Monev Bok PKM 2019

REKAPITULASI LAPORAN KEMAJUAN KEUANGAN DAN FISIK KEADAAN S/D JANUARI 2019
UNIT : DINAS KESEHATAN

PROGRAM/KEGIATAN : 15. PROGRAM UPAYA KESEHATAN MASYARAKAT
PENYEDIAAN BIAYA OPERASIONAL KESEHATAN (BOK) DAK NON FISIK
1.01.02.1.01.02.01.15.069
NILAI PAGU : Rp 685,282,885.00
SUMBER DANA : BOK
PPTK : PUSKESMAS PANAIKANG
PROSENTASE
VOLUME BIAYA BOBOT REALISASI SISA BIAYA
NO LOKASI FISIK KEMAJUAN
KONTRAK
URAIAN DIPDA (Rp.) (% ) ( Rp. ) ( Rp. ) KEU.
(Rp.)
2 3 4 5 6 7 8 9 10
15 PROGRAM UPAYA KESEHATAN MASYARAKAT 685,282,885 0 12.49% 0 627,397,885 0
039 Penyediaan Biaya Operasional Puskesmas 685,282,885 0 12.49% 0 627,397,885 0
Belanja Barang Dan Jasa 685,282,885 0 12.49% 0 627,397,885 0
1 BELANJA ALAT TULIS KANTOR Rp 25,000,000 0 2.92% 0 25,000,000 0
2 ATK Pis-PK Rp 5,000,000 0 0.73% 5,000,000 0
3 BELANJA BAHAN MAKANAN PENDAMPING Rp 15,000,000 0 2.19% 15,000,000 0
4 BELANJA JASA TRANSPORTASI Rp 351,682,885 0 15.76% Rp 52,285,000 299,397,885 15

5 BELANJA UPAH KERJA Rp 108,000,000 0 15.76% 108,000,000 0
PROMKES Rp 27,000,000 0 8.32% 0 27,000,000 0
SANIATARIAN Rp 27,000,000 0 3.94% 0 27,000,000 0
EPIDEMIOLOG Rp 27,000,000 0 3.94% 0 27,000,000 0
PEMBANTU PENGELOLAH KEUANGAN Rp 27,000,000 0 4.38% 0 27,000,000 0
BELANJA CETAK Rp 30,000,000 0 4.38% 30,000,000

6 CETAK ALAT PERAGA Rp 5,000,000 0 8.76% 0 5,000,000 0
7 CETAK PIS- PK Rp 25,000,000 0 8.76% 0 25,000,000 0
BELANJA PENGGANDAAN Rp 60,000,000 0 8.76% 60,000,000
8 PENGGANDAAN PKM Rp 45,000,000 0 12.49% 0 45,000,000 0
9 PENGGANDAAN PIS-PK Rp 15,000,000 0 9.57% 15,000,000 0
10 MAMIN RAPAT Rp 60,000,000 0 8.76% 60,000,000 0
11 MAMIN MMD Rp 5,600,000 0 0.82% Rp 5,600,000 0 100
12 MAMIN PIS-PK Rp 5,000,000 0 2.92% 0 5,000,000 0
13 BELANJA PERJALANAN DINAS DALAM DAERAH Rp 20,000,000 0 2.92% 0 20,000,000 0
627,397,885 8
TOTAL 685,282,885 Rp 57,885,000
Sinjai, 8 Mei 2019

KEPALA SKPD
dr. Andi Suryanto Asapa Bachtiar Abdullah, S.Sos, M.K

Nip. ………………………………………. Nip. 19660707 1987031 0
Petunjuk Pengisian Format :

1. Diisi nomor urut 9. Diisi sisa biaya dengan rumus nilai DIPDA dikurang nilai realis
2. Diisi nama program, Kegiatan, dan rincian belanja sesuai DPA/DPPA 10. Diisi rumus nilai realisasi dibagi nilai DIPDA dikalikan seratus (
3. Diisi lokasi pelaksanaan kegiatan 11. Diisi kemajuan fisik real
4. Diisi volume fisik kegiatan 12. Diisi rumus bobot dikali persentase kemajuan keuangan (kolom
5. Diisi nilai pagu anggaran sesuai DPA/DPPA 13. Diisi rumus bobot dikali persentase kemajuan fisik (kolom 7 x k
6. Diisi nilai kontrak bila kegiatan tersebut pengadaan barang dan jasa 14. Diisi pelaksana kegiatan
7. Diisi bobot kegiatan dengan rumus nilai kegiatan dibagi total dikalikan seratus 15. Diisi keterangan tambahan
8. Diisi nilai realisasi belanja
2019
PROSENTASE PROSENTASE
KEMAJUAN TERTIMBANG PELAK KET
FISIK KEU. FISIK SANA
11 12 13 14 15
0 1 1
0 1 1
0 1 1
38.32 0 0
0 0.00 0.00
0 0.00 0.00
26.89 0 0
0.00 0.00
0 0 0
0 0 0
0 0.00 0.00
0 0 0
0.00 0.00
0 0 0
0 0 0
0 0.00 0.00
33.33 1 1
100 1 1
0.00 0.00 0.00

100.00 0.82 0.82
0 0 0
0 0.00 0.00
22.47
Sinjai, 8 Mei 2019

PPTK
Bachtiar Abdullah, S.Sos, M.Kes

Nip. 19660707 1987031 010
DIPDA dikurang nilai realisasi (kolom 5 - kolom 8)

DIPDA dikalikan seratus (kolom 8/kolom 5 x 100)
kemajuan keuangan (kolom 7 x kolom 10)

kemajuan fisik (kolom 7 x kolom 11)
MEN PELAKSANAAN ANGGARAN
NOMOR DPA SKPD

N KERJA PERANGKAT
### 0 DAERAH
1.01.02.01 5 2
PEMERINTAH KABUPATEN SINJAI
TAHUN ANGGARAN 2019
DPA - SKPD 2.2.1
Urusan Pemerintahan
: 1.01.0 Kesehatan
Organisasi
: 1.01.0 - Dinas Kesehatan
Program
: 1.01.0 - PROGRAM UPAYA PELAYANAN KESEHATAN
Kegiatan - penyediaan biaya operasional puskesmas (DAU)
: 1.01.0
Waktu
: Januari
Pelaksanaan
s.d Desember 2019
Lokasi
: Kab.Sinjai
Kegiatan
Sumber
: DANA
DanaALOKASI UMUM (DAU)
INDIKATOR DAN TOLAK UKUR KINERJA

Tolok
Indikator
Target
Ukur Kinerja
Kerja
Capaian Program
Sem###
Masukan
Rp.6.628.710.000,00
Jum
Keluaran
16 Ter
puskesmas
HasilMen
###
Kelompok Sasaran Kegiatan :

kumen Pelaksanaan Anggaran Belanja Langsung Program dan Perkegiatan Organisasi Perangkat Daerah
Rincian Penghitungan
Kode Rekening Uraian Volume
1 2 3
5 BELANJA DAERAH
5 2 Belanja Langsung
5 2 2 Belanja Barang Dan Jasa
5 2 2 1 Belanja Bahan Pakai Habis
5 2 2 1 3 Belanja alat listrik dan elektronik ( lampu pijar, battery kering)
Puskesmas Manipi 1
Pustu wilayah Puskesmas Manipi 5
Puskesmas Tengngalembang 1
Pustu wilayah Puskesmas Tengngalembang 4
Poskesdes wilayah Puskesmas Tengngalembang 2
Puskesmas Borong Kompleks 1

Pustu wilayah Puskesmas Borong Kompleks 3
Poskesdes wilayah Puskesmas Borong 1

Kompleks
Puskesmas Biji Nangka 1
Pustu wilayah Puskesmas Biji Nangka 3
Puskesmas Samaenre 1
Pustu wilayah Puskesmas Samaenre 6
Poskesdes wilayah Puskesmas Samaenre 3
Puskesmas Aska 1
Pustu wilayah Puskesmas Aska 3
Puskesmas Mannanti 1
Pustu wilayah Puskesmas Mannanti 3
Poskesdes wilayah Puskesmas Mannanti 2
Puskesmas Lappae 1
Pustu wilayah Puskesmas Lappae 4
Puskesmas Panaikang 1
Pustu wilayah Puskesmas Panaikang 2
Puskesmas Samataring 1
Pustu wilayah Puskesmas Samataring 3
Puskesmas Kampala 1
Pustu wilayah Puskesmas Kampala 4
Puskesmas Lappadata 1
Pustu wilayah Puskesmas Lappadata 4
Puskesmas Manimpahoi 1
Pustu wilayah Puskesmas Manimpahoi 5
Poskesdes wilayah Puskesmas Manimpahoi 1
Puskesmas Bulupoddo 1
Pustu wilayah Puskesmas Bulupoddo 6
Poskesdes wilayah Puskesmas Bulupoddo 1
Puskesmas Balangnipa 1
Pustu wilayah Puskesmas Balangnipa 4
Poskesdes wilayah Puskesmas Balangnipa 1
Puskesmas Pulau IX 1
Pustu wilayah Puskesmas Pulau IX 3
Poskesdes wilayah Puskesmas Pulau IX 4
5 2 2 1 5 Belanja peralatan kebersihan dan bahan pembersih
Puskesmas Aska 1
Puskesmas Lappae 1
5 2 2 1 6 Belanja Bahan Bakar Minyak/Gas
Belanja BBM Mobil Ambulance Rujukan/Pusling 1
Air
Puskesmas Manipi 12
Puskesmas Aska 12
Puskesmas Lappae 12
Puskesmas Kampala 12
Belanja BBM Mesin Genset 1
Puskesmas Lappae 12
5 2 2 1 8 Belanja pengisian tabung gas
Pengisian tabung gas elpiji 1
Puskesmas Manipi 12
Puskesmas Lappae 24
Puskesmas Aska 24
5 2 2 3 Belanja Barang dan Jasa
5 2 2 3 2 Belanja air
Pustu wiyalah Puskesmas Samaenre 6 pustu x 12 bln 72
Poskesdes wiilayah Puskesmas Samaenre 3 pustu x 12 bln 36
Puskesmas Lappae 12
Pustu wilayah Puskesmas Lappae 4 pustu x 12 bln 48
Pustu wilayah Puskesmas Panaikang 2 pustu x 12 bln 24
Pustu wilayah Puskesmas Balangnipa 4 pustu x 12 bln 48
Pustu wilayah Puskesmas Pulau IX 2555
Poskesdes wilayah Puskesmas Pulau IX 2190
5 2 2 3 3 Belanja listrik
Puskesmas Manipi 12
Pustu wilayah Puskesmas Manipi 5 pustu x 12 bln 60
Pustu wilayah Puskesmas Tengngalembang 4 pustu x 12 bln 48

Pustu wilayah Puskesmas Borong Kompleks 3 pustu x 12 bln 36
kesedes wilayah Puskesmas Borong Kompleks 1 posk x 12 bln 12

Pustu wilayah Puskesmas Biji Nangka 3 pustu x 12 bln 36
Pustu wilayah Puskesmas Samaenre 6 pustu x 12 bln 72
Poskesdes wilayah Puskesmas Samaenre 3 Posk x 12 bln 36
Puskesmas Aska 12
Pustu wilayah Puskesmas Aska 3 pustu x 12 bln 36
Pustu wilayah Puskesmas Mannanti 6 pustu x 12 bln 72
Puskesmas Lappae 12
Pustu wilayah Puskesmas Lappae 4 pustu x 12 bln 48
Pustu wilayah Puskesmas Panaikang 2 pustu x 12 bln 24
Pustu wilayah Puskesmas Samataring 3 pustu x 12 bln 36
Pustu wilayah Puskesmas Kampala 4 pustu x 12 bln 48
Pustu wilayah Puskesmas Lappadata 4 pustu x 12 bln 48
Pustu wilayah Puskesmas Manimpahoi 5 pustu x 12 bln 60
Poskesdes wilayah Puskesmas Manimpahoi 12
Pustu wilayah Puskesmas Bulupoddo 7 pustu x 12 bln 84
Pustu wilayah Puskesmas Balangnipa 4 pustu x 12 bln 48
Poskesdes wilayah Puskesmas Balangnipa 12
Pustu wilayah Puskesmas Pulau IX 3 pustu x 12 bln 36
Poskesdes wilayah Puskesmas Pulau IX 4 Posk x 12 bln 48
5 2 2 3 5 Belanja surat kabar/majalah
Puskesmas Manipi 12
Puskesmas Aska 12
Puskesmas Lappae 12
5 2 2 3 30 Belanja Jasa Upah Kerja
Jasa upah security 1
Puskesmas Manipi 12
Puskesmas Aska 12
Puskesmas Lappae 12
Jasa upah kerja cleaning service 1
Puskesmas Manipi 24
Puskesmas Aska 24
Puskesmas Lappae 24
Jasa upah kerja sopir Ambulance/Pusling Air 1
Puskesmas Manipi 12
Puskesmas Aska 12
Puskesmas Lappae 12
5 2 2 5 Belanja Perawatan Kendaraan Bermotor
5 2 2 5 5 Belanja Surat Tanda Nomor Kendaraan
Belanja STNK Roda Empat 1
Puskesmas Manipi 2
Puskesmas Aska 2
Puskesmas Lappae 1
Puskesmas Kampala 2
5 2 2 7 Belanja SewaRumah/Gedung/Gudang/Parkir
5 2 2 7 2 Belanja sewa gedung/ kantor/tempat
Sewa rumah tugsus 1
Puskesmas Manipi 1
Puskesmas Lappae 1
5 2 2 11 Belanja Makanan dan Minuman
5 2 2 11 10 Belanja Makanan dan Minuman Pasien
Puskesmas Manipi 1440
Puskesmas Aska 1440
Puskesmas Lappae 1440
5 2 2 11 11 Belanja Makanan dan Minuman Dokter Jaga dan Petugas Jaga
Makan minum petugas jaga rawat inap 1
Puskesmas Aska 6060
Makan minum petugas jaga pada hari libur 1
Puskesmas Aska 1860
Makan minum petugas PSC 1
Puskesmas Aska 1092
Jumlah Bela
Rencana Penarikan Dana Per Triwulan
Triwulan I Rp. 1,657,179,000.00

Triwulan II Rp. 1,657,179,000.00
Triwulan III Rp. 1,657,179,000.00
Triwulan IV Rp. 1,657,173,000.00
Jumlah Rp. 6,628,710,000.00
Rincian Penghitungan
Satuan harga Jumlah
4 5 6=3x5
6,628,710,000
6,628,710,000
6,628,710,000
714,680,000
138,000,000
pt 5,000,000 5,000,000
pt 750,000 3,750,000
pt 3,000,000 3,000,000
pt 750,000 3,000,000
pt 500,000 1,000,000
pt 5,000,000 5,000,000
pt 750,000 2,250,000
pt 500,000 500,000
pt 5,000,000 5,000,000
pt 750,000 2,250,000
pt 8,000,000 8,000,000
pt 750,000 4,500,000
pt 500,000 1,500,000
pt 5,000,000 5,000,000
pt 750,000 2,250,000
pt 5,000,000 5,000,000
pt 750,000 2,250,000
pt 500,000 1,000,000
pt 5,000,000 5,000,000
pt 750,000 3,000,000
pt 5,000,000 5,000,000
pt 750,000 1,500,000
pt 5,000,000 5,000,000
pt 750,000 2,250,000
pt 5,000,000 5,000,000
pt 750,000 3,000,000
pt 5,000,000 5,000,000
pt 750,000 3,000,000
pt 5,000,000 5,000,000
pt 750,000 3,750,000
pt 500,000 500,000
pt 5,000,000 5,000,000
pt 750,000 4,500,000
pt 500,000 500,000
pt 8,000,000 8,000,000
pt 750,000 3,000,000
pt 500,000 500,000
pt 5,000,000 5,000,000
pt 750,000 2,250,000
pt 500,000 2,000,000
35,000,000
pt 5,000,000 5,000,000
pt 5,000,000 5,000,000
pt 5,000,000 5,000,000
pt 5,000,000 5,000,000
pt 5,000,000 5,000,000
pt 5,000,000 5,000,000
pt 5,000,000 5,000,000
492,600,000
0 459,000,000
bln 3,000,000 36,000,000

bln 3,000,000 36,000,000
bln 2,250,000 27,000,000
bln 2,500,000 30,000,000
bln 3,000,000 36,000,000
bln 2,000,000 24,000,000
bln 2,250,000 27,000,000
bln 2,250,000 27,000,000
bln 2,000,000 24,000,000
bln 2,000,000 24,000,000
bln 2,000,000 24,000,000
bln 2,000,000 24,000,000
bln 2,000,000 24,000,000
bln 2,000,000 24,000,000
bln 2,000,000 24,000,000
bln 4,000,000 48,000,000
0 33,600,000
bln 200,000 2,400,000
bln 200,000 2,400,000
bln 200,000 2,400,000
bln 200,000 2,400,000
bln 200,000 2,400,000
bln 200,000 2,400,000
bln 200,000 2,400,000
bln 200,000 2,400,000
bln 200,000 2,400,000
bln 1,000,000 12,000,000
49,080,000
0 49,080,000
tbg 185,000 2,220,000
tbg 185,000 2,220,000
tbg 200,000 4,800,000
tbg 195,000 2,340,000
tbg 170,000 2,040,000
tbg 170,000 4,080,000
tbg 180,000 2,160,000
tbg 180,000 4,320,000
tbg 160,000 3,840,000
tbg 170,000 2,040,000
tbg 170,000 2,040,000
tbg 170,000 2,040,000
tbg 165,000 3,960,000
tbg 195,000 2,340,000
tbg 180,000 4,320,000
tbg 180,000 4,320,000
1,315,900,000
176,890,000
bln 300,000 3,600,000
bln 100,000 1,200,000
bln 1,000,000 12,000,000
pustu / bln 100,000 7,200,000
pustu / bln 100,000 3,600,000
bln 1,000,000 12,000,000
pustu / bln 100,000 4,800,000
bln 250,000 3,000,000
pustu / bln 100,000 2,400,000
bln 100,000 1,200,000
bln 2,000,000 24,000,000
pustu / bln 100,000 4,800,000
jerg 7,000 63,875,000 7000
jerg 7,000 17,885,000
jerg 7,000 15,330,000
590,070,000
bln 2,200,000 26,400,000
pustu / bln 52,500 3,150,000
bln 2,000,000 24,000,000
pustu / bln 100,000 4,800,000
bln 2,000,000 24,000,000

pustu / bln 100,000 3,600,000
posk / bln 100,000 1,200,000
bln 1,500,000 18,000,000

pustu / bln 100,000 3,600,000
bln 5,000,000 60,000,000
pustu / bln 150,000 10,800,000
Posk / bln 100,000 3,600,000
bln 2,000,000 24,000,000
pustu / bln 100,000 3,600,000
bln 3,000,000 36,000,000
pustu / bln 100,000 7,200,000
bln 2,500,000 30,000,000
pustu / bln 100,000 4,800,000
bln 2,500,000 30,000,000
pustu / bln 150,000 3,600,000
bln 2,700,000 32,400,000
pustu / bln 150,000 5,400,000
pustu / bln 100,000 4,800,000
bln 2,000,000 24,000,000
bln 2,000,000 24,000,000
pustu / bln 100,000 4,800,000
bln 2,500,000 30,000,000
pustu / bln 100,000 6,000,000
bln 60,000 720,000
bln 3,000,000 36,000,000

pustu / bln 100,000 8,400,000
bln 4,000,000 48,000,000
pustu / bln 200,000 9,600,000
bln 100,000 1,200,000
bln 2,000,000 24,000,000
pustu / bln 100,000 3,600,000
Posk / bln 100,000 4,800,000
20,940,000
bln 150,000 1,800,000
bln 100,000 1,200,000
bln 185,000 2,220,000
bln 150,000 1,800,000
bln 100,000 1,200,000
bln 150,000 1,800,000
bln 120,000 1,440,000
bln 150,000 1,800,000
bln 120,000 1,440,000
bln 150,000 1,800,000
bln 150,000 1,800,000
bln 110,000 1,320,000
bln 110,000 1,320,000
528,000,000
0 120,000,000
OB 500,000 6,000,000
OB 500,000 6,000,000
OB 500,000 6,000,000
OB 500,000 6,000,000
OB 500,000 18,000,000
OB 500,000 6,000,000
OB 500,000 6,000,000
OB 500,000 6,000,000
OB 500,000 6,000,000
OB 500,000 6,000,000
OB 500,000 6,000,000
OB 500,000 6,000,000
OB 500,000 6,000,000
OB 500,000 6,000,000
OB 500,000 18,000,000
OB 500,000 6,000,000
0 192,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
OB 500,000 12,000,000
0 216,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 12,000,000
OB 1,000,000 24,000,000
OB 1,000,000 24,000,000
55,500,000
55,500,000
0 55,500,000
unit 2,500,000 5,000,000
unit 2,500,000 5,000,000
unit 2,000,000 4,000,000
unit 1,500,000 1,500,000
unit 2,000,000 4,000,000
unit 2,000,000 4,000,000
unit 1,500,000 3,000,000
unit 2,000,000 2,000,000
unit 2,000,000 4,000,000
unit 2,000,000 4,000,000
unit 2,000,000 4,000,000
unit 1,500,000 3,000,000
unit 2,000,000 4,000,000
unit 2,000,000 4,000,000
unit 2,000,000 4,000,000
60,000,000
60,000,000
0 60,000,000
unit 12,000,000 12,000,000
unit 12,000,000 12,000,000
unit 12,000,000 12,000,000
unit 12,000,000 12,000,000
unit 12,000,000 12,000,000
4,482,630,000
821,880,000
pasien/hr/bln 36,000 51,840,000
pasien/hr/bln 36,000 25,920,000
pasien/hr/bln 36,000 38,880,000
pasien/hr/bln 36,000 24,840,000
pasien/hr/bln 36,000 90,720,000
pasien/hr/bln 36,000 51,840,000
pasien/hr/bln 36,000 77,760,000
pasien/hr/bln 36,000 51,840,000
pasien/hr/bln 36,000 45,360,000
pasien/hr/bln 36,000 38,880,000
pasien/hr/bln 36,000 51,840,000
pasien/hr/bln 36,000 51,840,000
pasien/hr/bln 36,000 43,200,000
pasien/hr/bln 36,000 34,560,000
pasien/hr/bln 36,000 129,600,000
pasien/hr/bln 36,000 12,960,000
3,660,750,000
0 2,424,000,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
hr/ok 25,000 151,500,000
0 744,000,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
hr/ok 25,000 46,500,000
0 492,750,000
hr/ok 25,000 27,450,000
hr/ok 25,000 27,300,000
hr/ok 25,000 27,450,000
hr/ok 25,000 27,300,000
hr/ok 25,000 27,450,000
hr/ok 25,000 27,300,000
hr/ok 25,000 27,450,000
hr/ok 25,000 27,300,000
hr/ok 25,000 18,300,000
hr/ok 25,000 18,300,000
hr/ok 25,000 18,150,000
hr/ok 25,000 27,450,000
hr/ok 25,000 27,300,000
hr/ok 25,000 54,750,000
hr/ok 25,000 54,750,000
hr/ok 25,000 54,750,000
Jumlah Belanja Langsung 6,628,710,000
SINJAI, 23 Januari 2019

Mengesahkan :
Pejabat Pengelola Keuangan Daerah
Dra. Hj. RATNAWATI ARIF, M.Si

Pangkat : Pembina Utama Muda
Nip : 19641204 199102 2 001
REKAPITULASI LAPORAN KEMAJUA

PROGRAM/KEGIATAN : 16. PROGRAM UPAYA KESE
32. Penyediaan biaya operasional pusk
NILAI PAGU : Rp 402,610,000.00

SUMBER DANA : APBD II
PPTK :
NO
URAIAN
2
15 PROGRAM UPAYA KESEHATAN MASYARAKAT
039 Penyediaan Biaya Operasional Puskesmas
Belanja Barang Dan Jasa
Belanja Bahan Pakai Habis
Belanja alat listrik dan elektronik ( lampu pijar,
battery kering)
Puskesmas Manipi 1 pt 5,000,000
Pustu wilayah Puskesmas Manipi 5 pt 750,000
Belanja Bahan Bakar Minyak/Gas
Belanja BBM Mobil Ambulance Rujukan/Pusling 1 0
Air
Puskesmas Manipi 12 bln 3,000,000
Belanja pengisian tabung gas
Pengisian tabung gas elpiji 1 0
Puskesmas Manipi 12 tbg 185,000
Belanja Barang dan Jasa
Belanja listrik
Puskesmas Manipi 12 bln 2,200,000
Pustu wilayah Puskesmas Manipi 5 pustu x 12 bln 60 pustu / 52,500
bln
Belanja surat kabar/majalah
Puskesmas Manipi 12 bln 150,000
Belanja Jasa Upah Kerja
Jasa upah security 1 0
Puskesmas Manipi 12 OB 500,000
Jasa upah kerja cleaning service 1 0
Puskesmas Manipi 24 OB 500,000
Jasa upah kerja sopir Ambulance/Pusling Air 1 0
Puskesmas Manipi 12 OB 1,000,000

Belanja Perawatan Kendaraan Bermotor
Belanja Surat Tanda Nomor Kendaraan
Belanja STNK Roda Empat 1 0
Puskesmas Manipi 2 unit 2,500,000
Belanja SewaRumah/Gedung/Gudang/Parkir
Belanja sewa gedung/ kantor/tempat
Sewa rumah tugsus 1 0
Puskesmas Manipi 1 unit 12,000,000
Belanja Makanan dan Minuman
Belanja Makanan dan Minuman Pasien
Puskesmas Manipi 1440 pasien/ 36,000
hr/bln
Belanja Makanan dan Minuman Dokter Jaga

dan Petugas Jaga
Makan minum petugas jaga rawat inap 1 0
Puskesmas Manipi 6060 hr/ok 25,000
Makan minum petugas jaga pada hari libur 1 0
Makan minum petugas PSC 1 0
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut
2. Diisi nama program, Kegiatan, dan rincian belanja sesuai DPA/DPPA
3. Diisi lokasi pelaksanaan kegiatan
4. Diisi volume fisik kegiatan
5. Diisi nilai pagu anggaran sesuai DPA/DPPA
6. Diisi nilai kontrak bila kegiatan tersebut pengadaan barang dan jasa
7. Diisi bobot kegiatan dengan rumus nilai kegiatan dibagi total dikalikan seratus
I LAPORAN KEMAJUAN KEUANGAN DAN FISIK KEADAAN S/D JANUARI 2019
SEHATAN
GRAM UPAYA KESEHATAN MASYARAKAT
an biaya operasional puskesmas (DAU)
402,610,000.00
REALIS
VOLUME BIAYA BOBOT SISA BIAYA
LOKASI FISIK ASI
KONTRAK
DIPDA (Rp.) (% ) ( Rp. ) ( Rp. )
(Rp.)
3 4 5 6 7 8 9
402,610,000 0 100.00% 0 402,610,000
402,610,000 0 100.00% 0 402,610,000
402,610,000 0 100.00% 0 402,610,000
46,970,000 0 11.67% 0 46,970,000
8,750,000 0 2.17% 0 8,750,000
1 pt 5,000,000 0 1.24% 5,000,000
5 pt 3,750,000 0 0.93% 3,750,000
36,000,000 0 8.94% 0 36,000,000
1 36,000,000 0 8.94% 0 36,000,000
12 bln 36,000,000 0 8.94% 36,000,000

2,220,000 0 0.55% 0 2,220,000
1 2,220,000 0 0.55% 0 2,220,000
12 tbg 2,220,000 0 0.55% 2,220,000
61,350,000 0 15.24% 0 61,350,000
29,550,000 0 7.34% 0 29,550,000
12 bln 26,400,000 0 6.56% 26,400,000
60 pustu / 3,150,000
bln 0 0.78% 3,150,000
1,800,000 0 0.45% 0 1,800,000
12 bln 1,800,000 0 0.45% 1,800,000
30,000,000 0 7.45% 0 30,000,000
1 6,000,000 0 1.49% 0 6,000,000
12 OB 6,000,000 0 1.49% 6,000,000
1 12,000,000 0 2.98% 0 12,000,000
24 OB 12,000,000 0 2.98% 12,000,000
1 12,000,000 0 2.98% 0 12,000,000
12 OB 12,000,000 0 2.98% 12,000,000

5,000,000 0 1.24% 0 5,000,000
5,000,000 0 1.24% 0 5,000,000
1 5,000,000 0 1.24% 0 5,000,000
2 unit 5,000,000 0 1.24% 5,000,000
12,000,000 0 2.98% 0 12,000,000
12,000,000 0 2.98% 0 12,000,000
1 12,000,000 0 2.98% 0 12,000,000
1 unit 12,000,000 0 2.98% 12,000,000
277,290,000 0 68.87% 0 277,290,000
51,840,000 0 12.88% 0 51,840,000
1440 pasien 51,840,000
/hr/bln
0 12.88% 51,840,000
225,450,000 0 56.00% 0 225,450,000
1 151,500,000 0 37.63% 0 151,500,000
6060 hr/ok 151,500,000 0 37.63% 151,500,000
1 46,500,000 0 11.55% 0 46,500,000
1860 hr/ok 46,500,000 0 11.55% 46,500,000
1 27,450,000 0 6.82% 0 27,450,000
1098 hr/ok 27,450,000 0 6.82% 27,450,000
402,610,000
Sinjai, ………………
………………
Nip. ……………
9. Diisi sisa biaya dengan rumus nilai DIPDA d

10. Diisi rumus nilai realisasi dibagi nilai DIPDA
11. Diisi kemajuan fisik real
12. Diisi rumus bobot dikali persentase kemajua
14. Diisi pelaksana kegiatan
15. Diisi keterangan tambahan
9
KEMAJUAN TERTIMBANG
PELAK KET
KEU. FISIK KEU. FISIK SANA
10 11 12 13 14 15
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00

0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..
an rumus nilai DIPDA dikurang nilai realisasi (kolom 5 - kolom 8)

isasi dibagi nilai DIPDA dikalikan seratus (kolom 8/kolom 5 x 100)
kali persentase kemajuan keuangan (kolom 7 x kolom 10)

kali persentase kemajuan fisik (kolom 7 x kolom 11)
REKAPITULASI LAPORAN KEMAJUAN K

PROGRAM/KEGIATAN : 16. PROGRAM UPAYA KESEHAT
32. Penyediaan biaya operasional puskesmas
NILAI PAGU : Rp 361,440,000.00

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Tengngalembang 1 pt 3,000,000
Pustu wilayah Puskesmas Tengngalembang 4 pt 750,000
Poskesdes wilayah Puskesmas Tengngalembang 2 pt 500,000

Air
Puskesmas Tengngalembang 12 bln 3,000,000
Puskesmas Tengngalembang 12 tbg 185,000
Belanja listrik
Puskesmas Tengngalembang 12 bln 2,000,000
Pustu wilayah Puskesmas Tengngalembang 4 pustu x 12 bln 48 pustu / 100,000
bln
Puskesmas Tengngalembang 12 bln 100,000
Puskesmas Tengngalembang 12 OB 500,000
Puskesmas Tengngalembang 24 OB 500,000
Puskesmas Tengngalembang 12 OB 1,000,000

Puskesmas Tengngalembang 2 unit 2,500,000
Puskesmas Tengngalembang 720 pasien/ 36,000
hr/bln
dan Petugas Jaga
Puskesmas Tengngalembang 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut
I LAPORAN KEMAJUAN KEUANGAN DAN FISIK KEADAAN S/D JANUARI 2019
SEHATAN
RAM UPAYA KESEHATAN MASYARAKAT
n biaya operasional puskesmas (DAU)
361,440,000.00
REALIS
VOLUM BIAYA BOBOT SISA BIAYA
LOKASI E FISIK ASI
KONTRAK
DIPDA (Rp.) (% ) ( Rp. ) ( Rp. )
(Rp.)
3 4 5 6 7 8 9
361,440,000 0 100.00% 0 361,440,000
361,440,000 0 100.00% 0 361,440,000
361,440,000 0 100.00% 0 361,440,000
45,220,000 0 12.51% 0 45,220,000
7,000,000 0 1.94% 0 7,000,000
1 pt 3,000,000 0 0.83% 3,000,000
4 pt 3,000,000
0 0.83% 3,000,000
2 pt 1,000,000
0 0.28% 1,000,000
36,000,000 0 9.96% 0 36,000,000
1 36,000,000 0 9.96% 0 36,000,000
12 bln 36,000,000 0 9.96% 36,000,000

2,220,000 0 0.61% 0 2,220,000
1 2,220,000 0 0.61% 0 2,220,000
12 tbg 2,220,000 0 0.61% 2,220,000
60,000,000 0 16.60% 0 60,000,000
28,800,000 0 7.97% 0 28,800,000
12 bln 24,000,000 0 6.64% 24,000,000
48 pustu / 4,800,000
bln 0 1.33% 4,800,000
1,200,000 0 0.33% 0 1,200,000
12 bln 1,200,000 0 0.33% 1,200,000
30,000,000 0 8.30% 0 30,000,000
1 6,000,000 0 1.66% 0 6,000,000
12 OB 6,000,000 0 1.66% 6,000,000
1 12,000,000 0 3.32% 0 12,000,000
24 OB 12,000,000 0 3.32% 12,000,000
1 12,000,000 0 3.32% 0 12,000,000
12 OB 12,000,000 0 3.32% 12,000,000

5,000,000 0 1.38% 0 5,000,000
5,000,000 0 1.38% 0 5,000,000
1 5,000,000 0 1.38% 0 5,000,000
2 unit 5,000,000 0 1.38% 5,000,000
251,220,000 0 69.51% 0 251,220,000
25,920,000 0 7.17% 0 25,920,000
720 pasien/h 25,920,000 0 7.17% 25,920,000
r/bln
225,300,000 0 62.33% 0 225,300,000
1 151,500,000 0 41.92% 0 151,500,000
6060 hr/ok 151,500,000 0 41.92% 151,500,000
1 46,500,000 0 12.87% 0 46,500,000
1860 hr/ok 46,500,000 0 12.87% 46,500,000
1 27,300,000 0 7.55% 0 27,300,000
1092 hr/ok 27,300,000 0 7.55% 27,300,000
361,440,000
Sinjai, ……………………
………………………
Nip. ……………………
9. Diisi sisa biaya dengan rumus nilai DIPDA dikura

10. Diisi rumus nilai realisasi dibagi nilai DIPDA dika
12. Diisi rumus bobot dikali persentase kemajuan ke
13. Diisi rumus bobot dikali persentase kemajuan fis
2019
KEMAJUAN TERTIMBANG
PELAK KET
10 11 12 13 14 15
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00

0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..
gan rumus nilai DIPDA dikurang nilai realisasi (kolom 5 - kolom 8)

alisasi dibagi nilai DIPDA dikalikan seratus (kolom 8/kolom 5 x 100)
ikali persentase kemajuan keuangan (kolom 7 x kolom 10)

ikali persentase kemajuan fisik (kolom 7 x kolom 11)
REKAPITULASI LAPORAN KEMAJUAN KEU

NILAI PAGU : Rp 387,280,000.00

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Borong Kompleks 1 pt 5,000,000
Pustu wilayah Puskesmas Borong Kompleks 3 pt 750,000
Poskesdes wilayah Puskesmas Borong 1 pt 500,000

Kompleks
Belanja peralatan kebersihan dan bahan
pembersih
Puskesmas Borong Kompleks 1 pt 5,000,000
Air
Puskesmas Borong Kompleks 12 bln 2,250,000
Puskesmas Borong Kompleks 24 tbg 200,000
Belanja air
Puskesmas Borong Kompleks 12 bln 300,000
Belanja listrik
Puskesmas Borong Kompleks 12 bln 2,000,000
Pustu wilayah Puskesmas Borong Kompleks 3 pustu x 12 bln 36 pustu / 100,000
bln
kesedes wilayah Puskesmas Borong Kompleks 1 posk x 12 bln 12 posk / 100,000
bln
Puskesmas Borong Kompleks 12 OB 500,000
Puskesmas Borong Kompleks 24 OB 500,000
Puskesmas Borong Kompleks 12 OB 1,000,000

Puskesmas Borong Kompleks 2 unit 2,000,000
Puskesmas Borong Kompleks 1 unit 12,000,000
Puskesmas Borong Kompleks 1080 pasien/h 36,000
r/bln
dan Petugas Jaga
Puskesmas Borong Kompleks 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut
PORAN KEMAJUAN KEUANGAN DAN FISIK KEADAAN S/D JANUARI 2019
EHATAN
AM UPAYA KESEHATAN MASYARAKAT
iaya operasional puskesmas (DAU)
87,280,000.00
VOLUM REALIS PROSENTASE

LOKASI E FISIK BIAYA BOBOT SISA BIAYA
ASI KEMAJUAN
KONTRAK
DIPDA (Rp.) (% ) ( Rp. ) ( Rp. ) KEU.
(Rp.)
3 4 5 6 7 8 9 10
387,280,000 0 100.00% 0 387,280,000 0
387,280,000 0 100.00% 0 387,280,000 0
387,280,000 0 100.00% 0 387,280,000 0
44,550,000 0 11.50% 0 44,550,000 0
7,750,000 0 2.00% 0 7,750,000 0
1 pt 5,000,000 0 1.29% 5,000,000 0.00
3 pt 2,250,000
0 0.58% 2,250,000 0.00
1 pt 500,000
0 0.13% 500,000 0.00
5,000,000 0 1.29% 0 5,000,000 0
1 pt 5,000,000 0 1.29% 5,000,000 0.00
27,000,000 0 6.97% 0 27,000,000 0
1 27,000,000 0 6.97% 0 27,000,000 0
12 bln 27,000,000 0 6.97% 27,000,000 0.00

4,800,000 0 1.24% 0 4,800,000 0
1 4,800,000 0 1.24% 0 4,800,000 0
24 tbg 4,800,000 0 1.24% 4,800,000 0.00
62,400,000 0 16.11% 0 62,400,000 0
3,600,000 0 0.93% 0 3,600,000 0
12 bln 3,600,000 0 0.93% 3,600,000 0.00
28,800,000 0 7.44% 0 28,800,000 0
12 bln 24,000,000 0 6.20% 24,000,000 0.00
36 pustu / 3,600,000
bln 0 0.93% 3,600,000 0.00
12 posk / 1,200,000
bln 0 0.31% 1,200,000 0.00
30,000,000 0 7.75% 0 30,000,000 0
1 6,000,000 0 1.55% 0 6,000,000 0
12 OB 6,000,000 0 1.55% 6,000,000 0.00
1 12,000,000 0 3.10% 0 12,000,000 0
24 OB 12,000,000 0 3.10% 12,000,000 0.00
1 12,000,000 0 3.10% 0 12,000,000 0
12 OB 12,000,000 0 3.10% 12,000,000 0.00

4,000,000 0 1.03% 0 4,000,000 0
4,000,000 0 1.03% 0 4,000,000 0
1 4,000,000 0 1.03% 0 4,000,000 0
2 unit 4,000,000 0 1.03% 4,000,000 0.00
12,000,000 0 3.10% 0 12,000,000 0
12,000,000 0 3.10% 0 12,000,000 0
1 12,000,000 0 3.10% 0 12,000,000 0
1 unit 12,000,000 0 3.10% 12,000,000 0.00
264,330,000 0 68.25% 0 264,330,000 0
38,880,000 0 10.04% 0 38,880,000 0
1080 pasien/h 38,880,000 0 10.04% 38,880,000 0.00
r/bln
225,450,000 0 58.21% 0 225,450,000 0
1 151,500,000 0 39.12% 0 151,500,000 0
6060 hr/ok 151,500,000 0 39.12% 151,500,000 0.00
1 46,500,000 0 12.01% 0 46,500,000 0
1860 hr/ok 46,500,000 0 12.01% 46,500,000 0.00
1 27,450,000 0 7.09% 0 27,450,000 0
1098 hr/ok 27,450,000 0 7.09% 27,450,000 0.00
387,280,000
Sinjai, ……………………………
………………………………
Nip. ……………………………
9. Diisi sisa biaya dengan rumus nilai DIPDA dikurang nila

10. Diisi rumus nilai realisasi dibagi nilai DIPDA dikalikan s
12. Diisi rumus bobot dikali persentase kemajuan keuanga
13. Diisi rumus bobot dikali persentase kemajuan fisik (kolo
KEMAJUAN TERTIMBANG
PELAK KET
11 12 13 14 15
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0.00 0.00
0.00 0.00
0.00 0.00
0 0 0
0.00 0.00
0 0 0
0 0 0
0.00 0.00
0 0 0
0 0 0
0.00 0.00
0 0 0
0 0 0
0.00 0.00
0 0 0
0.00 0.00
0.00 0.00
0.00 0.00
0 0 0
0 0 0
0.00 0.00
0 0 0
0.00 0.00
0 0 0
0.00 0.00
0 0 0
0 0 0
0 0 0
0.00 0.00
0 0 0
0 0 0
0 0 0
0.00 0.00
0 0 0
0 0 0
0.00 0.00
0 0 0
0 0 0
0.00 0.00
0 0 0
0.00 0.00
0 0 0
0.00 0.00
ai, …………………………….. 2017

PPTK
………………………………..
ip. ………………………………..
us nilai DIPDA dikurang nilai realisasi (kolom 5 - kolom 8)

bagi nilai DIPDA dikalikan seratus (kolom 8/kolom 5 x 100)
sentase kemajuan keuangan (kolom 7 x kolom 10)

sentase kemajuan fisik (kolom 7 x kolom 11)
REKAPITULASI LAPORAN KEMAJUAN

NILAI PAGU : Rp 348,650,000.00

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Biji Nangka 1 pt 5,000,000
Pustu wilayah Puskesmas Biji Nangka 3 pt 750,000
Air
Puskesmas Biji Nangka 12 bln 2,500,000
Belanja BBM Mesin Genset 1 0
Puskesmas Biji Nangka 12 bln 200,000
Puskesmas Biji Nangka 12 tbg 195,000
Belanja air
Belanja listrik
Puskesmas Biji Nangka 12 bln 1,500,000
Pustu wilayah Puskesmas Biji Nangka 3 pustu x 12 bln 36 pustu / 100,000
bln
Puskesmas Biji Nangka 12 OB 500,000
Puskesmas Biji Nangka 24 OB 500,000
Puskesmas Biji Nangka 12 OB 1,000,000

Puskesmas Biji Nangka 1 unit 1,500,000
Puskesmas Biji Nangka 690 pasien/ 36,000
hr/bln
dan Petugas Jaga
Puskesmas Biji Nangka 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut
SI LAPORAN KEMAJUAN KEUANGAN DAN FISIK KEADAAN S/D JANUARI 2019
EHATAN
biaya operasional puskesmas (DAU)
348,650,000.00
VOLUM REALIS
LOKASI E FISIK BIAYA BOBOT SISA BIAYA
ASI
KONTRAK
DIPDA (Rp.) (% ) ( Rp. ) ( Rp. )
(Rp.)
3 4 5 6 7 8 9
348,650,000 0 100.00% 0 348,650,000
348,650,000 0 100.00% 0 348,650,000
348,650,000 0 100.00% 0 348,650,000
41,990,000 0 12.04% 0 41,990,000
7,250,000 0 2.08% 0 7,250,000
1 pt 5,000,000 0 1.43% 5,000,000
3 pt 2,250,000 0 0.65% 2,250,000
32,400,000 0 9.29% 0 32,400,000
1 30,000,000 0 8.60% 0 30,000,000
12 bln 30,000,000 0 8.60% 30,000,000

1 2,400,000 0 0.69% 0 2,400,000
12 bln 2,400,000 0 0.69% 2,400,000
2,340,000 0 0.67% 0 2,340,000
1 2,340,000 0 0.67% 0 2,340,000
12 tbg 2,340,000 0 0.67% 2,340,000
55,020,000 0 15.78% 0 55,020,000
1,200,000 0 0.34% 0 1,200,000
12 bln 1,200,000 0 0.34% 1,200,000
21,600,000 0 6.20% 0 21,600,000
12 bln 18,000,000 0 5.16% 18,000,000
36 pustu / 3,600,000
bln 0 1.03% 3,600,000
2,220,000 0 0.64% 0 2,220,000
12 bln 2,220,000 0 0.64% 2,220,000
30,000,000 0 8.60% 0 30,000,000
1 6,000,000 0 1.72% 0 6,000,000
12 OB 6,000,000 0 1.72% 6,000,000
1 12,000,000 0 3.44% 0 12,000,000
24 OB 12,000,000 0 3.44% 12,000,000
1 12,000,000 0 3.44% 0 12,000,000
12 OB 12,000,000 0 3.44% 12,000,000

1,500,000 0 0.43% 0 1,500,000
1,500,000 0 0.43% 0 1,500,000
1 1,500,000 0 0.43% 0 1,500,000
1 unit 1,500,000 0 0.43% 1,500,000
250,140,000 0 71.75% 0 250,140,000
24,840,000 0 7.12% 0 24,840,000
690 pasien/h 24,840,000
r/bln 0 7.12% 24,840,000
225,300,000 0 64.62% 0 225,300,000
1 151,500,000 0 43.45% 0 151,500,000
6060 hr/ok 151,500,000 0 43.45% 151,500,000
1 46,500,000 0 13.34% 0 46,500,000
1860 hr/ok 46,500,000 0 13.34% 46,500,000
1 27,300,000 0 7.83% 0 27,300,000
1092 hr/ok 27,300,000 0 7.83% 27,300,000
348,650,000
…………………
Nip. ………………
9. Diisi sisa biaya dengan rumus nilai DIPDA di

10. Diisi rumus nilai realisasi dibagi nilai DIPDA d
19
KEMAJUAN TERTIMBANG
PELAK KET
10 11 12 13 14 15
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00

0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..

sasi dibagi nilai DIPDA dikalikan seratus (kolom 8/kolom 5 x 100)


NILAI PAGU : Rp 517,890,000.00

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Samaenre 1 pt 8,000,000
Pustu wilayah Puskesmas Samaenre 6 pt 750,000
Poskesdes wilayah Puskesmas Samaenre 3 pt 500,000
Air
Puskesmas Samaenre 12 bln 3,000,000
Puskesmas Samaenre 12 bln 200,000
Puskesmas Samaenre 24 tbg 180,000
Belanja air
Pustu wiyalah Puskesmas Samaenre 6 pustu x 12 bln 72 pustu / 100,000
bln
Poskesdes wiilayah Puskesmas Samaenre 3 pustu x 12 bln 36 pustu / 100,000
bln
Belanja listrik
Pustu wilayah Puskesmas Samaenre 6 pustu x 12 bln 72 pustu / 150,000
bln
Poskesdes wilayah Puskesmas Samaenre 3 Posk x 12 bln 36 Posk / 100,000
bln
Puskesmas Samaenre 12 bln 150,000
Puskesmas Samaenre 36 OB 500,000
Puskesmas Samaenre 24 OB 500,000
Puskesmas Samaenre 12 OB 1,000,000

Puskesmas Samaenre 2 unit 2,000,000
Puskesmas Samaenre 2520 pasien 36,000
/hr/bln

dan Petugas Jaga
Puskesmas Samaenre 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut
ASI LAPORAN KEMAJUAN KEUANGAN DAN FISIK KEADAAN S/D JANUARI 2019
ESEHATAN
GRAM UPAYA KESEHATAN MASYARAKAT
aan biaya operasional puskesmas (DAU)
517,890,000.00
VOLU
ME REALIS
LOKASI FISIK BIAYA BOBOT SISA BIAYA
KONTRAK ASI
DIPDA (Rp.) (% ) ( Rp. ) ( Rp. )
(Rp.)
3 4 5 6 7 8 9
517,890,000 0 100.00% 0 517,890,000
517,890,000 0 100.00% 0 517,890,000
517,890,000 0 100.00% 0 517,890,000
56,720,000 0 10.95% 0 56,720,000
14,000,000 0 2.70% 0 14,000,000
1 pt 8,000,000 0 1.54% 8,000,000
6 pt 4,500,000 0 0.87% 4,500,000
3 pt 1,500,000 0 0.29% 1,500,000
38,400,000 0 7.41% 0 38,400,000
1 36,000,000 0 6.95% 0 36,000,000
12 bln 36,000,000 0 6.95% 36,000,000

1 2,400,000 0 0.46% 2,400,000
12 bln 2,400,000 0 0.46% 2,400,000
4,320,000 0 0.83% 0 4,320,000
1 4,320,000 0 0.83% 0 4,320,000
24 tbg 4,320,000 0 0.83% 4,320,000
141,000,000 0 27.23% 0 141,000,000
22,800,000 0 4.40% 0 22,800,000
12 bln 12,000,000 0 2.32% 12,000,000
72 pustu / bln 7,200,000
0 1.39% 7,200,000
36 pustu / bln 3,600,000
0 0.70% 3,600,000
74,400,000 0 14.37% 0 74,400,000
12 bln 60,000,000 0 11.59% 60,000,000
72 pustu / bln 10,800,000
0 2.09% 10,800,000
36 Posk / bln 3,600,000
0 0.70% 3,600,000
1,800,000 0 0.35% 0 1,800,000
12 bln 1,800,000 0 0.35% 1,800,000
42,000,000 0 8.11% 0 42,000,000
1 18,000,000 0 3.48% 0 18,000,000
36 OB 18,000,000 0 3.48% 18,000,000
1 12,000,000 0 0 0 12,000,000
24 OB 12,000,000 0 2.32% 12,000,000
1 12,000,000 0 0 0 12,000,000
12 OB 12,000,000 0 2.32% 12,000,000

4,000,000 0 0.77% 0 4,000,000
4,000,000 0 0.77% 0 4,000,000
1 4,000,000 0 0.77% 0 4,000,000
2 unit 4,000,000 0 0.77% 4,000,000
316,170,000 0 61.05% 0 316,170,000
90,720,000 0 17.52% 0 90,720,000
2520 pasien/hr/bl 90,720,000
n 0 90,720,000
17.52%
225,450,000 0 43.53% 0 225,450,000
1 151,500,000 0 29.25% 0 151,500,000
6060 hr/ok 151,500,000 0 29.25% 151,500,000
1 46,500,000 0 8.98% 0 46,500,000
1860 hr/ok 46,500,000 0 8.98% 46,500,000
1 27,450,000 0 5.30% 0 27,450,000
1098 hr/ok 27,450,000 0 5.30% 27,450,000
517,890,000
…………………
Nip. ………………

12. Diisi rumus bobot dikali persentase kemaju
kan seratus 15. Diisi keterangan tambahan
2019
10 11 12 13 14 15
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00

0.00 0.00
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00
0.00 0.00 0.00

0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00

0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00
0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..
ngan rumus nilai DIPDA dikurang nilai realisasi (kolom 5 - kolom 8)

dikali persentase kemajuan keuangan (kolom 7 x kolom 10)

dikali persentase kemajuan fisik (kolom 7 x kolom 11)

NILAI PAGU : Rp 380,510,000.00

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Aska 1 pt 5,000,000
Pustu wilayah Puskesmas Aska 3 pt 750,000
pembersih
Puskesmas Aska 1 pt 5,000,000
Air
Puskesmas Aska 12 bln 2,000,000
Puskesmas Aska 24 tbg 180,000
Belanja listrik
Puskesmas Aska 12 bln 2,000,000
Pustu wilayah Puskesmas Aska 3 pustu x 12 bln 36 pustu / 100,000
bln
Puskesmas Aska 12 bln 100,000
Puskesmas Aska 12 OB 500,000
Puskesmas Aska 24 OB 500,000
Puskesmas Aska 12 OB 1,000,000

Puskesmas Aska 2 unit 2,000,000
Puskesmas Aska 1440 pasien/ 36,000
hr/bln

dan Petugas Jaga
Puskesmas Aska 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut
LAPORAN KEMAJUAN KEUANGAN DAN FISIK KEADAAN S/D JANUARI 2019
EHATAN
RAM UPAYA KESEHATAN MASYARAKAT
380,510,000.00
REALIS
LOKASI FISIK ASI
KONTRAK
DIPDA (Rp.) (% ) ( Rp. ) ( Rp. )
(Rp.)
3 4 5 6 7 8 9
380,510,000 0 100.00% 0 380,510,000
380,510,000 0 100.00% 0 380,510,000
380,510,000 0 100.00% 0 380,510,000
40,570,000 0 10.66% 0 40,570,000
7,250,000 0 1.91% 0 7,250,000
1 pt 5,000,000 0 1.31% 5,000,000
3 pt 2,250,000 0 0.59% 2,250,000
5,000,000 0 1.31% 0 5,000,000
1 pt 5,000,000 0 1.31% 5,000,000
24,000,000 0 6.31% 0 24,000,000
1 24,000,000 0 6.31% 0 24,000,000
12 bln 24,000,000 0 6.31% 24,000,000

4,320,000 0 1.14% 0 4,320,000
1 4,320,000 0 1.14% 0 4,320,000
24 tbg 4,320,000 0 1.14% 4,320,000
58,800,000 0 15.45% 0 58,800,000
27,600,000 0 7.25% 0 27,600,000
12 bln 24,000,000 0 6.31% 24,000,000
36 pustu / 3,600,000
bln 0 0.95% 3,600,000
1,200,000 0 0.32% 0 1,200,000
12 bln 1,200,000 0 0.32% 1,200,000
30,000,000 0 7.88% 0 30,000,000
1 6,000,000 0 1.58% 0 6,000,000
12 OB 6,000,000 0 1.58% 6,000,000
1 12,000,000 0 3.15% 0 12,000,000
24 OB 12,000,000 0 3.15% 12,000,000
1 12,000,000 0 3.15% 0 12,000,000
12 OB 12,000,000 0 3.15% 12,000,000

4,000,000 0 1.05% 0 4,000,000
4,000,000 0 1.05% 0 4,000,000
1 4,000,000 0 1.05% 0 4,000,000
2 unit 4,000,000 0 1.05% 4,000,000
277,140,000 0 72.83% 0 277,140,000
51,840,000 0 13.62% 0 51,840,000
1440 pasien/ 51,840,000
hr/bln
0 13.62% 51,840,000
225,300,000 0 59.21% 0 225,300,000
1 151,500,000 0 39.81% 0 151,500,000
6060 hr/ok 151,500,000 0 39.81% 151,500,000
1 46,500,000 0 12.22% 0 46,500,000
1860 hr/ok 46,500,000 0 12.22% 46,500,000
1 27,300,000 0 7.17% 0 27,300,000
1092 hr/ok 27,300,000 0 7.17% 27,300,000
380,510,000
Sinjai, ……………………
………………………
Nip. ……………………
9. Diisi sisa biaya dengan rumus nilai DIPDA dikura

10. Diisi rumus nilai realisasi dibagi nilai DIPDA dikal
12. Diisi rumus bobot dikali persentase kemajuan keu
13. Diisi rumus bobot dikali persentase kemajuan fisi
2019
KEMAJUAN TERTIMBANG
PELAK KET
10 11 12 13 14 15
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00

0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..


REKAPITULASI LAPORAN KEMAJUAN KE

NILAI PAGU : Rp 431,100,000.00

PPTK :
NO LOKASI
URAIAN
2 3
battery kering)
Puskesmas Mannanti 1 pt 5,000,000
Pustu wilayah Puskesmas Mannanti 3 pt 750,000
Poskesdes wilayah Puskesmas Mannanti 2 pt 500,000
Air
Puskesmas Mannanti 12 bln 2,250,000
Puskesmas Mannanti 12 bln 200,000
Puskesmas Mannanti 12 tbg 170,000
Belanja listrik
Puskesmas Mannanti 12 bln 3,000,000
Pustu wilayah Puskesmas Mannanti 6 pustu x 12 bln 72 pust 100,000
u/
bln
Puskesmas Mannanti 12 OB 500,000
Puskesmas Mannanti 24 OB 500,000
Puskesmas Mannanti 12 OB 1,000,000

Puskesmas Mannanti 2 unit 1,500,000
Puskesmas Mannanti 1 unit 12,000,000
Puskesmas Mannanti 2160 pasi 36,000
en/h
r/bln

dan Petugas Jaga
Puskesmas Mannanti 6060 hr/ok 25,000


TOTAL
KEPALA PUSKESMAS
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut
ORAN KEMAJUAN KEUANGAN DAN FISIK KEADAAN S/D JANUARI 2019
UPAYA KESEHATAN MASYARAKAT

operasional puskesmas (DAU)
VOLUME REALIS PROSENTASE

FISIK BIAYA BOBOT SISA BIAYA
KONTRAK ASI KEMAJUAN
DIPDA (Rp.) (% ) ( Rp. ) ( Rp. ) KEU.
(Rp.)
4 5 6 7 8 9 10
431,100,000 0 100.00% 0 431,100,000 0
431,100,000 0 100.00% 0 431,100,000 0
431,100,000 0 100.00% 0 431,100,000 0
39,690,000 0 9.21% 0 39,690,000 0
8,250,000 0 1.91% 0 8,250,000 0
1 pt 5,000,000 0 1.16% 5,000,000 0.00
3 pt 2,250,000 0 0.52% 2,250,000 0.00
2 pt 1,000,000 0 0.23% 1,000,000 0.00
29,400,000 0 6.82% 0 29,400,000 0
1 27,000,000 0 6.26% 0 27,000,000 0
12 bln 27,000,000 0 6.26% 27,000,000 0.00

1 2,400,000 0 0.56% 2,400,000 0.00
12 bln 2,400,000 0 0.56% 2,400,000 0.00
2,040,000 0 0.47% 0 2,040,000 0
1 2,040,000 0 0.47% 0 2,040,000 0
12 tbg 2,040,000 0 0.47% 2,040,000 0.00
73,200,000 0 16.98% 0 73,200,000 0
43,200,000 0 10.02% 0 43,200,000 0
12 bln 36,000,000 0 8.35% 36,000,000 0.00
72 pustu / bln 7,200,000
0 1.67% 7,200,000 0.00

30,000,000 0 6.96% 0 30,000,000 0
1 6,000,000 0 1.39% 0 6,000,000 0
12 OB 6,000,000 0 1.39% 6,000,000 0.00
1 12,000,000 0 2.78% 0 12,000,000 0
24 OB 12,000,000 0 2.78% 12,000,000 0.00
1 12,000,000 0 2.78% 0 12,000,000 0
12 OB 12,000,000 0 2.78% 12,000,000 0.00

3,000,000 0 0.70% 0 3,000,000 0
3,000,000 0 0.70% 0 3,000,000 0
1 3,000,000 0 0.70% 0 3,000,000 0
2 unit 3,000,000 0 0.70% 3,000,000 0.00
12,000,000 0 2.78% 0 12,000,000 0
12,000,000 0 2.78% 0 12,000,000 0
1 12,000,000 0 2.78% 0 12,000,000 0
1 unit 12,000,000 0 2.78% 12,000,000 0.00
303,210,000 0 70.33% 0 303,210,000 0
77,760,000 0 18.04% 0 77,760,000 0
2160 pasien/hr/ 77,760,000
bln
0 18.04% 77,760,000 0.00

225,450,000 0 52.30% 0 225,450,000 0
1 151,500,000 0 35.14% 0 151,500,000 0
6060 hr/ok 151,500,000
0 35.14% 151,500,000 0.00
1 46,500,000 0 10.79% 0 46,500,000 0
1860 hr/ok 46,500,000
0 10.79% 46,500,000 0.00
1 27,450,000 0 6.37% 0 27,450,000 0
1098 hr/ok 27,450,000
0 6.37% 27,450,000 0.00
431,100,000
Sinjai, ……………………………..
……………………………….
Nip. ………………………………
9. Diisi sisa biaya dengan rumus nilai DIPDA dikurang nilai re

10. Diisi rumus nilai realisasi dibagi nilai DIPDA dikalikan serat
12. Diisi rumus bobot dikali persentase kemajuan keuangan (k
13. Diisi rumus bobot dikali persentase kemajuan fisik (kolom 7
11 12 13 14 15
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0.00 0.00
0.00 0.00
0.00 0.00
0 0 0
0 0 0
0.00 0.00
0.00
0.00 0.00
0 0 0
0 0 0
0.00 0.00
0 0 0
0 0 0
0.00 0.00
0.00 0.00
0 0 0
0 0 0
0.00 0.00
0 0 0
0.00 0.00
0 0 0
0.00 0.00
0 0 0
0 0 0
0 0 0
0.00 0.00
0 0 0
0 0 0
0 0 0
0.00 0.00
0 0 0
0 0 0
0.00 0.00
0 0 0
0 0 0
0.00 0.00
0 0 0
0.00 0.00
0 0 0
0.00 0.00
ai, …………………………….. 2017

PPTK
………………………………..
ip. ………………………………..
nilai DIPDA dikurang nilai realisasi (kolom 5 - kolom 8)

gi nilai DIPDA dikalikan seratus (kolom 8/kolom 5 x 100)
ntase kemajuan keuangan (kolom 7 x kolom 10)

ntase kemajuan fisik (kolom 7 x kolom 11)
REKAPITULASI LAPORAN KEMAJU

NILAI PAGU : Rp 421,020,000.00

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Lappae 1 pt 5,000,000
Pustu wilayah Puskesmas Lappae 4 pt 750,000
pembersih
Puskesmas Lappae 1 pt 5,000,000
Air
Puskesmas Lappae 12 bln 2,250,000
Puskesmas Lappae 12 bln 200,000
Puskesmas Lappae 24 tbg 170,000
Belanja air
Pustu wilayah Puskesmas Lappae 4 pustu x 12 bln 48 pustu / bln 100,000
Belanja listrik
Pustu wilayah Puskesmas Lappae 4 pustu x 12 bln 48 pustu / bln 100,000
Puskesmas Lappae 12 bln 150,000
Puskesmas Lappae 12 OB 500,000
Puskesmas Lappae 24 OB 500,000
Puskesmas Lappae 12 OB 1,000,000

Puskesmas Lappae 1 unit 2,000,000
Puskesmas Lappae 1 unit 12,000,000
10 Belanja Makanan dan Minuman Pasien
Puskesmas Lappae 1440 pasien/hr/bln 36,000
11 Belanja Makanan dan Minuman Dokter Jaga
dan Petugas Jaga
Puskesmas Lappae 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut

a operasional puskesmas (DAU)
421,020,000.00
REALIS
VOLUME BIAYA BOBOT
LOKASI FISIK ASI
KONTRAK
DIPDA (Rp.) (% ) ( Rp. )
(Rp.)
3 4 5 6 7 8
421,020,000 0 100.00% 0
421,020,000 0 100.00% 0
421,020,000 0 100.00% 0
46,480,000 0 11.04% 0
8,000,000 0 1.90% 0
1 pt 5,000,000 0 1.19%
4 pt 3,000,000 0 0.71%
5,000,000 0 1.19% 0
1 pt 5,000,000 0 1.19%
29,400,000 0 6.98% 0
1 27,000,000 0 6.41% 0
12 bln 27,000,000 0 6.41%

1 2,400,000 0 0.57% 0
12 bln 2,400,000 0 0.57%
4,080,000 0 0.97% 0
1 4,080,000 0 0.97% 0
24 tbg 4,080,000 0 0.97%
83,400,000 0 19.81% 0
16,800,000 0 3.99% 0
12 bln 12,000,000 0 2.85%
48 pustu / bln 4,800,000 0 1.14%
34,800,000 0 8.27% 0
12 bln 30,000,000 0 7.13%
48 pustu / bln 4,800,000 0 1.14%
1,800,000 0 0.43% 0
12 bln 1,800,000 0 0.43%
30,000,000 0 7.13% 0
1 6,000,000 0 1.43% 0
12 OB 6,000,000 0 1.43%
1 12,000,000 0 2.85% 0
24 OB 12,000,000 0 2.85%
1 12,000,000 0 2.85% 0
12 OB 12,000,000 0 2.85%
2,000,000 0 0.48% 0
2,000,000 0 0.48% 0
1 2,000,000 0 0.48% 0
1 unit 2,000,000 0 0.48%
12,000,000 0 2.85% 0
12,000,000 0 2.85% 0
1 12,000,000 0 2.85% 0
1 unit 12,000,000 0 2.85%
277,140,000 0 65.83% 0
51,840,000 0 12.31% 0
1440 pasien/hr/bln 51,840,000 0 12.31%
225,300,000 0 53.51% 0
1 151,500,000 0 35.98% 0
6060 hr/ok 151,500,000 0 35.98%
1 46,500,000 0 11.04% 0
1860 hr/ok 46,500,000 0 11.04%
1 27,300,000 0 6.48% 0
1092 hr/ok 27,300,000 0 6.48%
421,020,000
9. Diisi sisa biaya dengan rumus nilai DIP

10. Diisi rumus nilai realisasi dibagi nilai DI
12. Diisi rumus bobot dikali persentase kem
ARI 2019
SISA BIAYA
( Rp. ) KEU. FISIK KEU. FISIK SANA
9 10 11 12 13 14 15
421,020,000 0 0 0 0
421,020,000 0 0 0 0
421,020,000 0 0 0 0
46,480,000 0 0 0 0
8,000,000 0 0 0 0
5,000,000 0.00 0.00 0.00
3,000,000 0.00 0.00 0.00
5,000,000 0 0 0 0
5,000,000 0.00 0.00 0.00
29,400,000 0 0 0 0
27,000,000 0 0 0 0
27,000,000 0.00 0.00 0.00

2,400,000 0 0 0 0
2,400,000 0.00 0.00 0.00
4,080,000 0 0 0 0
4,080,000 0 0 0 0
4,080,000 0.00 0.00 0.00
83,400,000 0 0 0 0
16,800,000 0 0 0 0
12,000,000 0.00 0.00 0.00
4,800,000 0.00 0.00 0.00
34,800,000 0 0 0 0
30,000,000 0.00 0.00 0.00
4,800,000 0.00 0.00 0.00
1,800,000 0 0 0 0
1,800,000 0.00 0.00 0.00
30,000,000 0 0 0 0
6,000,000 0 0 0 0
6,000,000 0.00 0.00 0.00
12,000,000 0 0 0 0
12,000,000 0.00 0.00 0.00
12,000,000 0 0 0 0
12,000,000 0.00 0.00 0.00

2,000,000 0 0 0 0
2,000,000 0 0 0 0
2,000,000 0 0 0 0
2,000,000 0.00 0.00 0.00
12,000,000 0 0 0 0
12,000,000 0 0 0 0
12,000,000 0 0 0 0
12,000,000 0.00 0.00 0.00
277,140,000 0 0 0 0
51,840,000 0 0 0 0
51,840,000 0.00 0.00 0.00
225,300,000 0 0 0 0
151,500,000 0 0 0 0
151,500,000 0.00 0.00 0.00
46,500,000 0 0 0 0
46,500,000 0.00 0.00 0.00
27,300,000 0 0 0 0
27,300,000 0.00 0.00 0.00
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..
sa biaya dengan rumus nilai DIPDA dikurang nilai realisasi (kolom 5 - kolom 8)
mus nilai realisasi dibagi nilai DIPDA dikalikan seratus (kolom 8/kolom 5 x 100)
majuan fisik real
mus bobot dikali persentase kemajuan keuangan (kolom 7 x kolom 10)
mus bobot dikali persentase kemajuan fisik (kolom 7 x kolom 11)
laksana kegiatan
terangan tambahan
REKAPITULASI LAPORAN KEMAJUAN KEUANGAN DAN FISIK KEADAAN S/D JANUARI 2019
PROGRAM/KEGIATAN : 15. PROGRAM UPAYA KESEHATAN MASYARAKAT
PENYEDIAAN BIAYA OPERASIONAL KESEHATAN (BOK) DAK NON FISIK
1.01.02.1.01.02.01.15.069
NILAI PAGU : Rp 685,282,885.00
SUMBER DANA : BOK
PPTK : PUSKESMAS PANAIKANG
VOLUME PROSENTASE
BIAYA BOBOT REALISASI SISA BIAYA
NO LOKASI FISIK KEMAJUAN
KONTRAK
URAIAN DIPDA (Rp.) (% ) ( Rp. ) ( Rp. ) KEU.
(Rp.)
2 3 4 5 6 7 8 9 10
15 PROGRAM UPAYA KESEHATAN MASYARAKAT 685,282,885 0 12.49% 0 685,282,885 0
039 Penyediaan Biaya Operasional Puskesmas 685,282,885 0 12.49% 0 685,282,885 0
Belanja Barang Dan Jasa 685,282,885 0 12.49% 0 685,282,885 0
1 BELANJA ALAT TULIS KANTOR Rp 25,000,000 0 2.92% 0 25,000,000 0
2 ATK Pis-PK Rp 5,000,000 0 0.73% 5,000,000 0
3 BELANJA BAHAN MAKANAN PENDAMPING Rp 15,000,000 0 2.19% 15,000,000 0
4 BELANJA JASA TRANSPORTASI Rp 351,682,885 0 15.76% 0 351,682,885 0

5 BELANJA UPAH KERJA Rp 108,000,000 0 15.76% 108,000,000 0
PROMKES Rp 27,000,000 0 8.32% 0 27,000,000 0
SANIATARIAN Rp 27,000,000 0 3.94% 0 27,000,000 0
EPIDEMIOLOG Rp 27,000,000 0 3.94% 0 27,000,000 0
PEMBANTU PENGELOLAH KEUANGAN Rp 27,000,000 0 4.38% 0 27,000,000 0
BELANJA CETAK Rp 30,000,000 0 4.38% 30,000,000

6 CETAK ALAT PERAGA Rp 5,000,000 0 8.76% 0 5,000,000 0
7 CETAK PIS- PK Rp 25,000,000 0 8.76% 0 25,000,000 0
BELANJA PENGGANDAAN Rp 60,000,000 0 8.76% 60,000,000

8 PENGGANDAAN PKM Rp 45,000,000 0 12.49% 0 45,000,000 0
9 PENGGANDAAN PIS-PK Rp 15,000,000 0 9.57% 0 15,000,000 0
10 MAMIN RAPAT Rp 60,000,000 0 8.76% 60,000,000 0
11 MAMIN MMD Rp 5,600,000 0 0.82% 5,600,000 0
12 MAMIN PIS-PK Rp 5,000,000 0 2.92% 0 5,000,000 0
13 BELANJA PERJALANAN DINAS DALAM DAERAH Rp 20,000,000 0 2.92% 0 20,000,000 0
685,282,885 0
TOTAL 685,282,885
Sinjai, 5 April 2019
KEPALA SKPD
dr. Andi Suryanto Asapa Bachtiar Abdullah, S.Sos, M.Kes

Nip. ………………………………………. Nip. 19660707 1987031 010

1. Diisi nomor urut 9. Diisi sisa biaya dengan rumus nilai DIPDA dikurang nilai realis
2. Diisi nama program, Kegiatan, dan rincian belanja sesuai DPA/DPPA 10. Diisi rumus nilai realisasi dibagi nilai DIPDA dikalikan seratus (
3. Diisi lokasi pelaksanaan kegiatan 11. Diisi kemajuan fisik real
4. Diisi volume fisik kegiatan 12. Diisi rumus bobot dikali persentase kemajuan keuangan (kolom
5. Diisi nilai pagu anggaran sesuai DPA/DPPA 13. Diisi rumus bobot dikali persentase kemajuan fisik (kolom 7 x k
6. Diisi nilai kontrak bila kegiatan tersebut pengadaan barang dan jasa 14. Diisi pelaksana kegiatan
7. Diisi bobot kegiatan dengan rumus nilai kegiatan dibagi total dikalikan seratus 15. Diisi keterangan tambahan
I 2019
11 12 13 14 15
0 0 0
0 0 0
0 0 0
38 0 0
0 0.00 0.00
0 0.00 0.00
21 0 0
0.00 0.00
0 0 0
0 0 0
0 0.00 0.00
0 0 0
0.00 0.00
0 0 0
0 0 0
0 0.00 0.00
17 0 0
0 0 0
0.00 0.00 0.00

0.00 0.00 0.00
0 0 0
0 0.00 0.00
0.00
Sinjai, 5 April 2019

PPTK
Bachtiar Abdullah, S.Sos, M.Kes

Nip. 19660707 1987031 010
ai DIPDA dikurang nilai realisasi (kolom 5 - kolom 8)

nilai DIPDA dikalikan seratus (kolom 8/kolom 5 x 100)
se kemajuan keuangan (kolom 7 x kolom 10)

se kemajuan fisik (kolom 7 x kolom 11)

NILAI PAGU : Rp 368,870,000.00

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Samataring 1 pt 5,000,000
Pustu wilayah Puskesmas Samataring 3 pt 750,000
pembersih
Puskesmas Samataring 1 pt 5,000,000
Air
Puskesmas Samataring 12 bln 2,000,000
Puskesmas Samataring 24 tbg 160,000
Belanja listrik
Puskesmas Samataring 12 bln 2,700,000
Pustu wilayah Puskesmas Samataring 3 pustu x 12 bln 36 pustu / 150,000
bln
Puskesmas Samataring 12 bln 150,000
Puskesmas Samataring 12 OB 500,000
Puskesmas Samataring 24 OB 500,000
Puskesmas Samataring 12 OB 1,000,000

Puskesmas Samataring 2 unit 2,000,000
Puskesmas Samataring 1080 pasien/ 36,000
hr/bln
dan Petugas Jaga
Puskesmas Samataring 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut
EHATAN
368,870,000.00
REALIS
LOKASI FISIK ASI
KONTRAK
DIPDA (Rp.) (% ) ( Rp. ) ( Rp. )
(Rp.)
3 4 5 6 7 8 9
368,870,000 0 100.00% 0 368,870,000
368,870,000 0 100.00% 0 368,870,000
368,870,000 0 100.00% 0 368,870,000
40,090,000 0 10.87% 0 40,090,000
7,250,000 0 1.97% 0 7,250,000
1 pt 5,000,000 0 1.36% 5,000,000
3 pt 2,250,000 0 0.61% 2,250,000
5,000,000 0 1.36% 0 5,000,000
1 pt 5,000,000 0 1.36% 5,000,000
24,000,000 0 6.51% 0 24,000,000
1 24,000,000 0 6.51% 0 24,000,000
12 bln 24,000,000 0 6.51% 24,000,000

3,840,000 0 1.04% 0 3,840,000
1 3,840,000 0 1.04% 0 3,840,000
24 tbg 3,840,000 0 1.04% 3,840,000
69,600,000 0 18.87% 0 69,600,000
37,800,000 0 10.25% 0 37,800,000
12 bln 32,400,000 0 8.78% 32,400,000
36 pustu / 5,400,000
bln 0 1.46% 5,400,000
1,800,000 0 0.49% 0 1,800,000
12 bln 1,800,000 0 0.49% 1,800,000
30,000,000 0 8.13% 0 30,000,000
1 6,000,000 0 1.63% 0 6,000,000
12 OB 6,000,000 0 1.63% 6,000,000
1 12,000,000 0 3.25% 0 12,000,000
24 OB 12,000,000 0 3.25% 12,000,000
1 12,000,000 0 3.25% 0 12,000,000
12 OB 12,000,000 0 3.25% 12,000,000

4,000,000 0 1.08% 0 4,000,000
4,000,000 0 1.08% 0 4,000,000
1 4,000,000 0 1.08% 0 4,000,000
2 unit 4,000,000 0 1.08% 4,000,000
255,180,000 0 69.18% 0 255,180,000
38,880,000 0 10.54% 0 38,880,000
1080 pasien/ 38,880,000
hr/bln 0 10.54% 38,880,000
216,300,000 0 58.64% 0 216,300,000
1 151,500,000 0 41.07% 0 151,500,000
6060 hr/ok 151,500,000 0 41.07% 151,500,000
1 46,500,000 0 12.61% 0 46,500,000
1860 hr/ok 46,500,000 0 12.61% 46,500,000
1 18,300,000 0 4.96% 0 18,300,000
732 hr/ok 18,300,000 0 4.96% 18,300,000
368,870,000
…………………
Nip. ………………
9. Diisi sisa biaya dengan rumus nilai DIPDA di

019
10 11 12 13 14 15
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00

0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..


REKAPITULASI LAPORAN KEMA

NILAI PAGU : Rp 367,110,000.0

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Kampala 1 pt 5,000,000
Pustu wilayah Puskesmas Kampala 4 pt 750,000
Air
Puskesmas Kampala 12 bln 2,000,000
Puskesmas Kampala 24 tbg 180,000
Belanja listrik
Pustu wilayah Puskesmas Kampala 4 pustu x 12 bln 48 pustu / bln 100,000
Puskesmas Kampala 12 bln 2,000,000
Puskesmas Kampala 12 OB 500,000
Puskesmas Kampala 24 OB 500,000
Puskesmas Kampala 12 OB 1,000,000

Puskesmas Kampala 2 unit 2,000,000
Puskesmas Kampala 1440 pasien/hr/bln 36,000
dan Petugas Jaga
Puskesmas Kampala 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut

367,110,000.00
REALIS
VOLUME BIAYA BOBOT
LOKASI FISIK ASI
KONTRAK
DIPDA (Rp.) (% ) ( Rp. )
(Rp.)
3 4 5 6 7 8
367,110,000 0 100.00% 0
367,110,000 0 100.00% 0
367,110,000 0 100.00% 0
36,320,000 0 9.89% 0
8,000,000 0 2.18% 0
1 pt 5,000,000 0 1.36%
4 pt 3,000,000 0 0.82%
24,000,000 0 6.54% 0
1 24,000,000 0 6.54% 0
12 bln 24,000,000 0 6.54%

4,320,000 0 1.18% 0
1 4,320,000 0 1.18% 0
24 tbg 4,320,000 0 1.18%
58,800,000 0 16.02% 0
28,800,000 0 7.85% 0
48 pustu / bln 4,800,000 0 1.31%
12 bln 24,000,000 0 6.54%
30,000,000 0 8.17% 0
1 6,000,000 0 1.63% 0
12 OB 6,000,000 0 1.63%
1 12,000,000 0 3.27% 0
24 OB 12,000,000 0 3.27%
1 12,000,000 0 3.27% 0
12 OB 12,000,000 0 3.27%
4,000,000 0 1.09% 0
4,000,000 0 1.09% 0
1 4,000,000 0 1.09% 0
2 unit 4,000,000 0 1.09%
267,990,000 0 73.00% 0
51,840,000 0 14.12% 0
1440 pasien/hr/bln 51,840,000 0 14.12%
216,150,000 0 58.88% 0
1 151,500,000 0 41.27% 0
6060 hr/ok 151,500,000 0 41.27%
1 46,500,000 0 12.67% 0
1860 hr/ok 46,500,000 0 12.67%
1 18,150,000 0 4.94% 0
726 hr/ok 18,150,000 0 4.94%
367,110,000
9. Diisi sisa biaya dengan rumus nilai DI

10. Diisi rumus nilai realisasi dibagi nilai D
12. Diisi rumus bobot dikali persentase ke
13. Diisi rumus bobot dikali persentase ke
RI 2019
SISA BIAYA
9 10 11 12 13 14 15
367,110,000 0 0 0 0
367,110,000 0 0 0 0
367,110,000 0 0 0 0
36,320,000 0 0 0 0
8,000,000 0 0 0 0
5,000,000 0.00 0.00 0.00
3,000,000 0.00 0.00 0.00
24,000,000 0 0 0 0
24,000,000 0 0 0 0
24,000,000 0.00 0.00 0.00

4,320,000 0 0 0 0
4,320,000 0 0 0 0
4,320,000 0.00 0.00 0.00

58,800,000 0 0 0 0
28,800,000 0 0 0 0
4,800,000 0.00 0.00 0.00
24,000,000 0.00 0.00 0.00
30,000,000 0 0 0 0
6,000,000 0 0 0 0
6,000,000 0.00 0.00 0.00
12,000,000 0 0 0 0
12,000,000 0.00 0.00 0.00
12,000,000 0 0 0 0
12,000,000 0.00 0.00 0.00

4,000,000 0 0 0 0
4,000,000 0 0 0 0
4,000,000 0 0 0 0
4,000,000 0.00 0.00 0.00
267,990,000 0 0 0 0
51,840,000 0 0 0 0
51,840,000 0.00 0.00 0.00
216,150,000 0 0 0 0
151,500,000 0 0 0 0
151,500,000 0.00 0.00 0.00
46,500,000 0 0 0 0
46,500,000 0.00 0.00 0.00
18,150,000 0 0 0 0
18,150,000 0.00 0.00 0.00
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..
majuan fisik real
laksana kegiatan
terangan tambahan
REKAPITULASI LAPORAN KEMAJUA

NILAI PAGU : Rp 381,970,000.00

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Lappadata 1 pt 5,000,000
Pustu wilayah Puskesmas Lappadata 4 pt 750,000
pembersih
Puskesmas Lappadata 1 pt 5,000,000
Air
Puskesmas Lappadata 12 bln 2,000,000
Puskesmas Lappadata 12 bln 200,000
Puskesmas Lappadata 12 tbg 170,000
Belanja listrik
Puskesmas Lappadata 12 bln 2,000,000
Pustu wilayah Puskesmas Lappadata 4 pustu x 12 bln 48 pustu / 100,000
bln
Puskesmas Lappadata 12 bln 120,000
Puskesmas Lappadata 12 OB 500,000
Puskesmas Lappadata 24 OB 500,000
Puskesmas Lappadata 12 OB 1,000,000

Puskesmas Lappadata 2 unit 1,500,000
Puskesmas Lappadata 1440 pasien/hr 36,000
/bln
dan Petugas Jaga
Puskesmas Lappadata 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut
M UPAYA KESEHATAN MASYARAKAT

aya operasional puskesmas (DAU)
381,970,000.00
REALIS
LOKASI FISIK ASI
KONTRAK
DIPDA (Rp.) (% ) ( Rp. ) ( Rp. )
(Rp.)
3 4 5 6 7 8 9
381,970,000 0 100.00% 0 381,970,000
381,970,000 0 100.00% 0 381,970,000
381,970,000 0 100.00% 0 381,970,000
41,440,000 0 10.85% 0 41,440,000
8,000,000 0 2.09% 0 8,000,000
1 pt 5,000,000 0 1.31% 5,000,000
4 pt 3,000,000 0 0.79% 3,000,000
5,000,000 0 0 0 5,000,000
1 pt 5,000,000 0 1.31% 5,000,000
26,400,000 0 0 0 26,400,000
1 24,000,000 0 0 0 24,000,000
12 bln 24,000,000 0 6.28% 24,000,000

1 2,400,000 0 0 0 2,400,000
12 bln 2,400,000 0 0.63% 2,400,000
2,040,000 0 0 0 2,040,000
1 2,040,000 0 0 0 2,040,000
12 tbg 2,040,000 0 0.53% 2,040,000
60,240,000 0 0 0 60,240,000
28,800,000 0 0 0 28,800,000
12 bln 24,000,000 0 6.28% 24,000,000
48 pustu / 4,800,000
bln 0 1.26% 4,800,000
1,440,000 0 0 0 1,440,000
12 bln 1,440,000 0 0.38% 1,440,000
30,000,000 0 0 0 30,000,000
1 6,000,000 0 0 0 6,000,000
12 OB 6,000,000 0 1.57% 6,000,000
1 12,000,000 0 0 0 12,000,000
24 OB 12,000,000 0 3.14% 12,000,000
1 12,000,000 0 0 0 12,000,000
12 OB 12,000,000 0 3.14% 12,000,000

3,000,000 0 0 0 3,000,000
3,000,000 0 0 0 3,000,000
1 3,000,000 0 0 0 3,000,000
2 unit 3,000,000 0 0.79% 3,000,000
277,290,000 0 1 0 277,290,000
51,840,000 0 0 0 51,840,000
1440 pasien/hr 51,840,000
/bln 0 13.57% 51,840,000
225,450,000 0 1 0 225,450,000
1 151,500,000 0 0 0 151,500,000
6060 hr/ok 151,500,000 0 39.66% 151,500,000
1 46,500,000 0 0 0 46,500,000
1860 hr/ok 46,500,000 0 12.17% 46,500,000
1 27,450,000 0 7.19% 0 27,450,000
1098 hr/ok 27,450,000 0 7.19% 27,450,000
381,970,000
Sinjai, ……………
………………
Nip. ……………
9. Diisi sisa biaya dengan rumus nilai DIPDA

10. Diisi rumus nilai realisasi dibagi nilai DIPD
12. Diisi rumus bobot dikali persentase kemaj
9
10 11 12 13 14 15
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00

0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..



NILAI PAGU : Rp 383,710,000.00

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Manimpahoi 1 pt 5,000,000
Pustu wilayah Puskesmas Manimpahoi 5 pt 750,000
Poskesdes wilayah Puskesmas Manimpahoi 1 pt 500,000

pembersih
Puskesmas Manimpahoi 1 pt 5,000,000
Air
Puskesmas Manimpahoi 12 bln 2,000,000
Puskesmas Manimpahoi 12 bln 200,000
Puskesmas Lappadata 12 tbg 170,000
Belanja listrik
Puskesmas Manimpahoi 12 bln 2,500,000
Pustu wilayah Puskesmas Manimpahoi 5 pustu x 12 bln 60 pustu / bln 100,000
Poskesdes wilayah Puskesmas Manimpahoi 12 bln 60,000
Puskesmas Manimpahoi 12 bln 150,000
Puskesmas Manimpahoi 12 OB 500,000
Puskesmas Manimpahoi 24 OB 500,000
Puskesmas Manimpahoi 12 OB 1,000,000

Puskesmas Manimpahoi 2 unit 2,000,000
Puskesmas Manimpahoi 1200 pasien/hr/bln 36,000
dan Petugas Jaga
Puskesmas Manimpahoi 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut
LAPORAN KEMAJUAN KEUANGAN DAN FISIK KEADAAN S/D JANUARI 2019

383,710,000.00
REALIS
LOKASI FISIK ASI
KONTRAK
DIPDA (Rp.) (% ) ( Rp. ) ( Rp. )
(Rp.)
3 4 5 6 7 8 9
383,710,000 0 100.00% 0 383,710,000
383,710,000 0 100.00% 0 383,710,000
383,710,000 0 100.00% 0 383,710,000
42,690,000 0 11.13% 0 42,690,000
9,250,000 0 2.41% 0 9,250,000
1 pt 5,000,000 0 1.30% 5,000,000
5 pt 3,750,000 0 0.98% 3,750,000
1 pt 500,000
0 0.13% 500,000
5,000,000 0 0 0 5,000,000
1 pt 5,000,000 0 1.30% 5,000,000
26,400,000 0 0 0 26,400,000
1 24,000,000 0 0 0 24,000,000
12 bln 24,000,000 0 6.25% 24,000,000

1 2,400,000 0 0 0 2,400,000
12 bln 2,400,000 0 0.63% 2,400,000
2,040,000 0 0 0 2,040,000
1 2,040,000 0 0 0 2,040,000
12 tbg 2,040,000 0 0.53% 2,040,000
68,520,000 0 0 0 68,520,000
36,720,000 0 0 0 36,720,000
12 bln 30,000,000 0 7.82% 30,000,000
60 pustu / bln 6,000,000 0 1.56% 6,000,000
12 bln 720,000
0 0.19% 720,000
1,800,000 0 0 0 1,800,000
12 bln 1,800,000 0 0.47% 1,800,000
30,000,000 0 0 0 30,000,000
1 6,000,000 0 0 0 6,000,000
12 OB 6,000,000 0 1.56% 6,000,000
1 12,000,000 0 0 0 12,000,000
24 OB 12,000,000 0 3.13% 12,000,000
1 12,000,000 0 0 0 12,000,000
12 OB 12,000,000 0 3.13% 12,000,000

4,000,000 0 0 0 4,000,000
4,000,000 0 0 0 4,000,000
1 4,000,000 0 0 0 4,000,000
2 unit 4,000,000 0 1.04% 4,000,000
268,500,000 0 1 0 268,500,000
43,200,000 0 0 0 43,200,000
1200 pasien/hr/bln 43,200,000 0 11.26% 43,200,000
225,300,000 0 1 0 225,300,000
1 151,500,000 0 0 0 151,500,000
6060 hr/ok 151,500,000 0 39.48% 151,500,000
1 46,500,000 0 0 0 46,500,000
1860 hr/ok 46,500,000 0 12.12% 46,500,000
1 27,300,000 0 0 0 27,300,000
1092 hr/ok 27,300,000 0 7.11% 27,300,000
383,710,000
………………
Nip. ……………

10 11 12 13 14 15
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00
0.00 0.00 0.00

0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0.00 0.00 0.00
0.00 0.00 0.00

0 0 0 0
0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00

0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
0 0 0 0
0.00 0.00 0.00
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..


REKAPITULASI LAPORAN KEMAJ

NILAI PAGU : Rp 407,150,000.00

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Bulupoddo 1 pt 5,000,000
Pustu wilayah Puskesmas Bulupoddo 6 pt 750,000
Poskesdes wilayah Puskesmas Bulupoddo 1 pt 500,000
Air
Puskesmas Bulupoddo 12 bln 2,000,000
Puskesmas Bulupoddo 12 bln 200,000
Puskesmas Bulupoddo 12 tbg 170,000
Belanja air
Belanja listrik
Puskesmas Bulupoddo 12 bln 3,000,000
Pustu wilayah Puskesmas Bulupoddo 7 pustu x 12 bln 84 pustu / bln 100,000
Puskesmas Bulupoddo 12 OB 500,000
Puskesmas Bulupoddo 24 OB 500,000
Puskesmas Bulupoddo 12 OB 1,000,000

Puskesmas Bulupoddo 2 unit 2,000,000
Puskesmas Bulupoddo 960 pasien/hr/bln 36,000
dan Petugas Jaga
Puskesmas Bulupoddo 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut

407,150,000.00
REALIS
VOLUME BIAYA BOBOT
LOKASI FISIK ASI
KONTRAK
DIPDA (Rp.) (% ) ( Rp. )
(Rp.)
3 4 5 6 7 8
407,150,000 0 100.00% 0
407,150,000 0 100.00% 0
407,150,000 0 100.00% 0
38,440,000 0 9.44% 0
10,000,000 0 2.46% 0
1 pt 5,000,000 0 1.23%
6 pt 4,500,000 0 1.11%
1 pt 500,000 0 0.12%
26,400,000 0 0 0
1 24,000,000 0 0 0
12 bln 24,000,000 0 5.89%

1 2,400,000 0 0 0
12 bln 2,400,000 0 0.59%
2,040,000 0 0 0
1 2,040,000 0 0 0
12 tbg 2,040,000 0 0.50%
77,400,000 0 0 0
1,200,000 0 0 0
12 bln 1,200,000 0 0.29%
44,400,000 0 0 0
12 bln 36,000,000 0 8.84%
84 pustu / bln 8,400,000 0 2.06%
1,800,000 0 0 0
12 bln 1,800,000 0 0.44%
30,000,000 0 0 0
1 6,000,000 0 0 0
12 OB 6,000,000 0 1.47%
1 12,000,000 0 0 0
24 OB 12,000,000 0 2.95%
1 12,000,000 0 0 0
12 OB 12,000,000 0 2.95%
4,000,000 0 0 0
4,000,000 0 0 0
1 4,000,000 0 0 0
2 unit 4,000,000 0 0.98%
287,310,000 0 1 0
34,560,000 0 0 0
960 pasien/hr/bln 34,560,000 0 8.49%
252,750,000 0 1 0
1 151,500,000 0 0 0
6060 hr/ok 151,500,000 0 37.21%
1 46,500,000 0 0 0
1860 hr/ok 46,500,000 0 11.42%
1 54,750,000 0 0 0
2190 hr/ok 54,750,000 0 13.45%
407,150,000
9. Diisi sisa biaya dengan rumus nilai DIP

10. Diisi rumus nilai realisasi dibagi nilai DI
ARI 2019
SISA BIAYA
9 10 11 12 13 14 15
407,150,000 0 0 0 0
407,150,000 0 0 0 0
407,150,000 0 0 0 0
38,440,000 0 0 0 0
10,000,000 0 0 0 0
5,000,000 0.00 0.00 0.00
4,500,000 0.00 0.00 0.00
500,000 0.00 0.00 0.00
26,400,000 0 0 0 0
24,000,000 0 0 0 0
24,000,000 0.00 0.00 0.00

2,400,000 0 0 0 0
2,400,000 0.00 0.00 0.00
2,040,000 0 0 0 0
2,040,000 0 0 0 0
2,040,000 0.00 0.00 0.00
77,400,000 0 0 0 0
1,200,000 0 0 0 0
1,200,000 0.00 0.00 0.00
44,400,000 0 0 0 0
36,000,000 0.00 0.00 0.00
8,400,000 0.00 0.00 0.00
1,800,000 0 0 0 0
1,800,000 0.00 0.00 0.00
30,000,000 0 0 0 0
6,000,000 0 0 0 0
6,000,000 0.00 0.00 0.00
12,000,000 0 0 0 0
12,000,000 0.00 0.00 0.00
12,000,000 0 0 0 0
12,000,000 0.00 0.00 0.00

4,000,000 0 0 0 0
4,000,000 0 0 0 0
4,000,000 0 0 0 0
4,000,000 0.00 0.00 0.00
287,310,000 0 0 0 0
34,560,000 0 0 0 0
34,560,000 0.00 0.00 0.00
252,750,000 0 0 0 0
151,500,000 0 0 0 0
151,500,000 0.00 0.00 0.00

46,500,000 0 0 0 0
46,500,000 0.00 0.00 0.00

54,750,000 0 0 0 0
54,750,000 0.00 0.00 0.00
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..
majuan fisik real
laksana kegiatan
terangan tambahan

NILAI PAGU : Rp 571,130,000.00

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Balangnipa 1 pt 8,000,000
Pustu wilayah Puskesmas Balangnipa 4 pt 750,000
Poskesdes wilayah Puskesmas Balangnipa 1 pt 500,000
Air
Puskesmas Balangnipa 12 bln 2,000,000
Puskesmas Balangnipa 12 bln 200,000
Puskesmas Balangnipa 24 tbg 165,000
Belanja air
Pustu wilayah Puskesmas Balangnipa 4 pustu x 12 bln 48 pustu / 100,000
bln
Belanja listrik
Pustu wilayah Puskesmas Balangnipa 4 pustu x 12 bln 48 pustu / 200,000
bln
Poskesdes wilayah Puskesmas Balangnipa 12 bln 100,000
Puskesmas Balangnipa 12 bln 110,000
Puskesmas Balangnipa 36 OB 500,000
Puskesmas Balangnipa 24 OB 500,000
Puskesmas Balangnipa 24 OB 1,000,000

Puskesmas Balangnipa 2 unit 2,000,000
Puskesmas Balangnipa 3600 pasien/hr 36,000
/bln
dan Petugas Jaga
Puskesmas Balangnipa 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut
HATAN
iaya operasional puskesmas (DAU)
571,130,000.00
REALIS
LOKASI FISIK ASI
KONTRAK
DIPDA (Rp.) (% ) ( Rp. ) ( Rp. )
(Rp.)
3 4 5 6 7 8 9
571,130,000 0 100.00% 0 571,130,000
571,130,000 0 100.00% 0 571,130,000
571,130,000 0 100.00% 0 571,130,000
41,860,000 0 7.33% 0 41,860,000
11,500,000 0 2.01% 0 11,500,000
1 pt 8,000,000 0 1.40% 8,000,000
4 pt 3,000,000 0 0.53% 3,000,000
1 pt 500,000 0 0.09% 500,000
26,400,000 0 0 0 26,400,000
1 24,000,000 0 0 0 24,000,000
12 bln 24,000,000 0 4.20% 24,000,000

1 2,400,000 0 0 0 2,400,000
12 bln 2,400,000 0 0.42% 2,400,000
3,960,000 0 0 0 3,960,000
1 3,960,000 0 0 0 3,960,000
24 tbg 3,960,000 0 0.69% 3,960,000
142,920,000 0 0 0 142,920,000
28,800,000 0 0 0 28,800,000
12 bln 24,000,000 0 4.20% 24,000,000
48 pustu / 4,800,000
bln 0 0.84% 4,800,000
58,800,000 0 0 0 58,800,000
12 bln 48,000,000 0 8.40% 48,000,000
48 pustu / 9,600,000
bln 0 1.68% 9,600,000
12 bln 1,200,000 0 0.21% 1,200,000
1,320,000 0 0 0 1,320,000
12 bln 1,320,000 0 0.23% 1,320,000
54,000,000 0 0 0 54,000,000
1 18,000,000 0 0 0 18,000,000
36 OB 18,000,000 0 3.15% 18,000,000
1 12,000,000 0 0 0 12,000,000
24 OB 12,000,000 0 2.10% 12,000,000
1 24,000,000 0 0 0 24,000,000
24 OB 24,000,000 0 4.20% 24,000,000

4,000,000 0 0 0 4,000,000
4,000,000 0 0 0 4,000,000
1 4,000,000 0 0 0 4,000,000
2 unit 4,000,000 0 0.70% 4,000,000
382,350,000 0 1 0 382,350,000
129,600,000 0 0 0 129,600,000
3600 pasien/hr 129,600,000
/bln 0 22.69% 129,600,000
252,750,000 0 0 0 252,750,000
1 151,500,000 0 0 0 151,500,000
6060 hr/ok 151,500,000 0 26.53% 151,500,000
1 46,500,000 0 0 0 46,500,000
1860 hr/ok 46,500,000 0 8.14% 46,500,000
1 54,750,000 0 0 0 54,750,000
2190 hr/ok 54,750,000 0 9.59% 54,750,000
571,130,000
…………………
Nip. ………………

19
10 11 12 13 14 15
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0.00 0.00 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0.00 0.00 0
0 0 0 0
0.00 0.00 0
0.00 0.00 0
0.00 0.00 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0.00 0.00 0
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..



NILAI PAGU : Rp 522,110,000.00

PPTK :
NO
URAIAN
2
battery kering)
Puskesmas Pulau IX 1 pt 5,000,000
Pustu wilayah Puskesmas Pulau IX 3 pt 750,000
Poskesdes wilayah Puskesmas Pulau IX 4 pt 500,000
Air
Puskesmas Pulau IX 12 bln 4,000,000
Puskesmas Pulau IX 12 tbg 195,000
Belanja air
Puskesmas Pulau IX 9125 jerg 7,000
Pustu wilayah Puskesmas Pulau IX 2555 jerg 7,000
Poskesdes wilayah Puskesmas Pulau IX 2190 jerg 7,000
Belanja listrik
Pustu wilayah Puskesmas Pulau IX 3 pustu x 12 bln 36 pustu / 100,000
bln
Poskesdes wilayah Puskesmas Pulau IX 4 Posk x 12 bln 48 Posk / 100,000
bln
Puskesmas Pulau IX 12 bln 110,000
Puskesmas Pulau IX 12 OB 500,000
Puskesmas Pulau IX 24 OB 500,000
Puskesmas Pulau IX 24 OB 1,000,000

Puskesmas Pulau IX 1 unit 12,000,000
Puskesmas Pulau IX 360 pasien/hr 36,000
/bln
dan Petugas Jaga
Puskesmas Pulau IX 6060 hr/ok 25,000
TOTAL
KEPALA SKPD
……………………………………………
Nip. ……………………………………….

1. Diisi nomor urut
M UPAYA KESEHATAN MASYARAKAT

aya operasional puskesmas (DAU)
522,110,000.00
REALIS
LOKASI FISIK ASI
KONTRAK
DIPDA (Rp.) (% ) ( Rp. ) ( Rp. )
(Rp.)
3 4 5 6 7 8 9
522,110,000 0 100.00% 0 522,110,000
522,110,000 0 100.00% 0 522,110,000
522,110,000 0 100.00% 0 522,110,000
71,590,000 0 13.71% 0 71,590,000
9,250,000 0 1.77% 0 9,250,000
1 pt 5,000,000 0 0.96% 5,000,000
3 pt 2,250,000 0 0.43% 2,250,000
4 pt 2,000,000 0 0.38% 2,000,000
60,000,000 0 0 0 60,000,000
1 48,000,000 0 0 0 48,000,000
12 bln 48,000,000 0 9.19% 48,000,000

1 12,000,000 0 0 0 12,000,000
12 bln 12,000,000 0 2.30% 12,000,000
2,340,000 0 0 0 2,340,000
1 2,340,000 0 0 0 2,340,000
12 tbg 2,340,000 0 0.45% 2,340,000
172,810,000 0 0 0 172,810,000
97,090,000 0 0 0 97,090,000
9125 jerg 63,875,000 0 12.23% 63,875,000
2555 jerg 17,885,000 0 3.43% 17,885,000
2190 jerg 15,330,000 0 2.94% 15,330,000
32,400,000 0 0 0 32,400,000
12 bln 24,000,000 0 4.60% 24,000,000
36 pustu / 3,600,000
bln 0 0.69% 3,600,000
48 Posk / 4,800,000
bln 0 0.92% 4,800,000
1,320,000 0 0 0 1,320,000
12 bln 1,320,000 0 0.25% 1,320,000
42,000,000 0 0 0 42,000,000
1 6,000,000 0 0 0 6,000,000
12 OB 6,000,000 0 1.15% 6,000,000
1 12,000,000 0 0 0 12,000,000
24 OB 12,000,000 0 2.30% 12,000,000
1 24,000,000 0 0 0 24,000,000
24 OB 24,000,000 0 4.60% 24,000,000

12,000,000 0 0 0 12,000,000
12,000,000 0 0 0 12,000,000
1 12,000,000 0 0 0 12,000,000
1 unit 12,000,000 0 2.30% 12,000,000
265,710,000 0 1 0 265,710,000
12,960,000 0 0 0 12,960,000
360 pasien/hr 12,960,000
/bln 0 2.48% 12,960,000
252,750,000 0 0 0 252,750,000
1 151,500,000 0 0 0 151,500,000
6060 hr/ok 151,500,000 0 29.02% 151,500,000
1 46,500,000 0 0 0 46,500,000
1860 hr/ok 46,500,000 0 8.91% 46,500,000
1 54,750,000 0 0 0 54,750,000
2190 hr/ok 54,750,000 0 10.49% 54,750,000
522,110,000
Sinjai, ……………
……………
Nip. …………

9
10 11 12 13 14 15
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0.00 0.00 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0.00 0.00 0
0.00 0.00 0
0 0 0 0
0.00 0.00 0
0.00 0.00 0
0.00 0.00 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0 0 0 0
0.00 0.00 0
0 0 0 0
0.00 0.00
0 0 0 0
0.00 0.00 0
Sinjai, …………………………….. 2017

PPTK
………………………………..
Nip. ………………………………..

sasi dibagi nilai DIPDA dikalikan seratus (kolom 8/kolom 5 x 100)

1 Manipi Err:509
2 Tengalembang Err:509
3 Borong Kompleks Err:509
4 Bijinangka Err:509
5 Samaenre Err:509
6 Aska Err:509
7 Mannant Err:509
8 Lappae Err:509
9 Panaikang Err:509
10 Samataring Err:509
11 Kampala Err:509
12 Lappadata Err:509
13 Manimpahoi Err:509
14 Bulupoddo Err:509
15 Balangnipa Err:509
16 Pulau IX Err:509
Err:509

Monev Bok PKM 2019

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REKAPITULASI LAPORAN KEMAJUAN KEUANGAN DAN FISIK KEADAAN S/D JANUARI 2019

UNIT : DINAS KESEHATAN

4 BELANJA JASA TRANSPORTASI Rp 351,682,885 0 15.76% Rp 52,285,000 299,397,885 15

PROMKES Rp 27,000,000 0 8.32% 0 27,000,000 0

SANIATARIAN Rp 27,000,000 0 3.94% 0 27,000,000 0

EPIDEMIOLOG Rp 27,000,000 0 3.94% 0 27,000,000 0

PEMBANTU PENGELOLAH KEUANGAN Rp 27,000,000 0 4.38% 0 27,000,000 0

BELANJA CETAK Rp 30,000,000 0 4.38% 30,000,000

Sinjai, 8 Mei 2019

dr. Andi Suryanto Asapa Bachtiar Abdullah, S.Sos, M.K

Petunjuk Pengisian Format :

0.00 0.00 0.00

Sinjai, 8 Mei 2019

Bachtiar Abdullah, S.Sos, M.Kes

DIPDA dikurang nilai realisasi (kolom 5 - kolom 8)

kemajuan keuangan (kolom 7 x kolom 10)

NOMOR DPA SKPD

INDIKATOR DAN TOLAK UKUR KINERJA

Kelompok Sasaran Kegiatan :

Poskesdes wilayah Puskesmas Tengngalembang 2

Puskesmas Borong Kompleks 1

Poskesdes wilayah Puskesmas Borong 1

Puskesmas Borong Kompleks 12

kesedes wilayah Puskesmas Borong Kompleks 1 posk x 12 bln 12

Puskesmas Biji Nangka 12

Triwulan I Rp. 1,657,179,000.00

bln 3,000,000 36,000,000

bln 2,000,000 24,000,000

posk / bln 100,000 1,200,000

bln 1,500,000 18,000,000

bln 3,000,000 36,000,000

SINJAI, 23 Januari 2019

Dra. Hj. RATNAWATI ARIF, M.Si

UNIT : DINAS KESEHATAN

NILAI PAGU : Rp 402,610,000.00

Puskesmas Manipi 12 OB 1,000,000

Belanja Makanan dan Minuman Dokter Jaga

Petunjuk Pengisian Format :

12 bln 36,000,000 0 8.94% 36,000,000

12 OB 12,000,000 0 2.98% 12,000,000

9. Diisi sisa biaya dengan rumus nilai DIPDA d

0.00 0.00 0.00

0.00 0.00 0.00

0.00 0.00 0.00

0.00 0.00 0.00

Sinjai, …………………………….. 2017

an rumus nilai DIPDA dikurang nilai realisasi (kolom 5 - kolom 8)

kali persentase kemajuan keuangan (kolom 7 x kolom 10)

UNIT : DINAS KESEHATAN

NILAI PAGU : Rp 361,440,000.00

Poskesdes wilayah Puskesmas Tengngalembang 2 pt 500,000

Belanja Bahan Bakar Minyak/Gas

Puskesmas Tengngalembang 12 OB 1,000,000

Petunjuk Pengisian Format :

12 bln 36,000,000 0 9.96% 36,000,000

12 OB 12,000,000 0 3.32% 12,000,000

9. Diisi sisa biaya dengan rumus nilai DIPDA dikura

0.00 0.00 0.00

0.00 0.00 0.00

0.00 0.00 0.00

0.00 0.00 0.00

0.00 0.00 0.00

Sinjai, …………………………….. 2017