH CUKANGAKAR 8,000 - - - - - - - - 8,000
17 IYAH SADIAH MANDALAWANGI 8,000 - - - - - - - - 8,000
18 CUCU IZAZ NANGERANG 8,000 - - - - - - - - 8,000
19 DUDUNG FAJAR JAMUPU 8,000 - - - - - - - - 8,000
20 FAHRI KAWITAN 8,000 - - - - - - - - 8,000
21 SULTAN - - - - 15,000 - - - - 15,000
22 DEDE - - - 25,000 - - - - - 25,000
23 NAI - - - - 15,000 - - - - 15,000
24 ATHAR - - - - - - 25,000 - - 25,000
25 BILQIS - 70,000 - - - - - - - 70,000
26 ALYA - 35,000 - - - - - - - 35,000
JUMLAH 160,000 180,000 - 80,000 30,000 - 25,000 - - 475,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/19/2022 1 HASANAH CIPICUNG 8,000 - - - - - - - - 8,000
2 AZMIA NASIRA CIKEMBANG 8,000 - - - - - - - - 8,000
3 NURHASANAH CIBADAK 8,000 - - - - - - - - 8,000
4 WILI MULYASARI 8,000 - - - - - - - - 8,000
5 ARGA HENDI KARYAMANDALA 8,000 - - - - - - - - 8,000
6 DIFA MAULIDA MANDALAGUNA 8,000 - - - - - - - - 8,000
7 DERIS N MANDALAWANGI 8,000 - - - - - - - - 8,000
8 RISKA INDAH JAMUPU 8,000 - - - - - - - - 8,000
9 MAHADINA KAWITAN 8,000 - - - - - 20,000 - - 28,000
10 HASBI MULYASARI 8,000 - - - - - - - - 8,000
 11 DODI TANJUNGSARI 8,000 - - - - - - - - 8,000
12 SALMAN KAWITAN 8,000 - - - - - - - - 8,000
13 ELSA JAMUPU 8,000 - - - - - - - - 8,000
14 DEVAN TAMANSARI 8,000 - - - - - - - - 8,000
15 AHMAD DANI TAMANSARI 8,000 - - - - - - - - 8,000
16 ADE ROJIKIN CIKASUNGKA 8,000 - - - - - - - - 8,000
17 FIKRI - - - - - - 30,000 - - 30,000
18 RINA - - - 15,000 - - - - - 15,000
JUMLAH 128,000 - - 15,000 - - 50,000 - - 193,000

TANGGGAL NO NAMA ALAMAT KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH
7/20/2022 1 RIDWAN MARINGINAN 8,000 - - - - - - - - 8,000
2 ETIH MANDALAWANGI 8,000 - - - - - - - - 8,000
3 NURHASANAH MULYASARI 8,000 - - - - - - - - 8,000
4 PARHAN PATIMAH TAMANSARI 8,000 - - - - - - - - 8,000
5 SUPARMAN MARINGINAN 8,000 - - - - - - - - 8,000
6 M RIZKI MEKARWANGI 8,000 - - - - - - - - 8,000
7 RISMA MEKARWANGI 8,000 - - - - - - - - 8,000
8 RIZKA NADIROTUN MEKARWANGI 8,000 - - - - - - - - 8,000
9 FEBRIAN ALVIANSYAH TANJUNG 8,000 - - - - - - - - 8,000
10 DEDEH K CIBADAK 8,000 - - - - - - - - 8,000
11 AL DINO MANDALAHAYU 8,000 - - - - - - - - 8,000
12 KOKOM MANDALAWANGI 8,000 - - - - - - - - 8,000
13 WAFA KARYAMANDALA 8,000 - - - - - - - - 8,000
14 NOVAL DWI PUTRA BANJARAN 8,000 - - - - - - - - 8,000
15 EUIS DEDAH 8,000 - - - - - - - - 8,000
16 AKBAR 8,000 - - - - - - - - 8,000
17 DEDE NABILA 8,000 - - - - - - - - 8,000
18 ATAR 8,000 - - - - - - - - 8,000
19 AL MUKAROM 8,000 - - - - - - - - 8,000
20 8,000 - - - - - - - - 8,000
21 8,000 - - - - - - - - 8,000
22 8,000 - - - - - - - - 8,000
23 8,000 - - - - - - - - 8,000
24 8,000 - - - - - - - - 8,000
25 8,000 - - - - - - - - 8,000
26 8,000 - - - - - - - - 8,000
27 8,000 - - - - - - - - 8,000
28 8,000 - - - - - - - - 8,000
29 8,000 - - - - - - - - 8,000
30 8,000 - - - - - - - - 8,000
31 8,000 - - - - - - - - 8,000
32 8,000 - - - - - - - - 8,000
33 8,000 - - - - - - - - 8,000
34 8,000 - - - - - - - - 8,000
35 8,000 - - - - - - - - 8,000
36 - - - - - - - - - -
37 - - - - - - - - - -
JUMLAH 280,000 - - - - - - - - 280,000
TANGGAL KARCIS GIGI KIA/KB LAB KIR AMBULAN IGD USG PONED JUMLAH PUSTU
7/1/2022 192,000 75,000 - 100,000 - - - - - 367,000 Banjarwaringin 600,000
7/2/2022 184,000 110,000 - 225,000 - - - - - 519,000 Karyawangi 600,000
7/4/2022 344,000 155,000 - 210,000 25,000 - - - - 734,000 Tanjungsari 600,000
7/5/2022 120,000 - - 35,000 - - 33,000 - - 188,000 Mulyasari 600,000
7/6/2022 144,000 - - 316,000 25,000 - - - - 485,000 Mandalawangi 1,200,000
7/7/2022 200,000 - - 235,000 - - - - - 435,000 Jumlah 3,600,000
7/8/2022 200,000 75,000 - 130,000 - - - - 800,000 1,205,000
7/9/2022 168,000 - - 115,000 15,000 - - - - 298,000
7/11/2022 240,000 35,000 - 210,000 50,000 - - - - 535,000
7/12/2022 168,000 35,000 - 115,000 30,000 - - - - 348,000
7/13/2022 152,000 105,000 - - - - - - - 257,000
7/14/2022 216,000 - - - 75,000 - 48,000 - - 339,000 TOTAL 14,498,000
7/15/2022 184,000 - - - 15,000 - - - - 199,000
7/16/2022 176,000 - - 135,000 25,000 - - - - 336,000
7/18/2022 160,000 180,000 - 80,000 30,000 - 25,000 - - 475,000
7/19/2022 128,000 - - 15,000 - - 50,000 - - 193,000
7/20/2022 208,000 250,000 - 125,000 - - 115,000 - - 698,000
7/21/2022 240,000 35,000 - 300,000 - - - - - 575,000
7/22/2022 96,000 150,000 - - - - 140,000 - - 386,000
7/23/2022 72,000 75,000 - 25,000 50,000 - 80,000 - - 302,000
7/25/2022 248,000 - - 65,000 - - 20,000 - - 333,000
7/26/2022 160,000 110,000 - 298,000 25,000 - 140,000 - - 733,000
7/27/2022 176,000 - - 125,000 - - 75,000 - - 376,000
7/28/2022 272,000 - - 125,000 25,000 - - - - 422,000
7/29/2022 160,000 - - - - - - - - 160,000
JUMLAH 4,608,000 1,390,000 - 2,984,000 390,000 - 726,000 - 800,000 10,898,000
 PUSKESMAS SALOPA
BUKU KAS UMUM PEMBANTU
BULAN JANUARI 2022
Puskesmas Salopa
No. Penerimaan Pengeluaran Saldo
Tanggal Kode Rekening URAIAN
Urut (Rp.) (Rp.) (Rp.)
1 2 3 4 5 6 7
No. Penerimaan Pengeluaran Saldo
Tanggal Kode Rekening URAIAN
Urut (Rp.) (Rp.) (Rp.)
No. Penerimaan Pengeluaran Saldo
Tanggal Kode Rekening URAIAN
Urut (Rp.) (Rp.) (Rp.)
No. Penerimaan Pengeluaran Saldo
Tanggal Kode Rekening URAIAN
Urut (Rp.) (Rp.) (Rp.)
No. Penerimaan Pengeluaran Saldo
Tanggal Kode Rekening URAIAN
Urut (Rp.) (Rp.) (Rp.)
 Tanggal 1 2 4 5
Karcis Pelayanan Kesehatan 24 23 43 15
Tindakan Gigi 1 2 2
Keuring/Pemeriksaan Kesehatan 1
Tindakan Laboratorium 3 4 6 1
Tindakan Operasi Kecil/Medik 1
USG
Tindakan Persalinan
Jasa Ambulance
6 7 8 9 11 12 13 14 15 16
18 25 25 21 30 21 19 27 23 22
1 1 1 1 1
1 1 2 2 3 1 1
4 5 4 3 5 3 1
2

1
18 19 20 21 22 23 25 26 27 28
20 16 26 30 12 9 31 20 22 34
3 3 1 1 1 2
2 2 1 1
2 1 5 7 1 3 5 3 3
1 2 3 3 1 1 1 1
29 JUMLAH
20 576 450
21
18
69
16
0
1
0