FORMULIR PENGUKURAN BEBAN KERJA PEGAWAI
FORMULIR PENGUKURAN BEBAN KERJA PEGAWAI
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N NOO UURRAAIIAANNTUTUGGAA)) KKEETT * * ++ ,, -- .. // 00 11 * * TTuuggaas s PPoo!!oo!! *
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dan au(o"a(i6 %ro6ssor %ro6ssor 2 Prsia%an !as(7 fil"7
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2 Ad"inis(rasi +
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2 E;%os %asin .
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Loading < un loading Fil" s!aligus %n6u6ian /
/ IIddnn((iiffii!!aassi i PPaassiinn7 7 PPnnuulliissaan n AA""%%lloo% % ddaann !!ggiiaa((aann **44 **..4444 **44 455444//00 **4 4 %%aassiinn99""gggguu R86( Analisa
R86( Analisa 0
0 IInn((rr%%rr((aassi i ''aassiil l RRoonn((ggn n ss!!aalliigguuss !!ggiiaa((aann **.. **..4444 **44 4455**4444 **4 4 %%aassiinn99""gggguu !onsul(asi ! BP
!onsul(asi ! BP 1
1 MMrr!!aa% % KKuunn88uunnggaan n ddaan n LLaa%%oorraann !!ggiiaa((aann **++44 //444444 ** 445544++44 %%r r $$uullaann =
= PPnnggaa""$$iillaan n ''aassiil l RRoonn((ggn n ooll' ' PPaassiin n !!ggiiaa((aann .. **..4444 **44 455444,,,, **4 4 %%aassiinn99""gggguu ! radiologi
! radiologi *
*44 MM""$$aa66aa!!aan n ''aassiil l RRoonn((ggn n !! &&oo!!((r r ))%%RRaadd !!ggiiaa((aann //44 **..4444 ,, 4455**++44 ,,;;99""iinngggguu *
*** PPngngarara'a'an an PrPro(o(!!si si RaRadiadiasisi 2
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2 Pnda"%ing %asin di$ri %ngara'an *
*++ MM""$$rrss!!aan n %%rraallaa((aan n ssllssaai i %%""rrii!!ssaaaann !!ggiiaa((aann .. **..4444 **44 445544,,,, **4 4 %%aassiinn99""gggguu *
*,, MM""aa((ii!!aan n %%ssaa33aa( ( ssllssaai i %%""rrii!!ssaaaan n ddaann !!ggiiaa((aann **44 **..4444 ** 4455444400 ss((iiaa% % ''aarrii ""$rs!an ruangan radiologi
""$rs!an ruangan radiologi *
*-- PPnnggggaann((iiaan n 66aaiirraan n dd>>lloo%%rr< < ffii;;rr !!ggiiaa((aann //44 //444444 ** 445544**44 %%r r $$uullaann *
*.. PP""ssaannaan n ddaan n %%nnggaa""$$iillaan n BBHHP P !!ggiiaa((aann ,,44 //444444 ** 45544444.. ((rrggaann((uunng g ss((oo!! 2 Fil"7 &>lo%r 7 Fi;r
2 Fil"7 &>lo%r 7 Fi;r *
*// MMllaa!!uu!!aan n %%rraa33aa((aan n rriinnggaann !!ggiiaa((aann //44 //444444 ** 445544**44 %%r r $$uullaann 2 M"$rsi'!an !as( dan s6rn
2 M"$rsi'!an !as( dan s6rn 2 M"$rsi'!an %sa3a( dan 6on(rol %anl 2 M"$rsi'!an %sa3a( dan 6on(rol %anl *0
*0 PP(u(ugagas Ps Proro((!s!si Ri Radadiaiasisi 2
2 AAdd""nniiss((rraassi i ddaan n %%rr!!aa%%aan n FFiill" " $$aaddgg !!ggiiaa((aann **++44 ,,//444444 ** 44554444,, %%r r / / $$uullaann 2
2 PPnnggiirrii""aan n %%""$$aa66aaaan n ffiill" " $$aaddgg !!ggiiaa((aann //44 ,,//444444 ** 45544444++ %%r r / / $$uullaann
+
+ TTuuggaas s TTaa""$$aa''aann *
* BBndnda'a'arara a BOBOK K PuPuss!!s"s"asas 2
2 MM""$$uuaa( ( RRUUKK$$rrssaa""a a KKaaPPuus s ? ? llaa%%oorraann **++44 00++444444 -- 4455444400 %%r r ((aa''uunn P"gang
P"gang Progra"Progra" 2
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2 PP""$$uuaa((aan n )P)PJJ llaa%%oorraann **++44 //444444 11 4455**//44 %%r r $$uullaann 2
2 MMnn66aarri i 66aa% % ddaan n ((aanndda a ((aannggaan n ((oo!!oo !!ggiiaa((aann //44 //444444 11 4455441144 %%r r $$uullaann 2
2 MMnnggiirrii" " llaa%%oorraan n ))PPJ J !! &&KKKK llaa%%oorraann //44 //444444 -- 455444--44 %%r r $$uullaann 2
2 KKoonnssuull((aassi i LLaa%%oorraan n !! &&KKKK !!ggiiaa((aann ,,44 //444444 -- 445544++44 %%r r $$uullaann 2
2 MMnnrrii""a a ddaan n ""nnddiiss((rrii$$uussii!!aan n !!uuaannggaan n llaa%%oorraann **++44 //444444 11 4455**//44 %%r r $$uullaann ! P"
! P"gang Progra"gang Progra" 2
2 MMrr!!aa%%7 7 ""nnddoo!!uu""nn((aassii7 7 ""nnggggaannddaa!!aan n llaa%%oorraann **++44 //444444 ** 445544++44 %%r r $$uullaann La%oran
La%oran HasilHasil
+
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2 MMnngg((ii! ! LLaa%%oorraann llaa%%oorraann **.. **..4444 .. 445544..44 %%r r llaa%%oorraann 2
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2 MMnn66aa((aa( ( ddaan n ""nnggaaggnndda a ssuurraa( ( ""aassuu! ! !!ggiiaa((aann .. **..4444 **44 445544,,,, **4 4 ssuurraa((99""gggguu dan
dan !luar !luar 2
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da(a Pus!s"asPus!s"as 2
2 RR!!aa% % ddaa((a a ((aa''uunnaann llaa%%oorraann *+*+44 00++444444 .. 4554444411 %%r r ((aa''uunn 2
2 MMnngg((ii! ! &&PP,, llaa%%oorraann ,,44 0+0+444444 0044 445544++== %%r r ((aa''uunn
,
, TTuuggaas s PPnnuunn88aanngg *
* MMnngg''aaddiirri i MMiinniilloo!!aa!!aarraa KKggiiaa((aann **++44 //444444 ** 455444++44 %%r r $$uullaann +
+ RRaa%%aa( ( KKggiiaa((aann **++44 /4/44444 ** 445544++44 %%r r $$uullaann ,
, RRaa%%aa( ( PPrrooffssi i RRaaddiioollooggii KKggiiaa((aann **++44 **11444444 ** 4455444400 %%r r , , $$uullaann )ATUAN )ATUAN HA)IL HA)IL WAKTU WAKTU PEN@ELE PEN@ELE )AIAN )AIAN "ni( "ni( WAKTU WAKTU KERJA KERJA EFEKTIF EFEKTIF "ni( "ni( BEBAN BEBAN KERJA KERJA PEGAWAI PEGAWAI @ANG @ANG &IBUTUHKA &IBUTUHKA N N
FORMULIR PENGUKURAN BEBAN KERJA PEGAWAI
NAMA
:
E!o
Endang
Palu%i
NAMA
JABATAN
:
Radiografr
UNIT KERJA
: Pus!s"as #$ongan %ada &inas Ks'a(an Ko(a )ala(iga
IKHTI)AR JABATAN
: Pna(a Ron(gn %ada Pus!s"as #$ongan
NO URAIANTUGA) KET
* + , - . / 0 1
* Tugas Po!o!
* M"%rsia%!an %rala(an radiologi
2 War"ing u% %sa3a( ron(gn !gia(an ,4 *.44 / 45*+4 )(ia% 'ari dan au(o"a(i6 %ro6ssor
2 Prsia%an !as(7 fil"7 "ar!r7 $a8u %asin 2 Ad"inis(rasi
+ Mnri"a $lan!o %r"in(aan ron(gn7 !gia(an . *.44 *4 454,, *4 %asin9"ggu !onfir"asi ! %asin7 %n6a(a(an rgis(r %asin
, Prsia%an %"ri!saan !gia(an . *.44 *4 454,, *4 %asin9"ggu 2 Pasin di%rsila!an gan(i $a8u %asin
2 P(ugas "nia%!an !as(7 fil"7 "ar!r
- P"ri!saan ron(gn !gia(an *. *.44 *4 45*44 *4 %asin9"ggu 2 Pnga(uran %osisi %asin
2 Pnga(uran Fa!(or E;%osi 2 E;%os %asin
. Kgia(an Ka"ar Gla% !gia(an . *.44 *4 454,, *4 %asin9"ggu Loading < un loading Fil" s!aligus %n6u6ian
/ Idn(ifi!asi Pasin7 Pnulisan A"%lo% dan !gia(an *4 *.44 *4 454/0 *4 %asin9"ggu R86( Analisa
0 In(r%(asi 'asil Ron(gn s!aligus !gia(an *. *.44 *4 45*44 *4 %asin9"ggu !onsul(asi ! BP
1 M"$a6a!an 'asil Ron(gn ! &o!(r )%Rad !gia(an /4 *.44 , 45*+4 ,;9"inggu = Mr!a% Kun8ungan dan La%oran !gia(an *+4 /444 * 454+4 %r $ulan *4 Pnga"$ilan 'asil Ron(gn ol' Pasin !gia(an . *.44 *4 454,, *4 %asin9"ggu
! radiologi
** M"$rs!an %rala(an slsai %"ri!saan !gia(an . *.44 *4 454,, *4 %asin9"ggu *+ M"a(i!an %sa3a( slasi %"ri!saan dan !gia(an *4 *.44 / 454-4 s(ia% 'ari
""$rs!an ruangan radiologi *, Pngara'an Pro(!si Radiasi
2 Pn8lasan K%ada %asin s$lu" %"ri!saan !gia(an . *.44 *4 454,, *4 %asin9"ggu 2 Pnda"%ing %asin di$ri %ngara'an
*- Pnggan(ian 6airan d>lo%r< fi;r !gia(an /4 /444 * 454*4 %r $ulan *. Mla!u!an %ra3a(an ringan !gia(an /4 /444 * 454*4 %r $ulan
2 M"$rsi'!an !as( dan s6rn 2 M"$rsi'!an %sa3a( dan 6on(rol %anl + Tugas Ta"$a'an
* Bnda'ara BOP Pus!s"as
2 M"$ua( POA $ulanan la%oran /4 *.44 * 454-4 %r $ulan
2 P"$ua(an )PJ la%oran /4 /444 1 45414 %r !gia(an
2 Mngiri" la%oran )PJ ! &KK la%oran /4 /444 - 454-4 %r $ulan 2 Mnri"a dan "ndis(ri$usi!an !uangan la%oran *+4 *.44 * 45414 %r $ulan
! P"gang Progra"
2 Mr!a%7 "ndo!u"n(asi7 "ngganda!an la%oran *+4 *.44 * 45414 %r $ulan La%oran Hasil
+ Tnaga Ad"inis(rasi Lo!(
2 Mr!a% Kun8ungan Pasin la%oran * ,44 *.4 45.44 %r %asin 2 M"$ua( La%oran Kun8ungan Pasin la%oran *+4 /444 * 454+4 %r $ulan 2 Mr!a% dan "ndo!n(asi!an r!a%an la%oran *+4 /444 * 454+4 %r $ulan
!un8ungan %asin , Tugas Pnun8ang
* Mng'adiri Minilo!a!ara Kgia(an *+4 /444 * 454+4 %r $ulan
+ Ra%a( Profsi Radiologi Kgia(an *+4 *1444 * 45440 %r , $ulan *5/0, P"$ula(an + )ATUAN HA)IL WAKTU PEN@ELE)A IAN "ni( WAKTU KERJA EFEKTIF "ni( BEBAN KERJA PEGAWAI @ANG &IBUTUHKAN
FORMULIR PENGUKURAN BEBAN KERJA PEGAWAI
NAMA
:
)i(i
Mardia'
NAMA
JABATAN
:
)(af
TU
UNIT KERJA
: Pus!s"as #$ongan %ada &inas Ks'a(an Ko(a )ala(iga
IKHTI)AR JABATAN
: )(af Ta(a Usa'a Pada Pus!s"as #$ongan
NO URAIANTUGA) KET
* + , - . / 0 1
* Tugas Po!o!
* Mngagnda!an sura( "asu! dan !luar !gia(an . *.44 *4 454,, *4 sura(9"ggu + Mngiri" sura( ! &inas !gia(an /4 *.44 . 45+44 s(ia% 'ari , Mng!onsul(asi!an la%oran ! &inas !gia(an ,4 *.44 . 45*44 %r !gia(an - Pn6a(a(an in>n(arisasi $arang !gia(an ,4 *.44 * 454+4 %r $ulan . Mla!u!an !gia(an !arsi%an !gia(an *4 *.44 *4 454/0 %r !gia(an / Mla!u!an %nda(aan 3ilaa' dan !un8ungan Pus!s"as !gia(an /4 /444 * 454*4 %r $ulan 0 M"$ua( la%oran Pus!s"as !gia(an /4 /444 * 454*4 %r $ulan 1 Mnlnggara!an !gia(an sosial dala" ling!ungan !gia(an /4 *.44 + 45414 %r !gia(an
3ilaa' Pus!s"as
= Mla!u!an !oordinasi %ngu"%ulan da(a la%oran !gia(an *+4 /444 * 454+4 %r $ulan 'asil !gia(an $ulanan Pus!s"as
*4 Mr!a% dan "ndo!u"n(asi!an la%oran 'asil !gia(an *+4 *.44 * 45414 %r $ulan !gia(an $ulanan Pus!s"as
** Mla!u!an %r"a8aan da(a !%ga3aian7 !gia(an *+4 /444 * 454+4 %r $ulan da(a Pus!s"as
*+ Mla!u!an !oodinasi dngan %"gang %rogra" !gia(an ,4 *.44 . 45*44 %r !gia(an (r!ai( !lan6aran la%oran
*, Mngdar!an undangan di Wilaa' P!" #$ongan !gia(an /4 /444 *4 45*44 %r $ulan
*- Pnggandaan la%oran !gia(an ,4 *.44 - 45414 %r !gia(an
*. Mng!ons%&P, La%oran ,4 0+444 04 454+= %r(a'un
+ Tugas Pnun8ang
* Mng'adiri ra%a( !gia(an *+4 /444 * 454+4 %r !gia(an
+ Mng'adiri Minilo!a!ara !gia(an *+4 /444 * 454+4 %r !gia(an , Mn(or!an (a$ungan !o%rasi !gia(an /4 /444 * 454*4 %r $ulan
JUMLAH 45=== PEMBULATAN * )ATUAN HA)IL WAKTU PEN@ELE )AIAN "ni( WAKTU KERJA EFEKTIF "ni( BEBAN KERJA PEGAWAI @ANG &IBUTUHKAN
NAMA
:
)ARMO
NAMA
JABATAN
:
)(af
TU
UNIT KERJA
: Pus!s"as #$ongan %ada &inas Ks'a(an Ko(a )ala(iga
IKHTI)AR JABATAN
: P"$an(u Bnda'ara Pngluaran Pus!s"as #$ongan
NO
URAIAN
TUGA)
KET
*
+
,
-
.
/
0
1
* Tugas Po!o!
* Mn6a(a( arus %nri"aan dan %ngluaran La%oran -. *.44 * 454,4 %r $ulan !uangan Pus!s"as dala" $u!u !as u"u"
+ Mndo!u"n(asi!an rin6ian %nri"aan dan %ngluaran La%oran -. *.44 * 454,4 %r $ulan !uangan Pus!s"as dala" $u!u !as $an(u
, Mndis(ri$usi!an %ngluaran !uangan dala" $u!u La%oran /4 *.44 * 454-4 %r $ulan !as $an(u
- Mnri"a dan "n6a(a( 'asil %ngluaran r(ri$usi La%oran /4 *.44 * 454-4 %r $ulan dari uni( < uni( %laanan Pus!s"as
. Mn(or!an )PJ Ru(in Pus!s"as Kgia(an /4 *.44 * 454-4 %r $ulan / Konsul(asi ! Bnda'ara &KK Kgia(an ,4 *.44 * %r Kgia(an 0 Mr!a% dan "ndo!u"n(asi!an la%oran $ulanan Kgia(an /4 *.44 * 454-4 %r $ulan
%nri"aan ? %ngluaran r(ri$usi Pus!s"as
1 M"$ua( dan "ndo!u"n(asi!an %rn6anaan anggaran Kgia(an /4 *.44 * 454-4 %r $ulan dan ralisasi %nggunaan dana o%rasional Pus!s"as
= M"$ua( )PJ Ralisaisi %nggunaan dana o%rasional Kgia(an *. *.44 * 454*4 %r Kgia(an Pus!s"as
*4 Mla!u!an "on> (r'ada% %nggunaan !uangan Kgia(an ,4 *.44 * 454+4 %r "inggu Pus!s"as "ingguan
** M"$ua( sura( %sanan $lan8a Kgia(an /4 *.44 * 454-4 %r $ulan *+ M"$lan8a!an !$u(u'an ru(in Pus!s"as Kgia(an *+4 *.44 * 45414 %r $ulan *, Mng(i! A+ dan ""in(a 6a% dan (anda (angan (o!o Kgia(an *+4 *.44 * 45414 %r $ulan *- M"$ua( daf(ar %nri"aan Ja%l Pus!s"as Kgia(an *+4 *.44 * 45414 %r $ulan *. M"$agi!an 8a%l ! !ara3an Pus!5 Kgia(an *+4 /444 * 454+4 %r $ulan */ Mnga"$il7 "r!a% TPP dan uang "a!an Kgia(an *+4 /444 * 454+4 %r $ulan *0 M"$agi!an TPPdan uang "a!an ! !ara3an Pus!5 Kgia(an *+4 /444 * 454+4 %r $ulan *1 Konsul(asi !!urangan a(au !l$i'an TPP Kgia(an -. /444 * 45441 %r $ulan *= Mla!u!an %"sanan dan %nga"$ilan 6(a!an Kgia(an *+4 /444 - 45414 %r $ulan +4 M"$aar (agi'an P&AM Kgia(an *+4 /444 * 454+4 %r $ulan +* M"$aar (agi'an Lis(ri!7 Tl% Kgia(an /4 /444 * 454*4 %r $ulan ++ M"$aar Pa8a! P"$lan8aan Pus!s"as Kgia(an /4 /444 * 454*4 %r $ulan +, Pnggandaan da(a7 la%oran7 )PJ Pus!s"as Kgia(an /4 /444 * 454*4 %r $ulan +- Kgia(an %ng )PJ an BBM Kgia(an /4 /444 * 454*4 %r $ulan Kgia(an %ng )PJ an P&AM7 Lis(ri! Kgia(an /4 /444 * 454*4 %r $ulan
+ Tugas Pnun8ang
* Mnga'adirira%a( !gia(an *+4 *.44 * 45414
+ Mng'adiri Minilo!a!ara !gia(an *+4 *.44 * 45414 %r $ulan
JUMLAH 45=-1 PEMBULATAN *
)ATUAN
HA)IL
WAKTU
PEN@ELE
)AIAN
"ni(
WAKTU
KERJA
EFEKTIF
"ni(
BEBAN
KERJA
PEGAWAI
@ANG
&IBUTUHK
AN
FORMULIR PENGUKURAN BEBAN KERJA PEGAWAI
NAMA
:
)uadi
NAMA
JABATAN
:
)(af
TU
UNIT KERJA
: Pus!s"as #$ongan %ada &inas Ks'a(an Ko(a )ala(iga
IKHTI)AR JABATAN
: &ri>r Pada Pus!s"as #$ongan
NO URAIANTUGA) KET
* + , - . / 0 1
* Tugas Po!o!
* Plaanan Ru8u!an !gia(an /4 *.44 , 45*+4
+ Pngiri"an $arang9sura( ! &inas !gia(an /4 *.44 , 45*+4 , Pnga"$ilan $arang9O$a( ! &KK !gia(an /4 *.44 + 45414 - Kgia(an Posandu7 Pusling7 Pos!s(rn !gia(an *+4 *.44 / 45-14 + Tugas Ta"$a'an
* Mngagnda!an sura( "asu! dan !luar !gia(an . *.44 *4 454,, *4 sura(9"ggu + Mngiri" sura( ! &inas !gia(an /4 *.44 . 45+44 s(ia% 'ari , Mla!u!an !gia(an !arsi%an !gia(an *4 *.44 *4 454/0 %r !gia(an + Tugas Pnun8ang
* Mng'adiri ra%a( !gia(an *+4 /444 * 454+4 %r !gia(an
+ Mng'adiri Minilo!a!ara !gia(an *+4 /444 * 454+4 %r !gia(an
JUMLAH *5*-4 PEMBULATAN * )ATUAN HA)IL WAKTU PEN@ELE) AIAN "ni( WAKTU KERJA EFEKTIF "ni( BEBAN KERJA PEGAWAI @ANG &IBUTUHKA N
NAMA
:
)u"arno
Hidaa(
NAMA
JABATAN
:
)(af
TU
UNIT KERJA
: Pus!s"as #$ongan %ada &inas Ks'a(an Ko(a )ala(iga
IKHTI)AR JABATAN
: Bnda'ara Barang Non Mdis Pada Pus!s"as #$ongan
NO URAIANTUGA) KET
* + , - . / 0 1
* Tugas Po!o!
* Mnusun rn6ana !oordina(or urusan ru"a' (angga
2 Mnia%!an $a'an !r8a !gia(an *. *.44 * 454*44 2 Mnusun rn6ana !gia(an (ugas %na(a La%oran ,4 *.44 * 454*44 !ru"a'(anggaan
2 M"$ua( la%oran 'asil %nusunan rn6ana !gia(an La%oran ,4 *.44 * 454+44 !%ada %i"%inan
+ Mla!u!an %nglolaan !ndaraan dinas
2 Mla!u!an %ng6!an fisi! dan "nusun !gia(an /4 /444 *- 45*-44 s(i"asi !rusa!an $ila ada
2 Mla!u!an %ra3a(an a(au %r$ai!an ang ada !gia(an /4 /444 + 454+44 2 M"$ua( la%oran 'asil %la!sanaan !gia(an La%oran ,4 /444 * 4544.4
%nglolaan !ndaraan dinas , Mla!u!an %nga(uran ruang ra%a(
2 Mnusun lis( %nggunaan ruang ra%a( !gia(an *4 *.44 + 454*,, 2 Koordinasi ruang ra%a( dngan %ngguna !gia(an ,4 *.44 + 454-44 2 Koordinasi ruang ra%a( dngan (!nisi ? o%ra(or !gia(an /4 *.44 + 454144 2 Mla%or!an !sia%an ruang ra%a( un(u! !gia(an *4 *.44 + 454*,,
%la!asanaan !gia(an dinas
2 Mra%i!an !"$ali ruang ra%a( !gia(an /4 *.44 + 454144 2 M"$ua( la%oran %nggunaan ruang ra%a( La%oran *4 *.44 + 454*,,
!%ada %i"%inan
, Bnda'ara Logis(i! Pus!s"as
2 Mnri"a Barang logis(i! Pus!s"as !gia(an *+4 /444 * 454+44 !r(as7 (in(a7 "a%7 !li%7 %las(i!7 dll
2 &is(ri$usi $arang Logis(i! ssuai !$u(u'an !gia(an ,4 ,44 / 45/444 2 Pn6a(a(an dan %la%oran !gia(an /4 /444 * 454*44 + Tugas Pnun8ang
* Mng'adiri ra%a( !gia(an *+4 /444 * 454+44
+ Mng'adiri Minilo!a!ara !gia(an *+4 /444 * 454+44
JUMLAH *5**.4 PEMBULATAN * )ATUAN HA)IL WAKTU PEN@EL E)AIAN "ni( WAKTU KERJA EFEKTIF "ni( BEBAN KERJA PEGAWAI @ANG &IBUTUHKA N
