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    Unit Pelaksana Teknis Dinas Puskesmas Bendilwungu: Pemerintah Kabupaten Tulungagung

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    nanda mei
    1) This document is a travel order from the head of the Bendilwungu Community Health Center appointing Siti Indasah to travel to the Tulungagung Regency Health Office. 2) The purpose of the trip is to deliver the February monthly reports, functional expense reports, and BKU. 3) Siti Indasah will travel by public/official transportation, departing on April 6th, 2020 and returning the same day. The trip is funded by the Tulungagung Regency Health Office budget.

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    Unit Pelaksana Teknis Dinas Puskesmas Bendilwungu: Pemerintah Kabupaten Tulungagung

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    nanda mei
    31 views3 pages
    1) This document is a travel order from the head of the Bendilwungu Community Health Center appointing Siti Indasah to travel to the Tulungagung Regency Health Office. 2) The purpose of the trip is to deliver the February monthly reports, functional expense reports, and BKU. 3) Siti Indasah will travel by public/official transportation, departing on April 6th, 2020 and returning the same day. The trip is funded by the Tulungagung Regency Health Office budget.

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    Sppd April

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    1) This document is a travel order from the head of the Bendilwungu Community Health Center appointing Siti Indasah to travel to the Tulungagung Regency Health Office. 2) The purpose of the trip is to deliver the February monthly reports, functional expense reports, and BKU. 3) Siti Indasah will travel by public/official transportation, departing on April 6th, 2020 and returning the same day. The trip is funded by the Tulungagung Regency Health Office budget.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    31 views3 pages

    Unit Pelaksana Teknis Dinas Puskesmas Bendilwungu: Pemerintah Kabupaten Tulungagung

    Uploaded by

    nanda mei
    1) This document is a travel order from the head of the Bendilwungu Community Health Center appointing Siti Indasah to travel to the Tulungagung Regency Health Office. 2) The purpose of the trip is to deliver the February monthly reports, functional expense reports, and BKU. 3) Siti Indasah will travel by public/official transportation, departing on April 6th, 2020 and returning the same day. The trip is funded by the Tulungagung Regency Health Office budget.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 3

    PEMERINTAH KABUPATEN TULUNGAGUNG

    DINAS KESEHATAN
    UNIT PELAKSANA TEKNIS DINAS
    PUSKESMAS BENDILWUNGU
    Jalan Raya Bendilwungu no. Telp. (0355) 328541
    TULUNGAGUNGKodePos(66291)

    SURAT PERINTAH PERJALANAN DINAS


    (SPPD)

    1. Pejabat berwenang yang memberikan


    KepalaPuskesmasBendilwungu
    Perintah / Tugas
    2. Nama Pegawai yang diperintah Siti Indasah,Am.Keb
    Nomor Induk Pegawai 19770101 200801 2 046
    3. a. Pangkat dan Golongan menurut
    a. Pengatur Tk I /11c
    PGPS
    b. Bendahara Pengeluaran Pembantu
    b. Jabatan

    Pengiriman Laporan P1,SPJ Fungsional,


    4. Maksud Perjalanan Dinas
    BKU Bulan Februari
    5. Alat angkutan yang dipergunakan Dinas / Umum

    6. a. Tempat berangkat a.PuskesmasBendilwungu


    b. Tempat tujuan b.Dinkes Kab. Tulungagung

    7. a. Lamanya perjalanan a. 1 (satu) hari


    b. Tanggal berangkat b.06 April2020
    c. Tanggal harus kembali c. 06 April2020
    8. Pembebanan Anggaran : a. Dinas Kesehatan Kabupaten
    a. Satker Tulungagung

    b. Mata Anggaran b. Dana DIPA Tahun 2020


    9. Keterangan lain-lain Lihat Sebelah

    Ditetapkan di : Tulungagung
    PadaTanggal : 06 April2020

    KEPALA UPTD PUSKESMAS BENDILWUNGU

    SRI LESTARININGSIH,SKM
    NIP. 19640321 1986032 2 009
    40629 199003 1 004
    Berangkat dari
    :PuskesmasBendilwungu
    (Tempat kedudukan)
    Pada Tanggal: 06 April 2020
    Ke :Dinkes Kab.
    Tulungagung

    KEPALA PUSKESMAS

    SRI LESTARININGSIH,SKM
    NIP. 19640321 1986032 2 009

    II. Tiba di :Dinkes Kab. Berangkat dari :Dinkes Kab.


    Tulungagung Tulungagung
    Pada tanggal : 06 April 2020 Ke :PuskesmasBendilwungu
    Pada Tanggal : 06 April2020
    NIP. 1952
    Ka.Subbag Keuangan Ka.Subbag Keuangan

    Siti Munawaroh Siti Munawaroh


    NIP:19650512 198503 2 005198301 2 002 NIP:19650512 198503 2 005198301

    III. Tiba di : Berangkat dari :


    Pada Tanggal : Ke :
    Pada Tanggal :

    IV. Tiba di Telah diperiksa dengan keterangan,


    :PuskesmasBendilwungu bahwa perjalanan tersebut diatas benar
    (Tempat Kedudukan) dilakukan atas perintahnya dan semata-
    Pada Tanggal : 06 April2020 mata untuk kepentingan jabatan dalam
    waktu sesingkat-singkatnya.

    Kepala Puskesmas An. Kuasa Pengguna Anggaran


    Pejabat Pembuat Komitmen

    SRI LESTARININGSIH,SKM
    NIP. 19640321 1986032 2 009 BANGUN SETYONO, S.Kep
    NIP. 19691114 199503 1 003

    V. Catatan lain-lain :
    LAPORAN PERJALANAN DINAS

    I. DASAR : Surat Tugas Kepala UPTD Pusk.Bendilwungu No.


    094/087/47.103/2020
    II MAKSUD DAN TUJUAN : Pengiriman Laporan
    III. WAKTU PELAKSANAAN : 06 April 2020
    IV. NAMA PETUGAS : Siti Indasah
    V. DAERAH TUJUAN / INSTANSI : Dinas Kesehatan Kab. Tulungagung
    YANG DIKUNJUNGI
    VI. HASIL : - Mengirim laporan P1 Bulan Maret
    - Mengirim BKU
    - Mengirim SPJ Fungsional Bulan Maret

    VII. SARAN : -
    VIII LAIN – LAIN : -
    .

    Tulungagung,06 April 2020

    Yang Melaporkan

    SITI INDASAH
    NIP.19770101 200801 2 046

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