PERHITUNGAN PENERIMAAN JASA PELAYANAN OPERASIONAL RETRIBUSI

PUSKESMAS SELOGIRI BULAN OKTOBER 2018

Nama Puskesmas SELOGIRI

penerimaan
KEHADIRAN Kapitasin
Pendid Jenis Rangkap Jasa pelayanan
no Nama Pegawai Jabatan PAJAK JUMLAH TERIMA Tanda Tangan
ikan Ketenaga Masa Jumlah Tugas Jumlah Total Yang diterima
Kerja Administ seluruh point
an hari Jumlah rasi Jasa Pelayanan
Hari
masuk Kerja 45%
kerja

1 2 3 4 5 6 7 8=6X7/TOT.POIN 14=12-13 15
9 POIN
1 dr. Anita Apriliawati Ka.Pus S1 150 5 27 27 100 182 3,400,000 136,691 6,835 129,856 1 4527
2 Anita Sri S.Amd keb Ka TU S1 80 10 26 27 30 116 3,400,000 87,122 4,356 82,766 2 4527
3 dr.Endang S Dokter S1 150 10 27 27 187 3,400,000 140,446 21,067 119,379 3 4527
4 drg.Siti Rahmawati Drg S1 150 10 27 27 187 3,400,000 140,446 21,067 119,379 4 4527
5 Siti Maryamah Bidan D4 80 25 27 27 132 3,400,000 99,139 14,871 84,268 5 4527
6 Sri Sularti Perawat S1 100 25 27 27 152 3,400,000 114,159 17,124 97,036 6 4527
7 Sunarni Perawat S1 100 25 21 27 146 3,400,000 109,653 16,448 93,205 7 4527
8 Widhi Hastuti Perawat S1 80 25 25 27 130 3,400,000 97,636 14,645 82,991 8 4527
9 Sukanthi Perawat SPK 50 25 27 27 102 3,400,000 76,607 3,830 72,777 9 4527
10 Titik Sumarni Perawat SPK 50 25 27 27 102 3,400,000 76,607 3,830 72,777 10 4527
11 Anik suryanti Bidan D4 80 25 27 27 132 3,400,000 99,139 14,871 84,268 11 4527
12 Seno Raharjo Gizi S1 80 25 27 27 132 3,400,000 99,139 14,871 84,268 12 4527
13 Sugiyarni Bend.PeneSMA 25 25 27 27 77 3,400,000 57,831 2,892 54,939 13 4527
14 Winarningsih Bend.BaraS1 50 25 27 27 102 3,400,000 76,607 3,830 72,777 14 4527
15 Retno Sulistyowati Bidan D4 80 20 27 27 127 3,400,000 95,383 4,769 90,614 15 4527
16 Eko Cahyono Promkes S1 80 10 23 27 113 3,400,000 84,869 4,243 80,625 16 4527
17 Titik Widiyastuti PKL D1 50 20 27 27 97 3,400,000 72,852 3,643 69,209 17 4527
18 Heru Priyatmaka Perawat D3 60 15 27 27 102 3,400,000 76,607 3,830 72,777 18 4527
19 Maria Tri Wijayanti Promkes S1 80 15 27 27 122 3,400,000 91,628 4,581 87,047 19 4527
20 Herawati Any W Bend.JKN SMF 50 20 24 27 50 94 3,400,000 70,599 3,530 67,069 20 4527
21 Ainiyatul Maghfiroh Laborat D3 60 20 27 27 107 3,400,000 80,362 4,018 76,344 21 4527
22 Rahayu Fitri Perawat D3 60 5 27 27 92 3,400,000 69,097 3,455 65,642 22 4527
23 Jumirah Perawat S1 80 5 27 27 112 3,400,000 84,118 4,206 79,912 23 4527
24 Antonius Sugiri Laborat D3 60 10 24 27 94 3,400,000 70,599 3,530 67,069 24 4527
25 Martini Bidan D1 50 20 27 27 97 3,400,000 72,852 3,643 69,209 25 4527
26 Sigit Tri W Perawat GiD3 60 10 27 27 97 3,400,000 72,852 3,643 69,209 26 4527
27 Titin S Pengelola D3 60 10 27 27 97 3,400,000 72,852 3,643 69,209 27 4527
28 Tutik Suwitowati Bidan D3 60 20 27 27 107 3,400,000 80,362 4,018 76,344 28 4527
29 Fitri Waryanti Perawat D3 60 10 27 27 97 3,400,000 72,852 3,643 69,209 29 4527
30 Eny Setyaningtyas Bidan D1 50 15 27 27 92 3,400,000 69,097 - 69,097 30 4527
31 Dewi Mashithoh Bidan D1 50 20 27 27 97 3,400,000 72,852 - 72,852 31 4527
32 Atik Prasetyowati Bidan D3 60 10 27 27 97 3,400,000 72,852 - 72,852 32 4527
33 Estininglukitosari Bidan D1 50 20 27 27 97 3,400,000 72,852 - 72,852 33 4527
34 Emik Ermawati Bidan D1 50 10 27 27 87 3,400,000 65,341 - 65,341 34 4527
35 Sri Hanani Bidan D3 60 10 27 27 97 3,400,000 72,852 - 72,852 35 4527
36 Ucik K Dewi Bidan D3 0 0 0 0 0 - - - - 36 4527
37 Sri Wulandari Bidan D3 60 5 27 27 92 3,400,000 69,097 - 69,097 37 4527
38 Tri Maryani Bidan D3 60 5 26 27 91 3,400,000 68,345 - 68,345 38 4527
39 Emy Primiadiani Bidan D3 60 5 27 27 92 3,400,000 69,097 - 69,097 39 4527
40 Farida Bidan D3 60 5 27 27 92 3,400,000 69,097 - 69,097 40 4527
41 Suharyanti Admin SMA 25 10 27 27 62 3,400,000 46,565 - 46,565 41 4527
42 Sulistyowati Perawat D3 60 10 27 27 97 3,400,000 72,852 - 72,852 42 4527
4527 3,400,000 218,931 3,181,069 3,400,000
-
Selogiri, 30 Oktober 2018

Kuasa Pengguna Anggaran Ka.Subag.TU

 dr.Anita Apriliawat ANITA SRI S.SKM. MPH
NIP.19810421 201001 2 023 NIP.19770812 200212 2 005

123,462,700
74,077,620
masa kerjaPajak
13 5%
5%
13 15%
15 15%
36 15%
31 15%
29 15%
30 15%
30 5%
28 5%
28 15%
30 15%
28 5%
26 5%
24 5%
11 5%
25 5%
20 5%
18 5%
23 5%
23 5%
10 5%
10 5%
12 5%
22 5%
11 5%
11 5%
21 5%
5%
20
22
12
22
14
12
9
10
10
9
9
12
14
 PERHITUNGAN PENERIMAAN JASA PELAYANAN OPERASIONAL RETRIBUSI
PUSKESMAS SELOGIRI BULAN OKTOBER 2018

Nama Puskesmas SELOGIRI

Jasa pelayanan
no Nama Pegawai Jabatan GOL PAJAK JUMLAH TERIMA Tanda Tangan
Yang diterima

8=6X7/TOT.POIN 14=12-13 15
9 POIN masa kerjaPajak
1 dr. Anita Apriliawati Ka.Pus IIID 136,600 6,700 129,900 1 136,691 4592 13 5% 6834.548
2 Anita Sri S.Amd keb Ka TU IIIB 87,000 4,200 82,800 2 87,122 4592 5% 4356.086
3 dr.Endang S Dokter IVA 140,400 20,700 119,700 3 140,446 4592 13 15% 21066.93
4 drg.Siti Rahmawati Drg IVB 140,400 20,700 119,700 4 140,446 4592 15 15% 21066.93
5 Siti Maryamah Bidan IVC 99,100 14,600 84,500 5 99,139 4592 36 15% 14870.78
6 Sri Sularti Perawat IVC 114,100 16,800 97,300 6 114,159 4592 31 15% 17123.92
7 Sunarni Perawat IVC 109,600 16,200 93,400 7 109,653 4592 29 15% 16447.98
8 Widhi Hastuti Perawat IVB 97,600 14,400 83,200 8 97,636 4592 30 15% 14645.46
9 Sukanthi Perawat IIID 76,600 3,700 72,900 9 76,607 4592 30 5% 3830.351
10 Titik Sumarni Perawat IIID 76,600 3,700 72,900 10 76,607 4592 28 5% 3830.351
11 Anik suryanti Bidan IVA 99,100 14,600 84,500 11 99,139 4592 28 15% 14870.78
12 Seno Raharjo Gizi IVB 99,100 14,600 84,500 12 99,139 4592 30 15% 14870.78
13 Sugiyarni Bend.PenerimaaIIB 57,800 2,800 55,000 13 57,831 4592 28 5% 2891.54
14 Winarningsih Bend.Barang IIIC 76,600 3,700 72,900 14 76,607 4592 26 5% 3830.351
15 Retno Sulistyowati Bidan IIID 95,300 4,700 90,600 15 95,383 4592 24 5% 4769.163
16 Eko Cahyono Promkes IIID 84,800 4,100 80,700 16 84,869 4592 11 5% 4243.428
17 Titik Widiyastuti PKL IIID 72,800 3,500 69,300 17 72,852 4592 25 5% 3642.589
18 Heru Priyatmaka Perawat IIIc 76,600 3,700 72,900 18 76,607 4592 20 5% 3830.351
19 Maria Tri Wijayanti Promkes IIID 91,600 4,500 87,100 19 91,628 4592 18 5% 4581.4
20 Herawati Any W Bend.JKN IIID 70,500 3,400 67,100 20 70,599 4592 23 5% 3529.932
21 Ainiyatul Maghfiroh Laborat IIID 80,300 3,900 76,400 21 80,362 4592 23 5% 4018.114
22 Rahayu Fitri Perawat IIIA 69,000 3,400 65,600 22 69,097 4592 10 5% 3454.827
23 Jumirah Perawat IIIA 84,100 4,100 80,000 23 84,118 4592 10 5% 4205.876
24 Antonius Sugiri Laborat IIIA 70,500 3,400 67,100 24 70,599 4592 12 5% 3529.932
25 Martini Bidan IIIA 72,800 3,500 69,300 25 72,852 4592 22 5% 3642.589
26 Sigit Tri W Perawat Gigi IIIA 72,800 3,500 69,300 26 72,852 4592 11 5% 3642.589
27 Titin S Pengelola Obat IIIA 72,800 3,500 69,300 27 72,852 4592 11 5% 3642.589
28 Tutik Suwitowati Bidan IIIA 80,300 3,900 76,400 28 80,362 4592 21 5% 4018.114
29 Fitri Waryanti Perawat IIIB 72,800 3,500 69,300 29 72,852 4592 5% 3642.589
30 Eny Setyaningtyas Bidan IID 69,000 - 69,000 30 69,097 4592 20 0
31 Dewi Mashithoh Bidan IID 72,800 - 72,800 31 72,852 4592 22 0
32 Atik Prasetyowati Bidan IID 72,800 - 72,800 32 72,852 4592 12 0
33 Estininglukitosari Bidan IID 72,800 - 72,800 33 72,852 4592 22 0
34 Emik Ermawati Bidan IIC 65,300 - 65,300 34 65,341 4592 14 0
35 Sri Hanani Bidan IIC 72,800 - 72,800 35 72,852 4592 12 0
36 Ucik K Dewi Bidan IIC - - - 36 - 4592 9 0
37 Sri Wulandari Bidan IIC 69,000 - 69,000 37 69,097 4592 10 0
38 Tri Maryani Bidan IIC 68,300 - 68,300 38 68,345 4592 10 0
39 Emy Primiadiani Bidan IIC 69,000 - 69,000 39 69,097 4592 9 0
40 Farida Bidan IIC 69,000 - 69,000 40 69,097 4592 9 0
41 Suharyanti Admin IIB 48,800 - 48,800 41 46,565 4592 12 0
42 Sulistyowati Perawat IID 72,800 - 72,800 42 72,852 4592 14 0
3,400,000 214,000 3,186,000 3,400,000 3400000 218930.9

Selogiri, 30 Oktober 2018

Kuasa Pengguna Anggaran Ka.Subag.TU

 dr.Anita Apriliawat ANITA SRI S.SKM. MPH
NIP.19810421 201001 2 023 NIP.19770812 200212 2 005

123,462,700
74,077,620
 PERHITUNGAN PENERIMAAN JASA PELAYANAN OPERASIONAL RETRIBUSI
PUSKESMAS SELOGIRI BULAN OKTOBER 2018

Nama Puskesmas SELOGIRI

Jasa pelayanan
no Nama Pegawai Jabatan GOL Tanda Tangan
Yang diterima

8=6X7/TOT.POIN 15

1 dr. Anita Apriliawati Ka.Pus IIID 127,000 1 129900 2% 2,598 127,302

2 Anita Sri S.Amd keb Ka TU IIIB 81,000 2 82800 2% 1,656 81,144
3 dr.Endang S Dokter IVA 117,000 3 119700 2% 2,394 117,306
4 drg.Siti Rahmawati Drg IVB 117,000 4 119700 2% 2,394 117,306
5 Siti Maryamah Bidan IVC 82,000 5 84500 2% 1,690 82,810
6 Sri Sularti Perawat IVC 95,000 6 97300 2% 1,946 95,354
7 Sunarni Perawat IVC 91,000 7 93400 2% 1,868 91,532
8 Widhi Hastuti Perawat IVB 81,000 8 83200 2% 1,664 81,536
9 Sukanthi Perawat IIID 71,000 9 72900 2% 1,458 71,442
10 Titik Sumarni Perawat IIID 71,000 10 72900 2% 1,458 71,442
11 Anik suryanti Bidan IVA 82,000 11 84500 2% 1,690 82,810
12 Seno Raharjo Gizi IVB 82,000 12 84500 2% 1,690 82,810
13 Sugiyarni Bend.Pener IIB 58,000 13 55000 0% - 55,000
14 Winarningsih Bend.BarangIIIC 71,000 14 72900 2% 1,458 71,442
15 Retno Sulistyowati Bidan IIID 88,000 15 90600 2% 1,812 88,788
16 Eko Cahyono Promkes IIID 79,000 16 80700 2% 1,614 79,086
17 Titik Widiyastuti PKL IIID 67,000 17 69300 2% 1,386 67,914
18 Heru Priyatmaka Perawat IIIc 71,000 18 72900 2% 1,458 71,442
19 Maria Tri Wijayanti Promkes IIID 85,000 19 87100 2% 1,742 85,358
20 Herawati Any W Bend.JKN IIID 65,000 20 67100 2% 1,342 65,758
21 Ainiyatul Maghfiroh Laborat IIID 74,000 21 76400 2% 1,528 74,872
22 Rahayu Fitri Perawat IIIA 64,000 22 65600 2% 1,312 64,288
23 Jumirah Perawat IIIA 78,000 23 80000 2% 1,600 78,400
24 Antonius Sugiri Laborat IIIA 65,000 24 67100 2% 1,342 65,758
25 Martini Bidan IIIA 67,000 25 69300 2% 1,386 67,914
26 Sigit Tri W Perawat GigiIIIA 67,000 26 69300 2% 1,386 67,914
27 Titin S Pengelola OIIIA 67,000 27 69300 2% 1,386 67,914
28 Tutik Suwitowati Bidan IIIA 74,000 28 76400 2% 1,528 74,872
29 Fitri Waryanti Perawat IIIB 67,000 29 69300 2% 1,386 67,914
30 Eny Setyaningtyas Bidan IID 67,000 30 69000 2% 1,380 67,620
31 Dewi Mashithoh Bidan IID 71,000 31 72800 2% 1,456 71,344
32 Atik Prasetyowati Bidan IID 71,000 32 72800 2% 1,456 71,344
33 Estininglukitosari Bidan IID 71,000 33 72800 2% 1,456 71,344
34 Emik Ermawati Bidan IIC 63,000 34 65300 2% 1,306 63,994
35 Sri Hanani Bidan IIC 71,000 35 72800 2% 1,456 71,344
36 Ucik K Dewi Bidan IIC - 36 0 2% - -
37 Sri Wulandari Bidan IIC 67,000 37 69000 2% 1,380 67,620
38 Tri Maryani Bidan IIC 66,000 38 68300 2% 1,366 66,934
39 Emy Primiadiani Bidan IIC 67,000 39 69000 2% 1,380 67,620
40 Farida Bidan IIC 67,000 40 69000 2% 1,380 67,620
41 Suharyanti Admin IIB 51,000 41 48800 0% - 48,800
42 Sulistyowati Perawat IID 70,000 42 72800 2% 2598 70,202
43 Desy Warastuti 40,000 43 3186000
44 Kuniman 40,000 44
3,186,000
Selogiri, 30 Oktober 2018
Kuasa Pengguna Anggaran Ka.Subag.TU

dr.Anita Apriliawat ANITA SRI S.SKM. MPH

NIP.19810421 201001 2 023 NIP.19770812 200212 2 005

123,462,700
74,077,620