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1/13

KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI

UNIVERSITAS JENDERAL SOEDIRMAN

RUMAH SAKIT GIGI DAN MULUT PENDIDIKAN

Jl. Dr. Soeparno Purwokerto Kode Pos !"##

Telepon $%#&"' ()"#!!,()"#!), *aks++le $%#&"' (#-"("

Nomor : 708/UN23.RSGMP/TU.00.00/2015 24 November 2015Lampiran : Peri!a" : UN#$NG$N

.

Men%!arap &en%an !orma' (e!a&iran )apa(/*b+/Sa+&ara pa&a per'em+an ,an% a(an&i-e"en%%ara(an -bb. :

ari/ 'an%%a" : Rab+ 25 November 2015a('+ : P+(+" 13.30 *) -.& Se"e-aiTempa' : R. #TR UPU$ara : Rapa' oor&ina-i UPU

Men%in%a' pen'in%n,a aara 'er-eb+' &imo!on )apa(/*b+/Sa+&ara !a&ir 'epa' pa&aa('+n,a.

$'a- per!a'ian &an (e!a&iran Sa+&ara (ami +ap(an 'erima (a-i!

P6. Raa' a"an

#r%. on Triono$m&.om.SN*T. 19810812 201209 1 01Temb+-an:1. #ire('+r RSGMP Un-oe&.2. a(i" #ire('+r )i&an% ** RSGMP Un-oe&.


2/13

KEMENTERIAN PENDIDIKAN DAN KE/DA0AAN/NI1ERSITAS JENDERAL SOEDIRMAN

Jl. Pro2. DR. 3. un4a+n No. 5%& Kotak Pos "" 6 Purwokerto !"##

$%#&"' (!#-# $3/NTING' , (!&!!5 , (!&5- 6 *a7s. (#&5"%

8e9s+te : www.unsoed.a7.+d ea+l : ;uas


3/13

#$AT$R : UN#$NG$N PM$P$R$N #$N NARNS* PRS

No. #ina-/*n-'an-i e'eran%an

1. Re('or 1 oran%2. are(. )i&. $(a&emi( 1 oran%

3. are(. )i&. Um+m &an e+an%an 1 oran%

4. are(. )i&. ema!-i-aan &an $"+mni 1 oran%

5. are(. )i&. Perener6a-ama &an +ma- 1 oran%

. #e(an Aa(. Per'anian 1 oran%

7. #e(an Aa(. )io"o%i 1 oran%

8. #e(an Aa(. Pe'erna(an 1 oran%

9. #e(an Aa(. (onomi 1 oran%

10. #e(an Aa(. +(+m 1 oran%

11. #e(an Aa(. *S*P 1 oran%

12. #e(an Aa(. e&o('eran &an *"m+ e-e!a'an 1 oran%

13. #e(an Aa(. Sain- &an Te(ni( 1 oran%

14. e'+a LPPM 1 oran%

15. e'+a LP3 1 oran%

1. abiro $&m. $(a&emi( &an ema!a-i-aan 1 oran%

17. abiro $&m. Um+m &an e+an%an 1 oran%

18. abiro $&m. Peren. Si-'em *nBor &an +ma- 1 oran%

19. #ire('+r Pro%ram Pa-a Sar6ana 1 oran%

20. #ire('+r RSGMP 1 oran%

21. aba%. +ma- 1 oran%

22. a-+bba%. +ma- 1 oran%23. a-+bba%. Pe"a,anan *nBorma-i 1 oran%

24. #ire('+r Me&ia Sa'e"i' Po- 1 oran%

25. Pempre&. Me&ia Sa'e"i' Po- 1 oran%

2. Mana6er Mar(e'in% Me&ia Sa'e"i' Po- 1 oran%

27. ar'aan Me&ia Sa'e"i' Po- 1 oran%

28. Ao'o%raBer Me&ia Sa'e"i' Po- 1 oran%

29. epa"a Me&ia arian )an,+ma- 1 oran%

30. Mana6er Me&ia arian )an,+ma- 1 oran%

31. Mana6er Mar(e'in% Me&ia arian )an,+ma- 1 oran%

32. Ao'o%raBer Me&ia arian )an,+ma- 1 oran%33. epa"a Pema-aran Me&ia S+ara Mer&e(a 1 oran%

34. epa"a )iro Me&ia S+ara Mer&e(a 1 oran%

35. ar'aan Me&ia S+ara Mer&e(a 3 oran%

3. Ao'o%raBer Me&ia S+ara Mer&e(a 1 oran%

37. Genera" Mana6er Me&ia Ra&ar )an,+ma- 1 oran%

38. a(i" M Me&ia Ra&ar )an,+ma- 1 oran%

39. Pempre& Me&ia Ra&ar )an,+ma- 1 oran%

40. a(i" Pemre& Me&ia Ra&ar )an,+ma- 1 oran%


4/13

No. #ina-/*n-'an-i e'eran%an41. ar'aan Me&ia Ra&ar )an,+ma- 1 oran%

42. epa"a )iro Me&ia e&a+"a'an Ra(,a' 1 oran%43. ar'aan Me&ia e&a+"a'an Ra(,a' 2 oran%

44. ar'aan Me&ia aa-an 1 oran%

45. ar'aan Me&ia ompa- 1 oran%

4. ar'aan Me&ia Pi(iran Ra(,a' 1 oran%

47. ar'aan Me&ia Rep+b"i(a 1 oran%

48. ar'aan Me&ia *n&one-ia 1 oran%

49. ar'aan Ma6a"a! Ga'ra 1 oran%

50. epa"a RR* P+ro(er'o 1 oran%

51. a-+bba%. Pen,iaran RR* P+ro(er'o 1 oran%

52. ar'aan RR* P+ro(er'o 1 oran%

53. Mana6er Ra&io Mi'ra AM 1 oran%

54. ar'aan Ra&io Mi'ra AM 1 oran%

55. Se(-i Pemberi'aan Ra&io #ian Sara AM 1 oran%

5. ar'aan Ra&io #ian -ara AM 1 oran%

57. Mana6er Ra&io a-i(a AM 1 oran%

58. Pen,iar &an ar'aan Ra&io a-i(a AM 1 oran%

59. Pen,iar &an ar'aan Ra&io PP AM 1 oran%

0. ar'aan Ma6a"a! $n'ara 1 oran%

1. ar'aan Me&ia #e'i( >om 1 oran%

2. Mana6er Ra&io P+ro(er'o AM 1 oran%

3. ar'aan Me'ro T@ 1 oran%4. ar'aan Tran- T@ 1 oran%

5. ar'aan R>T* 1 oran%

. #ire('+r )an,+ma- T@ 1 oran%

7. Mana6er Mar(e'in% )an,+ma- T@ 1 oran%

8. ar'aan )an,+ma- T@ 1 oran%

9. Mana6er Sera,+ T@ 1 oran%

70. ar'aan Me&ia Mera! P+'i! n"ine 1 oran%

71. ar'aan Me&ia abar 17 n"ine 1 oran%

72. ar'aan Me&ia )eri'a n"ine 1 oran%

73. ar'aan Ma6a"a! #e'a( 1 oran%74. ar'aan Ma6a"a! S+(-e-i 1 oran%

75. ar'aan Ma6a"a! )an,+ma- Po- 1 oran%

7. ermaan Pra-o6o S'aB )a%. +ma-

77. Sri a!,+ni S'aB )a%. +ma-

78. Sri Na-'i'i SP S'aB )a%. +ma-

79. Ta-"im Ra!im S'aB )a%. +ma-

80. ar&i,a'mi S'aB )a%. +ma-


5/13

No. #ina-/*n-'an-i e'eran%an

81. Momm, a!ono P S'aB )a%. +ma-

82. Air&a+- +"ian'o S'aB )a%. +ma-

83. r,Ca Saba'!ino A S'aB )a%. +ma-

84. Novin&ra Pra'ama S'aB )a%. +ma-

85. Nar&i S'aB )a%. +ma-

8. epa"a Sa'pam 1 oran%

87. S+pir 1 oran%

88.

89.

90.

91.

92.93.

94.

95.

9.

97.

98.

99.

100.


6/13


7/13

No. M#*$ N$M$ TR$NG$N1. Me&ia Sa'e"i' Po- on #ire('+r

+niar'o Pempre&

Nono Mana6er Mar(e'in%

ana',o(o ar'aan

Ai(ri Ao'o%raBer

2. Me&ia arian )an,+ma- #i&i a!,+ epa"a#o&i Mana6er

$r&i N+%ro!o Mana6er Mar(e'in%

$%+- ar'aan

3. Me&ia S+ara Mer&e(a o(o epa"a Pema-aran

Si%i' epa"a )iro

aer+&in ar'aan Senior

$%+- ar'aan

Pan&+ N ar'aan

#ian Ao'o%raBer

4. Me&ia Ra&ar )an,+ma- Ae"&, Genera" Mana6er

ar, a(i" Genera" Mana%er

+&!i Pempre&

$-i&i a(i" Pempre&

*n&ri ar'aan

5. Me&ia e&a+"a'an Ra(,a' &i Roma&!on epa"a )iro

e-', ar'aan

Ri-'an'o ar'aan

. Me&ia aa-an Ninin% ar'aan

7. Me&ia ompa- #i(a ar'aan

8. Me&ia Pi(iran Ra(,a' vi,an'i ar'aan

9. Me&ia Rep+b"i(a (o ar'aan

10. Me&ia *n&one-ia Li"i( #armaan ar'aan

11. Ma6a"a! Ga'ra $rieB ar'aan

12. Ra&io Rep+b"i( *n&one-ia Na-irin $!ma& epa"a RR* P+ro(er'o

P+ro(er'o *n&a! a-+bba%. Pen,iaran

S+pri,an'o ar'aan

13. Ra&io Mi'ra AM $n6ar Mana6er

$ri ar'aan


8/13

No. M#*$ N$M$ TR$NG$N14. Ra&io #ian Sara AM Nen, Se(-i Pemberi'aan

Pono ar'aan

15. Ra&io a-i(a AM Merina Mana6er

Aer, Pen,iar &an ar'aan

1. Ra&io PP AM Pan6i Pen,iar #an ar'aan

17. Me&ia $n'ara S+maro'o ar'aan

18. Me&ia #e'i( >om $rb, ar'aan

19. Ra&io P+ro(er'o AM Lin&a Mana6er

20. Me'ro T@ #arbe ar'aan

21. Tran- T@ *mam $mbaro'o ar'aan

22. R>T* Sa"a&in ar'aan

23. )an,+ma- T@ Air&a+- #ire('+r

&, Mana6er Mar(e'in%

#arman'o ar'aan

24. Sera,+ T@ Mana6er

25. Me&ia Mera! P+'i! n"ine >ip'o ar'aan

2. Me&ia abar 17 n"ine Daena" ar'aan

27 Me&ia )eri'a n"ine (o ar'aan

28. Ma6a"a! #e'a( >ip'o ar'aan

29. Ma6a"a! S+(-e-i S+%en% ar'aan

30. Ma6a"a! )an,+ma- Po- a,+ ar'aan


9/13


10/13

MNTR*$N PN#*#*$N N$S*N$L

/NI1ERSITAS JENDERAL SOEDIRMAN". ProB. #R. . )+n,amin No. 708 o'a( Po- 115 E P+ro(er'o 53122


11/13

n&an% *-'an'i S MMN*P . 1911109 198901 2001

#aB'ar : Pe-er'a Pemb+baran Pani'ia So-ia"i-a-i

UU No. 14/2008ari/'%" : Se"a-a 3 Mei 2011

1. ProB. &, +ono P!#2. *r. )+&i R+-'omo M.R+r.S P!#3. #r. (o ari,an'o M.Si$(4. #r-. iraan e'omo5. n&an% *-'an'i S MM. S+nar&i S.*P7. ermaan Pra-o6o S8. Ta-"im Ra!im9. $%+- Pri,an'o10. Sri Na-'i'i S.P11. Sri a!,+ni12. Si'i N+rnani13. #r-. S+6aro MM

14. er+ )+n',a&i S.So-15. 6. N+r AaiHo! S MM1 Ma!ia T6a!6o ar&o(o S MM17. Momm, a!ono Pana'aran18. S+'ia-no19. S+i'o20. Nar&i21. P+6ian'o22. Li- S+"i-rianiS.So-23. N+r!i&a,a'i24. S+mi&a!

25. R+(+n

P+ro(er'o 2 Mei 2011

n&an% *-'an'iSMM

N*P. 1911109 198901 2 001


12/13


13/13

KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI

UNIVERSITAS JENDERAL SOEDIRMAN

RUMAH SAKIT GIGI DAN MULUT PENDIDIKAN

Jl. Dr. Soeparno Purwokerto Kode Pos !"##

Telepon $%#&"' ()"#!!,()"#!), *aks++le $%#&"' (#-"("

Nomor : 802/UN30.RSGMP/TU.00.00/2015 9 #e-ember 2015Lampiran : Peri!a" : UN#$NG$N

.

Men%!arap &en%an !orma' (e!a&iran )apa(/*b+/Sa+&ara pa&a per'em+an ,an% a(an&i-e"en%%ara(an -bb. :

ari/ 'an%%a" : ami- 10 #e-ember 2015a('+ : P+(+" 13.30 *) -.& Se"e-aiTempa' : R. #TR UPU$ara : Rapa' oor&ina-i UPU

Men%in%a' pen'in%n,a aara 'er-eb+' &imo!on )apa(/*b+/Sa+&ara !a&ir 'epa' pa&aa('+n,a.

$'a- per!a'ian &an (e!a&iran Sa+&ara (ami +ap(an 'erima (a-i!

P6. Raa' a"an

#r%. on Triono$m&.om.SN*T. 19810812 201209 1 01Temb+-an:1. #ire('+r RSGMP Un-oe&.2. a(i" #ire('+r )i&an% ** RSGMP Un-oe&.3. $r-ip

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