No. /BPK/BOK-PKM.CIJULANG/GU.

/2022
DAFTAR PENERIMAAN
UANG SAKU (PKK KECAMATAN)
KEGIATAN AMP KASUS
BULAN JUNI 2022
BLUD PUSKESMAS CIJULANG
JML YG
NO. NAMA JABATAN ALAMAT RINCIAN PAJAK 6% TANDA TANGAN
DITERIMA

1 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

JUMLAH = Rp 100,000 Rp 6,000 Rp 94,000

Mengetahui, Cijulang, 2022

Pemimpin BLUD Puskesmas Bendahara Pengeluaran Pembantu
Kec. Cijulang Puskesmas Cijulang

Dadang Saripudin, S.Kep.Ners Erah, AM.KG

NIP. 19770704 200212 1 003 NIP. 19660731 199002 2 002
No. /BPK/BOK-PKM.CIJULANG/GU. /2022
DAFTAR PENERIMAAN
UANG SAKU NON PNS (KADER)
KEGIATAN LOKAKARYA MINI TIGA BULANAN
BULAN DESEMBER 2022
BLUD PUSKESMAS CIJULANG
JML YG
NO. NAMA JABATAN ALAMAT RINCIAN PAJAK 6% TANDA TANGAN
DITERIMA

1 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

2 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

3 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

4 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

5 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

6 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

7 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

8 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

9 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

10 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

11 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

12 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

13 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

14 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

JUMLAH = Rp 1,400,000 Rp 84,000 Rp 1,316,000

Mengetahui, Cijulang, 2022

Pemimpin BLUD Puskesmas Bendahara Pengeluaran Pembantu
Kec. Cijulang Puskesmas Cijulang

Dadang Saripudin, S.Kep.Ners Erah, AM.KG

NIP. 19770704 200212 1 003 NIP. 19660731 199002 2 002
No. /BPK/BOK-PKM.CIJULANG/GU. /2022
DAFTAR PENERIMAAN
UANG SAKU NON PNS (ODGJ)
KEGIATAN KASWARI
BULAN AGUSTUS 2022
BLUD PUSKESMAS CIJULANG
JML YG
NO. NAMA JABATAN ALAMAT RINCIAN PAJAK 6% TANDA TANGAN
DITERIMA

1 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

2 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000
3 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000
4 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000
5 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000
6 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000
7 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000
8 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000
9 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000
10 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000
11 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000
12 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000
13 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000
14 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

15 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

16 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

17 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

18 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

19 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

20 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000

JUMLAH = Rp 2,000,000 Rp 120,000 Rp 1,880,000

Mengetahui, Cijulang, 2022

Pemimpin BLUD Puskesmas Bendahara Pengeluaran Pembantu
Kec. Cijulang Puskesmas Cijulang

Dadang Saripudin, S.Kep.Ners Erah, AM.KG

NIP. 19770704 200212 1 003 NIP. 19660731 199002 2 002
No. /BPK/BOK-PKM.CIJULANG/GU. /2022
DAFTAR PENERIMAAN
PERJALANAN DINAS NON PNS (KADER)
KEGIATAN SWEEPING BALITA YANG TIDAK DATANG KE POSYANDU
BULAN AGUSTUS 2022
BLUD PUSKESMAS CIJULANG
NO JABAT JML YG
NAMA ALAMAT RINCIAN TANDA TANGAN
. AN DITERIMA

1 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 1

2 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 2

3 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 3

4 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 4

5 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 5

6 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 6

7 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 7

8 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 8

9 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 9

10 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 10

11 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 11

12 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 12

13 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 13

14 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 14

15 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 15

16 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 16

17 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 17

18 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 18

19 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 19

20 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 20

21 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 21

22 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 22

23 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 23

24 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 24

25 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 25

26 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 26

27 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 27

28 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 28

29 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 29

30 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 30

31 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 31

32 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 32

33 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 33

34 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 34

35 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 35

36 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 36

37 Kader 1 Or x 1 KL x 25,000 = Rp 25,000 Rp 25,000 37

JUMLAH = Rp 925,000 Rp 925,000

Mengetahui, Cijulang, 2022

Pemimpin BLUD Puskesmas Bendahara Pengeluaran Pembantu
Kec. Cijulang Puskesmas Cijulang

Dadang Saripudin, S.Kep.Ners Erah, AM.KG

NIP. 19770704 200212 1 003 NIP. 19660731 199002 2 002
No. /BPK/BOK-PKM.CIJULANG/GU. /2022
DAFTAR PENERIMAAN
UANG SAKU NON PNS (PESERTA)
KEGIATAN PEMANTAPAN DAN PEMBINAAN DUKUN PARAJI
BULAN MARET 2022
UPTD PUSKESMAS CIJULANG

NO JML YG
NAMA JABATAN ALAMAT RINCIAN PAJAK 6% TANDA TANGAN
. DITERIMA

1 ARSIH PARAJI CIJULANG 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 1

2 HJ.ODAH PARAJI CIJULANG 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 2

3 SATIAH PARAJI CIJULANG 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 3

4 UKAMAH PARAJI CIJULANG 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 4

5 KENI PARAJI BATUKARAS 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 5

6 PIOH PARAJI BATUKARAS 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 6

7 NANI PARAJI BATUKARAS 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 7

8 OYOH PARAJI KERTAYASA 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 8

9 KOKON PARAJI CIBANTEN 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 9

10 KASTURI PARAJI MARGACINTA 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 10

11 ATIH PARAJI MARGACINTA 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 11

12 ISOH PARAJI MARGACINTA 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 12

13 RUMSAH PARAJI MARGACINTA 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 13

14 ENI PARAJI MARGACINTA 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 14

15 ITOH PARAJI KONDANGJAJAR 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 15

16 NURHAYATI PARAJI CIAKAR 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 16

17 KARTINI PARAJI CIAKAR 1 Or x 1 KL x 100,000 = Rp 100,000 Rp 6,000 Rp 94,000 17

JUMLAH = Rp 1,700,000 Rp 102,000 Rp 1,598,000

Mengetahui, Cijulang, 2022

Kepala UPTD Puskesmas Bendahara Pengeluaran Pembantu
Kec. Cijulang Puskesmas Cijulang

Dadang Saripudin, S.Kep.Ners Erah, AM.KG

NIP. 19770704 200212 1 003 NIP. 19660731 199002 2 002
No. /BPK/BOK-PKM.CIJULANG/GU. /2023
DAFTAR PENERIMAAN
PERJALANAN DINAS NON PNS (KADER)
KEGIATAN POSYANDU DESA CIJULANG
BULAN JANUARI 2023
UPTD PUSKESMAS CIJULANG

JML YG
NO. NAMA JABATAN ALAMAT RINCIAN TANDA TANGAN
DITERIMA

1 Atis Kader Haurseah 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 1

2 Aan Kader Haurseah 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 2

3 Iin Kader Haurseah 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 3

4 Cicih Kader Haurseah 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 4

5 Iis Kader Haurseah 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 5

6 Sri Wahyuni Kader Haurseah 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 6

7 Inna Kader Haurseah 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 7

8 Evi S Kader Haurseah 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 8

9 Dian Kader Haurseah 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 9

10 Farida Kader Haurseah 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 10

11 Maryana Kader Ciwaru 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 11

12 Cucu Kader Ciwaru 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 12

13 Yayah Yuliani Kader Ciwaru 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 13

14 Een R Kader Ciwaru 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 14

15 Yanibar Kader Ciwaru 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 15

16 Yaniar Kader Ciwaru 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 16

17 Piky Kader Ciwaru 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 17

18 Een Saenah Kader Ciwaru 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 18

19 Tinah Kader Ciwaru 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 19

20 Iis Aisah Kader Ciwaru 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 20

21 Yayah Maryamah Kader Kalenwadas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 21

22 Jumiati Kader Kalenwadas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 22

23 Imas Maslia Kader Kalenwadas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 23

24 Heni Purwa Kader Kalenwadas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 24

25 Irma Maria Kader Kalenwadas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 25

26 Neni Isnaeni Kader Kalenwadas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 26

27 Yuyun Y Kader Kalenwadas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 27

28 Siti Maryam Kader Kalenwadas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 28

29 Heti Rohayati Kader Kalenwadas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 29

30 Karmilah Kader Kalenwadas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 30

31 Tati Haryati Kader Nusagede 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 31

32 Erna Kader Nusagede 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 32

33 Ecih Sukaesih Kader Nusagede 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 33

34 Saji Sumarni Kader Nusagede 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 34

35 Imas Dudeh Kader Nusagede 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 35

36 Kusdianti Kader Nusagede 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 36

37 Ayu S R Kader Nusagede 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 37

38 Neneng Hasanah Kader Nusagede 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 38

39 Suminah Kader Nusagede 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 39

40 Rina Yulianti Kader Nusagede 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 40

41 Ocih Sriyanti Kader Barengkok 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 41

42 Itoh Siti masitoh Kader Barengkok 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 42

43 Aan Suhanah Kader Barengkok 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 43

44 Neneng Nurhayati Kader Barengkok 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 44

45 Siti Nuraidah Kader Barengkok 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 45

46 Marlina Kader Barengkok 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 46

47 Erni H Kader Barengkok 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 47

48 Idah Kader Barengkok 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 48

49 Elis sri mulyani Kader Barengkok 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 49

50 Lia Yulianti Kader Barengkok 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 50

JUMLAH = Rp 1,750,000 Rp 1,750,000

Mengetahui, Cijulang, 2023

Kepala UPTD Puskesmas Bendahara Pengeluaran Pembantu
Kec. Cijulang Puskesmas Cijulang

Dadang Saripudin, S.Kep.Ners Erah, AM.KG

NIP. 19770704 200212 1 003 NIP. 19660731 199002 2 002
No. /BPK/BOK-PKM.CIJULANG/GU. /2023
DAFTAR PENERIMAAN
PERJALANAN DINAS NON PNS (KADER)
KEGIATAN POSYANDU DESA BATUKARAS
BULAN JANUARI 2023
UPTD PUSKESMAS CIJULANG

JML YG
NO. NAMA JABATAN ALAMAT RINCIAN TANDA TANGAN
DITERIMA

1 Siti Musriah Kader Nagrog 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 1

2 Nur Aisyah Kader Nagrog 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 2

3 Nia Kurniasih Kader Nagrog 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 3

4 Kayah Kader Nagrog 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 4

5 Iit Atiyah Kader Nagrog 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 5

6 Siti Ristianti Kader Nagrog 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 6

7 Popon Patimah Kader Nagrog 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 7

8 Sopiah Kader Nagrog 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 8

9 Ipah Saripah Kader Nagrog 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 9

10 Mella Nuryati Kader Nagrog 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 10

11 Lia Rosalina Kader Cidahu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 11

12 Dedeh Ruwaidah Kader Cidahu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 12

13 Ririn Mulyani Kader Cidahu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 13

14 Pupung Kader Cidahu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 14

15 Uning Kader Cidahu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 15

16 Imas Masturoh Kader Cidahu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 16

17 Elin Marlina Kader Cidahu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 17

18 Nunung N Kader Cidahu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 18

19 Neni H Kader Cidahu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 19

20 Nina M Kader Cidahu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 20

21 Een H Kader Pasuketan 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 21

22 Iin Aisah Kader Pasuketan 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 22

23 Nursiti R Kader Pasuketan 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 23

24 Siti Halimah Kader Pasuketan 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 24

25 Idah R Kader Pasuketan 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 25

26 Nurhayati Kader Pasuketan 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 26

27 Reni Karlina Kader Pasuketan 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 27

28 Wina Nurjanah Kader Pasuketan 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 28

29 Widaningsih Kader Pasuketan 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 29

30 Wiwin Widaningsih Kader Pasuketan 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 30

31 Lasmini Kader Batukaras 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 31

32 Tati Kurniasih Kader Batukaras 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 32

33 Sugiarti Kader Batukaras 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 33

34 Sumarsih Kader Batukaras 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 34

35 Ikah Kader Batukaras 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 35

36 Mei Handayani Kader Batukaras 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 36

37 Esah Kader Batukaras 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 37

38 Cahyani Kader Batukaras 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 38

39 Dede Sumiati Kader Batukaras 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 39

40 Fitriah Kader Batukaras 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 40

41 Ani Komala D Kader S. Kalang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 41

42 Rosmawati Kader S. Kalang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 42

43 Adah Kader S. Kalang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 43

44 Jumiati Kader S. Kalang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 44

45 Nurhidayah Kader S. Kalang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 45

46 Sumarni Kader S. Kalang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 46

47 Rati Kader S. Kalang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 47

48 Heryani Kader S. Kalang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 48

49 Heni Kader S. Kalang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 49

50 Rina Kader S. Kalang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 50

51 Nurhayati Kader Mandala 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 51

52 Titi S Kader Mandala 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 52

53 Entin S Kader Mandala 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 53

54 Yeyen Kader Mandala 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 54

55 Ii Hamidah Kader Mandala 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 55

56 Nia K Kader Mandala 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 56

57 Ai Sumarni Kader Mandala 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 57

58 Dadah S Kader Mandala 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 58

59 Elin H Kader Mandala 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 59

60 Maya Kader Mandala 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 60

JUMLAH = Rp 2,100,000 Rp 2,100,000

Mengetahui, Cijulang, 2023

Kepala UPTD Puskesmas Bendahara Pengeluaran Pembantu
Kec. Cijulang Puskesmas Cijulang

Dadang Saripudin, S.Kep.Ners Erah, AM.KG

NIP. 19770704 200212 1 003 NIP. 19660731 199002 2 002
No. /BPK/BOK-PKM.CIJULANG/GU. /2023
DAFTAR PENERIMAAN
PERJALANAN DINAS NON PNS (KADER)
KEGIATAN POSYANDU DESA KERTAYASA
BULAN JANUARI 2023
UPTD PUSKESMAS CIJULANG

JML YG
NO. NAMA JABATAN ALAMAT RINCIAN TANDA TANGAN
DITERIMA

1 Esah Kader Tenjolaya 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 1

2 Wati Encih Kader Tenjolaya 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 2

3 Eroh Kader Tenjolaya 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 3

4 Karminah Kader Tenjolaya 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 4

5 Neni Kader Tenjolaya 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 5

6 Heni Kader Tenjolaya 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 6

7 Rorom Kader Tenjolaya 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 7

8 Aningsih Kader Tenjolaya 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 8

9 Tati Kader Tenjolaya 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 9

10 Titin Kader Tenjolaya 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 10

11 Idah Kader Karangpaci 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 11

12 Aisah Kader Karangpaci 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 12

13 Edeh Kader Karangpaci 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 13

14 Yani Kader Karangpaci 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 14

15 Mimi Kader Karangpaci 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 15

16 Yeni Kader Karangpaci 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 16

17 Siti M Kader Karangpaci 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 17

18 Ening Kader Karangpaci 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 18

19 Heni Kader Karangpaci 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 19

20 Iis Kader Karangpaci 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 20

21 Yani Heryani Kader Bugel 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 21

22 Haryati Kader Bugel 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 22

23 Jumaroh Kader Bugel 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 23

24 Kokom K Kader Bugel 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 24

25 Icah Latifah Kader Bugel 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 25

26 Idah N Kader Bugel 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 26

27 Rina N Kader Bugel 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 27

28 Ipah Kader Bugel 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 28

29 Dedeh H Kader Bugel 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 29

30 Eti Kusmayati Kader Bugel 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 30

31 Nunung Kader Cibuluh 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 31

32 Maryamah Kader Cibuluh 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 32

33 Iroh Kader Cibuluh 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 33

34 Isoh Kader Cibuluh 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 34

35 Yani Kader Cibuluh 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 35

36 Iin Kader Cibuluh 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 36

37 Rusyati Kader Cibuluh 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 37

38 Atik Kader Cibuluh 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 38

39 Yani Kader Cibuluh 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 39

40 Lilis Kader Cibuluh 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 40

41 Rina Kader Bantarkawung 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 41

42 Yeni Kader Bantarkawung 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 42

43 Kokom Kader Bantarkawung 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 43

44 Iis Kader Bantarkawung 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 44

45 Ihah Kader Bantarkawung 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 45

46 Mela Kader Bantarkawung 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 46

47 Rumyati Kader Bantarkawung 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 47

48 Titing Kader Bantarkawung 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 48

49 Een Kader Bantarkawung 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 49

50 Ani Kader Bantarkawung 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 50

JUMLAH = Rp 1,750,000 Rp 1,750,000

Mengetahui, Cijulang, 2023

Kepala UPTD Puskesmas Bendahara Pengeluaran Pembantu
Kec. Cijulang Puskesmas Cijulang

Dadang Saripudin, S.Kep.Ners Erah, AM.KG

NIP. 19770704 200212 1 003 NIP. 19660731 199002 2 002
No. /BPK/BOK-PKM.CIJULANG/GU. /2023
DAFTAR PENERIMAAN
PERJALANAN DINAS NON PNS (KADER)
KEGIATAN POSYANDU DESA CIBANTEN
BULAN JANUARI 2023
BLUD PUSKESMAS CIJULANG

JML YG
NO. NAMA JABATAN ALAMAT RINCIAN TANDA TANGAN
DITERIMA

1 Sukarnah Kader Cibanten 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 1

2 Hj. Yeti Kader Cibanten 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 2

3 Nining Syaripah Kader Cibanten 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 3

4 Ilah Susilawati Kader Cibanten 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 4

5 Imas Suryani Kader Cibanten 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 5

6 Ani Nuraeni Kader Cibanten 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 6

7 Umayah Kader Cibanten 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 7

8 Fitri Maulana Yusuf Kader Cibanten 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 8

9 Resti Kurnia Kader Cibanten 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 9

10 Maemunah Kader Cibanten 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 10

11 Siti Nulaela Kader Cicurug 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 11

12 Siti Aminah Kader Cicurug 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 12

13 Jumsih Kader Cicurug 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 13

14 Linda Inarotul Huda Kader Cicurug 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 14

15 Rasi Kader Cicurug 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 15

16 Rusminah Kader Cicurug 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 16

17 Mumun Karmunah Kader Cicurug 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 17

18 Siti Robiah Adawiah Kader Cicurug 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 18

19 Lilis Rosmawati Kader Cicurug 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 19

20 Kiki Mulkiah Kader Cicurug 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 20

21 Dede Yati Kader Cibodas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 21

22 Liknawati Kader Cibodas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 22

23 Ika Kader Cibodas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 23

24 Dede N Kader Cibodas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 24

25 Devi N F Kader Cibodas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 25

26 Nani Suryani Kader Cibodas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 26

27 Euis Masturoh Kader Cibodas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 27

28 Wida Kader Cibodas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 28

29 Cucun Rosita Kader Cibodas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 29

30 Cucu Aulia Kader Cibodas 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 30

31 Nuraeni Kader Cisagu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 31

32 Iyah Badriah Kader Cisagu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 32

33 Siti Nuraisyah Kader Cisagu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 33

34 Eva Susilawati Kader Cisagu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 34

35 Yati Jumiati Kader Cisagu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 35

36 Neng Rismayanti Kader Cisagu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 36

37 Heni Z Kader Cisagu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 37

38 Atih Syaidah Kader Cisagu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 38

39 Sumarni Kader Cisagu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 39

40 Jemah Kader Cisagu 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 40

41 Imas Masriah Kader Cilubang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 41

42 Siti Rohimah Kader Cilubang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 42

43 Ita Kader Cilubang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 43

44 Dedeh Kurniash Kader Cilubang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 44

45 Nurcahyawati Kader Cilubang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 45

46 Neni Handayani Kader Cilubang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 46

47 Amilah Kader Cilubang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 47

48 Lina Kader Cilubang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 48

49 Rosalina Widiya Kader Cilubang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 49

50 Lilis Muhlisoh Kader Cilubang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 50

jumlah Rp 1,750,000 Rp 1,750,000

Mengetahui, Cijulang, 2023

Kepala UPTD Puskesmas Bendahara Pengeluaran Pembantu
Kec. Cijulang Puskesmas Cijulang

Dadang Saripudin, S.Kep.Ners Erah, AM.KG

NIP. 19770704 200212 1 003 NIP. 19660731 199002 2 002
No. /BPK/BOK-PKM.CIJULANG/GU. /2023
DAFTAR PENERIMAAN
PERJALANAN DINAS NON PNS (KADER)
KEGIATAN POSYANDU DESA KONDANGJAJAR
BULAN JANUARI 2023
UPTD PUSKESMAS CIJULANG

JML YG
NO. NAMA JABATAN ALAMAT RINCIAN TANDA TANGAN
DITERIMA

1 Wini Kader Binangun 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 1

2 Endang Kader Binangun 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 2

3 Hanhan Kader Binangun 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 3

4 Teti Hayati Kader Binangun 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 4

5 Juhriah Kader Binangun 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 5

6 Ema Kader Binangun 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 6

7 Suryati Kader Binangun 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 7

8 Fujiati Kader Binangun 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 8

9 Uun Unasih Kader Binangun 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 9

10 Titin Kurnia Kader Binangun 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 10

11 Anisa Tri Lestari Kader Binangun 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 11

12 Nurjanah Kader Cikaler 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 12

13 Elin Kader Cikaler 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 13

14 Mia Kader Cikaler 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 14

15 Eti S Kader Cikaler 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 15

16 Iis Kader Cikaler 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 16

17 Yuni mulyati Kader Cikaler 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 17

18 Resti Kader Cikaler 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 18

19 Susilawati Kader Cikaler 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 19

20 Rodasih Kader Cikaler 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 20

21 Nining Kader Cikaler 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 21

22 Yeni Kader Cikaler 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 22

23 Hesti Kader Garunggang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 23

24 Henhen Kader Garunggang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 24

25 Atin Hartini Kader Garunggang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 25

26 Anggi Kader Garunggang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 26

27 Mira Kader Garunggang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 27

28 Sumiati Kader Garunggang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 28

29 Teti Kader Garunggang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 29

30 Yati Kader Garunggang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 30

31 Neni Suryani Kader Garunggang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 31

32 Nurhayati Kader Garunggang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 32

33 Perawati Kader Garunggang 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 33

34 Enung H Kader Kelensari 1 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 34

35 Darsih Kader Kelensari 1 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 35

36 H. Titi Kader Kelensari 1 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 36

37 Inay S Kader Kelensari 1 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 37

38 Adah Kader Kelensari 1 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 38

39 Sri D Kader Kelensari 1 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 39

40 Yuningsih Kader Kelensari 1 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 40

41 Enok Kader Kelensari 1 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 41

42 Heryani Kader Kelensari 1 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 42

43 Teni Kader Kelensari 1 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 43

44 Eti Suryati Kader Kalensari 2 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 44

45 Eti RT Kader Kalensari 2 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 45

46 Fany Kader Kalensari 2 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 46

47 Hartini Kader Kalensari 2 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 47

48 Titin Kader Kalensari 2 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 48

49 Eva Kader Kalensari 2 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 49

50 Ani Kader Kalensari 2 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 50

JUMLAH = Rp 1,750,000 Rp 1,750,000

Mengetahui, Cijulang, 2023

Kepala UPTD Puskesmas Bendahara Pengeluaran Pembantu
Kec. Cijulang Puskesmas Cijulang

Dadang Saripudin, S.Kep.Ners Erah, AM.KG

NIP. 19770704 200212 1 003 NIP. 19660731 199002 2 002
No. /BPK/BOK-PKM.CIJULANG/GU. /2023
DAFTAR PENERIMAAN
PERJALANAN DINAS NON PNS (KADER)
KEGIATAN POSYANDU DESA CIAKAR
BULAN JANUARI 2023
UPTD PUSKESMAS CIJULANG

JML YG
NO. NAMA JABATAN ALAMAT RINCIAN TANDA TANGAN
DITERIMA

1 Nita Kader Kertasari 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 1

2 Wiwin Windarsih Kader Kertasari 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 2

3 Armilah Kader Kertasari 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 3

4 Sri Mulyani Kader Kertasari 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 4

5 Yati R Kader Kertasari 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 5

6 Elin Nurjanah Kader Kertasari 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 6

7 Hj. Rohayati Kader Kertasari 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 7

8 Sutarsih Kader Kertasari 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 8

9 Ela Nurlaela Kader Kertasari 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 9

10 Riska Kader Kertasari 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 10

11 Desi Ratnasari Kader Cisodong 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 11

12 Dodoh Kader Cisodong 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 12

13 Leni Andriani Kader Cisodong 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 13

14 Idah Rosidah Kader Cisodong 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 14

15 Nine mulyani Kader Cisodong 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 15

16 Yeni Sumyati Kader Cisodong 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 16

17 Neneng Kader Cisodong 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 17

18 Beti f Kader Cisodong 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 18

19 Sopa nurohmah Kader Cisodong 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 19

20 Romyati Kader Cisodong 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 20

21 Beti Kader Cikareo 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 21

22 Ika Kader Cikareo 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 22

23 Anisah Kader Cikareo 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 23

24 Wina Kader Cikareo 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 24

25 Iyam Kader Cikareo 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 25

26 Neni Kader Cikareo 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 26

27 Siti Aisah A.S Kader Cikareo 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 27

28 Lilik Kader Cikareo 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 28

29 Dina N Kader Cikareo 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 29

30 Entin Suhartini Kader Cikareo 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 30

31 Enung Kader Ciakar 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 31

32 Yati Kader Ciakar 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 32

33 Heni Kader Ciakar 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 33

34 Titin Kader Ciakar 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 34

35 Tuti Kader Ciakar 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 35

36 Hasanah Saodah Kader Ciakar 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 36

37 Yeni Kader Ciakar 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 37

38 Komnasih Kader Ciakar 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 38

39 Ina Kader Ciakar 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 39

40 LIlis Kader Ciakar 1 Or x 1 KL x 35,000 = Rp 35,000 Rp 35,000 40

JUMLAH = Rp 1,400,000 Rp 1,400,000

Mengetahui, Cijulang, 2023

Kepala UPTD Puskesmas Bendahara Pengeluaran Pembantu
Kec. Cijulang Puskesmas Cijulang

Dadang Saripudin, S.Kep.Ners Erah, AM.KG

NIP. 19770704 200212 1 003 NIP. 19660731 199002 2 002
 DINAS KESEHATAN KABUPATEN PANGANDARAN
UPTD KESEHATAN PUSKESMAS CIJULANG
Jln. Bandara Nusawiru No. Cijulang - Pangandaran
Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR HADIR
SOSIALISASI SMD (SURVEI MAWAS DIRI) DESA CIBANTEN
TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN :

NO NAMA ALAMAT JABATAN TANDA TANGAN

1 1

2 2

3 3

4 4

5 5

6 6

7 7

8 8

9 9

10 10

11 11

12 12

13 13

14 14

15 15

16 16

17 17

18 18

19 19

20 20

21 21

22 22

23 23

24 24

25 25

26 26

27 27

28 28

29 29

30 30

31 31

32 32

33 33
 DINAS KESEHATAN KABUPATEN PANGANDARAN
UPTD KESEHATAN PUSKESMAS CIJULANG
Jln. Bandara Nusawiru No. Cijulang - Pangandaran
Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR HADIR
KEGIATAN :
TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN :
JENIS
NO NAMA KELAS ASAL SEKOLAH TANDA TANGAN
KELAMIN
1 1

2 2

3 3

4 4

5 5

6 6

7 7

8 8

9 9

10 10

11 11

12 12

13 13

14 14

15 15

16 16

17 17

18 18

19 19

20 20

21 21

22 22

23 23

24 24

25 25

26 26

27 27

28 28

29 29

30 30

31 31

32 32

33 33

34 34

35 35

36 36

37 37

38 38

39 39

40 40
 DINAS KESEHATAN KABUPATEN PANGANDARAN
UPTD KESEHATAN PUSKESMAS CIJULANG
Jln. Bandara Nusawiru No. Cijulang - Pangandaran
Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR HADIR
KEGIATAN :
TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN :
NAMA ANAK / NAMA JENIS
NO UMUR ALAMAT TANDA TANGAN
ORANG TUA KELAMIN
1 1

2 2

3 3

4 4

5 5

6 6

7 7

8 8

9 9

10 10

11 11

12 12

13 13

14 14

15 15

16 16

17 17

18 18

19 19

20 20

21 21

22 22

23 23

24 24

25 25

26 26

27 27

28 28

29 29

30 30

31 31

32 32

33 33

34 34

35 35
 DINAS KESEHATAN KABUPATEN PANGANDARAN
UPTD KESEHATAN PUSKESMAS CIJULANG
Jln. Bandara Nusawiru No. Cijulang - Pangandaran
Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR PENERIMA SNACK
KEGIATAN : : Kelas Ibu Hamil Desa Batukaras
TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN :
UMUR
NO NAMA IBU / SUAMI UMUR ALAMAT TANDA TANGAN
KEHAMILAN
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 UMUR
NO NAMA IBU / SUAMI UMUR ALAMAT TANDA TANGAN
KEHAMILAN
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 DINAS KESEHATAN KABUPATEN PANGANDARAN
UPTD KESEHATAN PUSKESMAS CIJULANG
Jln. Bandara Nusawiru No. Cijulang - Pangandaran
Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR PENERIMAAN SNACK
KEGIATAN :
TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN :

NO NAMA JABATAN JK / UMUR ALAMAT TANDA TANGAN

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 DINAS KESEHATAN KABUPATEN PANGANDARAN
UPTD KESEHATAN PUSKESMAS CIJULANG
Jln. Bandara Nusawiru No. Cijulang - Pangandaran
Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR HADIR
KEGIATAN : Rapat Konsolidasi
TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN :

NO NAMA NIP JABATAN UNIT KERJA TANDA TANGAN

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 DINAS KESEHATAN KABUPATEN PANGANDARAN
BLUD PUSKESMAS CIJULANG
Jln. Bandara Nusawiru No. Cijulang - Pangandaran
Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR HADIR
KEGIATAN : Kaswari
TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN :

NO NAMA ALAMAT TANDA TANGAN

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NO NAMA ALAMAT TANDA TANGAN

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 PEMERINTAH KABUPATEN PANGANDARAN
DINAS KESEHATAN
BLUD PUSKESMAS CIJULANG
Jln. Bandara Nusawiru Rt.023/Rw.005 Desa Kondangjajar
Kec. Cijulang Kab. Pangandaran Kode Pos 46394
Tlp. (0265) 633189
Email : puskesmascijulang@gmail.com
DAFTAR PENERIMAAN SNACK
Kegiatan : ANC Terpadu
Hari/ Tanggal :
Tempat Pelaksanaan :
UMUR
NO NAMA UMUR ALAMAT TANDA TANGAN
KEHAMILAN

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 UMUR
NO NAMA UMUR ALAMAT TANDA TANGAN
KEHAMILAN

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 PEMERINTAH KABUPATEN PANGANDARAN
DINAS KESEHATAN
BLUD PUSKESMAS CIJULANG
Jln. Bandara Nusawiru Rt.023/Rw.005 Desa Kondangjajar
Kec. Cijulang Kab. Pangandaran Kode Pos 46394
Tlp. (0265) 633189
Email : puskesmascijulang@gmail.com
DAFTAR PENERIMAAN SNACK
Kegiatan : Kelas Balita
Hari/ Tanggal :
Tempat Pelaksanaan :
JENIS
NO NAMA UMUR ALAMAT TANDA TANGAN
KELAMIN

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 JENIS
NO NAMA UMUR ALAMAT TANDA TANGAN
KELAMIN

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 DINAS KESEHATAN KABUPATEN PANGANDARAN
BLUD KESEHATAN PUSKESMAS CIJULANG
Jln. Bandara Nusawiru No. Cijulang - Pangandaran
Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR HADIR & PENERIMAAN SNACK
KEGIATAN : Kelas Bidan
TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN : Aula Puskesmas Cijulang

NO NAMA JABATAN ALAMAT TANDA TANGAN

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 PEMERINTAH KABUPATEN PANGANDARAN
DINAS KESEHATAN
BLUD PUSKESMAS CIJULANG
Jln. Bandara Nusawiru Rt.023/Rw.005 Desa Kondangjajar
Kec. Cijulang Kab. Pangandaran Kode Pos 46394
Tlp. (0265) 633189
Email : puskesmascijulang@gmail.com
DAFTAR HADIR & PENERIMAAN SNACK
Kegiatan :
Hari/ Tanggal
Tempat Pelaksanaan : Aula Desa Cijulang
UMUR
NO NAMA UMUR ALAMAT TANDA TANGAN
KEHAMILAN

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 UMUR
NO NAMA UMUR ALAMAT TANDA TANGAN
KEHAMILAN

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 PEMERINTAH KABUPATEN PANGANDARAN
DINAS KESEHATAN
BLUD PUSKESMAS CIJULANG
Jln. Bandara Nusawiru Rt.023/Rw.005 Desa Kondangjajar
Kec. Cijulang Kab. Pangandaran Kode Pos 46394
Tlp. (0265) 633189

DAFTAR PENERIMAAN SNACK

Kegiatan Pembentukan Jejaring Promkes Dalam Mendukung
Pelaksanaan Germas
Hari/ Tanggal :
Tempat Pelaksanaan :
NO NAMA ALAMAT TANDA TANGAN

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NO NAMA ALAMAT TANDA TANGAN

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 PEMERINTAH KABUPATEN PANGANDARAN
DINAS KESEHATAN
BLUD PUSKESMAS CIJULANG
Jln. Bandara Nusawiru Rt.023/Rw.005 Desa Kondangjajar
Kec. Cijulang Kab. Pangandaran Kode Pos 46394
Tlp. (0265) 633189
Email : puskesmascijulang@gmail.com
DAFTAR PENERIMAAN SNACK & NASI BOX
Kegiatan : Germas Segerac Remaja Desa Cijulang
Hari/ Tanggal :
Tempat Pelaksanaan :
NO NAMA UMUR ALAMAT TANDA TANGAN

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2 2

3 3

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NO NAMA UMUR ALAMAT TANDA TANGAN

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 DINAS KESEHATAN KABUPATEN PANGANDARAN
BLUD KESEHATAN PUSKESMAS CIJULANG
Jln. Bandara Nusawiru No. Cijulang - Pangandaran
Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR HADIR & PENERIMAAN SNACK
KEGIATAN : Lokakarya Mini Bulanan
TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN :

NO NAMA JABATAN ALAMAT TANDA TANGAN

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NO NAMA JABATAN ALAMAT TANDA TANGAN

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NO NAMA JABATAN ALAMAT TANDA TANGAN

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 DINAS KESEHATAN KABUPATEN PANGANDARAN
BLUD PUSKESMAS CIJULANG
Jln. Bandara Nusawiru No. Cijulang - Pangandaran
Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR HADIR & DAFTAR PENERIMAAN SNACK

KEGIATAN : Deklarasi ODF

TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN :

NO NAMA JABATAN ALAMAT TANDA TANGAN

1 1

2 2

3 3

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 DINAS KESEHATAN KABUPATEN PANGANDARAN
BLUD PUSKESMAS CIJULANG
Jln. Bandara Nusawiru RT/RW 23/05 Desa Kondangajajar Kec. Cijulang
Kab. Pangandaran Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR HADIR
KEGIATAN : : Kegiatan Verifikasi Lapangan Kompetisi KIJB
TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN :

NO NAMA JABATAN ALAMAT TANDA TANGAN

1 1

2 2

3 3

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NO NAMA JABATAN ALAMAT TANDA TANGAN

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NO NAMA JABATAN ALAMAT TANDA TANGAN

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NO NAMA JABATAN ALAMAT TANDA TANGAN

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NO NAMA JABATAN ALAMAT TANDA TANGAN

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 DINAS KESEHATAN KABUPATEN PANGANDARAN
BLUD PUSKESMAS CIJULANG
Jln. Bandara Nusawiru RT/RW 23/05 Desa Kondangajajar Kec. Cijulang
Kab. Pangandaran Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR HADIR
KEGIATAN : Lokakarya Mini Tiga Bulanan
TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN :

NO NAMA JABATAN ALAMAT TANDA TANGAN

1 1

2 2

3 3

4 4

5 5

6 6

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NO NAMA JABATAN ALAMAT TANDA TANGAN

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 DINAS KESEHATAN KABUPATEN PANGANDARAN
UPTD KESEHATAN PUSKESMAS CIJULANG
Jln. Bandara Nusawiru No. Cijulang - Pangandaran
Telp. (0265) 633189 Email : puskesmascijulang@gmail.com
DAFTAR PENERIMAAN SNACK
KEGIATAN : Deklarasi ODF
TANGGAL PELAKSANAAN :
TEMPAT PELAKSANAAN :

NO NAMA JABATAN ALAMAT TANDA TANGAN

1 1

2 2

3 3

4 4

5 5

6 6

7 7

8 8

9 9

10 10

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14 14

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