Daily Fit To Work RS Pertamina Balongan

Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 laundry TD:110/80 N/S:70/36,4 - 1
5 dapur TD:110/80 N/S:76/36 - 1
6 security TD:120/80 N/S:68/36,7 - 1
7 Driver TD:120/90 N/S:82/36,6 - 1
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 16 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:90/70 N/S:80/36,6 - 1
4 laundry TD:110/80 N/S:70/36,4 - 1
5 dapur TD:130/80 N/S:76/36 - 1
6 security TD:120/80 N/S:68/36,7 - 1
7 Driver TD:120/90 N/S:82/36,6 - 1
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:120/80 N/S:80/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/70 N/S:78/36,6 - 1
3 security TD:130/80 N/S:84/36,7 - 1
4 Driver TD:110/80 N/S:74/36,4 - 1
5
6
7
8
 Jumlah 16 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 laundry TD:120/80 N/S:70/36,4 - 1
5 dapur TD:110/80 N/S:76/36 - 1
6 security TD:120/80 N/S:68/36,7 - 1
7 Driver TD:120/90 N/S:82/36,6 - 1
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:130/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 16 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 laundry TD:110/80 N/S:70/36,4 - 1
5 dapur TD:110/80 N/S:76/36 - 1
6 security TD:120/80 N/S:68/36,7 - 1
7 Driver TD:120/90 N/S:82/36,6 - 1
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 16 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:90/70 N/S:80/36,6 - 1
4 laundry TD:110/80 N/S:70/36,4 - 1
5 dapur TD:130/80 N/S:76/36 - 1
6 security TD:120/80 N/S:68/36,7 - 1
7 Driver TD:120/90 N/S:82/36,6 - 1
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:120/80 N/S:80/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/70 N/S:78/36,6 - 1
3 security TD:130/80 N/S:84/36,7 - 1
4 Driver TD:110/80 N/S:74/36,4 - 1
5
6
7
8
 Jumlah 16 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 laundry TD:120/80 N/S:70/36,4 - 1
5 dapur TD:110/80 N/S:76/36 - 1
6 security TD:120/80 N/S:68/36,7 - 1
7 Driver TD:120/90 N/S:82/36,6 - 1
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:130/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 16 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 laundry TD:120/80 N/S:70/36,4 - 1
5 dapur TD:110/80 N/S:76/36 - 1
6 security TD:120/80 N/S:68/36,7 - 1
7 Driver TD:120/90 N/S:82/36,6 - 1
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/80 N/S:80/36,6 - 1
2 cs TD:120/80 N/S:70/36,4 - 1
3 Driver TD:120/70 N/S:68/36,3 - 1
4 security TD:110/80 N/S:78/36 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 16 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 laundry TD:120/80 N/S:70/36,4 - 1
5 dapur TD:110/80 N/S:76/36 - 1
6 security TD:120/80 N/S:68/36,7 - 1
7 Driver TD:120/90 N/S:82/36,6 - 1
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/80 N/S:80/36,6 - 1
2 cs TD:120/80 N/S:70/36,4 - 1
3 Driver TD:120/70 N/S:68/36,3 - 1
4 security TD:110/80 N/S:78/36 - 1
5 Dapur TD:120/80 N/S:70/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:110/80 N/S:82/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 16 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 laundry TD:120/80 N/S:70/36,4 - 1
5 dapur TD:110/80 N/S:76/36 - 1
6 security TD:120/80 N/S:68/36,7 - 1
7 Driver TD:120/90 N/S:82/36,6 - 1
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/80 N/S:80/36,6 - 1
2 cs TD:120/80 N/S:70/36,4 - 1
3 Driver TD:120/70 N/S:68/36,3 - 1
4 security TD:110/80 N/S:78/36 - 1
5 Dapur TD:120/80 N/S:70/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:110/80 N/S:82/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 16 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:110/80 N/S:70/36,4 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/80 N/S:80/35,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:110/80 N/S:70/36,4 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/80 N/S:80/35,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:120/80 N/S:70/36,4 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/70 N/S:68/36,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:130/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:120/80 N/S:70/36,4 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/70 N/S:68/36,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:130/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:90/70 N/S:80/36,6 - 1
4 cs TD:110/80 N/S:70/36,4 - 1
5 cs TD:130/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/80 N/S:80/35,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:120/80 N/S:80/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/70 N/S:78/36,6 - 1
3 security TD:130/80 N/S:84/36,7 - 1
4 Driver TD:110/80 N/S:74/36,4 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 laundry TD:120/80 N/S:80/36,6 - 1
4 dapur TD:110/80 N/S:70/36,4 - 1
5 security TD:110/80 N/S:76/36 - 1
6 Driver TD:120/80 N/S:68/36,7 - 1
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 15 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 dapur TD:120/80 N/S:80/36,6 - 1
4 security TD:110/70 N/S:70/37,8 - 1
5 Driver TD:110/80 N/S:76/36 - 1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:110/80 N/S:76/36,6 - 1
5 Dapur TD:120/70 N/S:68/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:110/80 N/S:76/36,6 - 1
5
6
7
8
 Jumlah 14 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:110/80 N/S:70/36,4 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/80 N/S:80/35,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:110/80 N/S:70/36,4 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/80 N/S:80/35,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:120/80 N/S:70/36,4 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:110/80 N/S:74/36,6 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/80 N/S:84/36,8 - 1
14 security TD:140/90 N/S:84/36,3 - - 1
15 Driver TD:100/70 N/S:80/36,6 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/80 N/S:80/36,6 - 1
2 cs TD:120/80 N/S:70/36,4 - 1
3 Driver TD:120/70 N/S:68/36,3 - 1
4 security TD:110/80 N/S:78/36 - 1
5 Dapur TD:120/80 N/S:70/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:110/80 N/S:82/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 23 1

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:120/80 N/S:70/36,4 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:110/80 N/S:74/36,6 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/80 N/S:84/36,8 - 1
14 security TD:110/70 N/S:72/36,3 - 1
15 Driver TD:100/70 N/S:80/36,6 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/80 N/S:80/36,6 - 1
2 cs TD:120/80 N/S:70/36,4 - 1
3 Driver TD:120/70 N/S:68/36,3 - 1
4 security TD:110/80 N/S:78/36 - 1
5 Dapur TD:120/80 N/S:70/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:110/80 N/S:82/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:110/70 N/S:70/37,8 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/80 N/S:80/35,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:110/80 N/S:76/36,6 - 1
5 Dapur TD:120/70 N/S:68/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:110/80 N/S:76/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 laundry TD:120/80 N/S:80/36,6 - 1
4 dapur TD:110/80 N/S:70/36,4 - 1
5 security TD:110/80 N/S:76/36 - 1
6 Driver TD:120/80 N/S:68/36,7 - 1
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 15 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 dapur TD:120/80 N/S:80/36,6 - 1
4 security TD:120/80 N/S:70/36,4 - 1
5 Driver TD:110/80 N/S:76/36 - 1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:130/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 14 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:120/80 N/S:70/36,4 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/70 N/S:68/36,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:130/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:110/80 N/S:70/36,4 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/80 N/S:80/35,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:120/80 N/S:70/36,4 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/70 N/S:68/36,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:130/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:110/80 N/S:70/36,4 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/80 N/S:80/35,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 cs TD:120/80 N/S:80/36,6 - 1
4 cs TD:110/70 N/S:70/37,8 - 1
5 cs TD:110/80 N/S:76/36 - 1
6 cs TD:120/80 N/S:68/36,7 - 1
7 cs TD:120/90 N/S:82/36,6 - 1
8 cs TD:110/70 N/S:80/35,7 - 1
9 cs TD:120/80 N/S:70/36 - 1
10 cs TD:130/80 N/S:84/36,7 - 1
11 cs TD:110/80 N/S:74/36,8 - 1
12 laundry TD:100/70 N/S:70/36 - 1
13 dapur TD:120/70 N/S:76/36 - 1
14 security TD:110/80 N/S:68/36,6 - 1
15 Driver TD:120/80 N/S:80/35,8 - 1
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:110/80 N/S:76/36,6 - 1
5 Dapur TD:120/70 N/S:68/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:110/80 N/S:76/36,6 - 1
5
6
7
8
 Jumlah 24 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 laundry TD:120/80 N/S:80/36,6 - 1
4 dapur TD:120/80 N/S:70/36,4 - 1
5 security TD:110/80 N/S:76/36 - 1
6 Driver TD:120/80 N/S:68/36,7 - 1
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/80 N/S:80/36,6 - 1
2 cs TD:120/80 N/S:70/36,4 - 1
3 Driver TD:120/70 N/S:68/36,3 - 1
4 security TD:110/80 N/S:78/36 - 1
5 Dapur TD:120/80 N/S:70/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:110/80 N/S:82/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 15 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama
 Daily Fit To Work RS Pertamina Balongan
Tanggal : 01/06/2019
Tes Keterangan
No Nama Pekerjaan Vital Sign Keseimba
Fit Fit With Note
ngan
Shift Pagi
1 cs TD:120/70 N/S:68/36,3 - 1
2 cs TD:110/80 N/S:78/36 - 1
3 dapur TD:120/80 N/S:80/36,6 - 1
4 security TD:110/80 N/S:70/36,4 - 1
5 Driver TD:110/80 N/S:76/36 - 1
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Shift Sore
1 cs TD:120/90 N/S:84/36,2 - 1
2 cs TD:120/80 N/S:74/36 - 1
3 Driver TD:110/70 N/S:72/36,3 - 1
4 security TD:130/80 N/S:86/36,6 - 1
5 Dapur TD:100/70 N/S:78/36,3 - 1
6
7
8
9
10
Shift Malam
1 cs TD:120/80 N/S:78/36 - 1
2 cs TD:110/80 N/S:70/36 - 1
3 security TD:120/80 N/S:80/35,7 - 1
4 Driver TD:130/80 N/S:74/36,6 - 1
5
6
7
8
 Jumlah 14 0

Mengetahui, HSE RS Pertamina Balongan

Wadir Medis dan Keperawatan

dr. Dian Andriani drg. M Gamal Gautama

ongan
Keterangan
Unfit
 0

mina Balongan

mal Gautama