Formulir 2a PU

BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan

BB006042 MEDAN ORTHOPAEDIC MEDAN ORTHOPAEDIC 01 2024

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP Iuran JKP
Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Pemberi Kerja Tenaga Kerja Pemberi Kerja Tenaga Kerja Pemberi Kerja Pemerintah Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.)
1 22100456197 1271031708700016 AGUS MULYADI PANE 17-08-1970 01-09-2022 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
2 17017853502 1271032812910007 AJI FAHMI SINUHAJI 28-12-1991 01-04-2017 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
3 15001800620 1271072503800002 ANDI PERRY WIJAYA RAMBE 25-03-1980 01-01-2015 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
4 21049308238 1223073004000007 ANDIKA SANJAYA SIAGIAN 30-04-2000 01-07-2021 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
5 18004065837 1207040904950003 ANDREA AFRIALDI 09-04-1995 01-01-2018 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
6 21017672664 1208064409910001 ANITA FRISKA TAMBUNAN 24-09-1991 01-03-2021 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
7 22017076518 1271211110940001 ASSAD MUNTAZHAR 11-10-1994 01-02-2022 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
8 11028469234 1271026002700002 ATIKA RAHIMAH 20-02-1970 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
9 99D30029175 1271111006790005 BAGITO 10-06-1979 01-04-1999 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
10 16059938254 1207045006820004 BERKARYA PANJAITAN 10-06-1982 01-12-2016 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
11 14032422348 1271030611910006 BINTARA ADI SAPUTRA 06-11-1991 01-10-2014 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
SIMORANGKIR
12 14032422413 1271180404700003 BOYKE 04-04-1970 01-10-2014 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
13 22100456205 1271192909040002 BRAJA MULYAKSA 29-09-2004 01-09-2022 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
14 11028469358 1207236109900005 CHYNTIA DEBBIE 21-09-1990 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
15 23174197790 1223085808970004 DEBY GUSWITA BR PASARIBU 18-08-1997 3,624,117.00 0.00 8,697.88 10,872.35 134,092.33 72,482.34 72,482.34 36,241.17 0.00 0.00 334,868.41
16 12040538444 1275052303880001 DENNY ELFRADA LUBIS 23-03-1988 01-09-2012 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
17 11028469259 1271146807840008 DEVI AMELIA PULUNGAN 28-07-1984 01-10-2011 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
18 11028469184 1207285101740001 DEVI ELYANI 11-01-1974 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
19 11026338993 1275052102920005 DEWARI BAHTERA GINTING 21-02-1992 01-09-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
20 14032422330 1207056812920002 DEWI ASTUTI 24-12-1991 01-10-2014 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
21 11014113572 1207236110850004 DEWI MURNI SIREGAR 21-10-1985 01-05-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
22 23032444616 1271206001770004 DEWI SURYANI TARIGAN 20-01-1977 01-03-2023 3,624,117.00 0.00 8,697.88 10,872.35 134,092.33 72,482.34 72,482.34 36,241.17 0.00 0.00 334,868.41
23 13003924191 1271035812860003 DINA ANANDA 18-12-1984 01-02-2013 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
24 22061026344 1271114210970002 DINDA MUTIA SARI 02-10-1997 01-06-2022 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
25 17068310915 1272076408840001 DWI AYUNDA HAPSARI 24-08-1984 01-12-2017 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
26 11028469366 1271115005890001 EFA FITRIANI 10-05-1989 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
27 21096706219 1203224106910001 0 ELVI HASIBUAN 01-06-1991 01-12-2021 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
28 18009819808 1275055801940002 ERINA PERMATA TARIGAN 18-01-1994 01-02-2018 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
29 22017076526 1509065408960002 ERMIYATI 14-08-1996 01-02-2022 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
30 15007098807 1223011705950006 ERWIN SYAHPUTRA 17-05-1995 01-02-2015 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
31 22100456130 1207224510770002 EVA DILIANA. SP 05-10-1977 01-09-2022 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
32 23045383371 1203130110940001 FACHRUDDIN SAPUTRA 01-10-1994 01-04-2023 3,624,117.00 0.00 3,624.12 7,248.23 134,092.33 72,482.34 72,482.34 36,241.17 8,697.88 0.00 334,868.41
 Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan

BB006042 MEDAN ORTHOPAEDIC MEDAN ORTHOPAEDIC 01 2024

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP Iuran JKP
Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Pemberi Kerja Tenaga Kerja Pemberi Kerja Tenaga Kerja Pemberi Kerja Pemerintah Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.)
33 23135414003 1271091004970002 FAHMI DIAPARI SIREGAR 10-04-1997 01-09-2023 3,624,117.00 0.00 3,624.12 7,248.23 134,092.33 72,482.34 72,482.34 36,241.17 8,697.88 0.00 334,868.41
34 15031942889 1271092004820008 FAJARUDDIN 20-04-1982 01-06-2015 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
35 14032422363 1308191105910001 FAUZI ILYAS 11-05-1991 01-10-2014 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
36 23174197782 1271070202820001 FEBRIANSYAH 02-02-1982 01-11-2023 3,624,117.00 0.00 8,697.88 10,872.35 134,092.33 72,482.34 72,482.34 36,241.17 0.00 0.00 334,868.41
37 18055608824 1271094109930001 FIKY WULANDARI ZAHRA 01-09-1993 01-07-2018 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
38 15028051918 1673074908930003 FINCE ARIANTI SILAEN 09-08-1993 01-05-2015 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
39 23196319067 1271185504900005 FIQIH AZIZAH TAMBUNAN 15-04-1990 01-12-2023 3,624,117.00 0.00 3,624.12 7,248.23 134,092.33 72,482.34 72,482.34 36,241.17 8,697.88 0.00 334,868.41
40 15028051900 1201156205890003 FITRIA DEWI SINAGA 22-05-1989 01-05-2015 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
41 22047867431 1208171606920002 HADI SUNANDAR 16-06-1992 01-05-2022 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
42 14032422371 1206122510890001 HARDIKNAS KARO-KARO 02-05-1989 01-10-2014 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
43 22100456171 1271142905880004 HENDRA 29-05-1988 01-09-2022 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
44 14032422397 1271214510790002 HERLINA 05-10-1979 01-10-2014 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
45 11039864894 1271065601920002 HERLITA VERONIKA 16-01-1992 01-12-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
SIALLAGAN
46 22047867449 1271210807980002 ICHLASUL ICHSAN WIJAYA 08-07-1998 01-05-2022 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
47 11028469374 1218084311880001 INDAH SARI PURBA 03-11-1988 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
48 17051529687 1271044902920001 JESSICA STEFFI MANALU 09-02-1992 01-10-2017 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
49 11028469267 1271204408760005 JULIANI 04-08-1976 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
50 11028469275 1271212607870003 JULIANTO 26-07-1987 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
51 17032563763 1222035607880003 JULIYANTI 16-07-1988 01-07-2017 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
52 23174197774 1108130106920001 JUNARTO 01-06-1992 01-11-2023 3,624,117.00 0.00 3,624.12 7,248.23 134,092.33 72,482.34 72,482.34 36,241.17 8,697.88 0.00 334,868.41
53 22152467159 1271211008940002 0 JUPANDRIK 10-08-1994 01-12-2022 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
54 23020090959 1271025812920003 0 KHAIRATUL AFNA 13-12-1992 01-02-2023 3,624,117.00 0.00 8,697.88 10,872.35 134,092.33 72,482.34 72,482.34 36,241.17 0.00 0.00 334,868.41
55 17068310907 1207265108930017 KHAIRUN NISA 11-08-1993 01-12-2017 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
56 21058233897 1213011809920001 KHOLIKOTUL FANSYURI 19-09-1992 01-08-2021 3,624,117.00 0.00 3,624.12 7,248.23 134,092.33 72,482.34 72,482.34 36,241.17 8,697.88 0.00 334,868.41
57 11028469101 1207234609920003 LELY AMALIYAH 06-09-1992 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
58 22152467126 1271184909850012 0 LENY SOFIA TANJUNG 09-09-1985 01-12-2022 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
59 13032900824 1271215707880001 5060128084111 LISBET HUTAGALUNG 17-07-1988 01-10-2013 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
60 21087730079 1101061108950003 MARYUDI SALAM 11-08-1995 01-11-2021 3,624,117.00 0.00 3,624.12 7,248.23 134,092.33 72,482.34 72,482.34 36,241.17 8,697.88 0.00 334,868.41
61 21049308204 1271146002790005 - MASLIA 20-02-1979 01-07-2021 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
62 11028469283 1271016709720001 MELVA NISAH PANGARIBUAN 27-09-1972 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
63 12007743896 1271036403840003 MISDALENA SARAGIH 24-03-1984 01-03-2012 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
64 13003924266 1271116607890004 MORISTA KARO-KARO 26-07-1989 01-02-2013 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
 Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan

BB006042 MEDAN ORTHOPAEDIC MEDAN ORTHOPAEDIC 01 2024

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP Iuran JKP
Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Pemberi Kerja Tenaga Kerja Pemberi Kerja Tenaga Kerja Pemberi Kerja Pemerintah Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.)
65 12007743920 1219011009850006 MUDIN 10-09-1985 01-03-2012 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
66 14032422421 1271101502730005 MUHAMMAD FEBY ANTONI 15-02-1973 01-10-2014 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
67 14032422405 1271036010840005 NANDA SRI ZULIANI 20-10-1984 01-10-2014 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
68 14032422355 1271156501790005 NETTY SEMBIRING 25-01-1979 01-10-2014 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
69 22100456163 1271116711000004 NISYWAH IZZATY 27-07-2000 01-09-2022 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
70 22152467134 1207235510810014 0 NITA WAHYUNI LUBIS 15-10-1981 01-12-2022 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
71 19037144565 1174044411980001 NOVI LIQUITA SIMBOLON 04-11-1997 01-05-2019 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
72 18117198392 1203055010920003 NUR ISLAMIYAH SIREGAR 10-10-1992 01-12-2018 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
73 11033215630 1219065111830002 NURAINUN 11-11-1983 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
74 14032422389 1271044701900004 NURHALIMAH 07-01-1990 01-10-2014 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
75 22017076500 1212014607940004 NURHALIMAH HASIBUAN 06-07-1994 01-02-2022 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
76 17051529695 1207264212920007 NURUL HASANAH LUBIS 02-12-1992 01-10-2017 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
77 11028469119 1271035605680007 NURUL SUBHI 16-05-1968 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
78 16033851359 1207050404880004 PASKA SINAGA 04-04-1988 01-08-2016 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
79 17038551531 1207264209890006 PRAPTI MARGI UTAMI 02-09-1989 01-08-2017 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
80 23135413997 1207237003990007 PURNAMA SARI 30-03-1999 01-09-2023 3,624,117.00 0.00 3,624.12 7,248.23 134,092.33 72,482.34 72,482.34 36,241.17 8,697.88 0.00 334,868.41
81 20057208629 1201014412850001 RAMAHYANI RAJAGUKGUK 04-12-1985 01-09-2020 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
82 23032444624 1275014909860004 RANI MARDIANI 09-09-1986 01-03-2023 3,264,117.00 0.00 3,264.12 6,528.23 120,772.33 65,282.34 65,282.34 32,641.17 7,833.88 0.00 301,604.41
83 13003924167 1271205712750002 RENILDA 17-12-1975 01-02-2013 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
84 11028469382 1271124911890001 RETNO HANDAYANI 09-11-1989 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
85 18055608832 1271176303740003 RIAMA KRISNAWATI SIAHAAN 23-03-1974 01-07-2018 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
86 22100456155 1208282111010008 RICKI RAMADONI 21-11-2001 01-09-2022 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
87 22152467142 1271090208040005 0 RIKI ANDRI FARDIANSYA 02-08-2004 01-12-2022 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
TAMBUNAN
88 11021597452 1116044501830004 RINA 05-01-1983 01-07-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
89 22100456148 1271035505870006 RIRIN SUWINUL ARIFIN 15-05-1987 01-09-2022 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
90 19029976651 1271095012900002 RITA NATALIA MAGDALENA 10-12-1990 01-04-2019 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
91 20044488367 1271075301940001 ROSITA RIA MARPAUNG 23-03-1995 01-07-2020 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
92 20044488375 1271115408900007 SABRINA BR UJUNG 14-08-1990 01-07-2020 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
93 19052031010 2101101502940001 SAIFULLAH 15-02-1994 01-07-2019 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
94 15031942897 1223010610910003 SAIPUL BAHRI PASARIBU 06-10-1991 01-06-2015 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
95 19037144573 1205144808930003 SALOM VICTORIA PASARIBU 08-08-1993 01-05-2019 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
96 15028051892 1208282008790002 SAMSUL BAHRI HASIBUAN 20-08-1979 01-05-2015 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
 Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan

BB006042 MEDAN ORTHOPAEDIC MEDAN ORTHOPAEDIC 01 2024

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP Iuran JKP
Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Pemberi Kerja Tenaga Kerja Pemberi Kerja Tenaga Kerja Pemberi Kerja Pemerintah Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.)
97 23045383389 1208010507960001 SANDRO SUMANDO 05-07-1996 01-04-2023 3,624,117.00 0.00 3,624.12 7,248.23 134,092.33 72,482.34 72,482.34 36,241.17 8,697.88 0.00 334,868.41
SIMARMATA
98 21049308220 1271201606940005 SANJAYADI 16-06-1994 01-07-2021 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
99 22100456189 1403051909927402 SELAMAT HARIANTO 19-09-1992 01-09-2022 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
100 16002760672 1271054604920005 SITI FITRIA NALIS 06-04-1992 01-01-2016 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
101 23135414011 1271034907850001 SOFTIANA ULFA 09-07-1985 01-09-2023 3,624,117.00 0.00 3,624.12 7,248.23 134,092.33 72,482.34 72,482.34 36,241.17 8,697.88 0.00 334,868.41
102 11028469291 1271037112790022 SRI HANDAYANI. AMK 31-12-1979 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
103 11028469408 1271104810890002 SRI PAULINA SIHALOHO 08-10-1989 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
104 09020020369 1201166202890003 SUMIYANTI SIHOMBING 22-02-1989 01-09-2009 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
105 21049308212 1205176608840010 SURYANNA SYAM TANJUNG 26-08-1984 01-07-2021 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
106 23174197766 1271034810770006 SUSI HARIYANI SIRAIT 08-10-1977 01-11-2023 3,624,117.00 0.00 8,697.88 10,872.35 134,092.33 72,482.34 72,482.34 36,241.17 0.00 0.00 334,868.41
107 11028469333 1220044903880003 SYAHRINA RISKI 09-03-1988 01-10-2011 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
108 01B00165171 1271070509790001 SYOFIAN HADI 05-09-1979 01-11-2001 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
109 20044488409 1223081601880004 TAUFIK AS'HARI 16-01-1988 01-07-2020 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
110 18004065829 1271140405940007 WAHYU ARDIAN 04-05-1994 01-01-2018 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
111 23045383397 1275030202900001 0 WAHYUDI PAMUNGKAS 02-02-1990 01-04-2023 3,624,117.00 0.00 8,697.88 10,872.35 134,092.33 72,482.34 72,482.34 36,241.17 0.00 0.00 334,868.41
HASIBUAN
112 19052031028 1205045305920002 WINARTI MEILINA BR 13-05-1992 01-07-2019 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
SURBAKTI
113 15007098799 1272035805850004 YOCHE TRIDONA HARAHAP 18-05-1985 01-02-2015 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
114 20069288619 1271071203960001 YOGI BUKIT 12-03-1996 01-08-2020 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
115 20044488391 1271095007970001 YOLANDA MAULINA SARI 10-07-1997 01-07-2020 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46
116 22100456122 1205070707970004 YULIANTO 07-07-1998 01-09-2022 3,624,117.59 0.00 3,624.12 7,248.23 134,092.35 72,482.35 72,482.35 36,241.18 8,697.88 0.00 334,868.46
117 00B50086063 1271076508780003 YUSTINI P.E. DERMAWAN 25-08-1978 01-08-2000 3,624,117.59 0.00 8,697.88 10,872.35 134,092.35 72,482.35 72,482.35 36,241.18 0.00 0.00 334,868.46

Jumlah Seluruhnya 423,661,748.59 0.00 570,801.08 952,422.39 15,675,484.63 8,473,234.79 8,473,234.79 4,236,617.90 764,549.44 0.00 39,146,345.00

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, 20 Februari 2024
 Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan

BB006042 MEDAN ORTHOPAEDIC MEDAN ORTHOPAEDIC 01 2024

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP Iuran JKP
Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Pemberi Kerja Tenaga Kerja Pemberi Kerja Tenaga Kerja Pemberi Kerja Pemerintah Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.) (Rp.)

(Nama dan Tanda Tangan Pimpinan Perusahaan)

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