email 21 mei 14 ke 1

KELOMPOK , AGUS LAS UTOMO,

FIT/UNFIT/
RESTRICTION
1 AGUS LAS UTOMO MALE SRAGEN/ AUGUST 11, 1975 OFFICER
DUTY DECK
DEPARTMENT
INDONESIA 6200098473010303 OCTOBER 21, 2013 OCTOBER 21, 2014 FIT
SIMVASTATIN 10MG,
ALLOPURINOL 300MG
6200098473MC0313
2 ALHIDAYAT MALE BOGOR/ JUNE 3, 1965 MASTER
DUTY DECK
DEPARTMENT
INDONESIA 6201194558010110 OCTOBER 22, 2013 OCTOBER 22, 2014 FIT GEMFRIBROZIL 6201194558MC0313
3 AKHID BAKHRODIN MALE SEMARANG / DECEMBER 6, 1968 OFFICER
DUTY DECK
DEPARTMENT
INDONESIA 6200081007013512 OCTOBER 24, 2013 OCTOBER 24, 2014 FIT 6200081007MC0313
4 EDY SUGIYANTO MALE SURABAYA / NOVEMBER 10, 1966 OFFICER
DUTY DECK
DEPARTMENT
INDONESIA 6200253642010113 OCTOBER 24, 2013 OCTOBER 24, 2014 FIT
SIMVASTATIN 10MG,
ALLOPURINOL 300MG
6200253642MC0313
5 HERZUN MALE
TG. BALAI KARIMUN / MARCH 7,
1972
MASTER
DUTY DECK
DEPARTMENT
INDONESIA 6200476463011007 OCTOBER 25, 2013 OCTOBER 25, 2014 FIT 6200476463MC0313
6 SAHIBUL ANWAR MALE JAKARTA / MAY 18, 1972
CHIEF
ENGINEER
DUTY ENGINE
DEPARTMENT
INDONESIA 6200476599011007 OCTOBER 22, 2013 OCTOBER 22, 2015 FIT 6200476599MC0313
7 WIBOWO MALE SUKOHARJO / JANUARY 27, 1973 ENGINEER
DUTY ENGINE
DEPARTMENT
INDONESIA 6200253643010113 OCTOBER 25, 2013 OCTOBER 25, 2014 FIT SIMVASTTIN 10MG 6200253643MC0313
8 SYAHRUL RAMDANI MALE JAKARTA / MAY 23, 1986 SAILOR
DUTY DECK
DEPARTMENT
INDONESIA 6201696157010112 NOVEMBER 14, 2013 NOVEMBER 14, 2015 FIT 6201696157MC0313
9 BANDUNG SUWARTO MALE PURWODADI / SEPTEMBER 9, 1976
THIRD
ENGINEER
DUTY ENGINE
DEPARTMENT
INDONESIA 6200542872010111 NOVEMBER 13, 2013 NOVEMBER 13, 2014 FIT SIMVASTATIN 10MG 6200542872MC0313
10 SYAMSU RIZAL TANASY MALE JAKARTA / APRIL 16, 1972
SECOND
OFFICER
DUTY DECK
DEPARTMENT
INDONESIA 6200068836010111 NOVEMBER 14, 2013 NOVEMBER 14, 2014 FIT 6200068836MC0313
11 MUSTAFA KAMAL MALE
UJUNG PANDANG / NOVEMBER 19,
1970
CHIEF
ENGINEER
DUTY ENGINE
DEPARTMENT
INDONESIA 620002789010102 OCTOBER 22, 2013 OCTOBER 22, 2014 FIT ATROVASTTIN 620002789MC0313
12 TRI WAHYUDI MALE KLATEN / JULY 12, 1969 MASTER
DUTY DECK
DEPARTMENT
INDONESIA 6200261139010108 OKTOBER 21,2013 OKTOBER 21,2014 FIT 6200261139MC0313
13 SYAMSIR MALE S.PENUH / JUNE 17, 1975
CHIEF
OFFICER
DUTY DECK
DEPARTMENT
INDONESIA 6200080888010102 NOVEMBER 12, 2013 NOVEMBER 12, 2014 FIT
ALLOPURINOL,
SIMVASTATIN 1OMG,
SIMVASTATIN 10MG
6200080888MC0313
14 ARIA WIDYO HARDONO MALE BALIKPAPAN / JANUARY 31, 1982 HELMSMAN
DUTY DECK
DEPARTMENT
INDONESIA 6200479463011507 NOVEMBER 15, 2013 NOVEMBER 15, 2014 FIT SIMVASTATIN 10MG 6200479463MC0313
15 MUCHAMAD IVAN APRILIADI MALE JAKARTA / APRIL 4, 1975 OILER
DUTY ENGINE
DEPARTMENT
INDONESIA 6200256861010107 NOVEMBER 12, 2013 NOVEMBER 12, 2014 FIT HP PRO 6200256861MC0313
DATE OF MEDICAL
CHEK UP
LIMITATION REMARK CERTIFICATE NUMBER
LAPORAN PENERBITAN SERTIFIKAT PENGUJIAN KESEHATAN PELAUT RUMAH SAKIT PELABUHAN JAKARTA
EMAIL TANGGAL 21 MEI 2014, REVISI TANGGAL 9 JUNI 2014
NO. NAME SEX PLACE/DATE OF BIRTH POSITION DEPARTMENT NATIONALITY
BASIC SAFETY TRAINNING
NUMBER
16 NUR TAUZIN MALE PEMALANG / MAY 29, 1985 OILER
DUTY ENGINE
DEPARTMENT
INDONESIA 6201192796010110 NOVEMBER 12, 2013 NOVEMBER 12, 2014 FIT 6201192796MC0313
17 SOLICHIN MALE JAKARTA / DECEMBER 116, 1971 MASTER
DUTY DECK
DEPARTMENT
INDONESIA 6200034606010111 OCTOBER 22, 2013 OCTOBER 22, 2015 FIT 6200034606MC0313
1 AGUS LAS UTOMO EMAIL TANGGAL 21 MEI 2014,TANGGAL,BULAN,TAHUN LAHIR, MARCH 11, 1975 ----REVISI, AUGUST 11, 1975
2 ALHIDAYAT EMAIL TANGGAL 21 MEI 2014 , NAMA : AL HIDAYAT------REVISI, NAMA : ALHIDAYAT
3 AKHID BAKHRODIN EMAIL TANGGAL 21 MEI 2014 TANGGAL LAHIR : 1,-----REVISI TANGGAL : 6
4 EDY SUGIYANTO EMAIL TANGGAL 21 MEI 2014 NAMA : EDI SUGIANTO, DEPARTMENT : ENGINE, ------REVISI , NAMA : EDY SUGIYANTO, DEPARTMENT : DECK
5 HERZUN EMAIL TANGGAL 21 MEI 2014, TEMPAT LAHIR : TG.BALAI,-----REVISI : TG.BALAI KARIMUN
6 SAHIBUL ANWAR EMAIL TANGGAL 21 MEI 2014, TAHUN BERAKHIR SERTIFIKAT : 2014,-----REVISI TAHUN 2015
7 WIBOWO EMAIL TANGGAL 21 MEI 2014, TANGGAL,BULAN,TAHUN BERAKHIR SERTIFIKAT : NOVEMBER 25,2014,----REVISI , OCTOBER 25, 2014
8 SYAHRUL RAMDANI EMAIL TANGGAL 21 MEI 2014, TANGGAL PEMERIKSAAN : 15, -----REVISI, TANGGAL : 14
9 BANDUNG SUWARTO EMAIL TANGGAL 21 MEI 2014 JABATAN : SECOND ENGINEER,------REVISI, JABATAN : THIRD ENGINEER
10 SYAMSU RIZAL TANASY EMAIL TANGGAL 21 MEI 2014, NAMA : SYAMSU RIZAL,----REVISI, NAMA : SYAMSU RIZAL TANASY
11 MUSTAFA KAMAL
EMAI TANGGAL 21 MEI 2014, NAMA : MUSTAPA KAMAL, TEMPAT,TANGGAL,BULAN,TAHUN LAHIR : JAKARTA/SEPTEMBER 27, 1967,---REVISI, NAMA : MUSTAFA KAMAL, UJUNG
PANDANG/NOVEMBER 19,1970
12 TRI WAHYUDI EMAIL TANGGAL 21 MEI 2014, TAHUN LAHIR : 1975,----REVISI , TAHUN 1969
13 SYAMSIR EMAIL TANGGAL 21 MEI 2014, TEMPAT LAHIR : JAMBI,-----REVISI, S.PENUH
14 ARIA WIDYO HARDONO EMAIL TANGGAL 21 MEI 2014, NAMA : ARIA WIDYO HANDONO, ------REVISI, NAMA : ARIA WIDYO HARDONO
email 21 mei 14 ke 1
NO. NAME KETERANGAN
LAPORAN PENERBITAN SERTIFIKAT PENGUJIAN KESEHATAN PELAUT RUMAH SAKIT PELABUHAN JAKARTA
KELOMPOK AGUS LAS UTOMO,EMAIL TANGGAL 21 MEI 2014 ,REVISI EMAIL TANGGAL, 9 JUNI 2014
15 MUCHAMAD IVAN APRILIADI EMAIL TANGGAL 21 MEI 2014,TAHUN BERAKHIR SERTIFIKAT : 2013,-----REVISI, TAHUN: 2014
16 NUR TAUZIN EMAIL TANGGAL 21 MEI 2014, TAHUN LAHIR : 1987,------REVISI, TAHUN : 1985
17 SOLICHIN EMAIL TANGGAL 21 MEI 2014, TANGGAL LAHIR : 12, ------REVISI, TANGGAL : 16