| NO | TGL | INSTITUSI | TUK | OBSERVER | KOORDINATOR | SUPERVISOR | CADANGAN |
| 1 | 08/10/2011 | PPNI Cilacap | Akper Seruling Mas | 1.Supadi,M.Kep.(Poltekes) | M Fatkhul M, Sp.Jiwa | H Edy Wuryanto | Observer Esthi budiningsih,Ns. |
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| 2.Chozin Abrori, (RS Cilacap) |
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| 3.Edi Sucipto,Ns(Cilacap) |
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| 4.Slamet Setiyadi,Ns(RSU BMS) |
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| 5.Darmini,Ns.(RS.Margono) |
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| 2 | 09/10/2011 | PPNI KAB KARANGANYAR | Karanganyar | 1.Didhing Supariti, Skep, Ns (sragen) | Harmoko, S.Kep.Ns | Untung Saeful R |
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| 2.Sri Hartini, Skep, Ns(sragen) |
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| 3.Yani Indrastuti, Skep, Ns(sragen) |
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| 4.Joko Sri Pujianto, Skep, Ns (surakarta) |
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| 5.Kusmiyati, Skep, Ns (surakarta) |
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| PPNI KAB PURWOREJO | Stikes Purworejo | 1.Hari Cahyono, SKep,Ns (kebumen) | Tri Hartiti, M.Kes |
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| 2.Saptono Susilo, Ns (kebumen) |
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| 3.Siti Mastuti, Skep, Ns (kebumen) |
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| 4.Ali Mustofa, Ns (kab magelang) |
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| 5.Anton Marianto, Ns (kab magelang) |
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| PPNI KAB MAGELANG | UMM | 1.Agus Purwoko, Skep, Ns (temanggung) | Sri Rejeki, Sp.Mat | Cadangan Observer Sri handayani, Eka laksmaida & Sugiarti |
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| 2.Giyanto, Skep, Ns (kota magelang) |
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| 3.Widyastuti Wibowo, Ns (kota magelang) |
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| 4.Dwi Rohadi, Ns (kota magelang) |
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| 5.Teguh Wibowo,Skep,Ns (purworejo) |
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| PPNI Kab Cilacap (74) | Akper Seruling Mas | 1.Chozin Abrori, Skep, Ns (cilacap) | M Fatkhul M, Sp.Jiwa |
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| 2.Esthi Budiningsih, Skep, Ns |
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| 3.Edi Sucipto, Skep, Ns (cilacap) |
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| 4.Sunardi Adi Wibowo,Skep,Ns (cilacap) |
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| 5.Arikh Ratna Purwadi, Ns (banyumas) |
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| PPNI KAB BANYUMAS | RSU Banyumas | 1.Indriati, Skep, Ns (purbalingga) | Eko Sadono, SKp |
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| 2.Sulistiani, Skep, Ns (purbalingga) |
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| 3.Herlina Widiastuti, Ns (banjarnegara) |
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| 4.Nanang Wardana, Ns (banjarnegara) |
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| 5.Widya Ariyanti, Ns (banjarnegara) |
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| UMS | UMS | 1.Agus Edy Tjahjono, Ns (karanganyar) | Untung Sujianto, M.Kes | Tri Ismu Pujianto |
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| 2.Dewi Listyorini, Skep, Ns (karanganyar) |
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| 3.Dwi Yuningsih, Skep, Ns (karanganyar) |
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| 4.Agus Setyawan, SKp (sukoharjo) |
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| 5.Sri Enawati, Skep, Ns (sukoharjo) |
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| 3 | 12/10/2011 | NGUDI WALUYO | PSIK Undip | 1.Supriyadi HS MN (semarang) | Kurnia Yuliastuti, M.Kep | Supriyadi, S.Kep. (Korwil Semarang) | Cadangan Observer Fitria handayani,Sp.KMB & Retno Setyowati,Sp.KMB. |
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| 2.Hery Susanto,Ns. (salatiga) |
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| 3.Nur Hamidah Amir (salatiga) |
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| 4.Retno Setyowati,Sp.KMB. (unisula) |
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| 5.Mamik,Ns. (ungaran) |
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| 4 | 16/10/2011 | PPNI KAB BANJARNEGARA | RSU Banjar Negara | 1.Indriati,Ns (purbalingga) | Edy Soesanto |
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| 2.Sulistiani,Ns (purbalingga) |
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| 3.Herlina Widiastuti,Ns (banjarnegara) |
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| 4.Nanang Wardhana,Ns (banjarnegara) |
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| 5.Widya Ariyanti,Ns. (banjarnegara) |
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| Semarang,4 Oktober 2011 |
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| Ketua PPNI JAWA TENGAH |
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| ttd |
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| EDY WURYANTO, Ns, M.KEP |
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