Está en la página 1de 127

REPORTE DE SERVICIOS POR TRASLADO NO CERRADO

COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1217 HOSPITAL VITARTE


1 210-14-40077868 ABARCA MARCELO NÍKOLAY ANDREW 0 210-2-78297364 28/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2 210-13-01228271 ABARCA VARGAS KATHERINE MARIA 18 050-2-70816006 03/08/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
3 210-17-24489512 ABREGU NAVARRO JOSEPH MILTON 8 230-2-73411749 03/12/2017 150103A101 150101A101 0.00 0.00 14.10 0.00 14.10
4 210-12-00191601 ACEDO CASTILLO NATALY FELICITA 24 210-2-70133822 07/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
5 210-13-00280665 ACEVEDO ALBARRACIN MERYDA SORAYDA 31 210-2-40929629 17/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
6 210-14-40020402 ACEVEDO MENDOZA MILAN NEYMAR 0 210-2-78347453 08/03/2014 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
7 210-11-03613999 ACHAS CAHUANA GLADYS BERTHA 39 210-2-43525011 14/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
8 210-11-03061868 ACOSTA COA YAJHAIRA ISABEL 11 210-2-74717076 02/07/2011 150103A101 150121A101 0.00 0.00 50.00 0.00 50.00
9 210-12-00798994 ACURIO QUISPE VICENTINA 79 210-2-47147971 04/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
10 210-14-40007924 ACUÑA MARTIN MIRIAM 25 210-2-46598353 29/01/2014 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
11 210-17-24456297 ACUÑA SALAZAR JEAMPIER JOSE NEYMAR 1 210-2-79375395 17/10/2017 150103A101 0000016918 0.00 0.00 9.89 0.00 9.89
12 210-13-00284539 ADCO ALMANZA RENZO YOEL 5 210-2-61107063 31/01/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
13 210-16-22833579 ADRIANO COMUN FLORENTINO 71 210-2-23222424 14/06/2016 150103A101 150115A101 0.00 0.00 10.27 0.00 10.27
14 210-13-01239428 ADVINCULA SANCHEZ GAUDENCIA 37 210-2-45190470 24/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
15 210-17-24295224 AGUADO SALDAÑA MAGALY DIANA 23 210-2-70482724 09/02/2017 150103A101 150111A101 0.00 0.00 7.76 0.00 7.76
16 210-14-40055962 AGUAYO ANYACO ABIGAIL 4 210-2-77194048 27/06/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
17 210-14-40116414 AGUERO GAVINO INES ANGELA 32 210-2-41404094 21/11/2014 150103A101 150101A105 0.00 0.00 17.05 0.00 17.05
18 210-13-01197092 AGUILAR BANCES MARIA LINDAURA 30 210-2-41893607 15/03/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
19 210-12-00810145 AGUILAR CAMARENA CINTHYA PAOLA 17 210-2-74241846 03/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
20 210-12-03899731 AGUILAR CANDIOTE NOEMI PILAR 17 220-2-48114487 21/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
21 210-12-00807096 AGUILAR GUERRA DEBORA LINETH 21 210-2-47064823 30/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
22 210-12-03902825 AGUILAR INGA ROBERTO DONATO 47 210-2-10422773 10/02/2012 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
23 210-18-42506216 AGUILAR LANDA RN-HV 0 210-E-29061529 27/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
24 210-11-03052682 AGUILAR MONTENEGRO SANTOS TOMASA 27 210-2-41910264 27/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
25 210-11-03056246 AGUILAR PALOMINO YESENIA SANDY 35 210-2-16125337 09/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
26 210-12-00185256 AGUILAR PAREDES YASMIN ZUSCEL 24 210-2-44665103 13/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
27 210-11-03607874 AGUILAR QUISPE CYNTHIA KAREN 17 210-2-48207535 09/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
28 210-14-40069034 AGUILAR SIESQUEN JHASMIN STEPHANIE 0 210-2-78622037 05/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90

Elaborado por OIE-SIS Página 1 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

29 210-17-24285876 AGUILAR VILCHEZ TANER ANDRÉ 1 210-2-79273189 26/01/2017 150103A101 150101A102 0.00 0.00 25.01 0.00 25.01
30 210-18-42558546 AGUIRRE CAMPOS IRENE CAROLINE 14 210-2-75244992 03/05/2018 150103A101 150137A101 0.00 0.00 7.06 0.00 7.06
31 210-18-42520260 AGUIRRE CAMPOS YESSENIA ELIZABETH 25 210-2-47789525 16/03/2018 150103A101 150111A205 0.00 0.00 11.92 0.00 11.92
32 210-12-00807019 AGUIRRE CARBAJAL VILMA 33 210-2-40246735 01/09/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
33 210-14-40077605 AGUIRRE ICAHUATE LISBETH ROSALVINA 38 210-2-10253735 27/08/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
34 210-14-40090323 AGUIRRE SANCHEZ BERTHA MAGALY 28 210-2-43688307 29/09/2014 150103A101 150111A101 0.00 0.00 11.08 0.00 11.08
35 210-12-00185365 AGUIRRE TINCO ABRAHAM DIONISIO 14 210-2-70086253 14/04/2012 150103A101 070102A101 0.00 0.00 0.00 0.00 0.00
36 210-13-00280214 AGÜERO ROSALES CELIA BEATRIZ 23 210-2-46082452 09/01/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
37 210-16-22932336 AHUAHARI CALAMPA RUTBER 41 340-2-00106664 27/11/2016 150103A101 150111A101 0.00 0.00 7.99 0.00 7.99
38 210-11-03050929 AHUANARI CAMPOS IQUEIDA 25 210-2-44308340 26/05/2011 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
39 210-12-00196997 AIRA PARIONA TATIANA ROCIO 5 210-2-60874343 21/04/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
40 210-17-24407122 ALACUTE CUSTODIO ERICKA MILAGROS 13 210-2-74871687 06/08/2017 150103A101 150105A101 0.00 0.00 24.49 0.00 24.49
41 210-17-24411172 ALACUTE CUSTODIO ERICKA MILAGROS 13 210-2-74871687 16/08/2017 150103A101 150105A101 0.00 0.00 13.05 0.00 13.05
42 210-16-22814227 ALAN LAZARO NANCY 50 210-2-06563388 11/05/2016 150103A101 150137A101 0.00 0.00 3.54 0.00 3.54
43 210-17-24343286 ALANIA CHACA HILDA LUZ 39 210-2-10601971 01/05/2017 150103A101 150111A101 0.00 0.00 8.12 0.00 8.12
44 210-17-24292548 ALANIA DE LA CRUZ GIANFRANCO JHOEL 12 210-2-60722616 05/02/2017 150103A101 150105A101 0.00 0.00 21.56 0.00 21.56
45 210-13-01214850 ALANIA LAURENCIO MIRIAM SARAI 23 210-2-46400603 31/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
46 210-11-03051773 ALANYA BUITRON NOEMI 23 210-2-44538835 10/06/2011 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
47 210-12-00194383 ALANYA GOMEZ CYNTHIA 21 210-2-47379123 28/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
48 210-11-03050861 ALANYA MENDOZA BERTHA 27 210-2-41836042 26/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
49 210-17-24314009 ALANYA PAYTAN PRECILA 28 210-2-45093564 11/03/2017 150103A101 150111A101 0.00 0.00 7.23 0.00 7.23
50 210-17-24285161 ALARCON ALVARADO RN 0 210-E-28686024 24/01/2017 150103A101 150111A101 0.00 0.00 7.76 0.00 7.76
51 210-11-03731792 ALARCON ARAUJO HELEN STEPHANY 20 210-2-47471474 28/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
52 210-12-00184582 ALARCON PRADO ALINA 32 210-2-44093648 09/04/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
53 210-13-01197310 ALARCON QUICAÑO ISABEL 25 210-2-44707483 15/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
54 210-13-01233471 ALARCON RUIZ RAYZA MANUELITA 21 210-2-47904922 01/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
55 210-17-24471551 ALARCON SAAVEDRA DEMETRIO FABIO 45 220-2-15425485 08/11/2017 150103A101 150111A101 0.00 0.00 8.34 0.00 8.34
56 210-12-00807682 ALARCON SALVADOR ZULLY THALIA MARJHARYN 19 210-2-47493588 20/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 2 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

57 210-12-00800633 ALARCON SANCHO ROSA ROSALVINA 52 220-2-20652092 13/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
58 210-13-01247907 ALARCON SOTO EDUARDO MARVIN 20 210-2-47611246 26/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
59 210-13-00284518 ALBERTO HINOSTROZA LEIDE LILIANA 30 210-2-41891002 31/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
60 210-11-03048080 ALBERTO PAUCAR OLGA ANITA 20 210-2-47874321 06/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
61 210-11-03608507 ALCALDE OBREGON DIEGO ARMANDO 9 210-2-74872387 21/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
62 210-12-01283858 ALCANTARA CCAHUA ERIKA ERMINIA 19 210-2-48149623 15/09/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
63 210-14-40015653 ALCANTARA LEIVA MARIA MARTHA 55 210-2-08221421 21/02/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
64 210-14-40059640 ALCANTARA PEREZ MARTHA MARIA 27 230-2-44592579 07/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
65 210-12-00798506 ALCANTARA QUISPE ERMILINDA 32 210-2-42409266 15/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
66 210-11-03730108 ALCARRAZ PARIONA ROSALINDA 31 210-2-41159438 27/11/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
67 210-14-40066168 ALCARRAZ QUISPE RN 0 210-7-70608130 27/07/2014 150103A101 150115A101 0.00 0.00 15.40 0.00 15.40
68 210-17-24309689 ALCAS MORENO ANA AMELIA 41 210-2-16752261 05/03/2017 150103A101 150111A101 0.00 0.00 8.13 0.00 8.13
69 210-17-24467534 ALDANA RAMIREZ DE FERRER CARMEN JULIA 58 210-2-06725521 03/11/2017 150103A101 150111A101 0.00 0.00 17.50 0.00 17.50
70 210-13-01251908 ALEGRE PASACHE MARIANO NICANOR JUNIOR 24 210-2-45896129 10/11/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
71 210-18-42510850 ALEGRIA CAPCHA EVELIN 28 210-2-47411384 04/03/2018 150103A101 150111A101 0.00 0.00 9.44 0.00 9.44
72 210-13-01226477 ALEJANDRIA RIVEROS ALICIA 26 210-2-44402832 18/07/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
73 210-13-01241773 ALEJANDRO ALVARADO GERMAN 72 210-2-19935534 02/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
74 210-13-01212211 ALEJO MAYLLI YUDI CARINA 28 210-2-43415804 20/05/2013 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
75 210-13-01225660 ALEJO SANTIAGO ELIZABELLA LUZ 23 210-2-46400679 14/07/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
76 210-11-03610570 ALFARO PALOMINO KAREM MELINA 20 210-2-46935009 12/10/2011 150103A101 150101A105 0.00 40.00 0.00 0.00 40.00
77 210-18-42488240 ALFARO SULLCA LIAM DANIEL 2 210-2-79176689 05/02/2018 150103A101 150105A101 0.00 0.00 13.62 0.00 13.62
78 210-17-24291701 ALIAGA ASTUCURI IVANOHE ABEL 23 210-2-48705581 04/02/2017 150103A101 150101A101 0.00 0.00 9.06 0.00 9.06
79 210-17-24374903 ALIAGA CAJA KELLY SULLMA 22 170-2-72416441 21/06/2017 150103A101 150101A105 0.00 0.00 10.04 0.00 10.04
80 210-12-03898799 ALIAGA CAMASCA MARGARITA 18 210-2-48412289 13/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
81 210-13-01231487 ALLCCA ALVA JOYSY PAMELA 17 210-2-76578394 23/08/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
82 210-12-03910443 ALMERCO SEGOVIA RN 0 140-7-22453575 08/03/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
83 210-13-00291846 ALMEYDA CANTO TOMAS 85 210-2-25645207 04/03/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
84 210-16-22831758 ALMEYDA MAGNO ALDAIR JULIO 5 210-2-74522127 10/06/2016 150103A101 150111A101 0.00 0.00 13.81 0.00 13.81

Elaborado por OIE-SIS Página 3 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

85 210-17-24498546 ALMEYDA SANCHEZ ANA MARIA 56 210-2-07328213 15/12/2017 150103A101 150111A101 0.00 0.00 8.93 0.00 8.93
86 210-12-00185276 ALMONACID CASABONA CAROLINA BERTHA 20 210-2-47600419 13/04/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
87 210-11-03611173 ALMONACID SANCHEZ NN 0 210-7-73782650 18/10/2011 150103A101 150121A101 0.00 0.00 45.00 0.00 45.00
88 210-12-00192626 ALTAMIRANO CHAMORRO MARIA ELIZABETH 25 210-2-44049860 02/06/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
89 210-14-40111691 ALTAMIRANO HUAMANI SMITH MAURO 5 230-2-61675723 11/11/2014 150103A101 150105A101 0.00 0.00 18.15 0.00 18.15
90 210-13-01225836 ALTAMIRANO PUMACAYO BRIAN SMITH 20 210-2-73262229 15/07/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
91 210-12-00196718 ALTAMIRANO QUISPE MARIBEL 24 210-2-44621690 24/04/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
92 210-14-40099780 ALTAMIRANO VALLES VICTOR 31 210-2-42056822 22/10/2014 150103A101 150118A202 0.00 0.00 32.65 0.00 32.65
93 210-12-00804283 ALTEZ AGUIRRE HELEN NATALY 18 210-2-73303199 10/08/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
94 210-17-24298925 ALTEZ FLOREZ LIRIA PRESCOPIA 48 210-2-21087950 16/02/2017 150103A101 150111A101 0.00 0.00 8.64 0.00 8.64
95 210-17-24388399 ALVARADO HUAMANYAURI PAMELA BRIGITT 16 220-2-73049708 11/07/2017 150103A101 150111A101 0.00 0.00 7.66 0.00 7.66
96 210-13-01209773 ALVARADO LOZANO CAROLINA 15 210-2-76170254 10/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
97 210-12-00192589 ALVARADO ORTEGA SINDY ISABELLA 26 210-2-44738950 06/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
98 210-12-00187563 ALVARES ARZAPALO GUIDA 28 210-2-45556258 13/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
99 210-17-24463251 ALVAREZ CHAUCAS CAREN YAMIRA 15 210-2-76000435 28/10/2017 150103A101 150141A101 0.00 0.00 14.22 0.00 14.22
100 210-13-01213744 ALVAREZ MERCADO MAYTHE PAMELA 20 210-2-48080049 27/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
101 210-17-24503643 ALVAREZ PONCE VICTOR JESUS 3 210-2-78821752 24/12/2017 150103A101 150105A101 0.00 0.00 16.92 0.00 16.92
102 210-11-03729503 ALVAREZ REYES KELY ZENAIDA 23 210-2-45413257 16/11/2011 150103A101 150132A205 0.00 0.00 40.00 0.00 40.00
103 210-11-03061872 ALVARO LIZARBE LIZBETH ANGELICA 6 210-2-62670309 03/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
104 210-17-24386995 ALVINO CHACA SINDY ISAMAR 25 200-2-72762806 08/07/2017 150103A101 150111A101 0.00 0.00 6.90 0.00 6.90
105 210-18-42553770 ALVITES BEDOYA KATHERIN PRICILA 28 210-2-48931184 27/04/2018 150103A101 150111A101 0.00 0.00 9.08 0.00 9.08
106 210-18-42540677 ALVITRES BENDEZU URBANO 48 130-2-23256017 11/04/2018 150103A101 150122A101 0.00 0.00 20.62 0.00 20.62
107 210-12-00799540 ALZAMORA HUAMAN MARUJA 20 210-2-47351075 22/07/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
108 210-12-00811637 ALZAMORA HUAMAN MARUJA 20 210-2-47351075 22/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
109 210-17-24272989 AMANCAY CONGORA JULIA 77 210-2-06612272 03/01/2017 150103A101 150101A102 0.00 0.00 16.82 0.00 16.82
110 210-17-24449544 AMAO CCAHUANA DORIS 20 210-2-73593110 08/10/2017 150103A101 150111A101 0.00 0.00 8.33 0.00 8.33
111 210-11-03607239 AMAO CHAVEZ ROCIO MONICA 30 210-2-40924734 05/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
112 210-11-03613580 AMAO DE LA CRUZ GOYA 26 210-2-42765948 22/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00

Elaborado por OIE-SIS Página 4 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

113 210-18-42465483 AMAO DE LA CRUZ GOYA 33 210-2-42765948 08/01/2018 150103A101 150111A205 0.00 0.00 12.52 0.00 12.52
114 210-17-24395282 AMARO GARCIA AMANDA SHARLINE 21 210-2-76460234 22/07/2017 150103A101 150121A101 0.00 0.00 18.12 0.00 18.12
115 210-12-00187138 AMASIFUEN PEZO DE TANCHIVA NILDA 32 210-2-01076857 15/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
116 210-13-01200395 AMASIFUEN TAPULLIMA NORMITH 30 210-2-41251213 30/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
117 210-17-24345153 AMASIFUEN VILLANUEVA URSULA THALIA 20 210-2-75861237 03/05/2017 150103A101 150111A101 0.00 0.00 7.67 0.00 7.67
118 210-17-24478394 AMAYA CCACCYA NAOMI BRIDALY 3 210-2-78840469 17/11/2017 150103A101 150111A101 0.00 0.00 7.99 0.00 7.99
119 210-11-03604312 AMBICHO ALVAREZ YERANDY 16 210-2-60401149 03/08/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
120 210-11-03055913 AMBICHO LOARTE RUFINA 38 210-2-22481806 12/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
121 210-11-03604925 AMBROCIO SHINGARI EPIFANIA MARIBEL 35 210-2-20587449 04/08/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
122 210-11-03056339 AMES SEDANO ANTONIA 28 210-2-41923905 06/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
123 210-12-00194384 ANAMPA POMA ELIZABETH JUDITH 15 210-2-71455460 27/04/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
124 210-12-00187586 ANAY GIL MAYRA GUILLERMINA 19 210-2-47769175 14/06/2012 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
125 210-17-24450685 ANAYA FAUSTINO YESENIA 19 210-2-77151237 09/10/2017 150103A101 150111A101 0.00 0.00 7.55 0.00 7.55
126 210-12-00277608 ANAYA MUCHA JADIEL ANGEL 2 210-2-75291439 08/01/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
127 210-11-03060752 ANCAJIMA GOMEZ OMARIS 18 210-2-47399768 16/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
128 210-12-00191411 ANCASSI TORRE TEODORA 22 170-6-50000348 04/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
129 210-17-24339574 ANCHELIA POMALIA KARINA MILAGROS 37 220-2-40358766 25/04/2017 150103A101 150137A206 0.00 0.00 6.33 0.00 6.33
130 210-17-24401972 ANCIETA MEDRANO MARCELA MILAS 84 170-2-21268857 02/08/2017 150103A101 150111A101 0.00 0.00 8.52 0.00 8.52
131 210-13-01215805 ANCO MAQUE ZEILA ELISBETH 24 210-2-45343020 04/06/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
132 210-17-24335380 ANDAMAYO LLACCTAS MARITZA MARIBEL 27 210-2-47741825 17/04/2017 150103A101 150111A101 0.00 0.00 9.04 0.00 9.04
133 210-18-42512807 ANDAMAYO QUISPE JENNY MILUSKA 13 210-2-75477772 06/03/2018 150103A101 150105A101 0.00 0.00 20.37 0.00 20.37
134 210-12-00808526 ANDIA NINAHUANCA NATALIA GABRIELA 25 210-2-44245634 07/09/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
135 210-12-00278433 ANDIA RIVAS MELANIA 17 210-2-75657273 20/01/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
136 210-13-01228528 ANDRADE FERNANDEZ SULMIRA 33 210-2-44708349 06/08/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
137 210-12-03900750 ANDRADE GAMARRA JANITTZA JESSENIA 20 210-2-46751749 29/01/2012 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
138 210-17-24340911 ANDRADE SULCA KATIE MARGOT 48 210-2-09361630 27/04/2017 150103A101 150111A101 0.00 0.00 9.04 0.00 9.04
139 210-12-00188036 ANGELES CUEVA CLEMENCIA GLICERIA 19 210-2-71529682 23/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
140 210-17-24283859 ANGELES PALOMINO ANGELÍ ARACELI MARISSA 4 210-2-77554486 21/01/2017 150103A101 150115A101 0.00 0.00 12.50 0.00 12.50

Elaborado por OIE-SIS Página 5 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

141 210-13-01213108 ANGELES SACRAVILCA LUISA AMANDA 26 210-2-45884182 23/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
142 210-17-24349236 ANGLAS QUINCHO MAURINA MARIA 57 170-2-21067721 09/05/2017 150103A101 150111A101 0.00 0.00 9.02 0.00 9.02
143 210-12-01284236 ANGLAS SABOYA KEVIN NEQUER 13 210-2-70908638 14/12/2012 150103A101 150118A202 0.00 0.00 77.00 0.00 77.00
144 210-17-24301085 ANGULO BARCO RN 0 280-E-28671584 21/02/2017 150103A101 150105A101 0.00 0.00 20.47 0.00 20.47
145 210-18-42478782 ANGULO PEREZ CHRISTELL GIANELLA 20 340-2-77059164 24/01/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
146 210-16-22869124 ANGULO TITO JOSE MATIAS 11 210-2-73746953 15/08/2016 150103A101 150105A101 0.00 0.00 13.45 0.00 13.45
147 210-13-01225694 ANTEZANO HUAYRE GLORIA LUCY 24 210-2-45680358 14/07/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
148 210-18-42460946 ANTICONA HUACHIHUACO FIORELLA FRANCISCA 18 210-2-78465317 03/01/2018 150103A101 150111A101 0.00 0.00 4.79 0.00 4.79
149 210-18-42465219 ANTICONA HUACHIHUACO FIORELLA FRANCISCA 18 210-2-78465317 06/01/2018 150103A101 150111A101 0.00 0.00 9.57 0.00 9.57
150 210-13-01226076 ANTONIO ANTICH LORENA 18 210-2-73891050 16/07/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
151 210-16-22856821 ANTONIO PEÑA SNAYDER NEYMAR 1 210-2-81600372 25/07/2016 150103A101 070102A101 0.00 0.00 19.82 0.00 19.82
152 210-14-40018314 ANYACO AQUINO NOEMI 26 210-2-46187671 02/03/2014 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
153 210-11-03614143 APAICO CAÑARI GERALDINE GLORIA 18 210-2-47846269 27/09/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00
154 210-11-03053424 APARCO ROMANI MONICA 14 210-2-72246096 06/06/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
155 210-12-00184786 APARICIO BARRERA MARIA ISABEL 28 210-2-42262121 12/04/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
156 210-12-00799305 APAZA TURPO HELEN YULIANA 21 210-2-46474744 07/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
157 210-14-40076147 APESTEGUI URIBE JOEL NAHUM 11 210-2-76766350 24/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
158 210-18-42475644 APFATA MEZA FRANCISCO SAMUEL 2 210-2-79811927 20/01/2018 150103A101 150105A101 0.00 0.00 16.81 0.00 16.81
159 210-18-42561252 APOLINARIO DAVILA SEBASTIAN ERNESTO 7 210-2-75295367 07/05/2018 150103A101 150101A109 0.00 0.00 21.69 0.00 21.69
160 210-12-03900626 APONTE SUDARIO SAIDA 29 210-2-41650993 25/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
161 210-11-03730134 AQUINO BASILIO WENDY MARILU 30 210-2-40927960 27/11/2011 150103A101 150111A205 0.00 0.00 40.00 0.00 40.00
162 210-13-01209435 AQUINO PALOMINO YESICA LISET 31 210-2-45412334 08/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
163 210-13-01217942 AQUINO PALOMINO YESICA LISET 31 210-2-45412334 12/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
164 210-11-03047828 AQUINO ROMERO MARIELA ROCIO 19 210-2-70164149 05/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
165 210-17-24418420 AQUINO TOLENTINO YOSI 17 140-2-75770194 27/08/2017 150103A101 150111A101 0.00 0.00 9.28 0.00 9.28
166 210-13-01247905 AQUISE ENCISO NN 0 210-7-43698648 26/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
167 210-12-03905344 AQUIÑO BARRIONUEVO ABEL LEONIDAS 22 210-2-70387402 28/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
168 210-18-42534757 ARANDA ESPINOZA ANYELYN THALIA 8 210-2-62374886 04/04/2018 150103A101 150101A101 0.00 0.00 14.24 0.00 14.24

Elaborado por OIE-SIS Página 6 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

169 210-17-24488383 ARANDA MESIAS RN-HV 0 210-E-28986771 01/12/2017 150103A101 150121A101 0.00 0.00 22.56 0.00 22.56
170 210-17-24328488 ARANDA SEAS RUTH GABRIEL 13 210-2-77853698 05/04/2017 150103A101 150111A101 0.00 0.00 8.13 0.00 8.13
171 210-11-03727083 ARANDA SEAS SHEYLA IRIS 18 210-2-48256234 05/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
172 210-18-42528568 ARANGO FLORES EUSEBIO JOSE 36 220-2-42430994 27/03/2018 150103A101 150118A101 0.00 0.00 27.82 0.00 27.82
173 210-11-03611661 ARANGO QUISPE ZENAIDA 18 210-2-48083885 03/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
174 210-12-00811301 ARAUJO PALLARCO LUZMILA 26 210-2-47715905 23/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
175 210-12-00190617 ARAUJO POMA OREANNA GERALDINA 1 210-2-75294653 31/05/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
176 210-11-03614892 ARCE ARIAS LUZ AUREA 22 210-2-45643029 25/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
177 210-17-24405546 ARCE PAITAN LISETH MARINA 22 210-2-70166300 08/08/2017 150103A101 150111A101 0.00 0.00 7.66 0.00 7.66
178 210-13-01213623 ARCE SANTOS JESÚS ANGEL 3 210-2-74016040 26/05/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
179 210-11-03058743 ARCOS PEÑA JANNETTE SAHARY 28 210-2-42216094 11/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
180 210-13-01227097 ARECHE JAVIER PERCY YACK 2 130-2-62080686 23/07/2013 150103A101 150101A104 0.00 0.00 53.20 0.00 53.20
181 210-17-24472995 ARELLANO ACEVEDO HAYDEE JULIA 29 210-2-45694216 09/11/2017 150103A101 150111A205 0.00 0.00 14.10 0.00 14.10
182 210-13-01216117 ARELLANO CHUICA DEYSI MIREL 33 210-2-40561117 05/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
183 210-18-42556445 ARENAS HINOSTROZA CAMILA MAYLI 6 210-2-77105878 01/05/2018 150103A101 150111A101 0.00 0.00 9.58 0.00 9.58
184 210-17-24324233 ARENAS PRADO FELICIANA 52 210-2-08799449 30/03/2017 150103A101 150111A101 0.00 0.00 9.04 0.00 9.04
185 210-17-24389624 ARGUMEDO MOLINA LUCILA 86 210-2-07094574 13/07/2017 150103A101 070102A101 0.00 0.00 23.84 0.00 23.84
186 210-12-01295011 ARIAS CHOQUE BELINDA 8 210-2-76703560 14/10/2012 150103A101 150110A101 0.00 0.00 0.00 0.00 0.00
187 210-17-24409961 ARIAS DOMINGUEZ ANDREA XIOMARA 11 050-2-75555869 14/08/2017 150103A101 0000016918 0.00 0.00 11.00 0.00 11.00
188 210-17-24298268 ARIAS HUATUCO ROSE LIZETH 14 210-2-77133798 15/02/2017 150103A101 150101A105 0.00 0.00 12.50 0.00 12.50
189 210-17-24343215 ARIAS ORDAYA STEVEN ANTHONY 8 210-2-72587091 01/05/2017 150103A101 150111A101 0.00 0.00 9.02 0.00 9.02
190 210-14-40078561 ARIAS OSCANOA KETTY MARITZA 19 210-2-71028709 29/08/2014 150103A101 150101A109 0.00 0.00 23.10 0.00 23.10
191 210-17-24287028 ARIAS PADILLA JUAN LIAM 1 210-E-28694205 30/01/2017 150103A101 150115A101 0.00 0.00 11.64 0.00 11.64
192 210-11-03050175 ARIAS PUENTE KATE MARLENE 34 210-2-40523905 25/04/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
193 210-14-40072650 ARIAS TIMANA LIONEL ANDRE 1 210-2-77972089 13/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
194 210-17-24319389 ARIRAMA TORRES JESUS ADRIAN 2 200-2-78698903 22/03/2017 150103A101 150111A101 0.00 0.00 9.94 0.00 9.94
195 210-11-03732088 ARIZAPANA DAVILA EMILIA AMANDA 25 210-2-43663880 01/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
196 210-17-24340183 ARMAS HUACCHA HIDALGO JHACSON 20 070-2-71555617 26/04/2017 150103A101 150111A101 0.00 0.00 11.30 0.00 11.30

Elaborado por OIE-SIS Página 7 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

197 210-12-00192060 ARO DIAZ MILAGROS LESLY 27 210-2-42587676 11/06/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
198 210-11-03052029 ARONE SILVA PAOLO DAVID 3 210-2-71674247 10/06/2011 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
199 210-12-00809914 ARONE SOTO LUZMILA ZENAIDA 21 210-2-46751224 22/08/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
200 210-17-24329222 ARONES HUARCAYA DANIEL DARIO 1 210-E-28700166 06/04/2017 150103A101 150115A101 0.00 0.00 11.75 0.00 11.75
201 210-12-00192574 ARONI ORE ROSALIN ESTEFANI 17 210-2-74903148 06/06/2012 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
202 210-11-03061340 AROTOMA CERDA JEREMY JEYSON 0 210-2-77000052 28/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
203 210-13-01208922 ARREDONDO ARTEAGA RICHARD 37 210-2-40529076 06/05/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
204 210-18-42501378 ARRIETA CURIMANIA MARITZA PAOLA 21 270-2-74367722 21/02/2018 150103A101 150107A204 0.00 0.00 11.41 0.00 11.41
205 210-11-03050898 ARRIETA GALVEZ CINDY EVELIN 21 210-2-46300260 26/05/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
206 210-13-01223410 ARRIETA ROJAS MELVIN FERNANDO 2 210-2-75637968 04/07/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
207 210-13-01197858 ARROYO CARHUAS JASSIE DAYANA 3 210-2-62336882 18/03/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
208 210-18-42520262 ARROYO DE MARTINEZ MAURILIA FELIPA 67 210-2-09056526 16/03/2018 150103A101 150111A101 0.00 0.00 9.94 0.00 9.94
209 210-13-01239406 ARROYO MORALES ERIKA ZOILA 37 210-2-42672654 23/09/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
210 210-13-01216751 ARROYO PANEZ OLIVIA YOELA 34 210-2-21127683 07/06/2013 150103A101 150107A204 0.00 0.00 42.00 0.00 42.00
211 210-17-24317268 ARTEZANO JUAN DE DIOS YERALDIN RUTH 20 170-2-76339788 18/03/2017 150103A101 150101A105 0.00 0.00 10.85 0.00 10.85
212 210-18-42563313 ARZAPALO FLORES RN-HV 0 210-E-28979095 09/05/2018 150103A101 150115A101 0.00 0.00 19.11 0.00 19.11
213 210-12-03907866 ARZAPALO MANTILLA SARUMI JANAI 1 210-2-76704621 24/03/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
214 210-18-42469358 ARZAPALO PICHIHUA ALEXIA XIMENA 4 210-2-78266492 10/01/2018 150103A101 150111A101 0.00 0.00 9.20 0.00 9.20
215 210-13-01216685 ASCANOA SANCHEZ PILAR ESTEFANI 21 210-2-47753988 07/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
216 210-14-40011711 ASCANOA YLDEFONSO ANTONIO 61 210-2-07412665 10/02/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
217 210-13-01199111 ASENCIO RAMOS ANDRE SEBASTIAN 5 210-2-73409868 23/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
218 210-12-01286658 ASMAT HERNANDEZ DANITZA MARGOT 26 210-2-43426773 10/11/2012 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
219 210-13-00290251 ASTETE MAITA AMANDA BERTA 76 170-2-47788318 25/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
220 210-11-03060245 ASTETE SOLIS JOSELYN MELISSA 15 210-2-76083121 24/06/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
221 210-11-03725726 ASTO BELITO TEODOSIA 21 210-2-60001236 23/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
222 210-17-24395560 ASTO PARIONA THIAGO LUIS 0 210-2-90113299 22/07/2017 150103A101 150105A101 0.00 0.00 23.49 0.00 23.49
223 210-17-24395728 ASTO PARIONA THIAGO LUIS 0 210-2-90113299 17/07/2017 150103A101 150111A101 0.00 0.00 8.85 0.00 8.85
224 210-14-40067932 ASTO POMA DELIA DORA 22 210-2-46811167 01/08/2014 150103A101 150101A109 0.00 0.00 23.10 0.00 23.10

Elaborado por OIE-SIS Página 8 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

225 210-17-24487268 ASTO SALVADOR FRANKLIN 14 210-2-73654918 30/11/2017 150103A101 150111A101 0.00 0.00 15.62 0.00 15.62
226 210-17-24284664 ASTUCURI CONDEZO EVELYN NAOMI 9 210-2-61165651 24/01/2017 150103A101 150105A101 0.00 0.00 19.43 0.00 19.43
227 210-18-42497370 ASTUHUAMAN CONDOR ANTONIA LORENZA 68 210-2-04038661 15/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
228 210-11-03612834 ASTUVILCA SALCEDO CINDY MILUSKA 25 210-2-43492893 23/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
229 210-17-24351807 ATACHAGUA JANCACHAGUA KARINA ELIZABETH 17 210-2-71098741 15/05/2017 150103A101 150111A101 0.00 0.00 8.12 0.00 8.12
230 210-18-42564946 ATACHAGUA JANCACHAGUA MARCELO DANIEL 7 210-2-74679416 12/05/2018 150103A101 150103A208 0.00 0.00 12.65 0.00 12.65
231 210-18-42566694 ATACHAGUA JANCACHAGUA MARCELO DANIEL 7 210-2-74679416 14/05/2018 150103A101 150111A101 0.00 0.00 10.80 0.00 10.80
232 210-11-03611665 ATAHUAMAN GONZALES LUCY MADELEY 18 210-2-70090995 04/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
233 210-18-42493872 ATALAYA URRUTIA MARIA ELENA 25 190-2-73571225 12/02/2018 150103A101 150111A205 0.00 0.00 10.06 0.00 10.06
234 210-12-00807874 ATAO BONIFACIO ALICIA 36 210-2-28297861 23/08/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
235 210-13-01217344 ATAUCUSI CASTRO ELIASAR JOAQUIN 5 210-2-60312630 10/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
236 210-14-40054873 ATAUCUSI QUISPE SUSANA 19 210-2-48566420 24/06/2014 150103A101 150137A206 0.00 0.00 8.80 0.00 8.80
237 210-14-40030286 ATAUCUSI ROJAS JULIA 38 210-2-40070162 06/04/2014 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
238 210-11-03047778 ATENCIO BAZAN ZEIDA LIZBETH 18 210-2-47984349 04/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
239 210-12-00805316 ATUYAP ORREGO CELIA 18 210-2-48251497 25/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
240 210-11-03610065 AUCCA MEDINA GIOVANNA GRIMANEZA 18 210-2-70089289 01/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
241 210-11-03055344 AUCCAISE CCAHUA SANTUSA 21 210-2-46160929 30/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
242 210-17-24384116 AUCCAPUCLLA MOLINA ANDREA WENDY 19 210-2-62948777 05/07/2018 150103A101 150111A101 0.00 0.00 7.66 0.00 7.66
243 210-11-03048324 AUCCAPURE ESPINOZA MARIBEL MAGALY 19 210-2-47558157 03/04/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
244 210-18-42552679 AVALOS DE LA CRUZ SANTOS MARCELINA 60 210-2-00047715 26/04/2018 150103A101 150101A102 0.00 0.00 21.11 0.00 21.11
245 210-17-24462191 AVENDAÑO BAEZ ADINSON ROBERTH 1 210-2-79590743 25/10/2017 150103A101 150105A101 0.00 0.00 9.89 0.00 9.89
246 210-16-22923114 AVENDAÑO BAZAN MICHAEL JANCO 6 210-2-74182125 10/11/2016 150103A101 0000016918 0.00 0.00 10.42 0.00 10.42
247 210-14-40076226 AVENDAÑO BAZAN MICHAEL JANCO 4 210-2-74182125 24/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
248 210-17-24330992 AVENDAÑO SOLIER SILVIA 35 210-2-41213464 08/04/2017 150103A101 150137A206 0.00 0.00 7.68 0.00 7.68
249 210-17-24346805 AVILA ALEJANDRO BETTY ADELAIDA 28 210-2-46370372 05/05/2017 150103A101 150111A101 0.00 0.00 9.02 0.00 9.02
250 210-17-24445823 AVILA CUADROS XANDER NIJASH 4 210-2-78441935 03/10/2017 150103A101 150115A101 0.00 0.00 7.89 0.00 7.89
251 210-12-01283164 AVILA LEON CAROLINA DIANA 17 210-2-76004067 30/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
252 210-11-03054053 AVILA LUQUE GRISEL DÁMARIS 1 210-2-74018701 18/05/2011 150103A101 150105A101 0.00 0.00 40.00 0.00 40.00

Elaborado por OIE-SIS Página 9 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

253 210-17-24462228 AVILA TAPIA KAELIN MAGDALENA 41 210-2-10260532 26/10/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
254 210-12-01291228 AVILES GONZALES JULIA 22 210-2-46666589 02/12/2012 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
255 210-11-03735043 AVILES ROBLES ULDA 17 210-2-48377588 20/12/2011 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
256 210-13-01199106 AYALA ALANIA NELIDA REBECA 47 210-2-07670032 23/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
257 210-12-03909533 AYALA ALARCON NICOLAS 77 210-2-20520423 28/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
258 210-18-42522758 AYALA ALARCON NICOLAS 83 210-2-20520423 19/03/2018 150103A101 150111A101 0.00 0.00 10.43 0.00 10.43
259 210-11-03048538 AYALA BOLAÑOS MARIA ERMILA 18 210-2-46948849 02/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
260 210-17-24447942 AYALA FARROÑAN ESTHER MARIA 0 210-2-90217940 05/10/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
261 210-17-24483712 AYALA FARROÑAN ESTHER MARIA 0 210-2-90217940 27/11/2017 150103A101 0000016918 0.00 0.00 12.45 0.00 12.45
262 210-17-24488644 AYALA FARROÑAN ESTHER MARIA 0 210-2-90217940 02/12/2017 150103A101 150105A101 0.00 0.00 18.33 0.00 18.33
263 210-17-24492714 AYALA FARROÑAN ESTHER MARIA 0 210-2-90217940 06/12/2017 150103A101 0000016918 0.00 0.00 12.69 0.00 12.69
264 210-11-03052635 AYALA GOMEZ GILMER ADRIAN 7 210-2-60285732 26/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
265 210-12-01283939 AYALA PILLACA SABINA BASILIA 37 210-2-10054109 15/09/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
266 210-18-42545199 AYALA QUINTO JESUS LINO 8 270-2-74187997 17/04/2018 150103A101 150105A101 0.00 0.00 18.65 0.00 18.65
267 210-18-42546649 AYALA QUINTO JESUS LINO 8 270-2-74187997 19/04/2018 150103A101 150105A101 0.00 0.00 18.65 0.00 18.65
268 210-16-22935962 AYALA TAIPE VIOLET KIARA MODESTA 3 210-E-28621168 04/12/2016 150103A101 150105A101 0.00 0.00 13.90 0.00 13.90
269 210-12-03904555 AYALA VILLODAS DAYRON JOHAN 5 210-2-60861442 30/03/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
270 210-12-03906666 AYBAR PINCO MARILYN ELIZABETH 20 210-2-47729740 14/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
271 210-12-00185745 AYLAS CURILLA ESTHER VERONICA 31 210-2-40601219 16/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
272 210-18-42514985 AYLAS NUÑEZ PATRICK ABDIEL 1 210-2-90111844 09/03/2018 150103A101 150115A101 0.00 0.00 13.41 0.00 13.41
273 210-17-24310077 AYLAS NUÑEZ RN 0 210-E-28733340 06/03/2017 150103A101 150115A101 0.00 0.00 12.64 0.00 12.64
274 210-17-24492644 AYQUIPA ACHULLA EFRAIN 27 270-2-46870138 06/12/2017 150103A101 150118A101 0.00 0.00 28.20 0.00 28.20
275 210-17-24389315 AYRA ARRIETA JOSE ANTONIO 25 210-2-47027986 12/07/2017 150103A101 150111A101 0.00 0.00 10.25 0.00 10.25
276 210-12-00808823 AYRAVILCA TITO ANGELO SAMIR 2 210-2-61753508 24/08/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
277 210-17-24374171 AYRE POMA CIPRIANA VICTORIA 72 170-2-20961006 20/06/2017 150103A101 150141A101 0.00 0.00 13.31 0.00 13.31
278 210-16-22869379 AZAÑA DOMINGUEZ BENIGNA 86 210-2-10171831 15/08/2016 150103A101 150122A101 0.00 0.00 14.51 0.00 14.51
279 210-13-01218398 AÑANCA CALSIN ARIANA CHANTAL 9 210-2-71385922 14/06/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
280 210-11-03063080 BABILONIA DAVILA MAB NODRITH 24 210-2-44079304 09/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00

Elaborado por OIE-SIS Página 10 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

281 210-12-00191547 BABILONIA NUBE LEA 25 210-2-44293422 02/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
282 210-17-24349697 BABILONIA NUBE LEA 30 210-2-44293422 10/05/2017 150103A101 150137A206 0.00 0.00 5.41 0.00 5.41
283 210-12-00186797 BABILONIA NUBE REBECA 20 210-2-48565361 19/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
284 210-11-03050333 BACA FERNANDEZ LUCERO HAYDEE 16 210-2-75325529 23/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
285 210-12-00188733 BACILIO HUALLPA NELSON JESUS 12 210-2-70608972 26/06/2012 150103A101 150101A103 0.00 0.00 0.00 0.00 0.00
286 210-14-40070506 BALBIN ANYACO HAYDEE MARITZA 33 210-2-40885382 08/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
287 210-14-40054231 BALBIN LARA GILMER 42 210-2-15358310 22/06/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
288 210-12-03908199 BALBIN MARIN CARMEN CHABELA 34 210-2-06811388 27/02/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
289 210-13-01221059 BALBOA FLORES JESUSA 27 210-2-44044212 25/06/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
290 210-12-00810320 BALDEON ESPINOZA BELISSA ADDY 27 210-2-42733929 06/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
291 210-13-00281475 BALDEON ESTEBAN ENMA VERONICA 29 210-2-41925485 26/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
292 210-12-01288662 BALDEON GOMEZ DELIA 35 210-2-10423789 28/10/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
293 210-17-24282741 BALDEON HILARIO CEVIRINA 56 210-2-07115219 19/01/2017 150103A101 150101A102 0.00 0.00 16.82 0.00 16.82
294 210-11-03604636 BALDEON MAYTA FRANK JOSELIN 11 210-2-74308166 07/08/2011 150103A101 150105A101 0.00 0.00 40.00 0.00 40.00
295 210-13-01200482 BALDEON SOLIS YESLY KELY 16 170-2-75973276 31/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
296 210-18-42563264 BALLÓN CASTILLO ROSA ROCÍO 23 300-2-48410130 10/05/2018 150103A101 150111A101 0.00 0.00 8.43 0.00 8.43
297 210-11-03728191 BALTAZAR CARDENAS MARTINA 36 210-2-10544435 10/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
298 210-18-42519802 BALTAZAR ESTEBAN SANDRA KARLA 16 210-2-77684668 15/03/2018 150103A101 150137A101 0.00 0.00 4.97 0.00 4.97
299 210-18-42492586 BALTAZAR PARIONA ANA MARIA 32 210-2-43817935 09/02/2018 150103A101 150111A205 0.00 0.00 13.13 0.00 13.13
300 210-11-03059064 BALTAZAR TORRES MARIBEL ERNESTINA 35 210-2-09955904 21/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
301 210-13-01242749 BALTAZAR TOTOS JOSE ANTONIO 12 210-2-71434735 07/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
302 210-13-01243361 BALTAZAR VALENCIA LUIGHI STEFANO 4 210-2-61637068 09/10/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
303 210-11-03611790 BARBA ARANA ENRIQUE 67 210-2-08107588 06/10/2011 150103A101 150101A101 0.00 0.00 40.00 0.00 40.00
304 210-13-01247883 BARBOZA RAMIREZ BRAYAN ALI 4 210-2-73717149 25/10/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
305 210-11-03604805 BARDALES ORDOÑEZ ZULEMA 34 210-2-42564475 04/08/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
306 210-18-42482266 BARDALES RODRIGUEZ MARIXA MAYUMI 8 210-2-73927256 29/01/2018 150103A101 150115A101 0.00 0.00 11.78 0.00 11.78
307 210-18-42482696 BARDALES RODRIGUEZ MARIXA MAYUMI 8 210-2-73927256 30/01/2018 150103A101 0000016918 0.00 0.00 11.78 0.00 11.78
308 210-17-24282502 BARRANTES CASTILLO JUAN DIEGO 3 210-2-80935884 19/01/2017 150103A101 150101A103 0.00 0.00 14.23 0.00 14.23

Elaborado por OIE-SIS Página 11 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

309 210-12-00189790 BARRANTES MONCADA ZULEMA 22 210-2-46262073 27/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
310 210-11-03734454 BARRANTES VILCA MARGARITA 33 210-2-02047956 02/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
311 210-11-03059499 BARRAZA CHUQUIHUAMANI BERTHA 29 210-2-42894842 15/07/2011 150103A101 150101A102 0.00 0.00 40.00 0.00 40.00
312 210-13-01241791 BARRENECHEA GENTILLE MARIA LUISA 17 210-2-77689609 02/10/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
313 210-17-24429022 BARRERA FELICES JOSE ANTONIO 8 210-2-61529999 10/09/2017 150103A101 150111A101 0.00 0.00 10.00 0.00 10.00
314 210-17-24402091 BARRETO ASTUHUAMAN ROBERTO 58 210-2-21138704 02/08/2017 150103A101 150101A102 0.00 0.00 28.30 0.00 28.30
315 210-13-01209462 BARRETO JAIMES TANIA VANESSA 27 210-2-43575963 08/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
316 210-18-42480968 BARRETO LIFONCIO RAQUEL 29 210-2-45711348 27/01/2018 150103A101 150137A206 0.00 0.00 6.14 0.00 6.14
317 210-12-00799240 BARRETO PRIALE VILMA 44 210-2-06810056 06/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
318 210-17-24504926 BARRIAL GONZALES YESSENIA YOSELIN 25 210-2-70088167 27/12/2017 150103A101 150111A101 0.00 0.00 9.40 0.00 9.40
319 210-12-00802297 BARRIENTOS FELIX TERESA SORAIDA 27 210-2-42877359 07/09/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
320 210-17-24304387 BARRIENTOS HUAMANI KELLY ALEXANDRA 17 210-2-76749928 27/02/2017 150103A101 150111A101 0.00 0.00 8.59 0.00 8.59
321 210-11-03047898 BARRIENTOS HUARANGA NAYSHA FLOR 10 230-6-01261596 06/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
322 210-17-24417690 BARRIENTOS MEJIA OLINDA 29 210-2-45257006 26/08/2017 150103A101 150111A101 0.00 0.00 7.34 0.00 7.34
323 210-13-00289865 BARRIENTOS TALAVERA YOURSH 2 210-2-60151589 23/02/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
324 210-14-40075538 BARRIGA SOTOMAYOR MAYRA JENNY 29 210-2-42882231 21/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
325 210-17-24299540 BARRIONUEVO ARAGON TRINIDAD ADORMELIA 36 210-2-40986586 17/02/2017 150103A101 150111A101 0.00 0.00 8.62 0.00 8.62
326 210-12-00807149 BARRIONUEVO GALARZA KIARA TALIA 2 210-2-73909355 31/08/2012 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
327 210-17-24442642 BARRIOS NEIRA SANTA ELENA 22 160-2-76748377 30/09/2017 150103A101 150111A101 0.00 0.00 9.55 0.00 9.55
328 210-12-00807365 BARTOLO HURTADO KELLY ROSALBINA 23 210-2-45504741 26/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
329 210-13-01243940 BARZOLA ALANYA ROSALINDA 17 210-2-70072776 11/10/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
330 210-12-00191910 BARZOLA AYBAR HELLEN MILUSKA 30 210-2-42750907 05/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
331 210-12-03906385 BARZOLA CCALE NN 0 210-7-47534646 04/04/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
332 210-17-24381794 BARZOLA CORTEZ RN-HV 0 210-E-28852046 01/07/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
333 210-13-01227459 BARZOLA ESPINOZA JENNIFER ESTHEPHANY 19 210-2-48681922 26/07/2013 150103A101 150132A205 0.00 0.00 68.60 0.00 68.60
334 210-11-03055725 BARZOLA ESTEBAN MILITO FORLAN 0 210-2-74516880 13/05/2011 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
335 210-11-03732181 BARZOLA GARCIA VANESSA LIZ 24 210-2-44867740 02/12/2011 150103A101 150101A102 0.00 0.00 45.00 0.00 45.00
336 210-18-42550427 BARZOLA LADERA STEFANNY JAZMIN 11 210-2-75343532 25/04/2018 150103A101 150121A101 0.00 0.00 18.65 0.00 18.65

Elaborado por OIE-SIS Página 12 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

337 210-17-24469191 BARZOLA ORTEGA SUSY ANNIA 27 210-2-70164917 04/11/2017 150103A101 150111A101 0.00 0.00 8.81 0.00 8.81
338 210-18-42560289 BARZOLA PARQUE RN 0 210-E-29134930 06/05/2018 150103A101 150111A101 0.00 0.00 9.58 0.00 9.58
339 210-11-03612030 BARZOLA PAUCAR MILENKO JENSI 0 210-2-74789265 07/10/2011 150103A101 150105A101 0.00 45.00 0.00 0.00 45.00
340 210-18-42481036 BARZOLA ZAPATA MARILIN SHUMARA 10 170-2-60552904 27/01/2018 150103A101 150115A101 0.00 0.00 11.41 0.00 11.41
341 210-17-24453179 BARZOLA ÑAUPA MARIA ISABEL 36 210-2-41128151 13/10/2017 150103A101 150111A205 0.00 0.00 10.89 0.00 10.89
342 210-11-03047124 BASHUALDO GARCIA RUTH 37 210-2-21263627 31/03/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
343 210-17-24432729 BASILIO JARA ESTHER KYARA 6 210-2-76493455 15/09/2017 150103A101 150105A101 0.00 0.00 14.66 0.00 14.66
344 210-12-00188758 BASILIO ROBLES MARCELINA 27 210-2-42680836 27/06/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
345 210-17-24281653 BASILIO TAPIA MARIA 89 210-2-48544115 17/01/2017 150103A101 150111A101 0.00 0.00 7.76 0.00 7.76
346 210-17-24334302 BAUTISTA ARENAS IVONNE VELIT 23 210-2-48269071 14/04/2017 150103A101 150101A102 0.00 0.00 18.98 0.00 18.98
347 210-13-01236828 BAUTISTA ARTICA SANDY ISABEL 21 210-2-46732311 13/09/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
348 210-13-01200045 BAUTISTA HUAUYA BIOLETA 30 210-2-41996042 28/03/2013 150103A101 150107A204 0.00 0.00 42.00 0.00 42.00
349 210-17-24415764 BAUTISTA MARTINEZ ANGIE ALEXANDRA 18 210-2-76190959 23/08/2017 150103A101 150111A205 0.00 0.00 12.30 0.00 12.30
350 210-17-24383200 BAUTISTA MENDOZA CARLA LIZBET 21 050-2-71401367 03/07/2017 150103A101 150137A206 0.00 0.00 5.50 0.00 5.50
351 210-17-24317568 BAUTISTA ROMANI GLORIA ISABEL 20 170-2-72258343 18/03/2017 150103A101 150137A101 0.00 0.00 4.97 0.00 4.97
352 210-11-03607788 BAUTISTA SANCHEZ LUIS JEFERSON 6 210-2-73497851 12/09/2011 150103A101 150121A101 0.00 0.00 45.00 0.00 45.00
353 210-13-00288041 BAUTISTA VARGAS LIZEIDA ALCIVIA 8 210-2-75198801 15/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
354 210-18-42541059 BAUTISTA VILLAR DORIS 32 210-2-46708926 12/04/2018 150103A101 150111A101 0.00 0.00 9.33 0.00 9.33
355 210-13-01210826 BAYLON ROQUE ANGEL GABRIEL 2 210-2-75292184 14/05/2013 150103A101 070102A101 0.00 0.00 168.00 0.00 168.00
356 210-11-03055682 BAZAN CUAGUILA CARMELA 42 210-2-09358437 17/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
357 210-17-24285996 BECERRA PEREZ MOISES 48 210-2-16696067 26/01/2017 150103A101 150101A101 0.00 0.00 11.21 0.00 11.21
358 210-17-24308920 BEDOYA HUARI NATIVIDAD 74 210-2-15283617 03/03/2017 150103A101 150101A102 0.00 0.00 15.45 0.00 15.45
359 210-17-24313548 BEGAZO CABREJOS IRENE AMALIA 68 210-2-09070889 11/03/2017 150103A101 150111A101 0.00 0.00 8.13 0.00 8.13
360 210-17-24459533 BEJAR CISNEROS INGRID KATHERINE 24 210-2-47632827 22/10/2017 150103A101 150101A105 0.00 0.00 12.22 0.00 12.22
361 210-11-03049889 BEJARANO DEL AGUILA JHERALDINE YAMILEI 2 210-2-72583777 09/04/2011 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
362 210-17-24426049 BELEN RIME MARISOL JULISSA 18 220-2-77142841 06/09/2017 150103A101 150101A109 0.00 0.00 15.44 0.00 15.44
363 210-17-24423762 BELITO OVALLE MOISES 48 210-2-23265279 03/09/2017 150103A101 0000023159 0.00 0.00 26.21 0.00 26.21
364 210-18-42572212 BELITO QUISPE SONIA 26 210-2-46784013 21/05/2018 150103A101 150137A206 0.00 0.00 7.12 0.00 7.12

Elaborado por OIE-SIS Página 13 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

365 210-16-22906213 BELLIDO BALTAZAR MAYLIN DAYANNA 8 210-2-71677593 12/10/2016 150103A101 150101A109 0.00 0.00 13.57 0.00 13.57
366 210-12-00802612 BELLIDO RAMOS ROSARIO 11 210-2-73350183 09/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
367 210-18-42540153 BELTRAN ARROYO KITTY 31 210-2-44929565 11/04/2018 150103A101 150111A205 0.00 0.00 10.80 0.00 10.80
368 210-17-24439794 BENAVIDES FERNANDEZ AUDINA 29 210-2-47443932 26/09/2017 150103A101 150101A102 0.00 0.00 14.66 0.00 14.66
369 210-17-24505154 BENDEZU CARTAGENA JAYURI KENDAL BRISET 8 210-2-73727759 27/12/2017 150103A101 150101A101 0.00 0.00 12.69 0.00 12.69
370 210-12-00189059 BENDEZU MARTINEZ MARLENE 29 210-2-41723259 23/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
371 210-18-42473566 BENDEZU QUISPE EDICIA 25 210-2-70794179 17/01/2018 150103A101 150111A101 0.00 0.00 10.06 0.00 10.06
372 210-17-24426465 BENITES BALDEON RN 1 210-E-27607224 05/09/2017 150103A101 150105A101 0.00 0.00 17.15 0.00 17.15
373 210-11-03605404 BENITES PEIXOTO KAREN ROMINA 18 210-2-73772787 14/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
374 210-13-00287061 BENITO ORIHUELA SELMIRA MIRELA 28 210-2-42919950 12/02/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
375 210-17-24503600 BENITO SICHA JULISSA URSULA 26 210-2-46977871 24/12/2017 150103A101 150111A101 0.00 0.00 9.40 0.00 9.40
376 210-17-24296252 BENITO SOTO RN 0 210-E-28688981 11/02/2017 150103A101 150111A101 0.00 0.00 9.06 0.00 9.06
377 210-11-03615091 BERMUDO HUARACA ELVA KEILY 22 210-2-47406484 03/09/2011 150103A101 150101A109 0.00 0.00 40.00 0.00 40.00
378 210-17-24376247 BERNACHEA COLCHADO ALANIS ABRIL 11 210-2-61139935 21/06/2017 150103A101 150115A101 0.00 0.00 15.45 0.00 15.45
379 210-12-03908397 BERNARDO FLORES YOLANDA 26 210-2-45705991 23/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
380 210-18-42462235 BERNARDO GAMBOA CANDELARIA 20 130-2-73613108 03/01/2018 150103A101 150121A101 0.00 0.00 19.76 0.00 19.76
381 210-16-22930770 BERNARDO MEDINA FRAY BILY 11 210-2-75072928 23/11/2016 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
382 210-14-40003496 BERROCAL BELTRAN FRASMI 25 210-2-45539759 14/01/2014 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
383 210-11-03732534 BERROCAL GOMEZ ISABEL MAGALI 20 210-2-47916737 09/12/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
384 210-11-03056150 BERROCAL PERALES JUDITH MARIBEL 25 210-2-43197801 07/05/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
385 210-17-24351019 BERROSPI MARCELO SERGIO SAMIR MIGUEL 7 210-2-62606139 12/05/2017 150103A101 150105A101 0.00 0.00 8.57 0.00 8.57
386 210-12-03905632 BERROSPI PALACIOS CLAUDIA EUGENIA 35 210-2-22719594 25/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
387 210-12-00810539 BERROSPI TAQUIRE CECILIA MARGOT 25 210-2-44619100 03/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
388 210-13-01202629 BEZADA PIZARRO KARINA SUSANA 28 210-2-43308697 09/04/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
389 210-18-42537964 BICERRA PINEDO KIMBERLY ESCARLY 19 240-2-70268824 08/04/2018 150103A101 150111A101 0.00 0.00 9.82 0.00 9.82
390 210-17-24398561 BLACIDO MENDOZA FRITZ NOE 25 140-2-46992045 29/07/2017 150103A101 150111A101 0.00 0.00 9.71 0.00 9.71
391 210-17-24337366 BLANCAS ESPINOZA JOSE TEODORO 64 210-2-09020259 20/04/2017 150103A101 150101A101 0.00 0.00 20.33 0.00 20.33
392 210-11-03604106 BLAS ALVAREZ BRAYAN YORDIN 2 210-2-72591162 02/08/2011 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 14 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

393 210-17-24393970 BLAS ELGUERA LORENA 21 210-2-71108377 19/07/2017 150103A101 150111A101 0.00 0.00 7.66 0.00 7.66
394 210-12-00803523 BOLAÑOS AYALA ROXANA 25 210-2-43810151 11/09/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
395 210-17-24298042 BOLIVAR ALVAREZ ELISA SAYURI 8 210-2-72344820 14/02/2017 150103A101 150121A101 0.00 0.00 18.11 0.00 18.11
396 210-12-03901664 BONDIA ARMIJO ELLA AUREA 24 210-2-44553735 04/02/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
397 210-13-01265980 BONZANO MACAZANA LIZBETH ANDREA 8 210-2-73081955 01/01/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
398 210-12-00188564 BORDA CUYA RUTH NOEMI 20 210-2-47490806 26/06/2012 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
399 210-14-40061070 BORDA PALOMINO VIOLETA CELESTINA 33 210-2-41045709 11/07/2014 150103A101 150101A109 0.00 0.00 22.15 0.00 22.15
400 210-11-03057938 BORJA HICHPAS JENNY MONICA 30 210-2-40714439 19/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
401 210-18-42511854 BORJA PINO ROSMERI LURDES 20 210-2-75995782 05/03/2018 150103A101 150111A101 0.00 0.00 9.44 0.00 9.44
402 210-11-03060449 BORJA VELASQUEZ RAQUEL ESTELA 31 210-2-80609116 18/06/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
403 210-11-03059362 BOZA POSADAS MARLENI GRADINA 38 210-2-10249456 22/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
404 210-12-03904715 BOZA ROBLES AMY BRIGITTE 21 210-2-46483735 18/02/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
405 210-18-42515439 BOÑON ARANA ALAN FRANCIS 34 230-2-41688776 09/03/2018 150103A101 150111A101 0.00 0.00 9.44 0.00 9.44
406 210-16-22847622 BRAVO CARDENAS JHONNY ANDRES 38 210-2-10605866 09/07/2016 150103A101 150101A103 0.00 0.00 11.33 0.00 11.33
407 210-17-24376792 BRAVO POCOMUCHA ANDRES 16 210-2-74494020 22/06/2017 150103A101 150111A101 0.00 0.00 10.60 0.00 10.60
408 210-12-00802504 BRAVO SOTELO NIEVES 18 210-2-76724219 08/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
409 210-11-03725917 BRAVO VILLENA BETZABETH LEA 33 210-2-10876382 25/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
410 210-11-03605798 BRAÑES TORRES MARCOS ANTONIO 41 210-2-09364145 16/08/2011 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
411 210-14-40078045 BRICEÑO HUERTA ANALI ROSMERY 24 210-2-47884131 28/08/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
412 210-17-24357214 BRICEÑO MENDOZA ANDERSON MANUEL 10 010-2-60247665 25/05/2017 150103A101 150105A101 0.00 0.00 15.34 0.00 15.34
413 210-17-24358022 BRICEÑO MENDOZA ANDERSON MANUEL 10 010-2-60247665 26/05/2017 150103A101 150105A101 0.00 0.00 19.40 0.00 19.40
414 210-17-24373970 BRIONES CONDOR ADA BRIYITTE FERNANDA 1 220-2-79704460 19/06/2017 150103A101 150111A101 0.00 0.00 8.12 0.00 8.12
415 210-11-03729892 BRISEÑO ALPAS MIGUELINA EPIFANIA 30 210-2-40775188 22/11/2011 150103A101 150103A208 0.00 0.00 45.00 0.00 45.00
416 210-16-40055890 BRITO ZARATE FRANCISCO 81 210-2-06715046 06/04/2016 150103A101 150115A101 0.00 0.00 8.89 0.00 8.89
417 210-14-40103326 BRONCANO CADILLO HERLINDA VICTORIA 21 210-2-70201806 31/10/2014 150103A101 150137A206 0.00 0.00 12.10 0.00 12.10
418 210-16-22872567 BRUNO MONAGO DANIEL RIGUBERTO 26 210-2-46537715 21/08/2016 150103A101 150122A101 0.00 0.00 13.81 0.00 13.81
419 210-14-40063858 BRUNO LIZANDRO 32 210-2-43075025 19/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
420 210-14-40072481 BUENDIA MAYTA FEDELY YOVANA 15 210-2-75454971 13/08/2014 150103A101 150137A101 0.00 0.00 2.75 0.00 2.75

Elaborado por OIE-SIS Página 15 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

421 210-12-00277981 BUITRON CANTARO EDITH DEYSI 21 210-2-46967601 08/01/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
422 210-17-24339119 BUITRON LOPEZ NAYARIT NOEMI 1 210-2-79470415 25/04/2017 150103A101 150105A101 0.00 0.00 17.17 0.00 17.17
423 210-11-03058231 BUITRON MARTINEZ YOVANA 25 210-2-43346178 21/07/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
424 210-18-42480524 BUITRON TAIPE RIGOBERTO 59 210-2-10420432 26/01/2018 150103A101 150111A101 0.00 0.00 9.20 0.00 9.20
425 210-13-01263347 BUJAICO CONGORA YESENIA MARIA 21 210-2-47041655 21/12/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
426 210-12-03899125 BULLON SILVESTRE GIOVANNA HAYDEE 28 210-2-42032160 16/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
427 210-13-01224969 BURGA PISCO MARISOL 19 210-2-72761878 11/07/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
428 210-18-42542106 BURGOS LINARES YANINA LEYDINAN 40 210-2-10604283 13/04/2018 150103A101 150111A101 0.00 0.00 9.82 0.00 9.82
429 210-13-01200397 BUSTAMANTE ALVAREZ JEFFREY OZMAR ALEXANDRE 3 200-2-74523509 31/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
430 210-11-03055412 BUSTAMANTE BAZAN JESSICA 30 210-2-42035564 01/05/2011 150103A101 150132A203 0.00 0.00 0.00 0.00 0.00
431 210-12-00188629 BUSTAMANTE CHAVEZ NATHALY PAOLA 19 210-2-47639240 26/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
432 210-11-03049834 BUSTAMANTE MARIN LUZ ANGELICA 27 210-2-44825066 09/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
433 210-11-01197973 BUSTAMANTE MENDEZ SABINA 27 210-2-43420302 19/03/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
434 210-12-00188035 BUSTAMANTE VEGA ERLINDA 20 210-2-70236072 23/06/2012 150103A101 150110A101 0.00 0.00 0.00 0.00 0.00
435 210-17-24449566 BUSTAMANTE ÑACARI JOSE FRANCISCO 52 210-2-23678845 08/10/2017 150103A101 150111A101 0.00 0.00 9.55 0.00 9.55
436 210-17-24502820 BUSTILLOS BASILIO ROSA MARIA 21 140-2-75005047 22/12/2017 150103A101 150101A105 0.00 0.00 14.10 0.00 14.10
437 210-14-40097390 CABALLERO CASTILLO RN 0 210-7-48723897 16/10/2014 150103A101 150101A101 0.00 0.00 32.45 0.00 32.45
438 210-18-42542660 CABANA ATAUCUSI MAYCOL ETHAN 3 210-2-78591491 13/04/2018 150103A101 150101A101 0.00 0.00 12.76 0.00 12.76
439 210-11-03055380 CABANILLAS VARAS LESLY JACKELYN 19 210-2-47305061 01/05/2011 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
440 210-12-03908131 CABELLO LINO MODESTA 82 200-2-22441382 21/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
441 210-17-24501537 CABELLO MACHACUAY KENNETH CARLOS 3 170-2-81412676 20/12/2017 150103A101 150111A101 0.00 0.00 13.16 0.00 13.16
442 210-18-42479028 CABEZAS FARFAN HONORATA 73 270-2-04323883 25/01/2018 150103A101 150111A101 0.00 0.00 9.57 0.00 9.57
443 210-18-42479726 CABEZAS FARFAN HONORATA 73 270-2-04323883 25/01/2018 150103A101 150111A101 0.00 0.00 9.57 0.00 9.57
444 210-12-00807499 CABEZAS FLORES GLORIA BEATRIZ 22 210-2-46429592 30/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
445 210-18-42557388 CABEZAS ROJAS JAHAIRA MERCEDES 13 210-2-71729871 02/05/2018 150103A101 150115A101 0.00 0.00 28.73 0.00 28.73
446 210-17-24464936 CABEZAS SALOME MARY ABIGAEL 27 210-2-46285053 31/10/2017 150103A101 150101A102 0.00 0.00 26.79 0.00 26.79
447 210-14-40062810 CABRERA ANCO ARACELI NORA 22 210-2-47846933 16/07/2014 150103A101 150132A205 0.00 0.00 35.20 0.00 35.20
448 210-14-40030744 CABRERA CAMAC MARIA 34 210-2-43858192 07/04/2014 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00

Elaborado por OIE-SIS Página 16 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

449 210-14-40116594 CABRERA LEDESMA ANDERSON ESVITH 9 210-2-76373599 22/11/2014 150103A101 150121A101 0.00 0.00 19.80 0.00 19.80
450 210-17-24466354 CABRERA OLIVEIRA LIRIA ALICIA 28 210-2-45775775 02/11/2017 150103A101 150101A109 0.00 0.00 15.51 0.00 15.51
451 210-11-03725850 CABRERA PAQUIYAURI ROCIO DEL PILAR 18 210-2-73686559 25/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
452 210-18-42484740 CABRERA SOLORZANO CARLOS A 88 210-2-06578466 31/01/2018 150103A101 150111A101 0.00 0.00 9.20 0.00 9.20
453 210-17-24444764 CACERES PAYANO WENDY JAZMIN 21 210-2-77574149 03/10/2017 150103A101 150111A101 0.00 0.00 6.78 0.00 6.78
454 210-12-00806502 CACHAY CHACON WANDA ELIZABETH 21 210-2-47797735 03/09/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
455 210-11-03047131 CADILLO CASTRO EDITH EUGENIA 39 210-2-22498891 01/04/2011 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
456 210-17-24449580 CADILLO ROMERO KETTY 20 210-2-75699828 08/10/2017 150103A101 150111A101 0.00 0.00 7.55 0.00 7.55
457 210-17-24308284 CAHUANA CARDENAS EPIFANIO 71 130-2-23649596 03/03/2017 150103A101 150101A101 0.00 0.00 12.65 0.00 12.65
458 210-13-01200407 CAHUANA COLLAHUACHO GUMERCINDA HILARIA 28 210-2-44455296 31/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
459 210-11-03057128 CAHUANA HERRERA CEFERINA YOLANDA 48 210-2-06615935 15/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
460 210-17-24349489 CAHUANA HUARANGA FELICITA CLEMENCIA 40 210-2-10256435 10/05/2017 150103A101 150111A101 0.00 0.00 8.12 0.00 8.12
461 210-11-03612097 CAHUAYA MUNIVE ROSARIO MILAGROS 24 210-2-43891971 08/10/2011 150103A101 150121A101 0.00 0.00 45.00 0.00 45.00
462 210-12-00802305 CAHUAZA SOBERON KATY JHAJAYRA 19 210-2-72455982 08/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
463 210-18-42547350 CAJAHUAMAN CAMAVILCA SOLEDAD MIA 0 210-2-90531019 20/04/2018 150103A101 150105A101 0.00 0.00 18.16 0.00 18.16
464 210-13-01251345 CAJAHUANCA ANTICONA DARLEY SNAIDER 2 210-2-63036177 07/11/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
465 210-12-03911169 CAJALEON HUERTO EDITH ISABEL 27 210-2-45123826 02/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
466 210-12-00807092 CAJAS FALCON MARIA ELENA 20 210-2-47898101 30/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
467 210-16-22941033 CALDAS QUISPE DANIEL SAID 1 210-2-81646666 10/12/2016 150103A101 150101A101 0.00 0.00 9.65 0.00 9.65
468 210-13-00281438 CALDERON CAPCHA HILDA 25 210-2-44926934 25/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
469 210-17-24339985 CALDERON DE KAWASHIMA ESPERANZA FELICITA 74 210-2-19931818 26/04/2017 150103A101 150111A101 0.00 0.00 8.92 0.00 8.92
470 210-11-03728084 CALDERON DELGADO MARIA ELENA 35 210-2-04060798 10/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
471 210-14-40020552 CALDERON FABIAN ARTEMIA 39 210-2-22670323 09/03/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
472 210-11-03057669 CALDERON FLORES BERTHA OLINDA 23 210-2-44878395 17/07/2011 150103A101 150132A203 0.00 0.00 40.00 0.00 40.00
473 210-12-03897782 CALDERON GARCIA ZOILA NATIVIDAD 32 210-2-40763149 08/01/2012 150103A101 150111A207 0.00 0.00 0.00 0.00 0.00
474 210-18-42480540 CALDERON MENDOZA RENE 24 210-2-47998123 27/01/2018 150103A101 150137A206 0.00 0.00 6.14 0.00 6.14
475 210-17-24317240 CALDERON ROBLES LAURA GERALDINA 31 210-2-43401226 17/03/2017 150103A101 150111A101 0.00 0.00 9.26 0.00 9.26
476 210-11-03051953 CALERO CISNEROS JUSTINA 27 210-2-42232108 08/06/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 17 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

477 210-13-01233444 CALISAYA APAZA ELICENE 28 210-2-42929329 01/09/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
478 210-13-01228294 CALIXTO CATALAN DE ALDABA ADITA 29 210-2-47551723 03/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
479 210-17-24499569 CALIXTO CHERREPANO AARON ANDRE 10 220-2-70949328 17/12/2017 150103A101 150115A101 0.00 0.00 13.16 0.00 13.16
480 210-12-03910440 CALLE MARIÑO MARYCRUSH 26 210-2-44671752 08/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
481 210-11-03731302 CALLIÑAUPA PUMA CARMEN ROSA 29 210-2-41323936 20/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
482 210-13-01200020 CALLUPE CHAVEZ MARIBEL PAOLA 34 210-2-20906496 27/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
483 210-18-42520993 CALLUPE CORDOVA ALEXIS FABIANO 9 210-2-61495536 17/03/2018 150103A101 150111A101 0.00 0.00 11.43 0.00 11.43
484 210-13-00292022 CALLUPE DIAZ FABIOLA ERNESTINA 24 210-2-46461069 05/03/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
485 210-11-03050695 CALLUPE LLANA KELY CLELIA 19 210-2-47583708 21/05/2011 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
486 210-14-40030778 CALVO SOTO JOSE ANTONIO 33 210-2-41637370 07/04/2014 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
487 210-11-03731754 CAMAC ALVIÑO MAYRA JHENNYFER 16 210-2-71711781 27/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
488 210-12-00808576 CAMACHO FERNANDEZ PERLA 19 210-2-48162162 28/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
489 210-16-22848194 CAMACHO PEREZ VERONICA YULIANA 34 210-2-43345141 10/07/2016 150103A101 150121A101 0.00 0.00 17.86 0.00 17.86
490 210-13-01242965 CAMANA DE LA CRUZ ANGELICA MARIA 33 210-2-41295296 08/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
491 210-11-03052027 CAMARENA GRANADOS JANNET GIOVANNA 20 210-2-47011710 10/06/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
492 210-14-40010930 CAMARENA OSORIO ANTONY ALFREDO 7 210-2-60431694 06/02/2014 150103A101 150135A101 0.00 0.00 112.00 0.00 112.00
493 210-11-03059256 CAMARENA SALCEDO ESCOLASTICA MARIA 70 210-6-00144471 21/07/2011 150103A101 150141A101 0.00 0.00 50.00 0.00 50.00
494 210-18-42524387 CAMARENA ZEVALLOS ESTEFANI MILAGROS 28 210-2-48113220 22/03/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
495 210-13-01244635 CAMARENA ZEVALLOS JACKEMI YULIANA 2 210-2-77362795 14/10/2013 150103A101 150133A101 0.00 0.00 70.00 0.00 70.00
496 210-17-24461604 CAMASCA RODRIGUEZ MARJORIE DENNIS 22 210-2-48771513 25/10/2017 150103A101 150111A205 0.00 0.00 7.52 0.00 7.52
497 210-13-01241172 CAMAVILCA ECHENIQUE MIRIAN DIOMINA 21 210-2-46767876 30/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
498 210-12-00196727 CAMAVILCA SOLIS ROCIO NATALY 25 210-2-44580877 24/04/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
499 210-17-24416336 CAMBILLO FLORES NELLY EDITH 38 210-2-80646638 24/08/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
500 210-14-40013977 CAMPA SALAZAR MAXIMO FERNANDO 65 210-2-09212340 17/02/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
501 210-13-01245767 CAMPANA CARTAGENA GLADIS 19 210-2-48270191 18/10/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
502 210-17-24319044 CAMPOBLANCO DIAZ IVONNE HAYDEE 25 210-2-47351116 21/03/2017 150103A101 150111A101 0.00 0.00 8.81 0.00 8.81
503 210-18-42553669 CAMPOS AMES ARIANA LUANA 1 210-2-79700072 27/04/2018 150103A101 150118A101 0.00 0.00 29.75 0.00 29.75
504 210-11-03612998 CAMPOS HUALLPA JACQUELINE SILVIA 30 210-2-40921413 23/09/2011 150103A101 150101A109 0.00 45.00 0.00 0.00 45.00

Elaborado por OIE-SIS Página 18 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

505 210-14-40005418 CAMPOS MALPARTIDA ABIGAIL CILDA 22 050-2-47759015 20/01/2014 150103A101 150107A204 0.00 0.00 30.80 0.00 30.80
506 210-17-24468026 CAMPOS PEREZ YON FREDY 41 210-2-10607522 03/11/2017 150103A101 150111A101 0.00 0.00 8.81 0.00 8.81
507 210-11-03053587 CAMPOS POMALLIHUA LOURDES YOLANDA 25 210-2-43859409 09/06/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
508 210-17-24275264 CAMPOS QUISPE RN 0 210-E-28670325 06/01/2017 150103A101 150111A101 0.00 0.00 8.62 0.00 8.62
509 210-17-24447993 CAMPOS ROJAS ALDONIA 45 070-2-01141233 06/10/2017 150103A101 150111A101 0.00 0.00 7.55 0.00 7.55
510 210-13-01213731 CAMPOS TORRE AYDEE 32 210-2-40615984 27/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
511 210-17-24357775 CAMPOSANO RAMOS YUDIT VANEZA 32 210-2-42514977 26/05/2017 150103A101 150101A101 0.00 0.00 12.63 0.00 12.63
512 210-17-24482622 CANAHUALPA CUEVA RUTH NOEMI 4 210-2-78316845 24/11/2017 150103A101 150105A101 0.00 0.00 18.91 0.00 18.91
513 210-11-03061460 CANAHUALPA VILCHEZ SOLEDAD CINTHYA 26 210-2-45294635 30/06/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
514 210-11-03730132 CANALES GALLARDO MERIELLEN YAJAIRA 33 210-2-46121628 27/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
515 210-14-40067479 CANALES MORIANO LUCY MARLENI 22 050-2-47038394 31/07/2014 150103A101 150137A206 0.00 0.00 8.25 0.00 8.25
516 210-13-01238711 CANCHARI ALANIA JOSE PAOLO 0 210-2-77959546 20/09/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
517 210-11-03057147 CANCHARI LAMAS MOISES 40 210-2-09374263 16/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
518 210-17-24443180 CANCHARI VALERIANO PABLO 64 210-2-09054065 02/10/2017 150103A101 150111A101 0.00 0.00 8.78 0.00 8.78
519 210-18-42497459 CANCHAS QUINCHO JOSUÉ EVANS 3 210-2-78859170 16/02/2018 150103A101 150105A101 0.00 0.00 17.55 0.00 17.55
520 210-18-42498234 CANCHAS QUINCHO JOSUÉ EVANS 3 210-2-78859170 17/02/2018 150103A101 150105A101 0.00 0.00 17.06 0.00 17.06
521 210-11-03605979 CANCHAYA VIVANCO KATHERINE LIZETH 23 210-2-44837010 14/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
522 210-13-01213482 CANCHO GUILLEN JACKELINE AGUSTINA 17 210-2-48611555 25/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
523 210-18-42549569 CANCHUMANI RICSE VICTOR RAMIRO 87 210-2-19919874 23/04/2018 150103A101 150111A101 0.00 0.00 9.33 0.00 9.33
524 210-13-01221813 CANDIOTTE MARCAS RUTH VIVIANA 26 210-2-44363886 28/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
525 210-12-03909164 CANDRO PEREZ SALOME 30 210-2-41176687 29/02/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
526 210-11-03609946 CANGAHUALA ALVAREZ ERIKA JENNY 23 210-2-45210519 01/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
527 210-14-40020242 CANGALAYA GONZALES ELIZET DORIA 32 210-2-43090227 07/03/2014 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
528 210-17-24418435 CANTEÑO VEGA LIDIA REYNA 24 140-2-48301800 27/08/2017 150103A101 150137A206 0.00 0.00 5.39 0.00 5.39
529 210-11-03055455 CAPACOILA ARAPA NIEVES 20 210-2-47471466 02/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
530 210-11-03611223 CAPCHA MENDEZ VANEXA 22 210-2-45550617 16/10/2011 150103A101 150137A206 0.00 25.00 0.00 0.00 25.00
531 210-11-03051889 CAPCHA QUISPE LUCIA 30 210-2-40744081 11/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
532 210-14-40032948 CAPCHA RICCI EDUARDO SAMUEL 0 210-2-78365811 14/04/2014 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20

Elaborado por OIE-SIS Página 19 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

533 210-12-00804195 CAPCHA ROQUE KATHERINE MARY 22 210-2-45972903 13/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
534 210-13-01229428 CAPCHA SANCHÉZ DULCE FABIOLA 6 210-2-60874570 14/08/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
535 210-11-03052203 CAPCHA YAÑAC PAULINA 29 210-2-41560957 13/06/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
536 210-11-03609089 CAPILLO PEÑALOZA KARINA DEL PILAR 31 210-2-40316774 27/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
537 210-11-03062296 CAPINOA LANZI JUANITA 31 210-2-43169778 07/07/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
538 210-14-40059437 CAPQUEQUI CHAMBI LEONEL 21 290-2-70291518 07/07/2014 150103A101 150137A101 0.00 0.00 2.20 0.00 2.20
539 210-11-03731667 CAPUÑAY SILVA LUZ MARINA 21 210-2-46737428 24/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
540 210-12-03902226 CARACUZMA SANCHEZ MARIA 25 210-2-44385561 06/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
541 210-17-24396063 CARBAJAL OLIVERA EDIEL ITZAE 1 210-2-79337704 24/07/2017 150103A101 150111A101 0.00 0.00 9.71 0.00 9.71
542 210-17-24427474 CARBAJAL YAURI RN-HV 0 210-E-28918744 07/09/2017 150103A101 150101A101 0.00 0.00 10.66 0.00 10.66
543 210-12-03898711 CARDENAS COTEMBO MARIA ESTHER 34 210-2-80123184 12/01/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
544 210-11-03059381 CARDENAS GONZALES ANA MARIA 36 210-2-10249018 22/07/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
545 210-12-00186751 CARDENAS GONZALES NICANOR 70 210-2-06965192 17/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
546 210-14-40070726 CARDENAS MENDIETA VERONICA 21 210-2-48279076 08/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
547 210-11-03612852 CARDENAS SALDAÑA ARCENIO 69 210-2-23644852 21/09/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00
548 210-11-03727278 CARDENAS SOSA YENNY EDELMIRA 22 210-2-47052358 31/10/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
549 210-17-24401452 CARDENAS TORREJON PAOLA KRISTELL 1 300-2-79339711 02/08/2017 150103A101 150101A109 0.00 0.00 16.94 0.00 16.94
550 210-11-03730357 CARDENAS TUESTA EGNER 50 210-2-00023562 30/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
551 210-18-42501688 CARDENAS YACHACHIN ANDREY AORY 9 210-2-72598598 22/02/2018 150103A101 150115A101 0.00 0.00 11.41 0.00 11.41
552 210-17-24452005 CARDENAS ZAVALA CELEDONIA NELLY 29 210-2-45309017 18/10/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
553 210-17-24438625 CARHUA JULCA VICTORIA VIVIANA 17 140-2-71303939 24/09/2017 150103A101 150101A109 0.00 0.00 7.89 0.00 7.89
554 210-18-42496671 CARHUALLANQUI ACEVEDO JUAN IGNACIO 10 210-2-61428324 15/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
555 210-17-24505343 CARHUALLOCLLO ESPINOZA JACK BRUCE 0 210-2-90435146 28/12/2017 150103A101 150105A101 0.00 0.00 17.86 0.00 17.86
556 210-18-42469805 CARHUALLOCLLO ESPINOZA JACK BRUCE 0 210-2-90435146 12/01/2018 150103A101 150105A101 0.00 0.00 14.85 0.00 14.85
557 210-17-24358388 CARHUAMACA BALDEON PEDRO EUSEBIO 65 210-2-80633474 26/05/2017 150103A101 150111A101 0.00 0.00 7.66 0.00 7.66
558 210-11-03731942 CARHUAMANTA VALENCIA GERALDINE 16 210-2-76203222 30/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
559 210-11-03050967 CARHUAPOMA GENEBROSO CLEOFE ZOILA 22 210-2-45924104 26/05/2011 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
560 210-11-03729544 CARHUAPOMA QUISPE NN 0 210-7-45069468 16/11/2011 150103A101 150118A101 0.00 0.00 45.00 0.00 45.00

Elaborado por OIE-SIS Página 20 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

561 210-17-24354302 CARHUARICRA JULCA DIANA SARITA 11 210-2-74142271 18/05/2017 150103A101 150101A101 0.00 0.00 9.48 0.00 9.48
562 210-13-01226567 CARHUARICRA PANDURO NOEMI SARITA 25 210-2-44630024 19/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
563 210-17-24280575 CARHUARICRA TRUJILLO LEONEL DAJHIRO 3 270-2-80710445 16/01/2017 150103A101 150105A101 0.00 0.00 17.68 0.00 17.68
564 210-18-42528638 CARHUARICRA TRUJILLO LEONEL DAJHIRO 4 270-2-80710445 27/03/2018 150103A101 0000016918 0.00 0.00 12.92 0.00 12.92
565 210-13-01200736 CARHUAS PANDURO ELVA MARIA 30 210-2-41319238 01/04/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
566 210-14-40030003 CARHUAS PANDURO MARITZA MARELYN 49 210-2-10504485 05/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
567 210-13-01197064 CARHUAVILCA DAVILA BERTHA YESSENIA 19 210-2-48129736 15/03/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
568 210-18-42570996 CARLIN MOGOLLON MILTON EDUARDO 49 310-2-03881271 20/05/2018 150103A101 150115A101 0.00 0.00 13.18 0.00 13.18
569 210-14-40019838 CARLOS PRADO ISAURA MARICRUZ 25 210-2-46528454 06/03/2014 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
570 210-14-40011568 CARNICA ESTEBAN ROMINA NICOLE 4 210-2-62375180 12/02/2014 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
571 210-14-40074147 CARRANZA BACA ANGELA BRIGUITTE 19 210-2-76339196 18/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
572 210-17-24472218 CARRANZA HERRERA ELI LIZBETH 28 120-2-45742264 09/11/2017 150103A101 150111A205 0.00 0.00 11.98 0.00 11.98
573 210-11-03725985 CARRASCO FLORES EPIFANIA 35 210-2-10319612 25/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
574 210-18-42511829 CARRASCO HERRERA CALIXTA 86 210-2-09180670 05/03/2018 150103A101 150111A101 0.00 0.00 9.94 0.00 9.94
575 210-14-40018909 CARRASCO MACAVILCA EDDIN JOEL 12 210-2-77903043 04/03/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
576 210-17-24391603 CARRASCO YANGUA ANGIE GIANELA 17 210-2-75969947 15/07/2017 150103A101 070102A101 0.00 0.00 16.51 0.00 16.51
577 210-11-03061292 CARRERA ESPINOZA ROBERTO CARLOS 2 210-2-72055969 28/06/2011 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
578 210-14-40009255 CARRILLO GUTIERREZ DE ZUMAETA SOLEDAD 69 210-2-06574296 01/02/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
579 210-11-03732498 CARRILLO MEJIA MAIRA SADITH 20 210-2-47635875 08/12/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
580 210-17-24371446 CARRIZO LIZARRAGA DOMINGO LUIS 39 170-2-20443855 14/06/2017 150103A101 150118A101 0.00 0.00 22.11 0.00 22.11
581 210-17-24356073 CARTAGENA APAZA FIORELLA PAOLA 1 260-2-79309525 22/05/2017 150103A101 150105A101 0.00 0.00 16.69 0.00 16.69
582 210-11-03055669 CARTAGENA MELO NAOMI MIDORI 16 210-6-00033295 16/05/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
583 210-18-42495743 CARTOLIN GOMEZ RN - VITARTE 0 210-E-29054164 13/02/2018 150103A101 150101A109 0.00 0.00 28.11 0.00 28.11
584 210-13-01252318 CASABONA GONZALES PEDRO DAVID 36 210-2-40200468 12/11/2013 150103A101 070102A101 0.00 0.00 168.00 0.00 168.00
585 210-13-01246242 CASAFRANCA GUTIERREZ KATERIN 18 210-2-74925875 21/10/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
586 210-12-00188565 CASAFRANCA NAVARRO MARIELA ROXANA 38 210-2-09845969 26/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
587 210-17-24398141 CASALLO ALVARADO MELISSA ROSARIO 24 200-2-48375844 27/07/2017 150103A101 150137A101 0.00 0.00 3.45 0.00 3.45
588 210-11-03056156 CASANOVA CONDORI MARICRUZ 26 210-2-42526002 07/05/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 21 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

589 210-17-24392264 CASAS ANGOME DE SANCHEZ TEOFILA YOLANDA 46 040-2-09811926 17/07/2017 150103A101 150103A208 0.00 0.00 11.00 0.00 11.00
590 210-17-24408828 CASAS ANGOME DE SANCHEZ TEOFILA YOLANDA 46 040-2-09811926 12/08/2017 150103A101 150111A101 0.00 0.00 8.85 0.00 8.85
591 210-17-24416991 CASAS ANGOME DE SANCHEZ TEOFILA YOLANDA 46 040-2-09811926 25/08/2017 150103A101 150101A101 0.00 0.00 11.87 0.00 11.87
592 210-17-24428507 CASAS ANGOME DE SANCHEZ TEOFILA YOLANDA 46 040-2-09811926 09/09/2017 150103A101 150101A101 0.00 0.00 13.11 0.00 13.11
593 210-17-24429784 CASAS ANGOME DE SANCHEZ TEOFILA YOLANDA 46 040-2-09811926 11/09/2017 150103A101 0000023159 0.00 0.00 26.21 0.00 26.21
594 210-16-22929369 CASAS MAYTA ISIDORA ENMA 83 220-2-16165032 21/11/2016 150103A101 150101A102 0.00 0.00 16.21 0.00 16.21
595 210-18-42563237 CASHANTIOTE LOPEZ SILIANA 19 170-2-76877983 09/05/2018 150103A101 150111A205 0.00 0.00 12.10 0.00 12.10
596 210-11-03060297 CASIHUI TITO LUIS 52 210-2-09070995 24/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
597 210-16-22947988 CASIMIRO APOLINARIO GLORIA CAROLINA 36 170-2-43396659 23/12/2016 150103A101 150111A101 0.00 0.00 7.33 0.00 7.33
598 210-14-40101087 CASO ROSALES MERY 34 210-2-48166200 24/10/2014 150103A101 150101A105 0.00 0.00 14.85 0.00 14.85
599 210-17-24409373 CASQUI HUAMAN ALEJANDRO 86 210-2-19889508 13/08/2017 150103A101 150101A101 0.00 0.00 12.73 0.00 12.73
600 210-12-00194841 CASTAÑEDA ARGOTE ALBERTO 76 210-2-09055668 23/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
601 210-13-01208026 CASTAÑEDA CHUCO LILIANA GRACIELA 32 210-2-41032684 02/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
602 210-12-03905732 CASTAÑEDA HUANAY MARCIAL FRANCO 69 210-2-07560118 29/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
603 210-17-24481692 CASTAÑEDA HUARACA PATRICIA 28 210-2-45748277 22/11/2017 150103A101 150111A205 0.00 0.00 12.45 0.00 12.45
604 210-13-01218527 CASTAÑEDA NIEVES ANTONIA 38 210-2-22665929 14/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
605 210-18-42530530 CASTAÑEDA PAZ DAYANNA ELIZABETH ESPERANZA 5 210-2-77981588 30/03/2018 150103A101 150105A101 0.00 0.00 18.38 0.00 18.38
606 210-13-01237751 CASTELLANOS ÑAHUINRIPA MARTHA MONICA 43 210-2-10420430 17/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
607 210-12-03899782 CASTILLEJO MIRAVAL FRECIA LOURDES 21 210-2-46424318 24/01/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
608 210-11-03729973 CASTILLO CHAVEZ ROSSMARY 16 210-2-76455614 24/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
609 210-14-40057525 CASTILLO KAHUAZA DEYSI DAYSUKI 17 210-2-75941215 02/07/2014 150103A101 150101A105 0.00 0.00 25.85 0.00 25.85
610 210-12-03910453 CASTILLO OCHANTE KAREN LAURA 24 210-2-44955185 08/03/2012 150103A101 150110A101 0.00 0.00 0.00 0.00 0.00
611 210-17-24445958 CASTILLO PEÑA SHANTAL CIELO 17 210-2-74964070 04/10/2017 150103A101 150111A101 0.00 0.00 9.40 0.00 9.40
612 210-16-22937344 CASTILLO RUIZ FRANK ALONSO 22 280-2-73519363 05/12/2016 150103A101 150110A101 0.00 0.00 25.86 0.00 25.86
613 210-17-24437260 CASTILLO SOSA RN-HV 0 210-E-28923420 22/09/2017 150103A101 150105A101 0.00 0.00 15.11 0.00 15.11
614 210-12-00187220 CASTILLO VASQUEZ GRÁCIANNIK GIOVANNY 1 210-2-75638030 15/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
615 210-14-40069287 CASTILLO VENTURA VERONICA JESUS 31 210-2-42190336 05/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
616 210-11-03608110 CASTRO ARBILDO JANETH KARINA 25 210-2-43446256 18/08/2011 150103A101 150118A101 0.00 0.00 45.00 0.00 45.00

Elaborado por OIE-SIS Página 22 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

617 210-17-24337810 CASTRO ASTAHUAMAN KELLY VERONICA 23 210-2-70805538 21/04/2017 150103A101 150137A206 0.00 0.00 5.87 0.00 5.87
618 210-11-03062335 CASTRO BARRETO ESTEFANY ELIZABETH 16 210-2-76735707 06/07/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
619 210-13-01200032 CASTRO CASTRO AGUSTINA 28 210-2-42429130 27/03/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
620 210-18-42515632 CASTRO CASTRO AGUSTINA 33 210-2-42429130 09/03/2018 150103A101 150111A205 0.00 0.00 12.92 0.00 12.92
621 210-12-00192379 CASTRO CHAVEZ KATHERINE KRISTEL 18 210-2-74746275 10/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
622 210-14-40018735 CASTRO FERNANDEZ DIEGO ALONSO 20 210-2-48261465 04/03/2014 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
623 210-17-24389454 CASTRO HICHCAS JOAB ABISAI 5 210-2-77602288 12/07/2017 150103A101 0000016918 0.00 0.00 8.09 0.00 8.09
624 210-16-22849954 CASTRO INGAROCA WILANDER DEYBIS 6 210-2-74008307 07/07/2016 150103A101 150105A101 0.00 0.00 9.20 0.00 9.20
625 210-16-22854362 CASTRO INGAROCA WILANDER DEYBIS 6 210-2-74008307 21/07/2016 150103A101 150105A101 0.00 0.00 13.10 0.00 13.10
626 210-18-42564844 CASTRO MENDOZA JESUS 47 210-2-09768484 11/05/2018 150103A101 150111A101 0.00 0.00 8.96 0.00 8.96
627 210-17-24449626 CASTRO PAREDES ELODIA 24 200-2-48290239 08/10/2017 150103A101 150111A101 0.00 0.00 9.55 0.00 9.55
628 210-14-40055938 CASTRO QUISPE ROSA MARIA 45 210-2-09359836 27/06/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
629 210-12-00195867 CASTRO RIOS GENESIS JASMINE 18 210-2-47996202 08/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
630 210-12-01295359 CASTRO SERNA MILUSKA 24 210-2-45151371 19/10/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
631 210-11-03051259 CASTRO TITO CECILIA 21 210-2-45899973 31/05/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
632 210-11-03049740 CATACHURA VILCA BRYAN ADRIEL 2 210-2-71668575 10/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
633 210-11-03730383 CATAY YARANGA ESTIFANE MARLINE 23 210-2-47294639 01/12/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
634 210-14-40018150 CAUPER MALCA GIAN FRANCO 19 210-2-73043331 01/03/2014 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
635 210-13-01225410 CAVERO AUQUI MARICELA YUDIT 38 210-2-08162232 13/07/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
636 210-11-03062717 CAYAMPI CACÑAHUARAY LISBETH 18 210-2-47389523 07/07/2011 150103A101 150111A205 0.00 0.00 25.00 0.00 25.00
637 210-13-00286724 CAYCHO CANCHUCAJA LOURDES GEOVANA 19 210-2-47843192 10/02/2013 150103A101 150132A205 0.00 0.00 68.60 0.00 68.60
638 210-14-40100302 CAYCHO VALENCIA MANUEL NICOLAS 62 210-2-07048759 23/10/2014 150103A101 150111A101 0.00 0.00 11.00 0.00 11.00
639 210-14-40102265 CAYCHO VALENCIA MANUEL NICOLAS 62 210-2-07048759 29/10/2014 150103A101 150111A101 0.00 0.00 11.00 0.00 11.00
640 210-12-03898205 CAYETANO YNGA KATHERINE MADELEIDY 18 210-2-48150246 09/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
641 210-18-42492142 CAYPO DUEÑAS DARIO GILBERTO 70 210-2-06576811 09/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
642 210-18-42499959 CAYPO DUEÑAS DARIO GILBERTO 70 210-2-06576811 20/02/2018 150103A101 150137A101 0.00 0.00 6.14 0.00 6.14
643 210-17-24505053 CAÑA FLORES RONALD SMITH 0 210-2-90231968 27/12/2017 150103A101 150111A101 0.00 0.00 9.40 0.00 9.40
644 210-13-01212748 CAÑARI OSCCO YULITZA 19 210-2-74688118 22/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00

Elaborado por OIE-SIS Página 23 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

645 210-11-03058258 CCACCSIRI VILLEGAS SILVIA 24 210-2-44316715 22/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
646 210-18-24498596 CCACCYA RIVERA NICOLE ALEXANDRA 9 210-2-71364390 17/02/2018 150103A101 150111A101 0.00 0.00 9.70 0.00 9.70
647 210-12-00800920 CCAHUANA RAMOS JUANITA 30 210-2-41388317 16/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
648 210-13-01222197 CCAICO CAMAYO FLOR MILAGROS 23 210-2-45982847 30/06/2013 150103A101 150141A101 0.00 0.00 35.00 0.00 35.00
649 210-11-03058195 CCAICO JAYO NORMA ERIKA 21 210-2-46868458 24/07/2011 150103A101 150103A208 0.00 0.00 50.00 0.00 50.00
650 210-14-40018186 CCAICO JAYO NORMA ERIKA 23 210-2-46868458 01/03/2014 150103A101 150128A204 0.00 0.00 53.20 0.00 53.20
651 210-18-42556459 CCALLUCHI HUAMAN FELIPA 40 210-2-44446812 01/05/2018 150103A101 150111A101 0.00 0.00 10.09 0.00 10.09
652 210-12-00195979 CCANTO CORDOVA SAYDA KATHERINE 21 210-2-46714231 14/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
653 210-13-01230140 CCANTO TAPARA JESSICA MILAGROS 18 210-2-73617335 17/08/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
654 210-12-01290670 CCASA CHAMPI LIBERATA 32 210-2-40579062 18/11/2012 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
655 210-18-42499158 CCELLCCA LUJAN MARI FLOR 4 050-2-80857149 19/02/2018 150103A101 150105A101 0.00 0.00 14.85 0.00 14.85
656 210-12-00191470 CCENCHO HUARANCCA ALEJANDRA 28 210-2-41997283 05/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
657 210-17-24284662 CCENCHO MELGAR JHAMPIER CRISTHIAN 12 210-2-73090666 24/01/2017 150103A101 150101A109 0.00 0.00 10.06 0.00 10.06
658 210-13-01213633 CCENCHO PADILLA JENOVEVA 32 210-2-40747473 26/05/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
659 210-14-40030998 CCENHUA SUMA EVELIN ANTOHANE 7 210-2-70626328 08/04/2014 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
660 210-12-00194834 CCENTE BARZOLA JHANETT ROMULA 25 210-2-46201264 23/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
661 210-17-24437083 CCOICCA PEREZ LESLY WENDY 21 210-2-48919424 21/09/2017 150103A101 150111A101 0.00 0.00 7.55 0.00 7.55
662 210-13-01226838 CCOICCA QUISPE SENOBIA VILMA 35 210-2-23689005 21/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
663 210-11-03062133 CCOICCA URBANO LUIS ANGEL 2 210-2-72818599 04/07/2011 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
664 210-13-01226338 CCORAHUA SANTOS DIANA EULOGIA 30 210-2-41650729 17/07/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
665 210-14-40031895 CEDANO MEDINA ANDREA NICOLE 17 230-2-76532893 11/04/2014 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
666 210-11-03059063 CELIS BORJA ROCIO JERALDINE 23 210-2-45743920 31/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
667 210-13-01213366 CENTENO TRINIDAD NANCY 21 210-2-70677560 24/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
668 210-13-01228272 CERRON HUAMAN STEFANO ALEXIS 0 210-2-78127515 03/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
669 210-17-24271602 CERRON PONCE LIONEL NILS ESTEBAN 6 210-2-74345737 02/01/2017 150103A101 150111A101 0.00 0.00 7.76 0.00 7.76
670 210-14-40075134 CERVANTES MENDOZA FABRICIO DAVID 9 210-2-76130974 20/08/2014 150103A101 150133A101 0.00 0.00 22.00 0.00 22.00
671 210-11-03612796 CERVANTES PACHECO CLORINDA 41 210-2-09647387 10/09/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
672 210-11-03728585 CHACCERI HUAMANI EDER LUCIANO 5 210-2-60045406 16/11/2011 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 24 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

673 210-17-24272190 CHACCHA DE LA CRUZ MILAGROS 39 210-2-80072239 03/01/2017 150103A101 150101A105 0.00 0.00 18.97 0.00 18.97
674 210-12-00197656 CHACCHI GOMEZ RAYDA 22 210-2-47673974 09/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
675 210-12-03898973 CHACCHI MARIÑAS MILAGROS DEL PILAR 21 210-2-46303386 11/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
676 210-18-42498972 CHACHI ARIAS NANCY MARITZA 30 020-2-44578567 18/02/2018 150103A101 150111A101 0.00 0.00 10.55 0.00 10.55
677 210-11-03606199 CHACON GOMEZ GIULIANNA MARILYN 25 210-2-43526494 17/09/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
678 210-17-24442894 CHACON HUACHO ROCY REVECA 29 210-2-45784558 30/09/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
679 210-16-22921282 CHACON MONTES YOHEYI JIKARI 3 210-2-78001418 07/11/2016 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
680 210-14-40056066 CHACON ORDOÑEZ NAYDA 25 290-2-45601061 27/06/2014 150103A101 150137A101 0.00 0.00 3.85 0.00 3.85
681 210-11-03611669 CHACON PEÑALOZA MEDALY TERESA 19 210-2-48017258 03/10/2011 150103A101 150101A102 0.00 0.00 45.00 0.00 45.00
682 210-13-01243692 CHAGUA CONDOR ANTONIA CRISINCIONA 38 210-2-10596981 11/10/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
683 210-12-00798965 CHAHUA SOTO GUISSELLA 24 170-2-45728535 03/07/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
684 210-14-40016169 CHAIÑA AQUIMA LIBIA 28 210-2-43562116 24/02/2014 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
685 210-18-42465378 CHALLCO BAUTISTA ANGELICA DENIS 20 110-2-75000601 07/01/2018 150103A101 150111A101 0.00 0.00 10.06 0.00 10.06
686 210-13-01197492 CHALLCO SINCHI ROCIO DEL CARMEN 37 210-2-10180622 16/03/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
687 210-11-03735226 CHAMORRO DE ROJAS FLORINDA 84 210-2-19886756 25/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
688 210-17-24351827 CHAMORRO GONGORA DERI THIAGO SNAYDER 2 210-2-81612754 15/05/2017 150103A101 150105A101 0.00 0.00 16.24 0.00 16.24
689 210-12-01295391 CHAMORRO RAMOS CINTHIA ANTONIA 30 210-2-41343735 19/10/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
690 210-14-40074721 CHANAME CORREA YANET ADELAIDA 37 210-2-32740507 20/08/2014 150103A101 150101A109 0.00 0.00 23.10 0.00 23.10
691 210-13-01199834 CHANCA SEDANO MIRIAN BRIYITH 6 210-2-60620840 27/03/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
692 210-12-03899319 CHANCAFE MIÑOPE MANUELA 23 210-2-47103161 17/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
693 210-12-01284655 CHANCAS HUAMAN FLOR DE MARIA 28 210-2-42274724 18/12/2012 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
694 210-18-42555072 CHANCAS MESAHUAMAN JIMENA ROSA 4 210-2-78500499 30/04/2018 150103A101 0000016918 0.00 0.00 14.63 0.00 14.63
695 210-13-00289185 CHANCAS QUISPE HERMELINDA 23 210-2-45994642 20/02/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
696 210-18-42487177 CHANGA SALAZAR GIULIANA LIZET 32 220-2-43442336 03/02/2018 150103A101 150111A101 0.00 0.00 9.70 0.00 9.70
697 210-12-00190167 CHATE CAHUANA VICTORIANA 28 210-2-42026271 22/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
698 210-18-42541934 CHAUCA MOLINA URBANO 56 210-2-07666640 12/04/2018 150103A101 150111A101 0.00 0.00 9.33 0.00 9.33
699 210-14-40060426 CHAUPIN RAMOS DE LOMA MARCELINA 54 210-2-06230430 09/07/2014 150103A101 150118A101 0.00 0.00 32.65 0.00 32.65
700 210-18-42487978 CHAUPIS CERVANTES YENI LUZ 20 140-2-74562543 04/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35

Elaborado por OIE-SIS Página 25 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

701 210-17-24419260 CHAUPIS GUTIERREZ FRANCIA VALESKA 11 200-2-60748740 28/08/2017 150103A101 150105A101 0.00 0.00 9.60 0.00 9.60
702 210-12-01293812 CHAVARRIA PAITAN MARYLUZ REBECA 32 210-2-47248769 21/11/2012 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
703 210-17-24375524 CHAVEZ AGUERO GLORIA 37 210-2-41073825 21/06/2017 150103A101 150111A101 0.00 0.00 8.80 0.00 8.80
704 210-11-03609859 CHAVEZ ALBERCA ERLITA 22 210-2-45836541 28/08/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
705 210-12-00808822 CHAVEZ APUMAITA FRANK ANYELO 6 210-2-75506685 24/08/2012 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
706 210-17-24336729 CHAVEZ AZAÑERO SHIRLEY MELIZA 22 210-2-76355447 19/04/2017 150103A101 150111A101 0.00 0.00 8.13 0.00 8.13
707 210-13-01208938 CHAVEZ BARRETO KARINA 28 210-2-42702176 07/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
708 210-13-01195891 CHAVEZ BOLAÑOS ALEXA GUADALUPE 17 210-2-48621354 09/03/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
709 210-11-03610363 CHAVEZ CONZA FREDESVINDA ANGELICA 37 210-2-10047182 11/10/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00
710 210-11-03615079 CHAVEZ COTRINA SUZAN 20 210-2-47810382 03/09/2011 150103A101 150101A109 0.00 0.00 40.00 0.00 40.00
711 210-11-03048433 CHAVEZ GOMEZ DELMIRA IBONY 19 210-2-47583044 03/04/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
712 210-11-03055491 CHAVEZ GONZALES JUSSY ANGELA 22 210-2-46227324 03/05/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
713 210-11-03610596 CHAVEZ GUIZADO ROSMERY 18 210-2-47904494 13/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
714 210-13-01223465 CHAVEZ HUAMALI MARIA LUZ 34 210-2-80652143 05/07/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
715 210-17-24423659 CHAVEZ HUAMANI MARTHA SOFIA 19 210-2-70908765 03/09/2017 150103A101 150111A205 0.00 0.00 10.33 0.00 10.33
716 210-17-24288166 CHAVEZ LIZARME LUIS FERNANDO GAEL 4 210-2-77747972 31/01/2017 150103A101 150105A101 0.00 0.00 19.40 0.00 19.40
717 210-11-03062334 CHAVEZ LOPE JANET KARINA 24 210-2-44380594 06/07/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
718 210-13-01202181 CHAVEZ MEJIA MANUELITA GREGORIA 32 210-2-40606383 07/04/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
719 210-11-03735117 CHAVEZ MENDOZA LIZ PAMELA 17 210-2-77025238 21/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
720 210-14-40071943 CHAVEZ MOREYRA ABIGAYELA 25 210-2-45927492 12/08/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
721 210-16-22828184 CHAVEZ NARVAES LUZ ANALÍA 6 210-2-62603338 04/06/2016 150103A101 150115A101 0.00 0.00 9.91 0.00 9.91
722 210-16-22837973 CHAVEZ QUISPE FAVIANA MAZIEL 0 210-2-81664465 23/06/2016 150103A101 150105A101 0.00 0.00 14.51 0.00 14.51
723 210-12-03910690 CHAVEZ RAYME ESTHEFANIA MASSIEL 21 210-2-46786171 02/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
724 210-11-03604995 CHAVEZ RUIZ FELIX LEONARDO GAUDENCIO 10 210-2-74288203 05/08/2011 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
725 210-11-03051737 CHAVEZ SANCHEZ PEDRO 59 210-2-09069510 09/06/2011 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
726 210-14-40031964 CHAVEZ SIFUENTES CESAR AUGUSTO 64 210-2-08024829 11/04/2014 150103A101 150141A101 0.00 0.00 17.49 0.00 17.49
727 210-13-00287028 CHAVEZ YAURI GLORIA YHELIN 40 210-2-20696154 11/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
728 210-17-24377256 CHAVEZ YAURI GLORIA YHELIN 45 210-2-20696154 25/06/2017 150103A101 150101A109 0.00 0.00 25.67 0.00 25.67

Elaborado por OIE-SIS Página 26 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

729 210-11-03613725 CHICCHIS PORRAS SANDRA MILAGROS 25 210-2-43354895 03/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
730 210-17-24441255 CHIHUA ORDAYA JENNIFER ESTHER 14 210-2-74892558 29/09/2017 150103A101 150105A101 0.00 0.00 18.77 0.00 18.77
731 210-13-01245763 CHIHUAN GAMARRA DE BRAVO LUISA 28 210-2-44862481 18/10/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
732 210-12-01284288 CHILENO ESTEBAN MARIA ELENA 31 210-2-40985964 17/12/2012 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
733 210-12-03898719 CHILIPIO ARCIBIA LIZBETH 18 210-2-48119169 12/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
734 210-14-40029436 CHILLCCE RAMIREZ KATHERINE GIOVANNI 21 050-2-47364573 03/04/2014 150103A101 150137A101 0.00 0.00 30.80 0.00 30.80
735 210-13-01210029 CHIMPAY JULCA JOSE RAUL 3 210-2-73922653 10/05/2013 150103A101 150121A101 0.00 0.00 140.00 0.00 140.00
736 210-13-01208615 CHINCHAY CRUZ OLGA JUANA 18 210-2-71501196 05/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
737 210-18-42524344 CHINCHAY YUPANQUI VICTOR 58 210-2-16161422 21/03/2018 150103A101 150115A101 0.00 0.00 17.39 0.00 17.39
738 210-13-01209353 CHINGUEL GARCIA SANTOS 30 210-2-42478831 08/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
739 210-18-42494661 CHIPA CARDENAS LUIS 37 210-2-42325390 12/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
740 210-14-40018178 CHIPANA ALLCCA VISITACION 34 210-2-40222096 01/03/2014 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
741 210-14-40063921 CHIPANA AQUINO MARIMAR CRUZ 19 210-2-77684552 19/07/2014 150103A101 070103A101 0.00 0.00 29.15 0.00 29.15
742 210-11-03610461 CHIPANA CONTRERAS ANA MARIA 34 210-2-10604849 12/10/2011 150103A101 150101A109 0.00 40.00 0.00 0.00 40.00
743 210-12-00191086 CHIPANA JIMENEZ VALERIANA INOCENTA 20 210-2-47745634 02/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
744 210-11-03053239 CHIQUILLAN ANAYA BETSI MARIA 17 210-2-48208959 06/06/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
745 210-17-24297990 CHIRA SURICHAQUI RN 0 210-E-28662733 11/02/2017 150103A101 070102A101 0.00 0.00 35.02 0.00 35.02
746 210-18-42510727 CHIRINOS MUCHA IRVIN JUSSET 11 210-2-60825021 04/03/2018 150103A101 150101A101 0.00 0.00 14.41 0.00 14.41
747 210-11-03613888 CHOCCA CURASMA ANA 23 210-2-45880074 02/09/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
748 210-12-00188572 CHOCCA JURADO ULISES MATEO 29 210-2-44092384 26/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
749 210-13-01200273 CHOCCA MENDOZA SULLY ANGIELY 0 090-2-63241042 29/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
750 210-11-03611497 CHOCCE CACERES JHOSMAN RONALDO SMITH 2 210-2-73841285 19/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
751 210-11-03608331 CHOCCE JAYO MIRIAM 18 210-2-48262792 20/08/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
752 210-14-40019052 CHOCLLO GOMEZ STEVEN FERNANDO 1 210-2-77844265 04/03/2014 150103A101 150135A101 0.00 0.00 112.00 0.00 112.00
753 210-12-00188516 CHOMBILE RAMOS OLGA 36 210-2-28696599 26/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
754 210-18-42577152 CHONG ZEVALLOS NATIVIDAD 75 200-2-06636355 27/05/2018 150103A101 150115A101 0.00 0.00 12.65 0.00 12.65
755 210-18-42579475 CHONG ZEVALLOS NATIVIDAD 75 200-2-06636355 29/05/2018 150103A101 150115A101 0.00 0.00 15.94 0.00 15.94
756 210-12-00194244 CHOQUE CONDORI VANESA SUSANA 26 210-2-43381372 17/05/2012 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 27 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

757 210-12-00194484 CHOQUE GABINO LESLI MARIA 22 210-2-47769577 14/05/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
758 210-13-01233060 CHOQUE OBREGON DORA MARIBELA 25 210-2-44983736 29/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
759 210-16-22836095 CHOQUEHUAYTA VALDIVIA JEFFERSON BENITO 12 210-2-77393014 19/06/2016 150103A101 150111A101 0.00 0.00 6.50 0.00 6.50
760 210-18-42483211 CHOQUETICO TICONA ROGELIO 56 230-2-10488923 30/01/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
761 210-17-24310602 CHOTA OJANAMA CLARITA 18 240-2-75583966 07/03/2017 150103A101 150111A101 0.00 0.00 8.47 0.00 8.47
762 210-17-24420952 CHOTA PACAYA ABIGAIL 18 210-2-75714643 31/08/2017 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
763 210-18-42549205 CHOTA PANDURO DORA 56 210-2-06973510 23/04/2018 150103A101 150111A101 0.00 0.00 9.33 0.00 9.33
764 210-11-03732755 CHOY TAPIA JASMIN ERIKA 15 210-2-76950587 13/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
765 210-14-40059193 CHUCHON HUARANCCA ROGGER DANIEL 11 210-2-75010181 07/07/2014 150103A101 150121A101 0.00 0.00 30.25 0.00 30.25
766 210-11-03604929 CHUCHON VILCA PAULINA 29 210-2-41708077 04/08/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
767 210-13-00278133 CHUCO HUAMALI JUDITH ELIANA 25 210-2-44443415 20/01/2013 150103A101 150132A205 0.00 0.00 68.60 0.00 68.60
768 210-18-42522861 CHUCO HUANCAS RN 0 210-E-29085754 20/03/2018 150103A101 150105A101 0.00 0.00 21.86 0.00 21.86
769 210-18-42524181 CHUCO HUANCAS RN-HV 0 210-E-29086044 21/03/2018 150103A101 150105A101 0.00 0.00 19.37 0.00 19.37
770 210-17-24474218 CHUCO MENDOZA KELLY 15 210-E-28971792 11/11/2017 150103A101 150111A101 0.00 0.00 7.52 0.00 7.52
771 210-11-03061808 CHUJUTALLI RODRIGUEZ MAGNOLIA 32 210-2-40136432 01/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
772 210-13-01225972 CHULLO MAMANI SILVIA YOLANDA 33 210-2-40492761 15/07/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
773 210-18-42467143 CHULLUNCUY CHAMORRO NERY SORAIDA 28 210-2-45967197 09/01/2018 150103A101 150111A101 0.00 0.00 9.57 0.00 9.57
774 210-17-24459193 CHULLUNCUY GONZALO RN-HV 0 210-E-28953739 21/10/2017 150103A101 150135A101 0.00 0.00 20.44 0.00 20.44
775 210-17-24348988 CHUMBE GARCIA MERLISA MARIELA 25 210-2-71069449 09/05/2017 150103A101 150103A208 0.00 0.00 11.73 0.00 11.73
776 210-12-00805981 CHUMBIRIZA DIAZ MIRTA ANDREA 27 210-2-46520358 19/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
777 210-11-03048328 CHUMPITAZ CHAVEZ ANGELICA MARIA 22 210-2-45510304 03/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
778 210-12-03897972 CHUNOCCA PARIONA JANNETT 26 210-2-44395123 08/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
779 210-12-00188467 CHUQUICAÑA HUAMANI NORLI YUBEL 23 210-2-45968564 26/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
780 210-12-00811578 CHUQUIHUACCHA QUIÑONES KAROL 17 210-2-48529631 22/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
781 210-13-01230874 CHUQUIHUANGA CARHUACHINCHAY MARIA BELINDA 28 210-2-42956306 21/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
782 210-13-01219373 CHUQUILLANQUI ASTUCURI MELISA 22 210-2-47749176 18/06/2013 150103A101 150132A203 0.00 0.00 30.80 0.00 30.80
783 210-17-24423607 CHUQUIYAURI HUANACHIN MARITZA 31 210-2-43318022 02/09/2017 150103A101 150111A205 0.00 0.00 11.33 0.00 11.33
784 210-11-03610620 CHUQUIYAURI LAURENTE JOSEFA 60 210-2-10598533 08/10/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00

Elaborado por OIE-SIS Página 28 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

785 210-18-42543222 CIERTO ANTONIO DOMITILA MAGDALENA 20 140-2-75351573 14/04/2018 150103A101 150137A206 0.00 0.00 7.36 0.00 7.36
786 210-17-24339618 CIERTO CAMPOS RN 0 300-E-28780684 26/04/2017 150103A101 150105A101 0.00 0.00 19.88 0.00 19.88
787 210-17-24341008 CIERTO CAMPOS RN 0 300-E-28780684 28/04/2017 150103A101 150105A101 0.00 0.00 17.62 0.00 17.62
788 210-11-03060363 CIERTO FIGUEROA NILA HILDA 37 230-2-10451679 26/06/2011 150103A101 150133A101 0.00 0.00 0.00 0.00 0.00
789 210-18-42541050 CIEZA ASTO SEGUNDO JHONAEL 1 210-2-79819616 11/04/2018 150103A101 150111A101 0.00 0.00 13.06 0.00 13.06
790 210-17-24451440 CIEZA RODRIGUEZ ALEXANDER 9 210-2-61294363 10/10/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
791 210-12-03906181 CIPRIANO SOTO SOLEDAD MAGDALENA 38 210-2-10045066 03/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
792 210-14-40066019 CIRINEO PAITA CIRILA 88 210-2-48312517 26/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
793 210-14-40064998 CISNEROS DE PRADO FELICITAS 74 210-2-09847862 23/07/2014 150103A101 150118A101 0.00 0.00 30.80 0.00 30.80
794 210-18-42570400 CISNEROS HINOSTROZA ANA 42 050-2-10316985 19/05/2018 150103A101 150111A101 0.00 0.00 12.25 0.00 12.25
795 210-13-01199366 CISNEROS MOGOLLON CARMEN VIOLETA 34 210-2-80391000 25/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
796 210-18-42466611 CISNEROS ROJAS LOAN ANTONY 1 210-2-79886930 09/01/2018 150103A101 150105A101 0.00 0.00 28.84 0.00 28.84
797 210-18-42468605 CISNEROS ROJAS LOAN ANTONY 1 210-2-79886930 11/01/2018 150103A101 150105A101 0.00 0.00 15.83 0.00 15.83
798 210-18-42469356 CISNEROS ROJAS LOAN ANTONY 1 210-2-79886930 12/01/2018 150103A101 150105A101 0.00 0.00 18.29 0.00 18.29
799 210-13-01200212 CISNEROS ROSALES ANGELO JEANPIER 0 210-2-77998537 30/03/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
800 210-14-40032737 CLAROS CLAROS GIULIANA MARIBEL 30 210-2-46890449 13/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
801 210-11-03731755 CLAROS LEANDRO MAURA ANGELICA 24 210-2-44407840 27/11/2011 150103A101 150111A205 0.00 0.00 45.00 0.00 45.00
802 210-16-22856839 CLAROS TORRES ASHLEY MILAGROS SOFIA 0 210-2-79289075 26/07/2016 150103A101 0000016918 0.00 0.00 7.79 0.00 7.79
803 210-12-00187635 CLAUDIO PACHECO ZEIDA MERY 19 210-2-47898006 21/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
804 210-12-00809834 CLAVIJO VELARDE ANGELA RENEE 26 200-2-43610020 27/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
805 210-13-01230006 CLEMENTE HUARCAYA ROSAURA 20 210-2-71379602 16/08/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
806 210-17-24467572 CLEMENTE RAMOS LUANA MILKA 6 210-2-77310694 03/11/2017 150103A101 150111A101 0.00 0.00 8.34 0.00 8.34
807 210-12-00197553 COAGUILA ESCOBAR LUZMILA 35 210-2-06809148 06/05/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
808 210-13-01237101 COBOS RAMIREZ JUAN CARLOS 22 240-2-48231592 14/09/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
809 210-17-24345081 COELLO VALLE MARIN 59 210-2-06581959 03/05/2017 150103A101 150111A101 0.00 0.00 9.02 0.00 9.02
810 210-13-01211945 COLLA VEGA DE MONTES VICTORIA 72 210-2-07072947 19/05/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
811 210-14-40032442 COLLACHAGUA ALANYA VANESSA YORELA 25 210-2-45400263 12/04/2014 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
812 210-11-03610849 COLLAZOS CORDOVA SANDRA LEONCIA 30 210-2-42084209 14/10/2011 150103A101 150110A101 0.00 0.00 25.00 0.00 25.00

Elaborado por OIE-SIS Página 29 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

813 210-12-03908977 CONDE GARCIA ESTHEFANY MILAGROS 18 210-2-48366257 28/02/2012 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
814 210-11-03609624 CONDEZO CARRILLO FABIAN 5 210-2-60408881 29/08/2011 150103A101 150101A102 0.00 0.00 40.00 0.00 40.00
815 210-18-42535147 CONDOR DE LA CRUZ YANET ROSMERY 24 210-2-48187298 04/04/2018 150103A101 150111A101 0.00 0.00 10.31 0.00 10.31
816 210-18-42552767 CONDOR DE QUISPE CRESENTINA 80 210-2-19872486 26/04/2018 150103A101 150111A101 0.00 0.00 9.82 0.00 9.82
817 210-18-42550297 CONDOR MELO FRANKLIN JONATHAN 3 210-2-78794710 24/04/2018 150103A101 150111A101 0.00 0.00 9.82 0.00 9.82
818 210-17-24436354 CONDOR TERREL WILLIAM 44 210-2-20894089 20/09/2017 150103A101 150111A101 0.00 0.00 7.55 0.00 7.55
819 210-14-40076636 CONDOR TICSE DANITHSSA MEDALITH 19 210-2-74698711 25/08/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
820 210-17-24381966 CONDOR YANGALI PILAR 26 210-2-70218105 02/07/2017 150103A101 150111A101 0.00 0.00 7.68 0.00 7.68
821 210-13-01217590 CONDOR YARASQUI YESSENIA PETROLINA 30 210-2-41676870 11/06/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
822 210-17-24502648 CONDORE CANCHANYA DORIS FLORENCIA 31 210-2-44063649 22/12/2017 150103A101 150111A101 0.00 0.00 9.87 0.00 9.87
823 210-12-00186846 CONDORI CARDEÑA MATILDE 32 210-2-40588069 18/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
824 210-17-24463672 CONDORI PAYTAN PAMELA 22 130-2-77497717 29/10/2017 150103A101 150111A205 0.00 0.00 10.46 0.00 10.46
825 210-17-24434893 CONDORI PHOCCO MERCEDES 43 210-2-23956188 18/09/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
826 210-17-24321627 CONDORI QUISPE ALEXIS EDWIN 1 210-2-79063195 26/03/2017 150103A101 150111A101 0.00 0.00 8.13 0.00 8.13
827 210-12-00802788 CONDORI QUISPE GLORIA DOLORES 35 210-2-43119606 11/09/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
828 210-12-00799865 CONDORI RAMOS FLOR ROXANA 26 210-2-43302767 08/07/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
829 210-14-40059951 CONDORI ROJAS FLAVIA ESTEFANIA 20 210-2-48652511 08/07/2014 150103A101 150137A206 0.00 0.00 5.50 0.00 5.50
830 210-18-42530342 CONDORI TICLLACURI ERIKA 31 210-2-44028341 29/03/2018 150103A101 150111A101 0.00 0.00 9.94 0.00 9.94
831 210-12-01284281 CONDORI TICSIHUA YENNIFER CLAUDIA 21 210-2-47764680 17/12/2012 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
832 210-17-24398875 CONOSCO SIMON JUSTINA 77 000-2-06566653 31/07/2017 150103A101 150111A101 0.00 0.00 8.09 0.00 8.09
833 210-17-24402235 CONOSCO SIMON JUSTINA 77 000-2-06566653 02/08/2017 150103A101 150111A101 0.00 0.00 17.66 0.00 17.66
834 210-16-40059497 CONOVILCA CCANTO RN 0 210-E-27607303 12/04/2016 150103A101 150105A101 0.00 0.00 15.73 0.00 15.73
835 210-17-24451413 CONTEÑA PAUCAR JENNIFER FELICITA 22 210-2-73253598 10/10/2017 150103A101 150111A101 0.00 0.00 8.33 0.00 8.33
836 210-17-24494494 CONTRERAS CALDERON RN-HV 0 210-E-28985107 10/12/2017 150103A101 150103A208 0.00 0.00 7.52 0.00 7.52
837 210-18-42475540 CONTRERAS CANCHALLA MARIA YSABEL 34 210-2-42072259 19/01/2018 150103A101 150111A205 0.00 0.00 12.52 0.00 12.52
838 210-14-40103583 CONTRERAS FLORES JUAN ZENON 56 210-2-09059179 31/10/2014 150103A101 150111A101 0.00 0.00 11.00 0.00 11.00
839 210-14-40032979 CONTRERAS HILARIO PEDRO 55 210-2-10254273 14/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
840 210-17-24297102 CONTRERAS HUAMAN FRANK LEONARD 9 230-2-60313510 13/02/2017 150103A101 150101A109 0.00 0.00 13.80 0.00 13.80

Elaborado por OIE-SIS Página 30 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

841 210-14-40010917 CONTRERAS JAUREGUI JESUS 73 210-2-07061857 06/02/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
842 210-17-24481009 CONTRERAS LAGOS EDDY ADRIAN 48 210-2-09838792 21/11/2017 150103A101 150111A101 0.00 0.00 9.16 0.00 9.16
843 210-12-00192494 CONTRERAS PABLO JOSEPH CELESTINO 4 210-2-70733626 07/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
844 210-11-03606478 CONTRERAS SANCHEZ ROSARIO KARINA 20 210-2-47599021 17/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
845 210-16-22921950 COPIA GUEVARA RN 0 210-E-28612322 08/11/2016 150103A101 150111A101 0.00 0.00 10.04 0.00 10.04
846 210-12-00810798 CORAL RUIZ DIANA CAROLINA 24 210-2-45052261 30/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
847 210-17-24465582 CORDERO GUTIERREZ ELMER JHONY 36 210-2-41928585 25/12/2017 150103A101 150111A101 0.00 0.00 8.93 0.00 8.93
848 210-17-24433260 CORDOVA ALVINO PILAR SADIT 21 210-2-74220570 15/09/2017 150103A101 150111A205 0.00 0.00 15.11 0.00 15.11
849 210-17-24318475 CORDOVA BASHUALDO TEODORO 71 210-2-09236070 21/03/2017 150103A101 150111A101 0.00 0.00 9.03 0.00 9.03
850 210-14-40030325 CORDOVA BAZAN MODESTA ELENA 18 210-2-48611599 07/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
851 210-17-24284632 CORDOVA CALERO NORIS NERI 28 210-2-45521641 23/01/2017 150103A101 150111A101 0.00 0.00 8.46 0.00 8.46
852 210-13-01195665 CORDOVA CARRASCO MERCY MARGOT 22 210-2-46804655 09/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
853 210-17-24275150 CORDOVA CASTRO JORGE ISAAC 11 210-2-74597861 06/01/2017 150103A101 150105A101 0.00 0.00 13.80 0.00 13.80
854 210-17-24275454 CORDOVA CASTRO JORGE ISAAC 11 210-2-74597861 07/01/2017 150103A101 150105A101 0.00 0.00 14.66 0.00 14.66
855 210-12-00191994 CORDOVA CRISOSTOMO BERNARDINO 52 210-2-04022003 06/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
856 210-13-01217965 CORDOVA FERNANDEZ MARIBEL 21 210-2-47935059 13/06/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
857 210-18-42475356 CORDOVA LOPEZ JOSE MANUEL 64 210-2-10605862 19/01/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
858 210-12-00194880 CORDOVA ORCON JULISSA STEPHANIE 16 210-2-77248208 24/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
859 210-17-24381983 CORDOVA PEÑALOZA RAISA JULISSA 27 210-2-46035949 03/07/2017 150103A101 150101A109 0.00 0.00 16.94 0.00 16.94
860 210-17-24423645 CORDOVA RAMOS ELIZABETH MILA 21 210-2-74446258 03/09/2017 150103A101 150111A205 0.00 0.00 11.33 0.00 11.33
861 210-11-03059654 CORDOVA ROJAS MAYUMI 18 210-2-48271026 27/07/2011 150103A101 150118A101 0.00 0.00 50.00 0.00 50.00
862 210-11-03609082 CORDOVA TORIBIO LUZ MONICA 33 210-2-10605470 27/08/2011 150103A101 150101A105 0.00 40.00 0.00 0.00 40.00
863 210-14-40093658 CORDOVA VARGAS CINDY PATRICIA 27 210-2-44088208 07/10/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
864 210-12-00806501 CORDOVA YAROS INGRID DACNID 19 210-2-47624704 03/09/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
865 210-14-40100503 CORILLOCLLA DE LA CRUZ HENRY DAVID 31 130-2-42169599 24/10/2014 150103A101 150111A101 0.00 0.00 19.25 0.00 19.25
866 210-14-41011461 CORNEJO AGUILAR ELVIRA MARGOT 39 210-2-10247079 18/11/2014 150103A101 150111A101 0.00 0.00 11.08 0.00 11.08
867 210-17-24454664 CORNEJO CAMACHO RN-HV 0 210-E-28948117 15/10/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
868 210-11-02705119 CORNEJO GAVILAN ELSA MARGOT 41 210-2-09597924 27/03/2011 150103A101 150141A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 31 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

869 210-13-01246601 CORNEJO LAURA SARITA ISABEL 30 210-2-41852245 22/10/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
870 210-13-01219402 CORNELIO CORNELIO ERLINDA YARACEL 25 180-2-46958959 18/06/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
871 210-14-40061199 CORONACION ROMERO HILDA 32 210-2-41030858 11/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
872 210-18-42547139 CORONACION VILA MARILUZ 20 210-2-77030301 20/04/2018 150103A101 150111A101 0.00 0.00 9.33 0.00 9.33
873 210-11-03053183 CORONADO MAQUERA ANA MARIA SUSANA 43 210-2-09355647 02/06/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
874 210-17-24420434 CORONEL HUAMAN DE RODRIGUEZ JULIA 55 210-2-10502088 29/08/2017 150103A101 0000023159 0.00 0.00 32.21 0.00 32.21
875 210-17-24426706 CORONEL HUAMAN DE RODRIGUEZ JULIA 55 210-2-10502088 06/09/2017 150103A101 0000023159 0.00 0.00 26.10 0.00 26.10
876 210-12-03908841 CORONEL RIVERA NN 0 210-7-40960481 25/02/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
877 210-12-00802006 CORONEL SANTOS HERMOSA ROSA 36 210-2-21139012 15/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
878 210-11-03049677 CORONEL TARRILLO MARIA JANNETH 21 210-2-46381876 15/04/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
879 210-17-24445933 CORONEL TUMYALAN MILAN SEBASTIAN 0 210-2-79980694 03/10/2017 150103A101 0000016918 0.00 0.00 9.89 0.00 9.89
880 210-17-24480509 CORREA QUISPE ESTEFANI ESTRELLA 21 210-2-77421919 21/11/2017 150103A101 150111A101 0.00 0.00 7.52 0.00 7.52
881 210-13-00289462 CORTEZ FLORES LILIANA DELIA 28 210-2-42698313 21/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
882 210-11-03725698 CORZO PAUCAR YOLANDA 40 210-2-46474172 24/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
883 210-11-03734370 COSI QUISPE NATTY 33 210-2-40011620 21/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
884 210-13-01211910 COSICHE AMES ANGELICA 23 210-2-45993609 19/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
885 210-12-00279482 COSME MICHUE JENNY MARGARITA 24 210-2-45176023 20/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
886 210-11-03060103 COSSIO ARECHE NN 0 210-7-43864666 22/06/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
887 210-13-01227090 COTARATE ONSIHUAY SEBASTIAN FABRICIO 3 210-2-74512598 23/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
888 210-16-22948609 COTRINA FERNANDEZ RONALD 35 210-2-41526879 26/12/2016 150103A101 150101A101 0.00 0.00 9.65 0.00 9.65
889 210-17-24418332 COVOS BAUTISTA GINA 26 240-2-48784425 26/08/2017 150103A101 150111A101 0.00 0.00 6.90 0.00 6.90
890 210-18-42503046 COYOTUPA SANABRIA ALICIA BEATRIZ 38 210-2-43001136 24/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
891 210-11-03051154 COZ JUSTINIANO EDELMIRA 19 210-2-47275767 27/05/2011 150103A101 150110A101 0.00 0.00 0.00 0.00 0.00
892 210-14-40073045 COZ PAULINO ELVA 27 210-2-44883362 14/08/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
893 210-17-24418584 CRISANTO LOPEZ VIRGINIA CRISTEL 11 210-2-74779655 28/08/2017 150103A101 150105A101 0.00 0.00 15.00 0.00 15.00
894 210-11-03731527 CRISOSTOMO DE CORDOVA JULIA 85 210-2-04056033 22/11/2011 150103A101 150122A101 0.00 0.00 0.00 0.00 0.00
895 210-12-00194816 CRISOSTOMO PRUDENCIO PEDRO MIGUEL 11 210-2-77573040 23/04/2012 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
896 210-17-24428377 CRISPIN AMBROSIO JHEREMY DAVID 6 210-2-77116438 08/09/2017 150103A101 150105A101 0.00 0.00 19.55 0.00 19.55

Elaborado por OIE-SIS Página 32 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

897 210-11-03054168 CRISPIN BONILLA LIZBETH CYNTIA 26 210-2-42525455 21/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
898 210-12-00187149 CRISPIN CONTRERAS OLIVIA 18 210-2-71904201 16/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
899 210-14-40069833 CRISTOBAL CAMARGO FEDERICO HECTOR 43 210-2-04080969 07/08/2014 150103A101 150111A205 0.00 0.00 11.66 0.00 11.66
900 210-13-00284112 CRISTOBAL SORIANO BRUNO RENZO 10 210-2-75832018 30/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
901 210-12-00195788 CRISTOBAL UCHUIPOMA FLOR FIORELLA 17 210-2-48500195 02/05/2012 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
902 210-11-03607298 CRUCES SANCHEZ IRENE FLORENCIA 18 210-2-47708326 07/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
903 210-17-24426689 CRUZ BALBUENA JHON KELVIN 2 210-2-78904805 06/09/2017 150103A101 0000016918 0.00 0.00 9.89 0.00 9.89
904 210-18-42510218 CRUZ CAPCHA KETTY INES 22 170-2-74126616 03/03/2018 150103A101 150137A206 0.00 0.00 6.95 0.00 6.95
905 210-17-24398671 CRUZ DE LA CRUZ ERMELINDA 50 210-2-20090937 29/07/2017 150103A101 150111A101 0.00 0.00 8.85 0.00 8.85
906 210-12-00193381 CRUZ FLORES DELIA 35 210-2-43323766 05/05/2012 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
907 210-17-24431720 CRUZ FLORES YESSENIA SANDY 28 200-2-45488012 13/09/2017 150103A101 150111A205 0.00 0.00 10.66 0.00 10.66
908 210-17-24340239 CRUZ HUAMANCCARI ADRIEL ALEXANDER 2 210-2-78861897 27/04/2017 150103A101 150105A101 0.00 0.00 14.01 0.00 14.01
909 210-17-24357816 CRUZ HUAQUI ELVA AURORA 31 200-2-46630763 26/05/2017 150103A101 150137A206 0.00 0.00 4.96 0.00 4.96
910 210-12-01293667 CRUZ HUIMAC SARA 24 210-2-45325477 20/12/2012 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
911 210-17-24351816 CRUZ LORENZO LUZVENIA VANGELIA 21 160-2-76472623 15/05/2017 150103A101 150111A101 0.00 0.00 9.35 0.00 9.35
912 210-17-24485928 CRUZ RAMOS RN-HV 0 210-E-28985019 30/11/2017 150103A101 150105A101 0.00 0.00 18.91 0.00 18.91
913 210-14-40018188 CRUZ REYES LILIANA NOEMI 30 210-2-42465085 01/03/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
914 210-11-03052790 CRUZ ROJAS NN 0 210-7-45188951 17/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
915 210-14-40005757 CRUZ SEDANO ALICIA ANA 12 130-2-61602616 21/01/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
916 210-18-42467996 CRUZ VARGAS RN-HV 0 210-E-29022034 10/01/2018 150103A101 150111A101 0.00 0.00 7.85 0.00 7.85
917 210-17-24494604 CRUZ VILLAR MARLENY 20 210-2-76122412 11/12/2017 150103A101 150103A101 0.00 0.00 9.60 0.00 9.60
918 210-11-03058252 CRUZADO AVILA GISELLA WENDY 32 210-2-40980390 22/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
919 210-11-03728639 CUADROS GUTIERREZ OFELIA HONORATA 32 230-2-40902659 25/11/2011 150103A101 150133A101 0.00 0.00 45.00 0.00 45.00
920 210-18-42502434 CUADROS JOAQUIN CELIA 30 210-2-44232332 23/02/2018 150103A101 150137A206 0.00 0.00 6.63 0.00 6.63
921 210-12-00193291 CUADROS LAUREANO RN 0 210-7-10500557 06/05/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
922 210-13-01208940 CUADROS NIÑO GRACIELA MERCEDES 31 210-2-40924509 07/05/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
923 210-12-01282390 CUADROS SILVA SAIRA ANDREA 10 210-2-75222645 26/09/2012 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
924 210-11-03726289 CUARESMA BENITES SONALY MAKAIRA 0 210-2-77301694 27/10/2011 150103A101 150121A101 0.00 45.00 0.00 0.00 45.00

Elaborado por OIE-SIS Página 33 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

925 210-17-24337581 CUBA HUACHEZ STEFANIA ELIZABETH 22 210-2-74597350 21/04/2017 150103A101 150137A206 0.00 0.00 5.87 0.00 5.87
926 210-12-03909385 CUBA TORRES LELYS MARINA 19 210-2-48083237 06/03/2012 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
927 210-18-42462554 CUBAS BALDEON FRANCISCO 51 210-2-06970564 04/01/2018 150103A101 150101A102 0.00 0.00 18.29 0.00 18.29
928 210-14-40033332 CUBAS BARDALES DELIA 19 210-2-48389037 15/04/2014 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
929 210-17-24448803 CUBAS CURITIMA MERI ESTHER 29 240-2-45344428 07/10/2017 150103A101 150111A101 0.00 0.00 7.11 0.00 7.11
930 210-17-24428973 CUBAS MALDONADO NELLY 38 140-2-41931086 10/09/2017 150103A101 150103A208 0.00 0.00 10.44 0.00 10.44
931 210-12-00192565 CUBILLAS QUISPE GISELA JANET 20 210-2-47359398 06/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
932 210-14-40053826 CUCHO VARGAS FELIX 79 170-2-21109085 20/06/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
933 210-14-40063826 CUCHO VARGAS FELIX 79 170-2-21109085 20/06/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
934 210-12-00807502 CUETO MALLASCA SONIA 23 210-2-45979809 30/07/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
935 210-17-24409277 CUETO OSORIO ALBERTA 39 210-2-42535980 13/08/2017 150103A101 150101A105 0.00 0.00 14.35 0.00 14.35
936 210-18-42526687 CUEVA HUALPA RN-HV 0 210-E-29093653 26/03/2018 150103A101 150135A101 0.00 0.00 23.35 0.00 23.35
937 210-18-42488575 CUEVA PEREZ MASSIEL 9 210-2-72069307 05/02/2018 150103A101 0000016918 0.00 0.00 10.92 0.00 10.92
938 210-17-24334934 CUEVAS RAMOS ANGELO HUMBERTO 3 210-2-78138427 17/04/2017 150103A101 150105A101 0.00 0.00 15.36 0.00 15.36
939 210-13-01222928 CUEVAS RAMOS NN 0 210-7-46443915 03/07/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
940 210-18-42510828 CULCOS BAUTISTA JANET FILICIANA 33 210-2-43753434 04/03/2018 150103A101 150101A105 0.00 0.00 15.40 0.00 15.40
941 210-12-01283761 CULQUI GARCIA GISSELA 19 210-2-48056529 22/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
942 210-14-40068664 CULQUI LLANOS MARIA BRIGIDA 28 210-2-45206628 04/08/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
943 210-18-42509808 CUMBAY HUAMAN GLADYS SOBEIDA 26 210-2-47347720 02/03/2018 150103A101 150111A101 0.00 0.00 11.92 0.00 11.92
944 210-11-03729687 CUNAYAPA SAIRO SUSAN DARINCA 23 210-2-46150586 18/11/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
945 210-17-24429844 CURASI BENDEZU ERICK MARIO 38 210-2-40071052 11/09/2017 150103A101 150101A101 0.00 0.00 11.55 0.00 11.55
946 210-14-40032448 CURASI PUENTE DE LA VEGA MARIA GISELLA 26 210-2-46276633 12/04/2014 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
947 210-18-42470155 CURI CAMACHO JANETH JAQUELINE 20 210-2-76035324 12/01/2018 150103A101 150111A101 0.00 0.00 9.20 0.00 9.20
948 210-18-42531534 CURI PALOMINO ELIAS 64 210-2-09064184 31/03/2018 150103A101 150111A101 0.00 0.00 10.93 0.00 10.93
949 210-11-03732627 CURI PEREZ SUSY 32 210-2-40108251 10/12/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
950 210-17-24276085 CURI QUISPE JUANA 36 210-2-40604052 08/01/2017 150103A101 150137A206 0.00 0.00 6.04 0.00 6.04
951 210-17-24303782 CURIMANIA JARA MARIA JESUS 11 270-2-73112216 27/02/2017 150103A101 150111A101 0.00 0.00 9.10 0.00 9.10
952 210-17-24434654 CURINUQUI CANAQUIRI ERICA 18 240-2-76153116 18/09/2017 150103A101 150101A105 0.00 0.00 13.88 0.00 13.88

Elaborado por OIE-SIS Página 34 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

953 210-13-01198353 CURIPACO ARAUJO JIMENA YASURI 8 210-2-70540395 20/03/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
954 210-16-22878055 CURISINCHE GONZALES JULIO CESAR 29 210-2-43875721 30/08/2016 150103A101 150111A101 0.00 0.00 7.08 0.00 7.08
955 210-12-00194469 CURO CHUMBE MARISOL 16 210-2-72081523 14/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
956 210-17-24432535 CURO FERNANDEZ APOLINARIA 30 210-2-44343826 14/09/2017 150103A101 150101A101 0.00 0.00 8.33 0.00 8.33
957 210-18-42460694 CURO OLIVARES JULIO 77 210-2-09457874 01/01/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
958 210-12-00805990 CURO ROMERO MIRIAM 18 210-2-48042116 20/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
959 210-13-01226914 CURTIS RAMON ANDREA ESTEFANY 22 210-2-47664024 22/07/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
960 210-11-03053657 CUSI RAMOS MARIBEL 20 210-2-47534445 08/06/2011 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
961 210-17-24412538 CUYA APCHO RN 0 210-E-28895913 17/08/2017 150103A101 150111A101 0.00 0.00 7.66 0.00 7.66
962 210-17-24474276 CUYA QUISPE YOCABED ANGELA 3 210-2-78570896 11/11/2017 150103A101 150115A101 0.00 0.00 13.63 0.00 13.63
963 210-11-03047891 CUYA SULCA ESTHER 16 210-2-74044516 06/04/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
964 210-17-24428314 DAGA GARCIA CAROLINA 37 210-2-40422935 08/09/2017 150103A101 150111A101 0.00 0.00 8.33 0.00 8.33
965 210-11-03608188 DAMAS MEDRANO ROSA JUANA 25 210-2-43678709 19/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
966 210-17-24433863 DAMIANO RAYMUNDO EDITH ALINA 23 210-2-76735933 16/09/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
967 210-14-40073387 DAVILA BADILLO LUCI DE ROSARIO 31 210-2-42377376 15/08/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
968 210-13-01232015 DAVILA DIAZ ESPERANZA 22 210-2-47076830 25/08/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
969 210-17-24392572 DAVILA DUEÑAS FRANCHESCA ROSA 13 210-2-74629797 18/07/2017 150103A101 150132A205 0.00 0.00 20.28 0.00 20.28
970 210-17-24388210 DAZA POLINAR GIANFRANCO 10 140-2-60493303 11/07/2017 150103A101 150105A101 0.00 0.00 16.18 0.00 16.18
971 210-16-22944445 DE LA CRUZ AQUINO BETTY ROSA 63 210-2-16145522 15/12/2016 150103A101 150101A102 0.00 0.00 9.65 0.00 9.65
972 210-12-01283962 DE LA CRUZ ATANACIO DOMITILA 26 210-2-44560053 15/09/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
973 210-12-00809739 DE LA CRUZ CAHUANA HERMELINDA 39 210-2-09666907 07/08/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
974 210-13-01202140 DE LA CRUZ CARCAMO SANTOS 54 210-2-03888938 07/04/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
975 210-17-24337142 DE LA CRUZ CASTILLO NICOLAS FALCAO 1 210-2-79270626 19/04/2017 150103A101 150111A101 0.00 0.00 8.13 0.00 8.13
976 210-18-42502346 DE LA CRUZ CHOCCA REBECA 26 210-2-47621332 23/02/2018 150103A101 150137A206 0.00 0.00 5.65 0.00 5.65
977 210-17-24394777 DE LA CRUZ CHUÑOCCA THIAGO SAMUEL 4 210-2-78158436 21/07/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
978 210-14-40113705 DE LA CRUZ DE LA CRUZ HERMINIA 21 210-2-47802068 15/11/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
979 210-18-42514643 DE LA CRUZ DE LA CRUZ ROSAURA 20 190-2-75988505 08/03/2018 150103A101 150111A101 0.00 0.00 12.42 0.00 12.42
980 210-16-22900221 DE LA CRUZ ESPINOZA ZOE TIRSA 3 220-2-78052671 03/10/2016 150103A101 150111A101 0.00 0.00 10.08 0.00 10.08

Elaborado por OIE-SIS Página 35 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

981 210-14-40114877 DE LA CRUZ INGARUCA SUJEYDI NAOMI 5 210-2-76703010 18/11/2014 150103A101 150115A101 0.00 0.00 14.85 0.00 14.85
982 210-13-01220337 DE LA CRUZ LLACUA ANA MARIA 32 210-2-45268794 22/06/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
983 210-11-03057948 DE LA CRUZ LLANTOY FLORCITA MELVA 27 210-2-42406480 20/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
984 210-17-24419529 DE LA CRUZ LOAYZA JEAN CARLOS 7 210-2-77634526 28/08/2017 150103A101 150121A101 0.00 0.00 17.69 0.00 17.69
985 210-17-24351575 DE LA CRUZ LOAYZA JOSE REYNALDO 13 210-2-73394851 13/05/2017 150103A101 150121A101 0.00 0.00 20.16 0.00 20.16
986 210-12-00186734 DE LA CRUZ MERCADO NENA 24 210-2-44579043 17/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
987 210-17-24456578 DE LA CRUZ MONTALVO NENA CARLOZA 21 220-2-76641241 18/10/2017 150103A101 150111A101 0.00 0.00 8.78 0.00 8.78
988 210-12-00196193 DE LA CRUZ MUCHA JACQUELINE 29 210-2-41679557 13/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
989 210-14-40064444 DE LA CRUZ NUÑEZ ELSA 27 210-2-44080856 22/07/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
990 210-13-01198052 DE LA CRUZ QUIÑA MARIA ALEJANDRINA 23 210-2-46166364 19/03/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
991 210-18-42522731 DE LA CRUZ RAMOS MARCO ANTONIO 30 210-2-46005128 19/03/2018 150103A101 150137A101 0.00 0.00 5.46 0.00 5.46
992 210-17-24279235 DE LA CRUZ ROJAS DAMARIS MARTHA 5 210-2-76709604 13/01/2017 150103A101 150111A101 0.00 0.00 8.19 0.00 8.19
993 210-12-00804723 DE LA CRUZ TORRES ELIZABETH KATHERIN 18 210-2-73461949 18/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
994 210-11-03606097 DE LA PEÑA MATEO MILAGROS JACKELIN 19 210-2-47147778 12/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
995 210-12-00804913 DE LA TORRE NEYRA MIRIAM 27 210-2-43859411 16/08/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
996 210-17-24297308 DEL AGUILA ACHO GILARY CRISTINA 1 240-2-79062904 13/02/2017 150103A101 0000016918 0.00 0.00 12.94 0.00 12.94
997 210-17-24463611 DEL AGUILA TANANTA MELISSA MARGARITA 30 210-2-44793269 29/10/2017 150103A101 150111A101 0.00 0.00 3.76 0.00 3.76
998 210-11-03047125 DEL CARPIO CELESTINO MARIA DEL CARMEN 14 200-2-60331395 31/03/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
999 210-17-24286441 DEL CASTILLO CABRERA NEYSER 18 160-2-60579484 28/01/2017 150103A101 150111A101 0.00 0.00 7.76 0.00 7.76
1,000 210-17-24343014 DEL SOLAR CORTEZ GUILLERMO FLORENTINO 50 230-2-09304279 30/04/2017 150103A101 150101A102 0.00 0.00 19.43 0.00 19.43
1,001 210-12-03899160 DELACRUZ GARAY TEODORA 15 140-2-77492527 16/01/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,002 210-14-40075139 DELAO PAUCARCAJA TANIA CLEYDE 18 210-2-76840359 20/08/2014 150103A101 150101A102 0.00 0.00 25.30 0.00 25.30
1,003 210-11-03059795 DELGADILLO CASAVERDE MATEO FELIPE 2 210-2-73722802 15/08/2011 150103A101 150115A101 0.00 0.00 40.00 0.00 40.00
1,004 210-18-42486414 DELGADO ACEVEDO FRANK KEVIN 10 210-2-70702815 01/02/2018 150103A101 150101A109 0.00 0.00 8.71 0.00 8.71
1,005 210-13-01208577 DELGADO CORONEL YERIXA MILAGROS 1 160-2-63324368 05/05/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
1,006 210-17-24453150 DELGADO GALLARDO AYDE BRIGIDA 28 210-2-45675565 12/10/2017 150103A101 150111A101 0.00 0.00 8.33 0.00 8.33
1,007 210-17-24343230 DELGADO ILATOMA ROSA ERODITA 24 210-2-47688522 01/05/2017 150103A101 150111A101 0.00 0.00 9.02 0.00 9.02
1,008 210-11-03055708 DELGADO PIO MARIA SILVIA 25 210-2-44560476 13/05/2011 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 36 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,009 210-11-03730035 DELGADO SANCHEZ LENNY DIANA 28 210-2-42029744 25/11/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
1,010 210-17-24406407 DEUDOR ROSALES ROCIO TEODORA 24 270-2-47787971 09/08/2017 150103A101 150128A204 0.00 0.00 20.71 0.00 20.71
1,011 210-11-03056434 DEUDOR ROSALES YENE VICTORIA 28 210-2-41770572 05/05/2011 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,012 210-13-01219158 DEUDOR TORRES NILDA 24 210-2-45598709 18/06/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,013 210-18-42490605 DIANDERAS OSORES FLOR ROCIO 29 210-2-45377179 07/02/2018 150103A101 150111A205 0.00 0.00 10.92 0.00 10.92
1,014 210-11-03733698 DIAZ CADILLO YACQUELIN LILIANA 32 210-2-40306260 23/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,015 210-17-24394621 DIAZ GUEVARA NIEVES NOEMI 23 220-2-48640019 20/07/2017 150103A101 150101A102 0.00 0.00 15.64 0.00 15.64
1,016 210-13-01209774 DIAZ LIZARBE DORA YSABEL 34 210-2-10874460 10/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,017 210-13-01208507 DIAZ PAUCAR ASTRID SOLANGE 3 210-2-62544693 04/05/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
1,018 210-13-01227559 DIAZ PORRAS JENNY MARLENE 39 210-2-20068210 27/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,019 210-17-24441943 DIAZ PULIDO FIORELLA NICOLE 14 210-2-61598670 30/09/2017 150103A101 150111A101 0.00 0.00 11.55 0.00 11.55
1,020 210-17-24467231 DIAZ RAICO LUHANA ZARETH 3 210-2-78589979 02/11/2017 150103A101 150111A101 0.00 0.00 7.99 0.00 7.99
1,021 210-11-03614900 DIAZ ROSALES ANGELICA MARIA 31 210-2-40342638 25/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
1,022 210-12-00195418 DIAZ ÑAUPA KATTY 18 210-2-70216943 17/04/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
1,023 210-11-03062464 DIONICIO BONILLA ANTONY JEHINER 3 210-2-71191413 22/06/2011 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
1,024 210-13-01225536 DIONICIO LEDEZMA SONIA LUZ 32 210-2-47954886 13/07/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,025 210-13-01228922 DOMINGO MARIÑO ILIANA MARILUZ 33 210-2-40676501 10/08/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,026 210-18-42576203 DOMINGO PINEDO YAGO FRANCISCO 9 210-2-71678247 26/05/2018 150103A101 150101A101 0.00 0.00 14.10 0.00 14.10
1,027 210-13-01241787 DOMINGUEZ CLAVO KATICSA KARINA 17 210-2-72295047 02/10/2013 150103A101 150103A208 0.00 0.00 30.80 0.00 30.80
1,028 210-13-01219169 DOMINGUEZ GOMEZ MARLENE 19 210-2-71962487 18/06/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,029 210-11-03054495 DOMINGUEZ SARAVIA LOURDES RITA 38 210-2-10700872 20/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,030 210-18-42503386 DONATO CAHUANA RN -HV 0 210-E-29065703 25/02/2018 150103A101 150111A101 0.00 0.00 7.85 0.00 7.85
1,031 210-17-24430154 DONAYRE LOSTAUNAU MARIA DEL ROSARIO 53 200-2-08418913 12/09/2017 150103A101 150111A101 0.00 0.00 8.77 0.00 8.77
1,032 210-17-24308111 DUEÑAS RAMIREZ DIANA BRENDA 4 200-2-78001337 02/03/2017 150103A101 0000016918 0.00 0.00 10.85 0.00 10.85
1,033 210-13-01246244 DURAN BEDOYA KATHYA CONSUELO 30 210-2-42254944 21/10/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,034 210-17-24480912 DURAN GOMEZ KAREN 32 210-2-43732755 21/11/2017 150103A101 150111A101 0.00 0.00 9.16 0.00 9.16
1,035 210-18-42495852 DURAN HUAMALI ANGEL AARON 0 210-E-29054085 13/02/2018 150103A101 150105A101 0.00 0.00 16.20 0.00 16.20
1,036 210-18-42495853 DURAN JAPA YURI DALILA 23 340-2-73207495 14/02/2018 150103A101 150111A205 0.00 0.00 2.21 0.00 2.21

Elaborado por OIE-SIS Página 37 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,037 210-11-03060676 DURAN LAPIERRE ISAAC LEVI 2 210-6-00107367 20/06/2011 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
1,038 210-17-24334513 DURAN LAZO RN 0 210-E-28776796 16/04/2017 150103A101 150101A102 0.00 0.00 16.27 0.00 16.27
1,039 210-17-24352075 DURAN LAZO RN HV 0 210-E-28780907 15/05/2017 150103A101 0000016918 0.00 0.00 12.25 0.00 12.25
1,040 210-13-00285398 DURAN PIMENTEL ILDA 22 210-2-47165203 04/02/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
1,041 210-12-00807018 DURAN QUICHCA JAZMIN GENOVEVA 5 210-2-70529682 31/08/2012 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
1,042 210-13-01216883 DURAN ROJAS ROSY TATIANA 20 210-2-47553457 08/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,043 210-16-22949343 DURAND BALVIN ANTHONY JOSUE 1 210-2-79143155 27/12/2016 150103A101 0000016918 0.00 0.00 9.65 0.00 9.65
1,044 210-13-01227341 DURAND VELASQUEZ IVET 23 210-2-45958428 25/07/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
1,045 210-12-03898651 DURAND VELASQUEZ VERONICA VANESSA 24 210-2-45053794 13/01/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
1,046 210-16-22933269 ECHACCAYA FIGUEROA MESAC ABEDNEGO 8 170-2-61419723 29/11/2016 150103A101 150105A101 0.00 0.00 13.12 0.00 13.12
1,047 210-13-01229741 ECHAVARRIA ADAMA STEPHANIE BIANCA 1 210-2-77310822 15/08/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
1,048 210-14-40002213 ECHEA VILLEGAS GEOVANNA IRIS 20 210-2-70241545 10/01/2014 150103A101 150101A105 0.00 0.00 20.99 0.00 20.99
1,049 210-13-01220299 ECHEVARRIA ALMEIDA LEYLA PAOLA 0 210-2-78119178 21/06/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
1,050 210-17-24330495 EGOAVIL ARONE HANDY SNAYDER 0 210-2-90098060 07/04/2017 150103A101 150111A101 0.00 0.00 9.04 0.00 9.04
1,051 210-17-24404472 ELGUERA SOLIS AMIR ETTO 9 340-2-77459650 05/08/2017 150103A101 150101A101 0.00 0.00 11.00 0.00 11.00
1,052 210-17-24301994 ELIZARBE VILCA NATSUMI 4 210-2-78596330 22/02/2017 150103A101 150115A101 0.00 0.00 28.20 0.00 28.20
1,053 210-12-00188145 ENCARNACION JAVIER ANDERSON BRAYAN 11 210-2-75403137 23/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,054 210-17-24474418 ENRIQUE VARGAS APARICIO 54 210-2-06012171 11/11/2017 150103A101 150111A101 0.00 0.00 8.34 0.00 8.34
1,055 210-11-03048992 ENRIQUEZ LIÑAN NN 0 210-7-40345596 25/04/2011 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,056 210-16-22900222 ENRIQUEZ SILVA MERCEDES 23 210-2-47991325 03/10/2016 150103A101 150111A101 0.00 0.00 9.69 0.00 9.69
1,057 210-17-24413983 ESCALANTE BLANCO YADIRA 22 210-2-48749884 20/08/2017 150103A101 150111A205 0.00 0.00 8.85 0.00 8.85
1,058 210-18-42499591 ESCALANTE HINOSTROZA LIDIA 35 210-2-41924275 19/02/2018 150103A101 150111A205 0.00 0.00 10.92 0.00 10.92
1,059 210-12-00185280 ESCALANTE LOPEZ GISELA ZITA 33 210-2-47802411 14/04/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,060 210-17-24359749 ESCALANTE VILA JHON THEYLOR 11 050-2-73978548 29/05/2017 150103A101 150101A109 0.00 0.00 28.88 0.00 28.88
1,061 210-18-42465410 ESCOBAL JAUNI MIRTHA 18 210-2-72993978 07/01/2018 150103A101 150111A205 0.00 0.00 13.01 0.00 13.01
1,062 210-18-42510494 ESCOBAR TAIPE JHAMIL JUNIOR 0 210-2-90595675 03/03/2018 150103A101 150105A101 0.00 0.00 18.88 0.00 18.88
1,063 210-18-42513857 ESCOBAR TAIPE JHAMIL JUNIOR 0 210-2-90595675 08/03/2018 150103A101 150105A101 0.00 0.00 18.88 0.00 18.88
1,064 210-16-22905610 ESCOBEDO INCHE RAQUEL JOHANA 0 210-2-79737947 12/10/2016 150103A101 150105A101 0.00 0.00 15.50 0.00 15.50

Elaborado por OIE-SIS Página 38 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,065 210-17-24384643 ESCRIBA SULCA VICTORIA 83 050-2-48310683 05/07/2017 150103A101 150101A102 0.00 0.00 16.51 0.00 16.51
1,066 210-11-03060560 ESLAVA UNOCC PAULINA 21 210-2-46035137 16/06/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
1,067 210-13-01226551 ESPARTA GRANDA NODET YAJAYRA 27 210-2-43291324 18/07/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,068 210-13-01253531 ESPEJO CABEZAS MARIBEL ERIKA 38 210-2-40811631 15/11/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,069 210-12-00191064 ESPINAL ARROYO ALEJANDRA 26 210-2-44490442 01/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,070 210-16-22933158 ESPINAL HUANASCA LEONCIO 47 210-2-19956923 28/11/2016 150103A101 150101A102 0.00 0.00 15.51 0.00 15.51
1,071 210-11-03048413 ESPINAL JAVIER KATIA DAYANI 1 210-6-00395005 02/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,072 210-17-24317300 ESPINAL PACHERRES TAYRA GAELA ESTRELLA 1 210-E-27594327 18/03/2017 150103A101 150105A101 0.00 0.00 15.90 0.00 15.90
1,073 210-17-24468211 ESPINAL SUAREZ JOSE CRUZ 83 100-6-00194081 03/11/2017 150103A101 150111A101 0.00 0.00 8.34 0.00 8.34
1,074 210-11-03727270 ESPINOZA ACOSTA SEBASTIAN ANTHONY 2 210-2-73843169 30/10/2011 150103A101 150101A109 0.00 45.00 0.00 0.00 45.00
1,075 210-11-03610067 ESPINOZA ADRIANO DOMINGA 19 210-2-48003277 02/09/2011 150103A101 150110A101 0.00 0.00 45.00 0.00 45.00
1,076 210-17-24287603 ESPINOZA ALVARADO ROQUE JACINTO 62 300-2-01018366 30/01/2017 150103A101 150111A101 0.00 0.00 7.76 0.00 7.76
1,077 210-17-24303105 ESPINOZA APOLINARIO MIRIAM CATHERINE 30 210-2-44011988 26/02/2017 150103A101 150111A101 0.00 0.00 20.33 0.00 20.33
1,078 210-17-24343126 ESPINOZA APOLINARIO MIRIAM CATHERINE 30 210-2-44011988 30/04/2017 150103A101 150111A101 0.00 0.00 8.13 0.00 8.13
1,079 210-14-40081528 ESPINOZA ASTUHUAMAN NOE 10 210-2-78741935 06/09/2014 150103A101 150105A101 0.00 0.00 19.80 0.00 19.80
1,080 210-13-01210244 ESPINOZA CARHUAMACA CESI IRMA 30 210-2-41778588 12/05/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,081 210-18-42565580 ESPINOZA CASTILLO GAHEL SAID 0 210-2-90713686 12/05/2018 150103A101 150103A208 0.00 0.00 11.73 0.00 11.73
1,082 210-13-00286229 ESPINOZA DOROTE EUSEBIA 20 210-2-47369232 07/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,083 210-18-42546026 ESPINOZA GUZMAN FRANCISCO VALENTIN 21 210-2-70906705 18/04/2018 150103A101 150121A101 0.00 0.00 19.64 0.00 19.64
1,084 210-16-22925287 ESPINOZA HUAPAYA RN 0 210-E-28615663 14/11/2016 150103A101 150105A101 0.00 0.00 12.74 0.00 12.74
1,085 210-17-24454829 ESPINOZA HUARICAPCHA SALY JANET 17 270-2-72792940 16/10/2017 150103A101 150101A101 0.00 0.00 11.55 0.00 11.55
1,086 210-17-24350550 ESPINOZA HUAYNATE LIZ JUANA 27 210-2-46207228 11/05/2017 150103A101 070102A101 0.00 0.00 16.69 0.00 16.69
1,087 210-16-22904573 ESPINOZA MENDOZA TALIA FRANCHESCA 2 020-2-78823515 10/10/2016 150103A101 150115A101 0.00 0.00 10.47 0.00 10.47
1,088 210-17-24360285 ESPINOZA MIRANDA DENYS JAMES EDWIN 1 210-2-81534911 30/05/2017 150103A101 150105A101 0.00 0.00 15.79 0.00 15.79
1,089 210-17-24321307 ESPINOZA MONDRAGON ELIZA YUDIT 21 210-2-75477741 26/03/2017 150103A101 150111A205 0.00 0.00 5.76 0.00 5.76
1,090 210-18-42485080 ESPINOZA ORTIZ RN- HV 0 210-E-29038647 28/01/2018 150103A101 150101A101 0.00 0.00 14.85 0.00 14.85
1,091 210-17-24415043 ESPINOZA PALOMINO MICHELLE ALEXANDRA 19 300-2-77160845 22/08/2017 150103A101 150111A101 0.00 0.00 8.09 0.00 8.09
1,092 210-17-24314056 ESPINOZA PILLPA JORGE LUIS 25 210-2-48650893 11/03/2017 150103A101 150111A101 0.00 0.00 2.71 0.00 2.71

Elaborado por OIE-SIS Página 39 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,093 210-12-00804289 ESPINOZA PORTAL ALICIA 23 210-2-45786904 11/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,094 210-11-03047780 ESPINOZA QUILLE ANGEL SEBASTIAN 2 210-6-00035721 08/05/2011 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
1,095 210-11-03607364 ESPINOZA QUISPE GIAN FRANCIS 1 210-2-62580486 07/09/2011 150103A101 150105A101 0.00 0.00 40.00 0.00 40.00
1,096 210-12-00188226 ESPINOZA ROJAS DELINA 30 210-2-47397973 25/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,097 210-17-24451825 ESPINOZA ROSALES CIELO GENESIS 0 210-2-90415698 11/10/2017 150103A101 070102A101 0.00 0.00 20.22 0.00 20.22
1,098 210-14-40030776 ESPINOZA SANZ FABIOLA MISHELY 18 210-2-48720069 08/04/2014 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
1,099 210-18-42492963 ESPINOZA SOLORZANO CYNTIA 33 210-2-44894133 10/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
1,100 210-18-42566143 ESPINOZA SULCA CIRILO 75 210-2-06984131 13/05/2018 150103A101 150111A101 0.00 0.00 9.88 0.00 9.88
1,101 210-11-03731617 ESPIRITU AYALA MISHELLE 19 210-2-47759864 23/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,102 210-16-22942471 ESPIRITU CISNEROS LEONARDO DANIEL 1 210-2-81653872 13/12/2016 150103A101 150103A208 0.00 0.00 9.65 0.00 9.65
1,103 210-11-03608446 ESPIRITU CORTEZ YAQUELINE YANHINA 32 210-2-40209566 20/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,104 210-13-01227830 ESPIRITU ESQUIBEL KELY 29 210-2-42149496 30/07/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,105 210-11-03733965 ESPIRITU PANEZ NILTON ELISEO 32 210-2-44293629 26/12/2011 150103A101 150122A101 0.00 0.00 0.00 0.00 0.00
1,106 210-17-24499519 ESPIRITU YACHAS MELINA GRIND 31 210-2-44268154 17/12/2017 150103A101 150101A105 0.00 0.00 12.69 0.00 12.69
1,107 210-17-24486630 ESQUEN ROJAS SANDRA JUDITH 24 210-2-47884718 30/11/2017 150103A101 150101A105 0.00 0.00 12.22 0.00 12.22
1,108 210-18-42471081 ESTEBAN HUARCAYA ALEJANDRINA BETZABET 31 210-2-46520337 13/01/2018 150103A101 150137A206 0.00 0.00 9.57 0.00 9.57
1,109 210-17-24474678 ESTEBAN MISARI ESTIBF CHEMSY 14 210-2-75130751 13/11/2017 150103A101 150105A101 0.00 0.00 15.15 0.00 15.15
1,110 210-13-01209661 ESTEBAN TORRES VANESSA YULIT 25 210-2-44552054 09/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,111 210-13-00287988 ESTELA CCAMA RUTH ABRIL 1 170-6-00072149 15/02/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
1,112 210-12-00805864 ESTELA PASTOR ESPERANZA 33 210-2-45667710 16/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,113 210-13-01227098 ESTRADA DE LA CRUZ MERY 24 210-2-45724385 23/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,114 210-17-24313408 ESTRADA MONTES ALESSANDRA CAROLINA 0 210-2-90073530 10/03/2017 150103A101 150101A105 0.00 0.00 13.10 0.00 13.10
1,115 210-14-40032713 ESTRADA TUDELANO NICOLASA 19 210-2-60459236 13/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,116 210-12-00802789 ESTRADA VILA LOURDES 23 210-2-45388704 11/09/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
1,117 210-14-40018702 ESTRELLA CARHUAPOMA LUZ CLARITA 11 170-2-73656616 03/03/2014 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
1,118 210-12-00189789 ESTRELLA PANEZ VANESSA FIORELLA 22 210-2-46094884 27/05/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,119 210-11-03726891 ESTRELLA ZUÑIGA MILAGROS JENNIFER 22 210-2-45658780 09/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,120 210-12-00192322 EUFRACIO DOMINGUEZ EUMALY 26 210-2-43200412 08/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 40 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,121 210-11-03606227 EULOGIO PEREZ ELIZABETH 22 210-2-70369926 14/09/2011 150103A101 150111A205 0.00 0.00 40.00 0.00 40.00
1,122 210-17-24450447 EVANGELISTA ROJAS GUADALUPE 66 170-2-48815506 09/10/2017 150103A101 150111A101 0.00 0.00 8.33 0.00 8.33
1,123 210-17-24411671 FABIAN MENA JULIHÑO 11 210-2-74813746 16/08/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
1,124 210-17-24272157 FABIAN VALERA MEDALITH KELITA 22 210-2-76656249 03/01/2017 150103A101 150111A101 0.00 0.00 8.62 0.00 8.62
1,125 210-12-00185808 FALCON ALLCCA NN 0 210-7-43998371 16/04/2012 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
1,126 210-12-03904109 FALCON BAUTISTA PILAR MIRIAN 4 210-2-70643102 21/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,127 210-12-01283928 FALCON BENAVIDES ROSA 23 210-2-48372062 15/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,128 210-11-03733957 FALCON SOLIS MILAGROS 18 210-2-48134645 26/12/2011 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
1,129 210-18-42573260 FANO LEON SANTIAGO 58 140-2-22643653 07/02/2018 150103A101 0000023159 0.00 0.00 29.82 0.00 29.82
1,130 210-14-40009937 FANOLA BARRIENTOS DARIA 84 210-2-47265169 04/02/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,131 210-14-40011240 FANOLA BARRIENTOS DARIA 84 210-2-47265169 07/02/2014 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
1,132 210-18-42502665 FASANANDO YAICATE PRISCILA NOELINA 24 240-2-71409384 23/02/2018 150103A101 150107A204 0.00 0.00 12.27 0.00 12.27
1,133 210-11-03605222 FATAMA MARAYAHUA CONSUELO 22 210-2-45902463 10/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,134 210-13-01250181 FELICIANO OLIVARES FABIANNA THAIS 2 210-2-75630799 04/11/2013 150103A101 150121A101 0.00 0.00 140.00 0.00 140.00
1,135 210-12-03910650 FELIPE LUIS SILVIA 74 210-2-06808892 02/03/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,136 210-12-00798150 FELIPE TAIPE ROSMERY 17 210-2-48516640 28/06/2012 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
1,137 210-17-24355879 FELIX DE MONTES TEOFILA 69 210-2-20986421 22/05/2017 150103A101 150111A101 0.00 0.00 8.57 0.00 8.57
1,138 210-18-42573684 FELIX DE ORE MODESTA 67 210-2-28310501 23/05/2018 150103A101 150115A101 0.00 0.00 15.02 0.00 15.02
1,139 210-11-03061760 FELIX NIETO MELISA AYELEN 13 210-2-75432340 01/07/2011 150103A101 150101A109 0.00 0.00 40.00 0.00 40.00
1,140 210-18-42542655 FELIX SOLANO JUAN CARLOS 37 210-2-43751984 12/04/2018 150103A101 150118A101 0.00 0.00 27.49 0.00 27.49
1,141 210-18-42553671 FERMIN HILARIO FABIOLA NICOL 3 210-2-78848064 27/04/2018 150103A101 150118A101 0.00 0.00 29.75 0.00 29.75
1,142 210-11-03062985 FERNANDEZ AGUIRRE MARIA DEL PILAR 25 210-2-43834947 10/07/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,143 210-12-00811582 FERNANDEZ ALMONACID IRIS NANCY 47 210-2-07116118 21/07/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,144 210-12-03904341 FERNANDEZ CABRERA NN 0 210-7-10596672 27/03/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
1,145 210-11-03054657 FERNANDEZ CARBAJAL JANET 23 210-2-44553732 11/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,146 210-12-00808924 FERNANDEZ CCECCAÑA EUGENIA 62 210-2-06563241 07/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,147 210-11-03053572 FERNANDEZ CONDORI YENY FATIMA 42 210-2-09500532 08/06/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,148 210-17-24408590 FERNANDEZ HUANCASACA YOVANA 32 210-2-42982991 10/08/2017 150103A101 150111A205 0.00 0.00 10.57 0.00 10.57

Elaborado por OIE-SIS Página 41 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,149 210-16-22838582 FERNANDEZ NAVARRO JOSUE RODOLFO 1 210-2-79161312 24/06/2016 150103A101 150118A101 0.00 0.00 20.18 0.00 20.18
1,150 210-13-01249334 FERNANDEZ ORTIZ ODALIS NORA 14 210-2-71784445 31/10/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
1,151 210-16-22948121 FERNANDEZ PARDO JOSE LUIS 43 210-2-40282918 24/12/2016 150103A101 150101A102 0.00 0.00 19.30 0.00 19.30
1,152 210-17-24380159 FERNANDEZ PARDO JOSE LUIS 43 210-2-40282918 30/06/2017 150103A101 150111A101 0.00 0.00 8.37 0.00 8.37
1,153 210-12-01282079 FERNANDEZ PARRAGA ROSITA DEL PILAR 32 210-2-40651935 03/10/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,154 210-11-03056523 FERNANDEZ TAIPE SHAYURI THAYIS 4 210-2-70634673 02/05/2011 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
1,155 210-11-03062319 FERNANDEZ TERRONES MIRIAN ELIZABETH 18 210-2-47323997 05/07/2011 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
1,156 210-11-03053736 FERNANDEZ TICONA DANAHI FIORELLA 23 210-2-44854129 12/06/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,157 210-13-01230880 FERNANDEZ VERASTEGUI KELLYM LUCIA 24 210-2-45755832 21/08/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,158 210-13-01237507 FERNANDEZ VILLEGAS AMADA ROXANA 19 210-2-73477034 16/09/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
1,159 210-11-03049892 FERRO GARATE VIRGINIA 36 210-2-10792383 09/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,160 210-12-00800300 FERRUA TORRES LHIA SARAHI 0 210-2-63104888 11/07/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,161 210-13-01201623 FIERRO AQUINO ANGELO JUAN DE DIOS 0 210-2-80977779 05/04/2013 150103A101 070102A101 0.00 0.00 168.00 0.00 168.00
1,162 210-11-03053486 FIERRO YARANGO MARIA SANDRA 21 210-2-46097224 09/06/2011 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
1,163 210-13-01200973 FIGUEROA FABIAN MIRNA MARILU 22 210-2-46836666 02/04/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,164 210-11-03727896 FIGUEROA HUAYANAY ESTHER LINDA 43 210-2-07453010 06/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,165 210-14-40032689 FLORECIN GARCIA EVER DANIEL 42 210-2-48161936 13/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,166 210-14-40030267 FLORES AGUILAR LUZ ELENA STEFANIA 9 200-2-62774886 06/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,167 210-13-00283958 FLORES ALANYA ELENA TERESA 26 210-2-43485906 11/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,168 210-18-42553855 FLORES ALEJANDRO YESSICA ELIDA 20 210-2-71561071 28/04/2018 150103A101 150137A206 0.00 0.00 7.06 0.00 7.06
1,169 210-12-00805982 FLORES CABRERA NELLY ELIZABETH 13 210-2-75230200 19/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,170 210-11-03731239 FLORES CHAVEZ BRENDA PAMELA 15 210-2-72783212 13/11/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,171 210-18-42518102 FLORES COLQUEHUANCA LIZET ELYA 6 290-2-62939828 13/03/2018 150103A101 150101A109 0.00 0.00 23.84 0.00 23.84
1,172 210-11-03057177 FLORES CUADROS ISMAEL 69 210-2-06552426 12/07/2011 150103A101 070102A101 0.00 0.00 50.00 0.00 50.00
1,173 210-11-03726880 FLORES DELGADO JENIFER EVELIN 17 210-2-77220010 08/11/2011 150103A101 150132A205 0.00 0.00 40.00 0.00 40.00
1,174 210-18-04249719 FLORES ESPINOZA ELIDA SADIT 26 210-2-47131276 15/02/2018 150103A101 150111A205 0.00 0.00 14.48 0.00 14.48
1,175 210-11-03731919 FLORES FALCON RAUL 56 240-2-05788927 29/11/2011 150103A101 150141A101 0.00 0.00 45.00 0.00 45.00
1,176 210-17-24478326 FLORES FASABI KARY GABRIELA 26 240-2-47697260 17/11/2017 150103A101 150111A101 0.00 0.00 8.34 0.00 8.34

Elaborado por OIE-SIS Página 42 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,177 210-12-00187244 FLORES FLORES CARMEN MILAGROS 37 210-2-10465556 15/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,178 210-18-42562381 FLORES FLORES LEDSON FREDDY 47 200-2-09761016 09/05/2018 150103A101 150101A102 0.00 0.00 18.03 0.00 18.03
1,179 210-12-03902499 FLORES FUENTES YANET 21 210-2-46590216 28/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,180 210-17-24467491 FLORES GALINDO KIARA BRIZETHA 13 150-2-62103159 02/11/2017 150103A101 150101A105 0.00 0.00 14.10 0.00 14.10
1,181 210-18-42497725 FLORES HILARIO NILDA CATALINA 28 210-2-47069123 16/02/2018 150103A101 150115A101 0.00 0.00 13.13 0.00 13.13
1,182 210-12-12025906 FLORES JIMENEZ JANET SOFIA 21 210-2-46855760 26/12/2012 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,183 210-13-01200047 FLORES MERMAO SALLY SHERLLY 18 210-2-48616419 27/03/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
1,184 210-12-00804185 FLORES OCHANTE MARLENE 35 210-2-10599911 13/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,185 210-13-01236251 FLORES PEREZ YARITZA SOLANCHI 18 210-2-77225877 12/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,186 210-17-24300984 FLORES POMA EDWIN ANDERSON 11 050-2-71470347 20/02/2017 150103A101 150111A101 0.00 0.00 9.10 0.00 9.10
1,187 210-11-03609942 FLORES QUISPE ASUNCION 42 210-2-41040740 31/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,188 210-17-24439750 FLORES RAMON RN-HV 0 210-E-28932154 26/09/2017 150103A101 150111A101 0.00 0.00 7.11 0.00 7.11
1,189 210-11-03611572 FLORES RAMOS JACQUELINE ROCIO 29 210-2-43199950 03/10/2011 150103A101 150101A109 0.00 0.00 40.00 0.00 40.00
1,190 210-17-24466123 FLORES RAMOS RN-HV 0 210-E-28962252 28/10/2017 150103A101 0000023159 0.00 0.00 25.61 0.00 25.61
1,191 210-17-24396257 FLORES RIVERA SHANYRA WHITNEY 1 210-2-79633143 24/07/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
1,192 210-17-24479016 FLORES RIVEROS RN 0 210-E-28974851 19/11/2017 150103A101 150121A101 0.00 0.00 18.09 0.00 18.09
1,193 210-14-40100409 FLORES RODRIGUEZ MARCELINA 53 210-2-06572088 23/10/2014 150103A101 150115A101 0.00 0.00 16.50 0.00 16.50
1,194 210-18-42535676 FLORES RUIZ RN 0 340-E-29060548 05/04/2018 150103A101 150111A101 0.00 0.00 11.29 0.00 11.29
1,195 210-17-24453985 FLORES SALDAÑA RN-HV 0 210-E-28930579 14/10/2017 150103A101 150101A101 0.00 0.00 12.33 0.00 12.33
1,196 210-12-03908576 FLORES SOTELO JULIAN 69 200-2-32486560 23/02/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
1,197 210-11-03056433 FLORES VELASQUEZ ELIDA 25 210-2-43119352 05/05/2011 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,198 210-13-01198616 FLOREZ ORCCON ALBERTINA 31 210-2-44920074 21/03/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,199 210-17-24354704 FOULLMAN MEDINA ANDREA ESTEFANNY 25 210-2-47243560 19/05/2017 150103A101 150111A101 0.00 0.00 8.57 0.00 8.57
1,200 210-17-24382876 FRAGA RODRIGUEZ KAORI ANAIS 4 210-2-77959856 03/07/2017 150103A101 150115A101 0.00 0.00 15.09 0.00 15.09
1,201 210-13-00288056 FRANCISCO TORRES NIDIA SANDY 22 210-2-46745740 15/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,202 210-11-03048300 FRANCO DIAZ ZOILA CLAUDIA 29 210-2-41215534 08/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,203 210-13-01195142 FRANCO HUAMAN ROSA AURELIA 33 210-2-43356395 07/03/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,204 210-12-00197648 FUENTES DONGO BETTY VALENTINA 18 210-2-48353195 09/05/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 43 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,205 210-14-40064680 FUENTES DONGO BETTY VALENTINA 21 210-2-48353195 22/07/2014 150103A101 150137A101 0.00 0.00 2.75 0.00 2.75
1,206 210-18-42498300 FUENTES SANTOS XIOMARA DEL PILAR 7 210-2-74193563 17/02/2018 150103A101 150101A101 0.00 0.00 11.41 0.00 11.41
1,207 210-11-03058332 FUSTER RAMOS YURI MARISOL 40 210-2-80647167 25/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,208 210-11-03056123 GABINO TICLLA JOSEPH MOISES 1 210-2-74260334 07/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,209 210-18-42472079 GABRIEL VASQUEZ TEYSY YULIT 32 210-2-44563653 15/01/2018 150103A101 150111A205 0.00 0.00 12.03 0.00 12.03
1,210 210-13-00283322 GALARZA HUACHOPOMA ANA MARIA 37 210-2-10424154 29/01/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,211 210-13-01217500 GALARZA MAYORCA JERITH ANGELA 13 210-2-70901481 11/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,212 210-18-42555054 GALARZA SOLIS ROSA ALEJANDRA 25 210-2-47029622 30/04/2018 150103A101 150111A101 0.00 0.00 9.08 0.00 9.08
1,213 210-16-22852189 GALEANO PEÑALOZA JOHANNA ALEXANDRA 12 210-2-76283531 17/07/2016 150103A101 150111A101 0.00 0.00 8.85 0.00 8.85
1,214 210-18-42487961 GALICIO ORDAYA RENATO MARCO ANTONIO 13 210-2-72776405 03/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
1,215 210-14-40018219 GALINDO PAHUACHO ERICKA NORMA 16 210-2-77392590 02/03/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,216 210-12-00805337 GALINDO SALAZAR LOURDES ROCIO 35 210-2-20101186 26/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,217 210-12-03898871 GALINDO SUELDO LUCY ROXANA 31 210-2-40899021 14/01/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
1,218 210-14-40020259 GALINDO TUCNO LUIS ANGEL 13 210-2-73252948 08/03/2014 150103A101 070102A101 0.00 0.00 168.00 0.00 168.00
1,219 210-13-01195892 GALLARDO BENITO ROCIO 32 210-2-40881147 10/03/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,220 210-13-01214987 GALLARDO RAMOS SANDRA KARIN 18 210-2-76762576 31/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,221 210-17-24465495 GALLARDO ZAMORA DARIA XIOMARA 4 040-2-81145104 12/12/2017 150103A101 150105A101 0.00 0.00 20.68 0.00 20.68
1,222 210-17-24299614 GALLEGOS SICCHA RN 0 210-E-28692157 17/02/2017 150103A101 150111A101 0.00 0.00 8.19 0.00 8.19
1,223 210-18-42521787 GALVAN CARRASCO RN-HV 0 210-E-29086022 18/03/2018 150103A101 150101A102 0.00 0.00 23.84 0.00 23.84
1,224 210-17-24473739 GALVEZ BAUTISTA JULIO CESAR 0 210-E-28951231 10/11/2017 150103A101 150115A101 0.00 0.00 19.27 0.00 19.27
1,225 210-17-24292388 GALVEZ CARDENAS ELIZABETH 24 210-2-47491893 06/02/2017 150103A101 150111A101 0.00 0.00 8.62 0.00 8.62
1,226 210-13-00289887 GALVEZ CUENCA MARIBEL 30 210-2-41322893 23/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,227 210-11-03050724 GAMARRA JARA CAROLINE MAYLEE 3 210-6-00065906 22/05/2011 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
1,228 210-13-01241458 GAMARRA RAMOS EMPERATRIZ NINA 19 210-2-74650811 01/10/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,229 210-17-24298106 GAMBOA MANIHUARI CRISTEL TIFFANY 0 210-2-79776553 15/02/2017 150103A101 150105A101 0.00 0.00 13.37 0.00 13.37
1,230 210-17-24301363 GAMBOA MANIHUARI CRISTEL TIFFANY 0 210-2-79776553 21/02/2017 150103A101 150105A101 0.00 0.00 14.55 0.00 14.55
1,231 210-17-24396512 GAMBOA MEDINA GUILLERMA 65 210-2-10175401 24/07/2017 150103A101 150111A101 0.00 0.00 11.54 0.00 11.54
1,232 210-11-03060604 GAMBOA PALOMINO MARLINE 27 210-2-42267370 17/06/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 44 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,233 210-13-01221165 GAMBOA POLLOQUERI NN 0 210-7-41074958 25/06/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
1,234 210-13-01212425 GAMONAL CUBAS BRISTELA 34 210-2-41689091 21/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,235 210-17-24433327 GARAGATTI PALOMARES GERMAN JOAQUIN 75 210-2-21106271 16/09/2017 150103A101 150101A102 0.00 0.00 12.33 0.00 12.33
1,236 210-11-03613937 GARAY CONTRERAS TERESA 49 210-2-22990531 14/09/2011 150103A101 150121A101 0.00 0.00 45.00 0.00 45.00
1,237 210-13-01227889 GARAY ESTRADA LUZ 16 210-2-70993074 30/07/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,238 210-14-40008469 GARAY MALLQUI RN 0 210-7-43875490 30/01/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,239 210-13-00284267 GARAY PALMA ABNER ESMIT 2 140-6-00684836 30/01/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
1,240 210-11-03051729 GARAYAR VENTURA JOSUE BENJAMIN 11 210-2-60861852 09/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,241 210-14-40044089 GARCIA AGUILAR CRISTEL MERY 0 210-2-78433513 20/05/2014 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
1,242 210-17-24284094 GARCIA AHUANARI MARIA BELEN 24 240-2-72233557 23/01/2017 150103A101 150101A105 0.00 0.00 12.50 0.00 12.50
1,243 210-13-01263470 GARCIA AROTOMA MARISOL 23 210-2-46212091 21/12/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,244 210-14-40030188 GARCIA ARTICA AMANDA ZENAIDA 51 210-2-16176983 05/04/2014 150103A101 150133A101 0.00 0.00 70.00 0.00 70.00
1,245 210-13-01219095 GARCIA BERROCAL JHESUS MANUEL 13 210-2-76058233 17/06/2013 150103A101 150121A101 0.00 0.00 140.00 0.00 140.00
1,246 210-11-03052056 GARCIA BORJA MARINA PAMELA 21 210-2-46253606 11/06/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,247 210-12-00197676 GARCIA CAJACHAGUA ROSARIO DEL PILAR 20 210-2-48096844 10/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,248 210-13-01217611 GARCIA CAMPOS ROCIO DEL PILAR 22 210-2-47737854 11/06/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,249 210-11-03062349 GARCIA CORREA YESENIA ANALI 24 210-2-46925937 06/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,250 210-12-00192627 GARCIA CUICAPUZA LUTHMER JANETH 22 210-2-46441271 02/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,251 210-11-03612082 GARCIA DE MANTILLA LUCINDA FORTUNATA 59 210-2-19979989 07/10/2011 150103A101 150122A101 0.00 45.00 0.00 0.00 45.00
1,252 210-17-24337743 GARCIA FIGUEROA ALONDRA DEYENTERI 0 210-2-90169524 21/04/2017 150103A101 150101A101 0.00 0.00 12.20 0.00 12.20
1,253 210-17-24326292 GARCIA GUERRA MAGLY ROSAURA 0 210-2-90088897 01/04/2017 150103A101 150105A101 0.00 0.00 18.53 0.00 18.53
1,254 210-11-03612546 GARCIA GUTIERREZ ANA CECILIA 25 210-2-43207036 01/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,255 210-13-01222228 GARCIA HUACHUILCA EULALIA 85 210-2-09503811 30/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,256 210-17-24317727 GARCIA LLANTOY MARYLUZ 26 210-2-46279228 19/03/2017 150103A101 150103A208 0.00 0.00 10.05 0.00 10.05
1,257 210-14-40018921 GARCIA LORENZO DORIZ 19 210-2-76304853 04/03/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,258 210-18-42518518 GARCIA LOZANO LUZMILA 49 210-2-20026096 14/03/2018 150103A101 150115A101 0.00 0.00 14.41 0.00 14.41
1,259 210-16-22843848 GARCIA MERCADO JOSE IGNACIO 0 210-2-79695970 04/07/2016 150103A101 150105A101 0.00 0.00 14.16 0.00 14.16
1,260 210-14-40029057 GARCIA MOSQUERA RAUL ISAAC 31 230-2-45343532 02/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00

Elaborado por OIE-SIS Página 45 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,261 210-13-01215273 GARCIA NIETO MUCIO 51 210-2-10142864 02/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,262 210-13-00287044 GARCIA OCHOA JOSSELYN PIERINA 19 210-2-47930725 11/02/2013 150103A101 150132A205 0.00 0.00 68.60 0.00 68.60
1,263 210-12-00809828 GARCIA OLIART GABRIELA STEPHANY 22 210-2-46127867 27/08/2012 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
1,264 210-14-40097771 GARCIA PANDURO GREGORIO 54 270-2-04035393 17/10/2014 150103A101 150111A101 0.00 0.00 13.20 0.00 13.20
1,265 210-18-42519375 GARCIA PASQUEL ROCIO LICETH 21 140-2-75945213 15/03/2018 150103A101 150111A205 0.00 0.00 20.37 0.00 20.37
1,266 210-12-00195420 GARCIA PRADO LISBETH 18 210-2-47862831 17/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,267 210-18-42469307 GARCIA REQUEJO JHELENY 21 300-2-70549221 11/01/2018 150103A101 150111A205 0.00 0.00 12.03 0.00 12.03
1,268 210-14-40062054 GARCIA RODRIGUEZ ADRIANO LEONEL 6 210-2-71677558 14/07/2014 150103A101 150115A101 0.00 0.00 15.40 0.00 15.40
1,269 210-17-24321303 GARCIA SALAZAR YOLA 33 210-2-43826007 26/03/2017 150103A101 150111A101 0.00 0.00 12.43 0.00 12.43
1,270 210-11-03048447 GARCIA SALVATIERRA NANCY REYNA 39 210-2-28274272 03/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,271 210-17-24388793 GARCIA SANCHEZ ESTRELLA 21 240-2-71136342 11/07/2017 150103A101 150111A101 0.00 0.00 7.66 0.00 7.66
1,272 210-17-24497367 GARCIA SANCHEZ ISABEL CRISTINA 65 210-2-06699707 14/12/2017 150103A101 150121A101 0.00 0.00 20.21 0.00 20.21
1,273 210-14-40075577 GARCIA SUCASACA THIAGO ANDRE 0 210-2-78672063 21/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
1,274 210-13-01210300 GARCIA YALTA CARMEN MILAGROS 26 210-2-48503761 12/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,275 210-18-42548135 GARCIA YARANGA DINALDO MARTIN 14 170-2-60660367 21/04/2018 150103A101 150115A101 0.00 0.00 15.22 0.00 15.22
1,276 210-11-03612350 GARNIQUE RAMOS DANILO THOMAS 1 210-2-74193695 19/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,277 210-11-03728740 GASPAR BAUTISTA YUDY AIDA 24 210-2-45407524 05/11/2011 150103A101 150132A205 0.00 0.00 40.00 0.00 40.00
1,278 210-17-24506341 GAVINO MASQUEZ BRIANA ESTELA 0 210-2-81817535 30/12/2017 150103A101 150105A101 0.00 0.00 16.45 0.00 16.45
1,279 210-14-40069194 GENTE ASTO YANET OLGA 26 210-2-45191552 05/08/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
1,280 210-16-22941243 GERONIMO MARTOS BRAYANS BRUCE 12 070-2-71883786 11/12/2016 150103A101 150111A101 0.00 0.00 6.95 0.00 6.95
1,281 210-11-03607500 GESTRO MORALES BETHZABET KELLY MARYCRUZ 18 210-2-47752725 07/09/2011 150103A101 150121A101 0.00 0.00 45.00 0.00 45.00
1,282 210-18-42467503 GEÑUA APOLINARIO ESTEFANY SENAYDA 21 210-2-60203637 10/01/2018 150103A101 150101A105 0.00 0.00 16.81 0.00 16.81
1,283 210-12-03899880 GILBONIO LAZO CRISPIN 78 210-2-06583450 21/01/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,284 210-17-24408969 GILVONIO HUARINGA ALESSANDRA KIRA 12 210-2-74862274 12/08/2017 150103A101 150115A101 0.00 0.00 13.05 0.00 13.05
1,285 210-11-03056099 GILVONIO HUARINGA KATHERINE SUGEIN 17 210-2-48086622 11/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,286 210-17-24490988 GIRALDEZ CASTRO EDDIT CATHERINE 20 210-2-76435638 05/12/2017 150103A101 150111A101 0.00 0.00 9.40 0.00 9.40
1,287 210-18-42499095 GIRAO PEREZ ELIZABETH ANTOANNETTE 32 200-2-43622471 19/02/2018 150103A101 150137A206 0.00 0.00 6.14 0.00 6.14
1,288 210-11-03054985 GIRON CORDERO MARIA ELENA 30 210-2-40968711 06/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 46 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,289 210-13-00287056 GODOY NEGRETE JHAMIR JORGE 0 210-2-80977934 11/02/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
1,290 210-11-03734900 GODOY RAQUI MELINA YOLANDA 23 210-2-44885728 21/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,291 210-17-24284637 GODOY SANTOS EMELY YANET 6 140-2-62468796 23/01/2017 150103A101 150111A101 0.00 0.00 7.76 0.00 7.76
1,292 210-11-03062281 GOICOCHEA SANCHEZ MARIA ESPERANZA 36 210-2-46772293 06/07/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
1,293 210-17-24330349 GOMEZ AGUIRRE JESSICA YALU 11 210-2-71320859 07/04/2017 150103A101 150115A101 0.00 0.00 12.20 0.00 12.20
1,294 210-11-03060436 GOMEZ ALIAGA SONIA LUCILA 36 210-2-09881236 18/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,295 210-17-24462367 GOMEZ ANCO EDWARS ALEXANDER 9 210-2-71687236 27/10/2017 150103A101 150105A101 0.00 0.00 17.62 0.00 17.62
1,296 210-17-24468615 GOMEZ ANCO EDWARS ALEXANDER 9 210-2-71687236 04/11/2017 150103A101 150105A101 0.00 0.00 9.16 0.00 9.16
1,297 210-17-24417689 GOMEZ ARELLANO JENIFER CANDY 20 210-2-70899061 26/08/2017 150103A101 150101A105 0.00 0.00 8.85 0.00 8.85
1,298 210-11-03050253 GOMEZ BARRIOS LUZ JAQUELINE 35 210-2-21136020 23/04/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,299 210-11-03732379 GOMEZ CASTRO YENY 18 210-2-73479082 07/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,300 210-11-03611660 GOMEZ CHACALIAZA DORA 25 210-2-43314017 03/10/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
1,301 210-17-24424873 GOMEZ CRUZ RN-HV 0 210-E-28907734 05/09/2017 150103A101 150105A101 0.00 0.00 16.22 0.00 16.22
1,302 210-17-24426544 GOMEZ CRUZ RN-HV 0 210-E-28907734 06/09/2017 150103A101 150105A101 0.00 0.00 14.66 0.00 14.66
1,303 210-17-24431803 GOMEZ CRUZ RN-HV 0 210-E-28907734 14/09/2017 150103A101 150105A101 0.00 0.00 16.66 0.00 16.66
1,304 210-11-03732626 GOMEZ CUEVA NN 0 210-7-47696653 10/12/2011 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
1,305 210-16-22927569 GOMEZ GUADALUPE VICTOR DAYRO EDU 5 210-2-77105096 16/11/2016 150103A101 150115A101 0.00 0.00 13.12 0.00 13.12
1,306 210-18-42548478 GOMEZ HINOSTROZA BRYANA MARCELA 0 210-2-90381522 21/04/2018 150103A101 0000023159 0.00 0.00 27.49 0.00 27.49
1,307 210-17-24428390 GOMEZ HUIZA ARACELY 27 210-2-46253960 09/09/2017 150103A101 150101A102 0.00 0.00 17.44 0.00 17.44
1,308 210-11-03733081 GOMEZ HUIZA ELVIRA 35 210-2-21288874 13/12/2011 150103A101 150122A101 0.00 0.00 0.00 0.00 0.00
1,309 210-11-03060200 GOMEZ PAZ JUANA MARIBEL 22 210-2-45911421 02/07/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,310 210-17-24398858 GOMEZ PIANTO JANETH CARINA 29 210-2-44492398 30/07/2017 150103A101 150101A105 0.00 0.00 12.30 0.00 12.30
1,311 210-14-40077370 GOMEZ QUISPE WALTER ELEUTERIO 49 210-2-04011456 27/08/2014 150103A101 150101A102 0.00 0.00 25.30 0.00 25.30
1,312 210-12-00187564 GOMEZ RAMOS REYNA 25 210-2-43685521 13/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,313 210-17-24391964 GOMEZ RODRIGUEZ XIOMARA YASURI NAILYN 10 210-2-70589936 17/07/2017 150103A101 150101A101 0.00 0.00 11.87 0.00 11.87
1,314 210-11-03732173 GOMEZ TEAGUA JESUS DEL PILAR 31 210-2-42061133 02/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,315 210-11-03057062 GOMEZ TUTAYA DELIA SARA 35 210-2-80153941 26/04/2011 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,316 210-13-01226158 GONZALES CASTAÑEDA FROILAN 81 210-2-07335749 16/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00

Elaborado por OIE-SIS Página 47 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,317 210-17-24455767 GONZALES CHUQUIYAURI JUANITA 27 210-2-46599215 16/10/2017 150103A101 150111A101 0.00 0.00 9.75 0.00 9.75
1,318 210-16-22922121 GONZALES CONDORI EDDY WILLIAM 1 150-2-78872496 09/11/2016 150103A101 150105A101 0.00 0.00 13.90 0.00 13.90
1,319 210-18-42499556 GONZALES HUAMAN BONIFACIO VICTOR 73 210-2-04206334 19/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
1,320 210-17-24393983 GONZALES HUAMANI ROSA LUZ 25 070-2-47470735 20/07/2017 150103A101 150111A101 0.00 0.00 8.55 0.00 8.55
1,321 210-11-03051167 GONZALES JORGE LIEZBETH SUSANA 20 210-2-47851093 28/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,322 210-17-24370826 GONZALES ORTEGA RUBÍ VALENTINA 4 210-2-77888319 14/06/2017 150103A101 150105A101 0.00 0.00 15.45 0.00 15.45
1,323 210-17-24372255 GONZALES ORTEGA RUBÍ VALENTINA 4 210-2-77888319 16/06/2017 150103A101 150105A101 0.00 0.00 18.61 0.00 18.61
1,324 210-13-01228248 GONZALES PALOMINO LIDIA ESTHER 24 210-2-46621552 03/08/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,325 210-13-01242572 GONZALES PAUCAR JULIA 26 210-2-44396491 06/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,326 210-17-24300998 GONZALES PORRAS ERIKA ELIZABETH 21 270-2-63731802 21/02/2017 150103A101 150101A105 0.00 0.00 12.28 0.00 12.28
1,327 210-17-24423368 GONZALES VELIZ ZOILA ELENA 34 080-2-47652712 02/09/2017 150103A101 150111A101 0.00 0.00 8.66 0.00 8.66
1,328 210-18-42517513 GONZALES VILLACORTA ANA CECILIA 20 210-2-77140356 12/03/2018 150103A101 150101A109 0.00 0.00 19.87 0.00 19.87
1,329 210-12-00187587 GONZALEZ SAAVEDRA DE ROMERO AYDEE LOURDEZ 39 210-2-23688270 14/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,330 210-18-42510639 GONZALEZ VEGA LUZ MERY 18 100-2-70878590 04/03/2018 150103A101 150111A101 0.00 0.00 10.93 0.00 10.93
1,331 210-18-42548360 GONZALO MONTOYA EDUARDO NICOLAS 33 210-2-42906322 21/04/2018 150103A101 150111A101 0.00 0.00 13.25 0.00 13.25
1,332 210-12-00185669 GONZALO SOTO PIERO ALEXANDER 2 210-2-73909608 15/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,333 210-11-03061062 GOYA HUAMACCTO PATY YAQUELIN 23 210-2-45280830 17/06/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,334 210-14-40018220 GOÑI LAZO ZENAIDA 41 210-2-22652714 01/03/2014 150103A101 150128A204 0.00 0.00 53.20 0.00 53.20
1,335 210-17-24321269 GRANADOS FRANCO ESTER LETICIA 23 210-2-48698003 25/03/2017 150103A101 150121A101 0.00 0.00 20.79 0.00 20.79
1,336 210-13-00280256 GRANADOS LAURA SILVIA FIORELLA 24 210-2-45341238 10/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,337 210-17-24413443 GRANADOS SANCHEZ CARMEN ROSA 36 210-2-40935140 18/08/2017 150103A101 150101A101 0.00 0.00 12.73 0.00 12.73
1,338 210-12-00189807 GRANDEZ BRAVO MILAGROS BETZABETH 0 210-2-77442437 25/05/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
1,339 210-13-00286669 GRIJALVA PALACIN KAREM MERLY 20 210-2-47178348 10/02/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,340 210-12-01292375 GUADAMUR MELCHOR VICTORIA 33 210-2-40356180 30/11/2012 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,341 210-13-01218787 GUAYAMA CARHUAVILCA ALEXA DANIELA 2 210-2-76710666 16/06/2013 150103A101 150103A208 0.00 0.00 30.80 0.00 30.80
1,342 210-17-24440580 GUERE ARBOLEDA RN-HV 0 210-E-28932947 28/09/2017 150103A101 0000023159 0.00 0.00 24.21 0.00 24.21
1,343 210-12-01295351 GUERRA ARZAPALO BETZABE 17 210-2-74405734 18/10/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
1,344 210-12-03897899 GUERRA BALTAZAR BETZABETH ROSARIO 13 210-2-76635093 09/01/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 48 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,345 210-12-03903994 GUERRA CORVACHO SANDRA 30 210-2-48208625 18/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,346 210-14-40032705 GUERRA DELGADILLO ISABEL LISBETH 17 210-2-70908572 13/04/2014 150103A101 150137A101 0.00 0.00 30.80 0.00 30.80
1,347 210-11-03054970 GUERRA HUAYMACARI ELVA 39 210-2-10112606 05/05/2011 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
1,348 210-17-24436399 GUERRA JAYO MIREYA CHELITA 20 210-2-75813883 20/09/2017 150103A101 150111A101 0.00 0.00 8.77 0.00 8.77
1,349 210-12-00811574 GUERRA MENDOZA JUAN JOSE 50 210-2-06575011 21/07/2012 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
1,350 210-11-03061056 GUERRA RIMACHI MALENA MIDA 17 210-2-48104471 17/06/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,351 210-11-03726314 GUERRERO ALIAGA ERICK ABEL HERMES 22 210-2-46129848 27/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,352 210-12-01295354 GUERRERO JIMENEZ ISABEL DIANA 19 210-2-48497328 18/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,353 210-18-42551385 GUERRERO NOLORBE ALBERTO REYNALDO 0 210-2-90360380 25/04/2018 150103A101 150115A101 0.00 0.00 12.76 0.00 12.76
1,354 210-18-42470137 GUERRERO VALVERDE CAMILA YIDDA 5 200-2-77779686 12/01/2018 150103A101 150115A101 0.00 0.00 10.55 0.00 10.55
1,355 210-11-03605408 GUEVARA BUSTILLOS MELISSA ESTRELLA 24 210-2-44969353 14/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,356 210-14-40062074 GUEVARA BUSTILLOS MELISSA ESTRELLA 27 210-2-44969353 15/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
1,357 210-14-40060642 GUEVARA FERREÑAN MARIA GLADYS 46 210-2-17539108 10/07/2014 150103A101 150111A101 0.00 0.00 11.08 0.00 11.08
1,358 210-11-03729335 GUEVARA GUEVARA MANUEL 59 300-6-00282934 12/11/2011 150103A101 070103A101 0.00 0.00 45.00 0.00 45.00
1,359 210-14-40067364 GUIA ALARCON ZUNILDA 33 210-2-48337850 31/07/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
1,360 210-12-00810851 GUILLEN CLAROS LUZ ANGELA 20 210-2-47077369 26/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,361 210-18-42560297 GUILLEN LIZANA YOSELIN 24 210-2-48173180 06/05/2018 150103A101 150111A205 0.00 0.00 13.62 0.00 13.62
1,362 210-13-01250715 GUILLEN SORIA MARILU ADRIANA 4 210-2-61859471 05/11/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
1,363 210-12-00808146 GUILLERMO DAMIAN DELIA 35 210-2-47774900 01/09/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,364 210-11-03730374 GUILLERMO DURAND DAYANA BRIGETT 22 210-2-46030253 01/12/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
1,365 210-11-03062322 GUILLERMO RICAPA JUDIT 19 210-2-48066978 05/07/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
1,366 210-11-03053565 GUISADO CCORIMANYA AIDE YOVANA 27 210-2-47443480 07/06/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,367 210-17-24415280 GUIVAR PEREZ RAQUEL 22 160-2-76852918 22/08/2017 150103A101 150111A101 0.00 0.00 9.28 0.00 9.28
1,368 210-17-24434922 GUIVAR PEREZ RAQUEL 22 160-2-76852918 18/09/2017 150103A101 150137A206 0.00 0.00 7.89 0.00 7.89
1,369 210-11-03735290 GUIZADO DE LA CRUZ MARICELA REYNALDA 35 210-2-10607447 25/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,370 210-11-03063038 GUIZADO QUISPE MAURO 22 210-2-45716646 09/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,371 210-17-24295151 GURMENDI SEMINARIO THIAGO LIONEL 0 210-E-28664960 09/02/2017 150103A101 150115A101 0.00 0.00 13.64 0.00 13.64
1,372 210-11-03052754 GUTIERRES MENDEZ MARCELINO 68 210-6-00021249 29/05/2011 150103A101 070102A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 49 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,373 210-14-40093445 GUTIERREZ AMASIFUEN NICOLE NADHIA 6 210-2-70954209 06/10/2014 150103A101 150105A101 0.00 0.00 21.57 0.00 21.57
1,374 210-14-40096185 GUTIERREZ AMASIFUEN NICOLE NADHIA 6 210-2-70954209 13/10/2014 150103A101 150105A101 0.00 0.00 13.75 0.00 13.75
1,375 210-11-02705041 GUTIERREZ ANGULO NN 0 210-7-40455853 27/03/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,376 210-11-03614843 GUTIERREZ ANTONIO NN 0 210-7-41551923 24/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,377 210-17-24462717 GUTIERREZ BALTAZAR ANGELINA 9 170-2-61283632 07/11/2017 150103A101 150111A101 0.00 0.00 9.16 0.00 9.16
1,378 210-12-00804912 GUTIERREZ CAYLLAHUA MAGALY 25 210-2-44157040 16/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,379 210-11-03055100 GUTIERREZ CERON ROSA JUSTINA 35 210-2-45408897 05/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,380 210-17-24332707 GUTIERREZ CORONADO RN 0 210-E-28772478 11/04/2017 150103A101 150101A101 0.00 0.00 12.20 0.00 12.20
1,381 210-12-00188138 GUTIERREZ DE RODRIGUEZ CLAUDIA 79 210-2-28563143 23/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,382 210-11-03050090 GUTIERREZ GAMARRA PIERO ALESSANDRO 0 210-2-74681187 15/04/2011 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
1,383 210-12-03911011 GUTIERREZ GOMEZ EDITH BELGICA 19 210-2-48321354 01/02/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
1,384 210-12-01283918 GUTIERREZ HUAYNATES SUJEI ROSA 16 220-2-70105823 14/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,385 210-11-03051147 GUTIERREZ MEDRANO DANIELA NAOMI 4 210-2-60828829 27/05/2011 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
1,386 210-18-42539177 GUTIERREZ MENDOZA MARIA VICTORIA 59 210-2-06571842 10/04/2018 150103A101 150118A101 0.00 0.00 34.36 0.00 34.36
1,387 210-11-03060757 GUTIERREZ PEREZ ROCIO SILVIA 21 210-2-46243335 17/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,388 210-11-03728478 GUTIERREZ PONCE JULIANA HATALY 1 210-2-61681612 16/11/2011 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
1,389 210-18-42523141 GUTIERREZ PORRAS CASTO LEODRIA 64 210-2-06614049 20/03/2018 150103A101 150111A101 0.00 0.00 10.93 0.00 10.93
1,390 210-12-00801638 GUTIERREZ QUISPE JANNINA 23 210-2-45969350 18/07/2012 150103A101 150133A101 0.00 0.00 0.00 0.00 0.00
1,391 210-14-40065378 GUTIERREZ SUPA JUANA MARIA 25 210-2-45695665 24/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
1,392 210-11-03059639 GUZMAN ALVARADO DAYSI 18 210-2-71640416 26/07/2011 150103A101 150121A101 0.00 0.00 50.00 0.00 50.00
1,393 210-11-03063081 GUZMAN JESUS GEOVANNA 34 210-2-44891468 10/07/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
1,394 210-11-03058249 GUZMAN MONTES NELVA ROXANA 22 210-2-45754985 22/07/2011 150103A101 150118A101 0.00 0.00 50.00 0.00 50.00
1,395 210-11-03055364 GUZMAN QUILCA IDA MAGDALENA 26 210-2-42807180 30/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,396 210-17-24334534 HAVELA FERNANDEZ CELESTINA 67 170-2-20979545 16/04/2017 150103A101 150111A101 0.00 0.00 8.59 0.00 8.59
1,397 210-13-01211641 HEINSOHN OROSCO SUDET SIHOMARA 15 210-2-77813269 17/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,398 210-13-01214709 HERBAS AYALA RUTH NOEMI 27 210-2-43793735 31/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,399 210-18-42464374 HEREDIA HEREDIA NEYVA 22 160-2-63407399 05/01/2018 150103A101 150101A109 0.00 0.00 17.80 0.00 17.80
1,400 210-14-40093209 HEREDIA SANTIAGO BRIZETH TIFANY 11 210-2-77321907 06/10/2014 150103A101 150111A101 0.00 0.00 11.00 0.00 11.00

Elaborado por OIE-SIS Página 50 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,401 210-11-03733238 HERHUAY ALTAMIRANO MANUEL ALBERTO 14 210-2-76926925 16/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,402 210-14-40007918 HERMENEGILDO RESURRECCION XIOMARA STEPHANIE 25 210-2-45082038 29/01/2014 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,403 210-13-01225134 HERMOZA NIEVES LUIS ENRIQUE 17 210-2-76660205 11/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,404 210-13-01226097 HERNANDEZ CORREA LIZ YANETH 19 210-2-76516687 16/07/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,405 210-11-03052688 HERNANDEZ HUAMAN ELIZABETH YOBANA 36 210-2-09849449 27/05/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,406 210-18-42543418 HERNANDEZ ORDUZ VICTORIA CAROLINA 0 210-2-90399980 15/04/2018 150103A101 0000016918 0.00 0.00 12.27 0.00 12.27
1,407 210-11-03060758 HERNANDEZ QUIROZ ADELINDA 31 210-2-42077129 17/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,408 210-18-42469302 HERNANDEZ TASAYCO CESAR AUGUSTO 60 210-2-09059051 11/01/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
1,409 210-11-02706524 HERNANDO HUAMANCAJA ROMINA IZCIA DEL PILAR 19 210-2-47062691 30/03/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,410 210-11-03052305 HERRERA CHAVEZ OLIVIA DIANA 27 210-2-42261282 21/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,411 210-17-24433937 HERRERA JULCAMORO LEIDY 15 070-2-74835324 17/09/2017 150103A101 150111A101 0.00 0.00 7.55 0.00 7.55
1,412 210-11-03056241 HERRERA PAITAMPOMA MAGDALENA 26 210-2-42647821 08/05/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,413 210-11-03607626 HERRERA PILLACA JOSEPH VALENTINO 0 210-2-76484430 11/09/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
1,414 210-17-24357345 HERRERA QUISPE RN 0 210-E-28817950 25/05/2017 150103A101 150111A101 0.00 0.00 8.12 0.00 8.12
1,415 210-17-24426858 HERRERA RAMIREZ JUAN CARLOS 10 190-2-61052525 07/09/2017 150103A101 150105A101 0.00 0.00 15.66 0.00 15.66
1,416 210-17-24427714 HERRERA RAMIREZ JUAN CARLOS 10 190-2-61052525 08/09/2017 150103A101 150105A101 0.00 0.00 16.11 0.00 16.11
1,417 210-18-42551740 HERRERA SIERRA OCTAVIO WALTER 43 210-2-09778352 26/04/2018 150103A101 150111A101 0.00 0.00 9.33 0.00 9.33
1,418 210-17-24356650 HERRERA YNUMA MARCIA 18 240-2-76672287 23/05/2017 150103A101 150111A101 0.00 0.00 9.48 0.00 9.48
1,419 210-12-00802619 HERRERA YUCRA MOLLY GUADALUPE 1 210-2-62670282 10/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,420 210-14-40069882 HICHCAS ESPINOZA DANIA ISABEL 33 210-2-40729618 07/08/2014 150103A101 150128A204 0.00 0.00 18.70 0.00 18.70
1,421 210-13-01252430 HIDALGO DEL AGUILA LUZ MARIELA 28 210-2-46284843 12/11/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
1,422 210-11-03735010 HIDALGO MAYTA EVELYN TERESA 24 210-2-44075143 20/12/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
1,423 210-14-40017913 HIDALGO NUÑEZ MAGALLI 21 210-2-70037025 01/03/2014 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,424 210-12-03904772 HIDALGO PURIS AMANDA 19 210-2-47178922 20/02/2012 150103A101 150110A101 0.00 0.00 0.00 0.00 0.00
1,425 210-11-03733678 HILARIO DE YAPO ALEJANDRA 65 210-2-07074205 22/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,426 210-17-24398641 HILARIO PAREDES PRUDENCIO 48 210-2-09313017 29/07/2017 150103A101 150121A101 0.00 0.00 22.01 0.00 22.01
1,427 210-11-03047698 HILARIO URCUHUARANGA SARA NADIA 20 210-2-70091084 04/04/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
1,428 210-13-01225097 HILARIO VARGAS JUSTINA 65 210-2-23448072 11/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00

Elaborado por OIE-SIS Página 51 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,429 210-17-24456564 HILARIO ZUÑIGA CECILIA GIOVANNA 33 200-2-42522871 17/10/2017 150103A101 150111A101 0.00 0.00 9.80 0.00 9.80
1,430 210-18-42560965 HINOJOSA SEHUINCHO YELINA 18 210-2-77274564 16/02/2018 150103A101 150111A205 0.00 0.00 10.92 0.00 10.92
1,431 210-14-40030174 HINOSTROZA BARTOLO CESAR ANGEL 22 140-2-70417371 05/04/2014 150103A101 150137A101 0.00 0.00 112.00 0.00 112.00
1,432 210-17-24433886 HINOSTROZA SOLANO AVELINA 27 210-2-47211041 27/09/2017 150103A101 150111A101 0.00 0.00 7.11 0.00 7.11
1,433 210-13-00283336 HINOSTROZA TELLO ERIKA CLEYDE 24 210-2-45467740 29/01/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,434 210-17-24339050 HITO CAMARENA REYNALDA 85 200-2-20653456 25/04/2017 150103A101 150111A101 0.00 0.00 8.13 0.00 8.13
1,435 210-14-40072604 HONO BALDEON JOSE ARMANDO 9 210-2-73929819 13/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
1,436 210-14-40033375 HORTEGA PALACIOS GREGORIA 48 210-2-06569400 15/04/2014 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
1,437 210-11-03730087 HUACACHI JAIME KATHERINE ELVIRA 19 210-2-47614631 26/11/2011 150103A101 150132A205 0.00 0.00 45.00 0.00 45.00
1,438 210-12-00798158 HUACACHI PINO AIDE DELIA 50 210-2-09055838 29/06/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
1,439 210-13-01226900 HUACACHI VEGA LIZETH ROSMERY 21 210-2-47566093 22/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,440 210-11-03062235 HUACAUSI JUSCAMAYTA BRILY YOSELIN 18 210-2-48037370 06/07/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,441 210-18-42522728 HUACCACHI ARANGO MERCEDES 37 210-2-44820824 19/03/2018 150103A101 150111A101 0.00 0.00 10.93 0.00 10.93
1,442 210-13-01215184 HUACCACHI DONAYRE MIRNA YANINA 35 210-2-10874235 01/06/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
1,443 210-13-01240805 HUACHACA CAVERO AIXA MAOLY 25 210-2-45233553 28/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,444 210-18-42533056 HUACHACA CCORIMANYA VALERIANO 37 210-2-44313490 02/04/2018 150103A101 150111A101 0.00 0.00 10.80 0.00 10.80
1,445 210-11-03048226 HUACHHUACO ROJAS HERMITA 35 210-2-21122745 07/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,446 210-14-40075945 HUAILLANI MORENO GENESIS VALENTINA 1 210-2-81011533 23/08/2014 150103A101 0000016918 0.00 0.00 12.10 0.00 12.10
1,447 210-18-42551621 HUAIRA ANDIA RN-HV 0 210-E-29114962 26/04/2018 150103A101 0000016918 0.00 0.00 13.75 0.00 13.75
1,448 210-14-40059874 HUAJAICACHAC LLASAJE JULIA 75 210-2-16176923 08/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
1,449 210-12-03907388 HUALLANCA GOMEZ ODELIA 19 210-2-47817926 20/03/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,450 210-13-01202167 HUALLPA ARIAS KATY DIANA 19 210-2-48195986 07/04/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
1,451 210-18-42493876 HUALLPA PARIANSULCA ANITA MARTHA 25 210-2-47604964 12/02/2018 150103A101 150111A101 0.00 0.00 9.70 0.00 9.70
1,452 210-16-22913086 HUAMALI CHOQUEHUANCA JONATHAN JAIR 8 210-2-71174517 25/10/2016 150103A101 150111A101 0.00 0.00 7.08 0.00 7.08
1,453 210-17-24342026 HUAMAN AGURTO LOURDES YOVANI 31 200-2-42940077 29/04/2017 150103A101 150111A101 0.00 0.00 9.04 0.00 9.04
1,454 210-12-00799464 HUAMAN ALARCON HILDA 28 210-2-42128925 12/07/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,455 210-11-03732191 HUAMAN ALEGRIA CELINA REBECA 42 210-2-09313229 03/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,456 210-12-03898444 HUAMAN ALVARADO ELIZABETH JULISSA 21 210-2-46345953 12/01/2012 150103A101 150132A212 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 52 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,457 210-18-42530220 HUAMAN ATOC CESAR COSME 55 210-2-21249620 28/03/2018 150103A101 150122A101 0.00 0.00 20.86 0.00 20.86
1,458 210-13-00281299 HUAMAN BELTRAN FRANCIS HERMINIO 10 210-2-75382567 25/01/2013 150103A101 150121A101 0.00 0.00 140.00 0.00 140.00
1,459 210-16-22931405 HUAMAN BERROCAL RN 0 210-E-27814334 25/11/2016 150103A101 150105A101 0.00 0.00 17.37 0.00 17.37
1,460 210-11-03613731 HUAMAN CARHUARICRA ELY ROSA 26 210-2-42757252 03/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
1,461 210-12-01292890 HUAMAN CARRION DELIA ROSA 22 210-2-46325057 21/12/2012 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
1,462 210-13-01252637 HUAMAN CHANCHA MARITA MIRIAM 20 210-2-47924864 13/11/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,463 210-17-24320063 HUAMAN DE LA CRUZ YOSHIRO YAREL 4 210-2-78370357 23/03/2017 150103A101 150105A101 0.00 0.00 14.91 0.00 14.91
1,464 210-12-00197937 HUAMAN DIAZ DANIELA JESSICA 19 210-2-73778355 03/05/2012 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
1,465 210-11-03050255 HUAMAN DIAZ JANETH ISABEL 34 210-2-20092515 23/04/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,466 210-14-40054561 HUAMAN FERNANDEZ VICTORIA 28 210-2-43964167 23/06/2014 150103A101 150101A105 0.00 0.00 19.80 0.00 19.80
1,467 210-12-39390839 HUAMAN GALINDO DENISSE 25 210-2-44305857 23/02/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,468 210-11-03730587 HUAMAN GARCIA ALEXANDER SMITH 5 210-2-60930814 06/12/2011 150103A101 150105A101 0.00 0.00 25.00 0.00 25.00
1,469 210-17-24391042 HUAMAN HUACHHUACO LEYA 13 210-2-70737381 14/07/2017 150103A101 070102A101 0.00 0.00 13.05 0.00 13.05
1,470 210-14-40013976 HUAMAN HUILLCA CLAUDIO 60 210-2-06612229 17/02/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,471 210-13-01226917 HUAMAN JAVIER NERI LUZ 29 210-2-42397453 22/07/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,472 210-11-03605264 HUAMAN JORGE YULISA MILAGROS 19 210-2-70776340 12/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,473 210-12-01294771 HUAMAN LEGUIA NEISA 26 210-2-44230638 22/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,474 210-18-42479021 HUAMAN MONTES NICOLE ANGIEE 19 210-2-76230308 25/01/2018 150103A101 150101A102 0.00 0.00 18.90 0.00 18.90
1,475 210-14-40057799 HUAMAN MORALES JEFREY FRANCISCO 9 210-2-75915998 02/07/2014 150103A101 150121A101 0.00 0.00 27.50 0.00 27.50
1,476 210-11-03058192 HUAMAN MOSCOSO NOHELIA GUDALUPE 17 210-2-47965050 24/07/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
1,477 210-12-00187060 HUAMAN QUISPE MARTHA 25 210-2-44122524 14/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,478 210-18-42541743 HUAMAN QUISPE MATEO FABRICIO MOISES 0 210-2-90706091 12/04/2018 150103A101 150111A101 0.00 0.00 10.31 0.00 10.31
1,479 210-13-01225609 HUAMAN QUISPE MILLY 24 210-2-45462864 13/07/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,480 210-17-24386698 HUAMAN RUPAY KATE VALESKA 3 210-2-78482538 08/07/2017 150103A101 150105A101 0.00 0.00 13.92 0.00 13.92
1,481 210-11-03726758 HUAMAN SEGUNDO EMILIA 29 210-2-48293792 04/11/2011 150103A101 150111A205 0.00 0.00 40.00 0.00 40.00
1,482 210-17-24434034 HUAMAN TICONA LUIS ANGEL 11 210-2-70636167 17/09/2017 150103A101 150115A101 0.00 0.00 12.22 0.00 12.22
1,483 210-12-00800315 HUAMAN TORREJON MIGUEL ANGEL 1 210-2-77002119 12/07/2012 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
1,484 210-11-03608477 HUAMAN TORRES FLORANGEL LIDIA 39 210-2-09805809 21/08/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00

Elaborado por OIE-SIS Página 53 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,485 210-17-24329991 HUAMAN YURIVILCA BRIANNA KAHORY 0 210-2-79703261 07/04/2017 150103A101 150115A101 0.00 0.00 12.65 0.00 12.65
1,486 210-14-40017933 HUAMANCAJA MENDOZA ESTHEFANY 17 210-2-74446482 01/03/2014 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,487 210-17-24350551 HUAMANCHA SILVESTRE DAKIRA JOLIE 3 210-2-78660652 11/05/2017 150103A101 150105A101 9.02 0.00 0.00 0.00 9.02
1,488 210-12-00196271 HUAMANCHAU MANAYCO YAQUELIN 37 210-2-09780054 01/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,489 210-18-42479140 HUAMANCHUMO VILLANUEVA THIAGO GAHEL 0 210-2-81712186 24/01/2018 150103A101 150105A101 0.00 0.00 18.41 0.00 18.41
1,490 210-12-03903288 HUAMANI CONDOR DYLANN LENNY 0 210-7-47382166 15/02/2012 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
1,491 210-13-01211959 HUAMANI CURI MARIFFE KINESHY 3 210-2-61930499 19/05/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
1,492 210-17-24454956 HUAMANI DE LA CRUZ ANAHI SULEMA 10 210-2-77199462 11/10/2017 150103A101 150105A101 0.00 0.00 13.44 0.00 13.44
1,493 210-11-03057092 HUAMANI HUAMAN MARIA ISABEL 27 210-2-45345108 27/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,494 210-16-22903710 HUAMANI LIMA ROSA 23 210-2-47879711 08/10/2016 150103A101 150111A101 0.00 0.00 10.08 0.00 10.08
1,495 210-12-00191816 HUAMANI MEDINA EUDOLIA 68 210-2-10038007 03/06/2012 150103A101 150101A103 0.00 0.00 0.00 0.00 0.00
1,496 210-11-03614037 HUAMANI ORE ROMARIO BENITO 0 210-2-76116177 12/09/2011 150103A101 150135A101 0.00 0.00 45.00 0.00 45.00
1,497 210-18-42515661 HUAMANI PINARES JOSE ANTONIO 12 030-2-71294142 09/03/2018 150103A101 150115A101 0.00 0.00 14.90 0.00 14.90
1,498 210-13-00290279 HUAMANI PUMAHUACRE VICTOR JOSE 41 210-2-10168012 26/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,499 210-11-03726878 HUAMANI RUIZ NN 0 210-7-40985955 08/11/2011 150103A101 150121A101 0.00 0.00 45.00 0.00 45.00
1,500 210-11-03728193 HUAMANI SALAS HILDA 17 210-2-71771425 11/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,501 210-12-01292987 HUAMANI SOTO ROSILIA CLARA 29 210-2-41926271 23/11/2012 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,502 210-11-03052855 HUAMANI UNOCC RAIDA MAURA 35 210-2-40772013 30/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,503 210-14-40058842 HUAMANLAZO MARTINEZ ROSA ELVIRA 46 210-2-10043188 05/07/2014 150103A101 150118A101 0.00 0.00 30.25 0.00 30.25
1,504 210-17-24493503 HUAMANTICA GAMBOA JHAIR SEBASTIAN 2 210-2-79239869 07/12/2017 150103A101 150101A109 0.00 0.00 19.27 0.00 19.27
1,505 210-18-42500626 HUAMANTICA GAMBOA JHAIR SEBASTIAN 2 210-2-79239869 20/02/2018 150103A101 150101A109 0.00 0.00 15.34 0.00 15.34
1,506 210-18-42538525 HUAMANYAURI NAVARRO CLORINDA EUGENIA 55 210-2-09068362 09/04/2018 150103A101 150141A101 0.00 0.00 11.29 0.00 11.29
1,507 210-14-40066860 HUAMANÑAHUI ESPINOZA SIXTO 54 210-2-31027675 30/07/2014 150103A101 150115A101 0.00 0.00 15.40 0.00 15.40
1,508 210-14-40067473 HUAMANÑAHUI ESPINOZA SIXTO 54 210-2-31027675 31/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
1,509 210-17-24438638 HUANCA COELLO DARCY PAOLA 26 210-2-47747412 25/09/2017 150103A101 150111A205 0.00 0.00 26.55 0.00 26.55
1,510 210-17-24479099 HUANCA PARDO RN-HV 0 210-E-28968005 19/11/2017 150103A101 150115A101 0.00 0.00 12.22 0.00 12.22
1,511 210-18-42497418 HUANCAS ARROYO NANCY LUZME 40 210-2-10467099 16/02/2018 150103A101 150101A105 0.00 0.00 14.48 0.00 14.48
1,512 210-14-40070921 HUANCAS CRUZ GREISY MELISSA 21 210-2-48147824 09/08/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00

Elaborado por OIE-SIS Página 54 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,513 210-13-01208055 HUANQUI VIZA NORMA VICTORIA 38 210-2-42705528 03/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,514 210-11-03059773 HUAPAYA CASTRO JULIA ROSA 25 210-2-43602217 27/07/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
1,515 210-11-03056342 HUARACA CAUNA YOSELYN ROXANA 17 210-2-70734122 09/05/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,516 210-11-03729163 HUARACA LOPEZ HILDA 29 210-2-41340163 11/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,517 210-12-03902222 HUARACA PILLACA MARLENI LILIANA 30 210-2-42098766 06/02/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,518 210-12-00196725 HUARACA RETAMOZO NANCI 24 210-2-45113552 24/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,519 210-17-24348480 HUARACA SALAZAR MARY CIELO 17 210-2-73474927 08/05/2017 150103A101 150111A101 0.00 0.00 8.57 0.00 8.57
1,520 210-11-03731696 HUARACA SANCHEZ ZENON 55 210-2-06548885 25/11/2011 150103A101 150101A101 0.00 0.00 40.00 0.00 40.00
1,521 210-18-42565589 HUARACHA HUAMAN JORGE LUIS 24 210-2-70194881 13/05/2018 150103A101 150111A101 0.00 0.00 9.35 0.00 9.35
1,522 210-14-40054656 HUARANCCA HUARCAYA ROXANA 23 210-2-48136300 23/06/2014 150103A101 150133A101 0.00 0.00 25.30 0.00 25.30
1,523 210-11-03062596 HUARANGA NAVARRO NN 0 210-7-47368074 23/06/2011 150103A101 150121A101 0.00 0.00 50.00 0.00 50.00
1,524 210-11-03047892 HUARCAYA ASTO GLADYS ELBA 29 210-2-41236958 06/04/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,525 210-13-01198781 HUARCAYA CCANTO JOSEFINA 19 210-2-48290149 22/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,526 210-18-42478818 HUARCAYA VILLCAS MARCO ADRIAN 6 210-2-77446788 24/01/2018 150103A101 150111A101 0.00 0.00 10.06 0.00 10.06
1,527 210-13-01232633 HUARHUACHI REYES KATY 30 210-2-41510234 28/08/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
1,528 210-17-24286417 HUARINGA AGUIRRE SINDI YANET 29 210-2-45435599 27/01/2017 150103A101 150111A101 0.00 0.00 29.75 0.00 29.75
1,529 210-11-03727069 HUARINGA OCAÑO YENI 24 210-2-44891761 04/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,530 210-17-24423816 HUARINGA ZARATE SEBASTIAN MATHIEU 7 210-2-73928055 04/09/2017 150103A101 150115A101 0.00 0.00 13.55 0.00 13.55
1,531 210-13-01208613 HUARIPATA QUISPE YOLLY MARIETA 21 210-2-47587472 05/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,532 210-18-42541931 HUAROCC RAMOS JIMENA NOELIA 21 130-2-71296925 12/04/2018 150103A101 150111A101 0.00 0.00 10.31 0.00 10.31
1,533 210-11-03051261 HUAROTO AQUINO ROSARIO 28 210-2-41731651 31/05/2011 150103A101 150132A203 0.00 0.00 0.00 0.00 0.00
1,534 210-11-03725974 HUARSAYA CCORICASA GIOVANA MARIBEL 27 210-2-43271894 25/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,535 210-14-40084879 HUASACCA DE POMA VIRGINIA 31 210-2-41509871 16/09/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
1,536 210-13-01237064 HUASHUAYO PALOMINO DE HUAMAN APOLINARIA 85 210-2-28233891 14/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,537 210-18-42476476 HUAYAMA CAMIZAN DILCIA 38 160-2-40143029 22/01/2018 150103A101 150101A103 0.00 0.00 13.99 0.00 13.99
1,538 210-17-24311483 HUAYANA ZUÑIGA JUAN DAVID 2 210-2-81600635 08/03/2017 150103A101 150105A101 0.00 0.00 15.36 0.00 15.36
1,539 210-17-24312780 HUAYANA ZUÑIGA JUAN DAVID 2 210-2-81600635 10/03/2017 150103A101 150105A101 0.00 0.00 18.53 0.00 18.53
1,540 210-11-03059901 HUAYHUA SANTIAGO VIVIANA SHANDRELY 23 210-2-44922687 31/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00

Elaborado por OIE-SIS Página 55 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,541 210-12-03909650 HUAYLINOS PARRA MARTHA MARIA 31 210-2-40687767 11/03/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,542 210-14-40091781 HUAYLLA ROQUE ELENA BERTHA 32 210-2-42103515 02/10/2014 150103A101 150111A101 0.00 0.00 11.00 0.00 11.00
1,543 210-13-01211128 HUAYLLACAYAN SALAZAR HAYMME KARINA 23 210-2-45973416 15/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,544 210-18-42470181 HUAYLLACCAHUA GUTIERREZ SUSANA 34 210-2-42909938 13/01/2018 150103A101 150111A205 0.00 0.00 16.32 0.00 16.32
1,545 210-12-00191824 HUAYLLACCAHUA QUISPE PAOLA RUMINA 20 210-2-47221475 04/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,546 210-13-00288635 HUAYLO BALTAZAR MARLENE YOVANA 18 210-2-70811092 19/02/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,547 210-11-03059336 HUAYNAPOMAS LLIUYACC THARSILA 21 210-2-46171716 22/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,548 210-14-40072642 HUAYRA ESCOBAR GLORIA 36 210-2-40925241 13/08/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
1,549 210-18-42465381 HUAYRE OSORIO IXEYA RUTH ESTHER 3 210-2-78868191 07/01/2018 150103A101 150111A101 0.00 0.00 11.78 0.00 11.78
1,550 210-11-03614890 HUAYTAN GAMERO GENOVEVA 30 210-2-40935419 25/09/2011 150103A101 150111A205 0.00 0.00 40.00 0.00 40.00
1,551 210-11-03058935 HUAYTAN LOBATO JULIO 74 210-2-07460715 30/07/2011 150103A101 150101A102 0.00 0.00 40.00 0.00 40.00
1,552 210-18-42516100 HUERE CRISOSTOMO SHEYLA NAYELI 15 270-2-76597451 10/03/2018 150103A101 150111A101 0.00 0.00 9.57 0.00 9.57
1,553 210-17-24355360 HUERTA CIERTO CELYNA 28 210-2-45261695 20/05/2017 150103A101 150137A206 0.00 0.00 6.32 0.00 6.32
1,554 210-13-01248252 HUERTA DAZA GLORIA VIOLETA 23 210-2-46548470 27/10/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,555 210-14-40068945 HUILLCA BAYONA CIRILO 46 210-2-23858307 04/08/2014 150103A101 150118A101 0.00 0.00 30.80 0.00 30.80
1,556 210-14-40019801 HUILLCAPUMA ARCE ROSALIA 19 210-2-71010670 06/03/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,557 210-12-00194482 HUILLCARA DE MEDINA LEONCIA 71 210-2-28805703 14/05/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,558 210-13-01213636 HUINCHO APONTE TANIA ERICKA 16 210-2-74486470 26/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,559 210-18-42520358 HUITRON ARANGO CARMEN ROSA 41 210-2-10416788 16/03/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
1,560 210-17-24451200 HUMAREDA BELITO DANIEL GEDEÓN 0 210-2-90391147 10/10/2017 150103A101 150105A101 0.00 0.00 15.66 0.00 15.66
1,561 210-13-01240432 HURTADO CALLE NANCY SURANA 31 210-2-42561061 27/09/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,562 210-12-01288081 HURTADO NAPANGA PAMELA MARGOTH 16 130-2-70398534 03/11/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,563 210-13-01214045 IBARRA JARA GEORGINA 34 210-2-40022912 28/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,564 210-13-01231133 IGNACIO ANCHELIA ESTEFANY KATERYN 16 210-2-75255124 21/08/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
1,565 210-17-24454672 IGNACIO HUANGAL LEYLA ESTHER 32 180-2-43192316 15/10/2017 150103A101 150111A205 0.00 0.00 12.69 0.00 12.69
1,566 210-12-01294084 IGNACIO IGNACIO MARIBEL 41 210-2-10539386 24/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,567 210-17-24285471 IGNACIO INGA DIONICIO LUIS 35 220-2-48091955 25/01/2017 150103A101 150111A101 0.00 0.00 14.23 0.00 14.23
1,568 210-17-24397037 IGNACIO LLANTO ISAI 20 210-2-73571828 25/07/2017 150103A101 150111A101 0.00 0.00 7.66 0.00 7.66

Elaborado por OIE-SIS Página 56 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,569 210-17-24403113 ILDEFONSO VALENCIA SUMMI KIARA 5 210-2-62924413 03/08/2017 150103A101 150105A101 0.00 0.00 16.94 0.00 16.94
1,570 210-18-42476324 ILIZARBE JULIO XIOMARA 2 210-2-90235813 21/01/2018 150103A101 150111A101 0.00 0.00 10.06 0.00 10.06
1,571 210-11-03048749 ILIZARBE LAZO RUTH NOEMI 21 210-2-45910879 12/04/2011 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
1,572 210-14-40068420 ILLA CHICCHE FELICITAS 30 210-2-43472629 03/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
1,573 210-11-03606479 ILLACONZA QUISPE MARIA 29 210-2-43124860 17/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,574 210-11-03608887 ILLANES DE LA CRUZ CRISTINA 16 210-2-76339351 25/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,575 210-11-03048245 INCA NARVAES VICTORIA 23 210-2-44814672 08/04/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,576 210-12-01283760 INCHE CAPILLO JOELY STEFFI 17 210-2-48451781 22/09/2012 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
1,577 210-11-03612779 INFANTE ROJAS ROSMERY MAITE 20 210-2-46716592 10/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,578 210-18-42563243 INFANTES RIOS ANGELICA MARIA 28 210-2-46285207 09/05/2018 150103A101 150101A109 0.00 0.00 17.15 0.00 17.15
1,579 210-17-24458179 INGA HUACCACHI TONY JUNIOR 4 210-2-77963440 19/10/2017 150103A101 150132A205 0.00 0.00 21.33 0.00 21.33
1,580 210-13-01210301 INGA MORALES LIZ MARGOT 22 210-2-47118298 12/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,581 210-17-24475399 INGA SILVA NEVILA NOEMI 26 200-2-47494816 13/11/2017 150103A101 150111A205 0.00 0.00 10.46 0.00 10.46
1,582 210-11-03053474 INGA YUPANQUI CARLOS AGUSTO 30 050-6-00002878 08/06/2011 150103A101 070102A101 0.00 0.00 50.00 0.00 50.00
1,583 210-14-40072423 INGALLA HUANCA MONICA 37 210-2-02034285 13/08/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
1,584 210-12-00801467 INGARUCA CAPARACHIN SARA IRENE 25 210-2-44556628 19/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,585 210-18-42510823 INGARUCA SUPHO CATHERINE JAZZMIN 20 210-2-75590398 04/03/2018 150103A101 150115A101 0.00 0.00 10.43 0.00 10.43
1,586 210-12-01295530 INOCENTE CASTAÑEDA MARIA ELENA 17 140-2-72149690 12/10/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,587 210-13-01250519 INOCENTE DEXTER NOEMI JOSELIN 18 210-2-77421912 05/11/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,588 210-12-00192335 INUMA HUANSI DORLITH 23 210-2-46137327 08/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,589 210-13-01234536 INZA TORIBIO EVELIN DORIS 19 210-2-71831510 05/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,590 210-18-42513822 IRARICA AHUANARI LEYLA MARGARITA 29 210-2-45098707 08/03/2018 150103A101 150137A206 0.00 0.00 7.45 0.00 7.45
1,591 210-13-01208616 IRCAÑAUPA MARTINEZ KATHERIN LIZBHET 19 210-2-74372969 05/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,592 210-14-40066961 IRCAÑAUPA YAURIMO ELEUTERIO 49 210-2-06551199 30/07/2014 150103A101 150118A101 0.00 0.00 30.80 0.00 30.80
1,593 210-11-03731750 ISIDRO LOAYZA CATALINA 17 210-2-71548319 27/11/2011 150103A101 150132A205 0.00 0.00 45.00 0.00 45.00
1,594 210-17-24461633 ISUIZA SANGAMA SEMIRA 28 300-2-47592158 25/10/2017 150103A101 150101A105 0.00 0.00 15.98 0.00 15.98
1,595 210-17-24405333 ISUIZA TUANAMA RN-HV 0 210-E-28886972 07/08/2017 150103A101 150111A101 0.00 0.00 8.09 0.00 8.09
1,596 210-18-42483941 ITURBE YCHPAS JENNIFER VERONICA 17 210-2-70330804 30/01/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35

Elaborado por OIE-SIS Página 57 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,597 210-12-00188033 IZARRA BRAVO KEYLA FIORELLA 20 210-2-47625920 23/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,598 210-17-24411194 IÑAPI SALAZAR RN-HV 0 210-E-28889735 16/08/2017 150103A101 150105A101 13.49 0.00 0.00 0.00 13.49
1,599 210-11-03725915 JABO RIVERA MARIA ROSA LIRIA 23 210-2-45354205 24/10/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
1,600 210-18-42565690 JACAY MAGNO MINIMA VICTORIA 59 210-2-21079711 13/05/2018 150103A101 150111A101 0.00 0.00 9.88 0.00 9.88
1,601 210-12-00807020 JACO ARZAPALO ROSSI MARY 35 210-2-20906423 31/08/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,602 210-17-24500394 JACO ZAMORA DEALEXANDRO ARMANDO 8 210-2-73282263 19/12/2017 150103A101 150121A101 0.00 0.00 9.60 0.00 9.60
1,603 210-11-03056069 JAIME CHANDUVI ANGELICA ROCIO 20 210-2-70377596 07/05/2011 150103A101 150132A203 0.00 0.00 0.00 0.00 0.00
1,604 210-13-01199611 JAIME CHAVEZ BERCY YSABEL 26 210-2-43856863 26/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,605 210-14-40121297 JANAMPA AMAYA BRANDY LEYLA 17 210-2-74899946 02/12/2014 150103A101 150101A109 0.00 0.00 20.90 0.00 20.90
1,606 210-14-40078587 JANAMPA BALVIN JUAN CARLOS 25 210-2-46083887 30/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
1,607 210-12-00809667 JANAMPA CARBAJAL MARIA ELENA 28 210-2-42517874 06/08/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,608 210-17-24346859 JANAMPA CARBAJAL MARIA ELENA 32 210-2-42517874 05/05/2017 150103A101 150111A101 0.00 0.00 9.02 0.00 9.02
1,609 210-18-42473957 JANAMPA CHACCEDI JORGENIA 40 230-2-10600761 17/01/2018 150103A101 150111A101 0.00 0.00 9.57 0.00 9.57
1,610 210-12-00805144 JANAMPA MENDOZA NN 0 210-7-47312874 28/08/2012 150103A101 150135A101 0.00 0.00 0.00 0.00 0.00
1,611 210-17-24323772 JANCCO CAÑAZACA HILDA 34 210-2-41300285 29/03/2017 150103A101 150111A101 0.00 0.00 8.13 0.00 8.13
1,612 210-11-03606569 JARA ALDANA NELLY REYNALDA 40 210-2-21121877 18/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,613 210-11-03060388 JARA PALOMINO YAZUMI LI 6 210-2-76526297 27/06/2011 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
1,614 210-11-03055363 JARA RAMOS SANDRA 26 210-2-42740857 30/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,615 210-17-24485874 JARA RIOS MARIA ESTELA 26 180-2-48378398 30/11/2017 150103A101 150111A205 0.00 0.00 10.10 0.00 10.10
1,616 210-11-03610450 JARAMILLO DE CORONEL ELVA FAUSTINA 58 210-2-21251408 11/10/2011 150103A101 150101A102 0.00 45.00 0.00 0.00 45.00
1,617 210-13-01209175 JARAMILLO LLANA SARA SILVIA 27 210-2-43065146 07/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,618 210-12-00187699 JAUREGUI DELGADO MIRELLA SORALLA 15 210-2-70582196 22/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,619 210-11-03606971 JAUREGUI GRADOS JENNY CARMEN 36 210-2-10315076 07/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
1,620 210-17-24506577 JAUREGUI NUÑEZ CESAR RAYMUNDO 0 210-2-90501552 31/12/2017 150103A101 150111A101 0.00 0.00 8.46 0.00 8.46
1,621 210-11-03047860 JAVIER ROJAS EDITH AMANDA 21 210-2-46559360 06/04/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
1,622 210-17-24418379 JESUS SANDOVAL CRISTALINA CRISTINA 21 210-2-77342656 27/08/2017 150103A101 150137A206 0.00 0.00 5.50 0.00 5.50
1,623 210-18-42509625 JESUS SULCA JOHANA FRANCESCA 26 210-2-48052715 02/03/2018 150103A101 150111A101 0.00 0.00 9.94 0.00 9.94
1,624 210-13-01225996 JESUS TOLENTINO CARMEN MARIANA 28 210-2-46584054 15/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00

Elaborado por OIE-SIS Página 58 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,625 210-17-24479722 JIMENES ROJAS CESAR ALCIDES 53 210-2-21088723 20/11/2017 150103A101 150101A101 0.00 0.00 10.46 0.00 10.46
1,626 210-12-00194882 JIMENEZ CCANTO LISZET EMILY 19 210-2-70091081 04/04/2012 150103A101 150133A101 0.00 0.00 0.00 0.00 0.00
1,627 210-17-24404613 JIMENEZ CCANTO LISZET EMILY 25 210-2-70091081 06/08/2017 150103A101 150132A212 0.00 0.00 9.60 0.00 9.60
1,628 210-14-40108868 JIMENEZ FERNANDEZ CARLOS NAEL 0 210-2-78428945 06/11/2014 150103A101 150111A101 0.00 0.00 12.10 0.00 12.10
1,629 210-11-03613889 JIMENEZ GARCIA MARIA MARLENI 28 210-2-41526382 02/09/2011 150103A101 150111A205 0.00 0.00 40.00 0.00 40.00
1,630 210-13-00286751 JIMENEZ GUTIERREZ CYNTHIA CRISTINA 29 210-2-46974910 10/02/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,631 210-11-03732448 JIMENEZ LIMAHUAYA BETZY 18 210-2-70162569 07/12/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,632 210-17-24471330 JIMENEZ MAMANI PIERO FARID 13 210-2-75328959 08/11/2017 150103A101 150111A101 0.00 0.00 9.16 0.00 9.16
1,633 210-11-03606082 JIMENEZ OROZCO OLGA 23 210-2-47175902 12/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,634 210-14-40066960 JIMENEZ PALOMINO JACKLIN JOHANNA 33 210-2-43804141 30/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
1,635 210-13-01213730 JIMENEZ TORRES ADRIANA CAROLINA 19 210-2-70192339 27/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,636 210-12-03909737 JIPA TAPULLIMA LUZ MINERVA 20 210-2-72625517 11/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,637 210-17-24278217 JOAQUIN ORDOÑEZ R0SMERY 21 210-2-76302283 11/01/2017 150103A101 150111A101 0.00 0.00 9.06 0.00 9.06
1,638 210-14-10115843 JORGE AQUINO ROSAYDA JENETH 17 220-2-77542045 20/11/2014 150103A101 150101A105 0.00 0.00 20.99 0.00 20.99
1,639 210-17-24472217 JORGE GUTIERREZ ERMA ANTONIA 30 210-2-44629560 09/11/2017 150103A101 150132A205 0.00 0.00 20.09 0.00 20.09
1,640 210-12-01295254 JORGE QUISPE DARIA 40 210-2-28582574 17/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,641 210-17-24321105 JORGE SIMON YENNY MARIELA 19 210-2-78372531 25/03/2017 150103A101 150111A101 0.00 0.00 7.68 0.00 7.68
1,642 210-14-40019795 JORGE VASQUEZ ELIZABETH JANET 34 210-2-40598467 06/03/2014 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,643 210-17-24398808 JOYO MALLMA RECIEN NACIDO 0 210-E-28879242 30/07/2017 150103A101 0000016918 0.00 0.00 11.44 0.00 11.44
1,644 210-18-42476478 JUAN DE DIOS SEBASTIAN SARA ESTHER 29 140-2-46273380 22/01/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
1,645 210-13-01232634 JUAREZ CERPA LETICIA 27 210-2-43594653 28/08/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
1,646 210-11-03729187 JULCA ATACHAGUA NATALI AMPARO 25 210-2-43529925 12/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,647 210-12-00195956 JULCA HERRERA YOSSY 22 210-2-45924512 13/05/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,648 210-11-03606169 JULCA QUISPE ERIKA EULALIA 23 210-2-44799630 15/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
1,649 210-14-40090314 JULCA TORRES JENYFER LIZET 19 210-2-76225694 29/09/2014 150103A101 190113A101 0.00 0.00 32.65 0.00 32.65
1,650 210-13-00280653 JULCARIMA BERNAL BALERIA ELIZABET 1 210-2-77412324 16/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,651 210-17-24275950 JULCARIMA SALAZAR DELIA CLAUDIA 23 200-2-47917250 07/01/2017 150103A101 150101A109 0.00 0.00 18.97 0.00 18.97
1,652 210-12-00193432 JURADO HUAMAN SABINA 35 210-2-23275039 03/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 59 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,653 210-17-24337880 JURADO LEANDRO GEANELLA FRANCISCA 14 210-2-75118454 22/04/2017 150103A101 150105A101 0.00 0.00 16.27 0.00 16.27
1,654 210-17-24342445 JURADO LEANDRO GEANELLA FRANCISCA 14 210-2-75118454 29/04/2017 150103A101 150105A101 0.00 0.00 14.91 0.00 14.91
1,655 210-17-24343650 JURADO LEANDRO GEANELLA FRANCISCA 14 210-2-75118454 02/05/2017 150103A101 150105A101 0.00 0.00 15.79 0.00 15.79
1,656 210-13-01226558 JURADO ÑAHUINRIPA ALICIA CARMEN 34 210-2-10819955 19/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,657 210-12-01295274 JUSTINIANI ACCOSTUPA NOEMI 23 210-2-45767555 18/10/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,658 210-14-40029426 LAGOS GONZALES SILVIA EDITH 26 210-2-44791661 03/04/2014 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,659 210-12-03900757 LANAZCA HUACHACA LIDA 24 210-2-44202238 25/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,660 210-17-24293874 LANDEO GONZALES JEREMY DEYVID 14 210-2-70710300 08/02/2017 150103A101 150101A101 0.00 0.00 10.78 0.00 10.78
1,661 210-17-24305112 LANGA ALDABA RN 0 210-E-28726916 28/02/2017 150103A101 150111A101 0.00 0.00 8.19 0.00 8.19
1,662 210-18-42525518 LAOS GALINDO TOSHIRO ALEXANDER 9 210-2-71685107 23/03/2018 150103A101 150101A109 0.00 0.00 18.88 0.00 18.88
1,663 210-18-42481514 LAPA CABREJOS ALEXIA EMILY 0 210-2-90576698 29/01/2018 150103A101 150105A101 0.00 0.00 18.90 0.00 18.90
1,664 210-13-01216741 LAPA HUAMAN YANELA KARY 18 210-2-48704583 07/06/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,665 210-11-03049928 LAPA LAIME ROCIO 16 210-2-76503085 14/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,666 210-11-03052942 LAPA QUISPE ERIKA CRISTINA 27 210-2-42188730 30/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,667 210-17-24298203 LAPA YAUYO YURIA YAMILA 2 210-2-78871903 15/02/2017 150103A101 150105A101 0.00 0.00 14.10 0.00 14.10
1,668 210-17-24300515 LAPA YAUYO YURIA YAMILA 2 210-2-78871903 20/02/2017 150103A101 150105A101 0.00 0.00 18.65 0.00 18.65
1,669 210-17-24494431 LARA SULCA VANIA ZULEM 18 210-2-70908604 09/12/2017 150103A101 150111A101 0.00 0.00 9.40 0.00 9.40
1,670 210-13-01242561 LARA TANANTA ALONDRA ABIGAIL 2 210-2-63035366 06/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,671 210-17-24402275 LARA VENTOSILLA PRIMITIVA 22 210-2-74277339 03/08/2017 150103A101 150137A206 0.00 0.00 4.21 0.00 4.21
1,672 210-12-00807076 LARICO QUISPE MARISOL BRIGIDA 30 210-2-41384559 29/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,673 210-12-00184602 LAURA AVENDAÑO JHASMIN ROSARIO 16 210-2-77528564 09/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,674 210-14-40004698 LAURA CCENTE JHIMMY JAIMITO 3 210-2-62198789 17/01/2014 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
1,675 210-17-24438226 LAURA CORIPACO GUISELLA ROSALI 30 210-2-46333241 23/09/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
1,676 210-14-40061521 LAURA HUAMANI GUISELA NOEMI 21 210-2-73222375 13/07/2014 150103A101 150128A204 0.00 0.00 9.90 0.00 9.90
1,677 210-11-03052046 LAURA MEJIA BELGICA MIRELLA 22 210-2-45257454 11/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,678 210-17-24476367 LAURA QUISPE JORDY 4 210-2-78150690 15/11/2017 150103A101 150101A104 0.00 0.00 20.68 0.00 20.68
1,679 210-17-24477032 LAURA QUISPE JORDY 4 210-2-78150690 14/11/2017 150103A101 150101A104 0.00 0.00 23.03 0.00 23.03
1,680 210-11-03613660 LAURA TAIPE MAURA 66 210-2-06570509 26/09/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00

Elaborado por OIE-SIS Página 60 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,681 210-18-42504807 LAURA VARGAS GUALDALUPE 23 210-2-72267469 26/02/2018 150103A101 150111A205 0.00 0.00 10.55 0.00 10.55
1,682 210-17-24447065 LAUREANO SOTO ISAIAS DANIEL 4 210-2-81399854 05/10/2017 150103A101 150105A101 0.00 0.00 16.66 0.00 16.66
1,683 210-11-03048905 LAURENTE LAZO KATHERINE MAGALY 25 210-2-43237244 24/04/2011 150103A101 150107A204 0.00 0.00 0.00 0.00 0.00
1,684 210-12-03898979 LAURO TORRES JHOANA LIN 26 210-2-45330275 15/01/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,685 210-11-03611811 LAVERIO QUISPE ANGELO ABEL 1 210-2-74273754 30/10/2011 150103A101 150101A101 0.00 40.00 0.00 0.00 40.00
1,686 210-12-00184136 LAYANGO HUIÑAPI MILADI 29 210-2-42008528 07/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,687 210-18-42520969 LAYANGO MURGA JACKER JESSÉL 1 210-2-79706463 16/03/2018 150103A101 0000016918 0.00 0.00 12.92 0.00 12.92
1,688 210-17-24281858 LAYME CCORIMANYA MARIA FERNANDA 3 210-2-78155346 17/01/2017 150103A101 150111A101 0.00 0.00 8.19 0.00 8.19
1,689 210-14-40020548 LAYME QUICHCA KATIUSKA 33 210-2-40899719 09/03/2014 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,690 210-13-01195924 LAZARO ACOSTA DANIELA NATALY 1 210-2-63035325 10/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,691 210-17-24362110 LAZARO CORTEZ EDWIN YSAAC 44 150-2-21871216 31/05/2017 150103A101 150111A101 0.00 0.00 8.12 0.00 8.12
1,692 210-14-40018324 LAZARO GAMION YLDA MARIA 26 210-2-47575416 03/03/2014 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,693 210-13-01221039 LAZARO HUAYANAY MARIA 34 210-2-80165595 25/06/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,694 210-14-40030945 LAZARO MACHUCA ELENA 26 210-2-44501822 08/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,695 210-18-42515542 LAZARO MENDIETA WILDA 26 140-2-47665951 09/03/2018 150103A101 150111A205 0.00 0.00 14.90 0.00 14.90
1,696 210-12-00280329 LAZARO RIOS MARIELA MILAGROS 22 170-2-47799196 08/01/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,697 210-11-03606982 LAZARO YARANGA ROMALDA 16 210-2-75367866 07/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
1,698 210-17-24326707 LAZO ARCOS MEDIZ 38 210-2-20122635 03/04/2017 150103A101 150111A101 0.00 0.00 8.59 0.00 8.59
1,699 210-16-22858426 LAZO MESIAS CRISTIAN EMANUEL 4 210-2-77581216 28/07/2016 150103A101 150111A101 0.00 0.00 9.91 0.00 9.91
1,700 210-11-03604295 LAZO SEGURA NISKAR DEL PILAR 27 210-2-42370629 04/08/2011 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
1,701 210-11-03056194 LEANDRO LUNA MAGDALENA 29 210-2-47763197 08/05/2011 150103A101 150132A203 0.00 0.00 0.00 0.00 0.00
1,702 210-16-22913253 LEDESMA SEDANO VICTOR ULISES 14 130-2-70793111 25/10/2016 150103A101 0000016918 0.00 0.00 17.83 0.00 17.83
1,703 210-16-22913389 LEDESMA SEDANO VICTOR ULISES 14 130-2-70793111 26/10/2016 150103A101 150105A101 0.00 0.00 14.73 0.00 14.73
1,704 210-16-22916052 LEDESMA SEDANO VICTOR ULISES 14 130-2-70793111 31/10/2016 150103A101 150105A101 0.00 0.00 10.47 0.00 10.47
1,705 210-11-03729837 LEIVA DAGA JOBQUINS ELUNEY 0 210-2-76713992 22/11/2011 150103A101 150110A101 0.00 0.00 45.00 0.00 45.00
1,706 210-17-24454505 LEIVA TACZA JOSE JESUS 10 210-2-60008679 14/10/2017 150103A101 150111A101 0.00 0.00 8.66 0.00 8.66
1,707 210-13-01231877 LEON ALANYA MERCEDES 39 210-2-07495062 24/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,708 210-14-40065883 LEON GALINDO FRANCISCO A 74 210-2-09062693 26/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90

Elaborado por OIE-SIS Página 61 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,709 210-13-00290393 LEON GERONIMO ERIKA IRIS 29 210-2-42104169 26/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,710 210-13-00284542 LEON HUAMAN NELIDA VANESSA 21 210-2-46951003 31/01/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
1,711 210-11-03059335 LEON HUAMANI SOLEDAD 32 210-2-80675492 22/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,712 210-16-22888899 LEON MENDIVIL JESÚS DANIEL 2 200-2-78775232 14/09/2016 150103A101 150105A101 0.00 0.00 16.28 0.00 16.28
1,713 210-18-42511872 LEON ORTIZ STIVEN DANIEL 5 280-2-81061650 06/03/2018 150103A101 150105A101 0.00 0.00 19.37 0.00 19.37
1,714 210-18-42492160 LEON PORTAL MARYBEL 32 210-2-43056845 09/02/2018 150103A101 150137A206 0.00 0.00 5.65 0.00 5.65
1,715 210-18-42508860 LEON QUIQUIA VANESSA 19 210-2-75863258 02/03/2018 150103A101 0000006247 0.00 0.00 25.83 0.00 25.83
1,716 210-17-24407899 LEON SABINO HERMILIANO 71 210-2-07286312 10/08/2017 150103A101 150111A101 0.00 0.00 8.09 0.00 8.09
1,717 210-12-00802007 LEON TELLO MAYUMI SARAI 10 210-2-75450169 16/09/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,718 210-18-42554861 LEON TINEO GABRIELA DE LOS ANGELES 29 210-E-29128244 29/04/2018 150103A101 150101A102 0.00 0.00 24.21 0.00 24.21
1,719 210-13-01202492 LEON VILLALOBOS KATTYA MARISOL 22 210-2-48011207 08/04/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,720 210-13-01225345 LEON YANCCE EDILBERTA 37 210-2-40572845 12/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,721 210-14-40020452 LEON YANTAS AGUSTINA 49 170-2-20904478 06/03/2014 150103A101 150101A103 0.00 0.00 42.00 0.00 42.00
1,722 210-18-42544240 LEONARDO DOLORES SONIA MIGUELINA 52 210-2-10615521 16/04/2018 150103A101 150111A101 0.00 0.00 21.60 0.00 21.60
1,723 210-17-24349849 LERZUNDE VELASQUE NANCY 30 210-2-43610479 10/05/2017 150103A101 150111A101 0.00 0.00 8.57 0.00 8.57
1,724 210-11-03730122 LIBIA ALZA JESSICA JOHANA 21 210-2-46990432 27/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,725 210-13-00281781 LIMA ATAYPOMA MAGDALENA 25 210-2-44553018 29/01/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,726 210-12-00184858 LIMA CUADROS NANCI 23 210-2-47734431 10/04/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,727 210-12-00806510 LIMA CUYO MARTHA 27 210-2-42709516 03/09/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,728 210-12-00188842 LIMA LICONA JHOSVELINA 19 210-2-48045082 28/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,729 210-17-24454696 LIMA RAMIREZ MARITZA 22 050-2-48600117 15/10/2017 150103A101 150137A206 0.00 0.00 8.93 0.00 8.93
1,730 210-17-24334227 LIMA TAYPE JUAN CARLOS 19 210-2-70992998 15/04/2017 150103A101 150101A102 0.00 0.00 15.82 0.00 15.82
1,731 210-17-24335846 LIMA TAYPE JUAN CARLOS 19 210-2-70992998 18/04/2017 150103A101 150111A101 0.00 0.00 12.20 0.00 12.20
1,732 210-13-01221756 LIMACHE CRISPIN EDBER ENRIQUE 28 210-2-42992190 27/06/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
1,733 210-17-24323465 LIMAS MARTINEZ YANETH MERCEDES 32 210-2-42819271 29/03/2017 150103A101 150111A101 0.00 0.00 8.13 0.00 8.13
1,734 210-13-01252970 LIMAYLLA ALFARO JUDITH ROXANA 29 210-2-43148466 14/11/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,735 210-11-03055532 LIMAYLLA OSCANOA GUISELA KATHIA 20 210-2-48049629 14/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,736 210-13-00288089 LIMAYLLA ZURITA LUCY MERY 50 210-2-07378172 15/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00

Elaborado por OIE-SIS Página 62 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,737 210-14-40013900 LIMAYMANTA DE LA CRUZ RN 0 210-7-21261877 16/02/2014 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
1,738 210-11-03056327 LIMAYMANTA ROJAS ROSA CELIA 30 210-2-40647504 06/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,739 210-17-24373897 LINARES CUMBIA PAUL ANTENOR 9 210-2-70728763 19/06/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
1,740 210-11-03734161 LINARES GUERRA IDA JUDITH 31 210-2-40648526 28/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,741 210-18-42473030 LINDO REYES JULIA ENMA 24 210-2-70848543 17/01/2018 150103A101 150111A205 0.00 0.00 12.03 0.00 12.03
1,742 210-13-01241496 LINDO RUIZ JUSTIN JORGE 12 210-2-76851029 02/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,743 210-11-03054152 LINO GAGO DIANA GABRIELA 23 230-2-70063918 22/06/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,744 210-13-01263634 LINO ROSALES NAIDA HERMELINDA 33 210-2-43177738 21/12/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,745 210-17-24437851 LIRA SAGASTEGUI ROSA MERCEDES 22 210-2-77281145 22/09/2017 150103A101 150111A101 0.00 0.00 10.66 0.00 10.66
1,746 210-11-03052202 LIVIA CALLE ANA MARIA 22 210-2-60163681 13/06/2011 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,747 210-14-40068970 LIVIA CASTILLO JUDITH 18 210-2-74360646 05/08/2014 150103A101 150101A109 0.00 0.00 23.10 0.00 23.10
1,748 210-14-40072425 LIVIA RAMOS FILADELFIA CELIA 31 210-2-41722392 13/08/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
1,749 210-11-03731063 LIVIA RAMOS LILIANA VANESSA 23 210-2-45375634 11/12/2011 150103A101 150132A205 0.00 0.00 40.00 0.00 40.00
1,750 210-12-00192164 LIZANA BARRIENTOS RUDY 22 210-2-46063575 20/05/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
1,751 210-13-01198909 LIZARRAGA SOTO EGERZA GLINDA 18 210-2-74496827 23/03/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,752 210-16-22830610 LLACSAHUANGA ALBERCA LEYSI 1 210-2-78715092 09/06/2016 150103A101 150105A101 0.00 0.00 11.29 0.00 11.29
1,753 210-17-24337527 LLACSAHUANGA ALBERCA LEYSI 2 210-2-78715092 21/04/2017 150103A101 150105A101 0.00 0.00 23.05 0.00 23.05
1,754 210-17-24441125 LLACSAHUANGA ALBERCA LEYSI 3 210-2-78715092 28/09/2017 150103A101 150111A101 0.00 0.00 7.55 0.00 7.55
1,755 210-14-40114524 LLACSAHUANGA ALBERCA LEYSI 0 210-2-78715092 17/11/2014 150103A101 150105A101 0.00 0.00 18.15 0.00 18.15
1,756 210-14-40067071 LLACSAHUANGA ALBERCA NN 0 210-7-45030290 28/07/2014 150103A101 150105A101 0.00 0.00 21.57 0.00 21.57
1,757 210-14-40068653 LLACSAHUANGA ALBERCA NN 0 210-7-45030290 04/08/2014 150103A101 150105A101 0.00 0.00 21.57 0.00 21.57
1,758 210-11-03056422 LLACTAHUAMAN LLALLAHUI ERICKSON JACOB 0 210-2-76493138 05/05/2011 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
1,759 210-12-03903583 LLACTAS LIMACHI JENNY 25 210-2-44555599 13/02/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,760 210-12-03906173 LLALLE MONTENEGRO ERSELI 32 210-2-40555033 03/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,761 210-17-24350572 LLALLE MONTENEGRO ERSELI 37 210-2-40555033 11/05/2017 150103A101 150111A101 0.00 0.00 9.48 0.00 9.48
1,762 210-11-03607354 LLAMACCHIMA HUAMAN MARITZA 19 210-2-47460459 07/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
1,763 210-12-03907802 LLAMOCCA ZAMUDIO ROSA ISABEL 29 210-2-42840460 23/03/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
1,764 210-17-24326705 LLAMOJA ÑAHUINCOPA LAURA LUCIA 23 210-2-70997388 03/04/2017 150103A101 150118A101 0.00 0.00 23.95 0.00 23.95

Elaborado por OIE-SIS Página 63 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,765 210-17-24442501 LLANOS ALLAZU MANUELA 76 040-2-80231480 30/09/2017 150103A101 150111A101 0.00 0.00 7.55 0.00 7.55
1,766 210-13-00278189 LLANOS AMASIFUEN ANA GABRIELA 20 210-2-48491602 21/01/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,767 210-17-24382554 LLANOS BALBIN JOSE RAÚL 2 210-2-78828774 03/07/2017 150103A101 150115A101 0.00 0.00 12.73 0.00 12.73
1,768 210-13-01249502 LLANOS TRINIDAD EUFRASINA ESCOLASTICA 30 210-2-41656220 31/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,769 210-12-00189442 LLANTOY GABRIEL MARLIN ELIZABETH 37 210-2-10243830 24/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,770 210-14-40097636 LLANTOY SALINAS EYAL ADRIANO 0 210-2-78536894 17/10/2014 150103A101 150105A101 0.00 0.00 18.70 0.00 18.70
1,771 210-14-40099398 LLANTOY SALINAS EYAL ADRIANO 0 210-2-78536894 22/10/2014 150103A101 150105A101 0.00 0.00 21.57 0.00 21.57
1,772 210-14-40101244 LLANTOY SALINAS EYAL ADRIANO 0 210-2-78536894 26/10/2014 150103A101 150105A101 0.00 0.00 20.90 0.00 20.90
1,773 210-14-40104132 LLANTOY SALINAS EYAL ADRIANO 0 210-2-78536894 23/10/2014 150103A101 150105A101 0.00 0.00 21.57 0.00 21.57
1,774 210-17-24391418 LLASHAG MUÑOZ JULIANA 70 210-2-06809601 15/07/2017 150103A101 150103A208 0.00 0.00 11.87 0.00 11.87
1,775 210-18-42560470 LLERENA AURIS KRISTEL DE LOS ANGELES 5 200-2-78126742 07/05/2018 150103A101 150105A101 0.00 0.00 17.53 0.00 17.53
1,776 210-17-24491813 LLERENA MONSEFU ANGEL SEBASTIAN 2 210-2-79356185 30/11/2017 150103A101 0000016918 0.00 0.00 28.67 0.00 28.67
1,777 210-17-24492715 LLERENA MONSEFU ANGEL SEBASTIAN 2 210-2-79356185 07/12/2017 150103A101 150105A101 0.00 0.00 16.45 0.00 16.45
1,778 210-17-24322660 LLOCLLA MESARES LYAM SAID 0 210-2-90089020 28/03/2017 150103A101 150115A101 0.00 0.00 12.65 0.00 12.65
1,779 210-18-42468431 LOARDO VILA LINDICIO 84 210-2-09809850 10/01/2018 150103A101 150101A105 0.00 0.00 14.48 0.00 14.48
1,780 210-18-42470680 LOARDO VILA LINDICIO 84 210-2-09809850 13/01/2018 150103A101 150111A101 0.00 0.00 9.20 0.00 9.20
1,781 210-17-24503754 LOARTE VELASQUEZ FIORELA 18 210-2-61828608 25/12/2017 150103A101 150101A109 0.00 0.00 11.75 0.00 11.75
1,782 210-17-24477043 LOAYZA CALDERON MAYOMI VALERIA 14 210-2-74540491 15/11/2017 150103A101 150101A101 0.00 0.00 11.28 0.00 11.28
1,783 210-14-40030324 LOAYZA DE SEGOVIA SEVERINA 83 130-2-23206033 06/04/2014 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
1,784 210-11-03606397 LOAYZA FARFAN FERNANDINO 51 210-2-09439935 16/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,785 210-11-03050692 LOAYZA ORTIZ JULIA SUSY 26 210-2-43086966 20/05/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,786 210-17-24318462 LOAYZA SEGOVIA CRISTOFER JOEL 6 130-2-61751507 20/03/2017 150103A101 150115A101 0.00 0.00 10.85 0.00 10.85
1,787 210-17-24349239 LOBATO CASTRO ANGELITA MARIA 23 210-2-71127883 10/05/2017 150103A101 150111A101 0.00 0.00 8.12 0.00 8.12
1,788 210-18-42476577 LOBATON PEREZ LEONARD LEVÍT 4 210-2-78359113 22/01/2018 150103A101 150105A101 0.00 0.00 17.55 0.00 17.55
1,789 210-18-42479826 LOBATON PEREZ LEONARD LEVÍT 4 210-2-78359113 26/01/2018 150103A101 150105A101 0.00 0.00 17.30 0.00 17.30
1,790 210-17-24309605 LOBO RUPAY ROGER 48 210-2-80570424 05/03/2017 150103A101 150111A101 0.00 0.00 8.13 0.00 8.13
1,791 210-18-42533614 LOLI ROJAS ISABEL PRISCILA 59 210-2-80590490 03/04/2018 150103A101 150122A101 0.00 0.00 21.60 0.00 21.60
1,792 210-17-24290090 LONGA ALVARADO ELIANA MORENA 3 210-2-78469501 01/02/2017 150103A101 150135A101 0.00 0.00 19.84 0.00 19.84

Elaborado por OIE-SIS Página 64 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,793 210-17-24331092 LOPEZ ALBITES HEIDY CRISTINA 14 210-2-70462791 08/04/2017 150103A101 150101A105 0.00 0.00 9.40 0.00 9.40
1,794 210-12-00186847 LOPEZ AQUINO LIDIA VICTORIA 36 210-2-10261577 18/06/2012 150103A101 150132A203 0.00 0.00 0.00 0.00 0.00
1,795 210-12-00802626 LOPEZ BANDA BANELLY DANNAE 7 210-2-74010542 10/09/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,796 210-17-24390408 LOPEZ BULEJE DANTE BENJAMIN 1 210-2-79398488 14/07/2017 150103A101 150105A101 0.00 0.00 15.00 0.00 15.00
1,797 210-17-24393449 LOPEZ BULEJE DANTE BENJAMIN 1 210-2-79398488 10/07/2017 150103A101 150105A101 0.00 0.00 13.92 0.00 13.92
1,798 210-17-24402371 LOPEZ BULEJE DANTE BENJAMIN 1 210-2-79398488 03/08/2017 150103A101 150105A101 0.00 0.00 13.49 0.00 13.49
1,799 210-17-24404449 LOPEZ BULEJE DANTE BENJAMIN 1 210-2-79398488 05/08/2017 150103A101 150105A101 0.00 0.00 11.97 0.00 11.97
1,800 210-17-79398488 LOPEZ BULEJE DANTE BENJAMIN 1 210-2-79398488 25/07/2017 150103A101 150105A101 0.00 0.00 16.94 0.00 16.94
1,801 210-13-01221521 LOPEZ CASTILLO NATIVIDAD YANINA 27 210-2-43123023 27/06/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,802 210-11-03061867 LOPEZ DE LA CRUZ ELIZABET MARLENY 28 210-2-42594269 02/07/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,803 210-18-42577925 LOPEZ GONZALES GHAEL DAJIRO 3 210-2-78564081 23/02/2018 150103A101 150101A109 0.00 0.00 26.76 0.00 26.76
1,804 210-17-24440313 LOPEZ GUERRERO ANTONELLA YASURI 8 210-2-73159422 27/09/2017 150103A101 150111A101 0.00 0.00 7.55 0.00 7.55
1,805 210-13-01217950 LOPEZ LICAPA LIDIA NILA 26 210-2-44191963 12/06/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
1,806 210-12-00800929 LOPEZ MAMANI ADOLIA 41 210-2-10418669 16/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,807 210-17-24479604 LOPEZ MENDOZA BRITNEY LUANA 1 210-2-79823973 16/11/2017 150103A101 150105A101 0.00 0.00 14.69 0.00 14.69
1,808 210-17-24483771 LOPEZ MENDOZA BRITNEY LUANA 1 210-2-79823973 27/11/2017 150103A101 150105A101 0.00 0.00 15.51 0.00 15.51
1,809 210-17-24484388 LOPEZ MENDOZA BRITNEY LUANA 1 210-2-79823973 28/11/2017 150103A101 150105A101 0.00 0.00 24.91 0.00 24.91
1,810 210-13-01229713 LOPEZ PEREZ JESSICA PATRICIA 21 210-2-47299934 15/08/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,811 210-17-24493496 LOPEZ PINEDA HENRY ISRAEL 1 210-2-79887451 07/12/2017 150103A101 150101A109 0.00 0.00 19.27 0.00 19.27
1,812 210-17-24443906 LOPEZ PORRAS YANINA KATTIA 37 210-2-40489805 02/10/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
1,813 210-13-01195922 LOPEZ QUINCHUYA HYISSE MARGOTH 21 210-2-47400053 10/03/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,814 210-12-03899573 LOPEZ QUISPE SORAYDA 18 210-2-73828251 19/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,815 210-18-42519382 LOPEZ VALVERDE MAGDALENA JAKELYN 25 210-2-47572920 15/03/2018 150103A101 150101A109 0.00 0.00 11.48 0.00 11.48
1,816 210-11-03735018 LORENZO CESPEDES MARY CARMEN 20 210-2-46796825 20/12/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
1,817 210-12-03899781 LORENZO DE LA CRUZ YUDY SOLEDAD 29 210-2-41859072 23/01/2012 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
1,818 210-18-42487298 LOZA VDA DE ESPINOZA LEONARDA 87 150-2-23556125 03/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
1,819 210-18-42491683 LOZA VDA DE ESPINOZA LEONARDA 87 150-2-23556125 08/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
1,820 210-18-42492186 LOZA VDA DE ESPINOZA LEONARDA 87 150-2-23556125 09/02/2018 150103A101 150111A101 0.00 0.00 11.78 0.00 11.78

Elaborado por OIE-SIS Página 65 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,821 210-17-24457395 LOZANO BARZOLA FLOR NALDA 29 210-2-45095706 18/10/2017 150103A101 150101A102 0.00 0.00 16.22 0.00 16.22
1,822 210-12-00187585 LOZANO CACERES LELITA 28 210-2-44738956 14/06/2012 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
1,823 210-17-24427541 LOZANO ESPIRITU RUTH NICOLE 14 210-2-76089919 07/09/2017 150103A101 150137A101 0.00 0.00 4.33 0.00 4.33
1,824 210-18-42541957 LOZANO GALLEGOS MARCELINA 62 210-2-06616811 13/04/2018 150103A101 150103A208 0.00 0.00 12.27 0.00 12.27
1,825 210-11-03061077 LOZANO MANRIQUE RUTH EMMA LILIA 30 210-2-45809893 19/06/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,826 210-18-42512882 LOZANO TELLO PRIMITIVA ROMULA 51 210-2-09060360 07/03/2018 150103A101 150101A101 0.00 0.00 13.91 0.00 13.91
1,827 210-12-03905346 LUCAS BLANCO EDWIN DAVID 37 210-2-41647506 29/03/2012 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
1,828 210-11-03732185 LUDEÑA CCORAHUA ALEJANDRA 35 210-2-31487684 03/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,829 210-11-03726330 LUDEÑA ORTIZ BERTHA 22 210-2-47262648 28/10/2011 150103A101 150101A109 0.00 0.00 40.00 0.00 40.00
1,830 210-16-22935413 LUDEÑA SILVA ORFA 47 210-2-08874167 01/12/2016 150103A101 150111A101 0.00 0.00 6.95 0.00 6.95
1,831 210-11-03734349 LUJAN BAUTISTA LUISA 63 050-6-00250614 30/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,832 210-12-03911324 LUJAN BORDA JUANA 38 210-2-09775616 05/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,833 210-14-40063508 LUJAN BORQUEZ ALEJANDRO 68 210-2-06577517 18/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
1,834 210-11-03057078 LUJAN CHAVEZ KELLY 16 170-6-00290166 26/04/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
1,835 210-12-00800943 LULO TAPARA EMILIA 30 210-2-41388141 17/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,836 210-17-24433976 LUNA PROA ANDRE SEBASTIAN ROBERT 6 210-2-76497520 17/09/2017 150103A101 150111A101 0.00 0.00 7.11 0.00 7.11
1,837 210-17-24401335 LUNA ROSALES BRENDA MARIANGELICA 21 210-2-72978224 01/08/2017 150103A101 150111A101 0.00 0.00 6.90 0.00 6.90
1,838 210-12-03903764 LUNA URETA LIDIA SUSANA 20 210-2-47410858 16/02/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,839 210-17-24423563 LUQUE HUAPAYA ALDO EDUARDO 30 210-2-43827218 02/09/2017 150103A101 150137A101 0.00 0.00 4.78 0.00 4.78
1,840 210-17-24482968 LUYO SUMIRE RN-HV 0 210-E-28979067 24/11/2017 150103A101 150101A102 0.00 0.00 17.50 0.00 17.50
1,841 210-17-24349181 LUZARDO PACHERREZ BARBARA MARIA 25 210-2-47269691 09/05/2017 150103A101 150132A203 0.00 0.00 13.99 0.00 13.99
1,842 210-13-01238732 MACEDO ARIMUYA ANIXA LLERLITA 18 210-2-70761544 21/09/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,843 210-17-24287013 MACHA MARTINEZ ALISSON GIANELLA 7 210-2-73408861 29/01/2017 150103A101 150133A101 0.00 0.00 20.70 0.00 20.70
1,844 210-16-22945204 MACHA RODRIGUEZ GOYO 46 210-2-19989944 18/12/2016 150103A101 150137A101 0.00 0.00 3.54 0.00 3.54
1,845 210-18-42579470 MACHA TAMANI ROXANA ADELINA 29 340-2-45356524 29/05/2018 150103A101 150111A101 0.00 0.00 8.96 0.00 8.96
1,846 210-13-01238104 MACHACA MAMANI KELLY MILAGROS 17 210-2-76385723 18/09/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
1,847 210-17-24420938 MACHACUAY ARIAS KATY JHOVANA 33 210-2-42191197 31/08/2017 150103A101 150111A205 0.00 0.00 11.97 0.00 11.97
1,848 210-17-24453200 MACHACUAY ZEVALLOS SADI MIRIAM 34 210-2-41533079 13/10/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89

Elaborado por OIE-SIS Página 66 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,849 210-13-01227997 MACHACUY QUISPE SANDRA KATY 16 210-2-76556086 31/07/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
1,850 210-17-24431274 MACHUCA CORDOVA ANITA DE LOS ANGELES 21 210-2-77806001 13/09/2017 150103A101 150111A101 0.00 0.00 7.11 0.00 7.11
1,851 210-12-00189881 MACHUCA HILARIO MARIA DEL CARMEN 19 210-2-47190291 26/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,852 210-11-03735468 MACHUCA LAIME SAYURI 1 210-2-62080690 29/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,853 210-17-24473022 MACHUCA URBINA VICTORIA 29 210-2-45261835 10/11/2017 150103A101 150111A205 0.00 0.00 10.10 0.00 10.10
1,854 210-18-42504023 MAGNO POMA STEPHANY 21 210-2-75002470 26/02/2018 150103A101 150101A102 0.00 0.00 20.62 0.00 20.62
1,855 210-16-22899112 MAHUANCA VIARI FLORA MERLY 27 210-2-45921926 02/10/2016 150103A101 150111A101 0.00 0.00 9.69 0.00 9.69
1,856 210-12-03903642 MAICHIL MALPARTIDA SEBASTIAN FABRICIO 0 210-2-77113872 15/02/2012 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
1,857 210-11-03731091 MAIZ PRESENTACION MILY 21 210-2-46396105 12/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,858 210-18-42546231 MALDONADO AYALA BRUCE ANDERSÓN 8 210-2-73715382 18/04/2018 150103A101 150111A101 0.00 0.00 8.84 0.00 8.84
1,859 210-17-24320227 MALDONADO BERRU YELLY ASTERIA 20 280-2-76505768 23/03/2017 150103A101 150137A206 0.00 0.00 5.76 0.00 5.76
1,860 210-17-24493526 MALDONADO OLAYA KEILA JASMINDA 20 280-2-75461418 08/12/2017 150103A101 150111A205 0.00 0.00 12.22 0.00 12.22
1,861 210-17-24435022 MALDONADO ORELLANA ALANIS ALESSANDRA DEL MILAGRO 0 210-2-90388003 19/09/2017 150103A101 150105A101 0.00 0.00 13.44 0.00 13.44
1,862 210-17-24436351 MALDONADO ORELLANA ALANIS ALESSANDRA DEL MILAGRO 0 210-2-90388003 20/09/2017 150103A101 150105A101 0.00 0.00 17.44 0.00 17.44
1,863 210-17-24436557 MALDONADO ORELLANA ALANIS ALESSANDRA DEL MILAGRO 0 210-2-90388003 21/09/2017 150103A101 150105A101 0.00 0.00 13.11 0.00 13.11
1,864 210-17-24439879 MALDONADO ORELLANA ALANIS ALESSANDRA DEL MILAGRO 0 210-2-90388003 27/09/2017 150103A101 150105A101 0.00 0.00 15.44 0.00 15.44
1,865 210-17-24446037 MALDONADO ORELLANA ALANIS ALESSANDRA DEL MILAGRO 0 210-2-90388003 04/10/2017 150103A101 150105A101 0.00 0.00 16.66 0.00 16.66
1,866 210-13-01212750 MALDONADO TOCTO ROSITA AMELIA 21 210-2-47864461 22/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,867 210-13-01251958 MALLCO BARTOLO YESSICA 20 210-2-47888360 11/11/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,868 210-11-03610422 MALLMA CERDA AIDEE CAROLINA 21 210-2-46747396 11/10/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00
1,869 210-11-03614774 MALLMA DELGADO JESUS ENOC 3 210-2-61841308 28/09/2011 150103A101 150105A101 0.00 0.00 45.00 0.00 45.00
1,870 210-11-03048321 MALLMA PARIAN MARITZA MELISSA 20 210-2-46764712 02/04/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,871 210-11-03735089 MALLMA QUISPE DELIA 28 210-2-48362555 21/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,872 210-17-24399360 MALLMA SANTOS SHEYLA SABRINA 23 210-2-70830064 31/07/2018 150103A101 150122A101 0.00 0.00 35.49 0.00 35.49
1,873 210-12-00188003 MALLQUI ARENAS MILAYDI 27 210-2-42813631 22/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,874 210-13-01203455 MALLQUI CARDENAS CARMEN 30 210-2-43224106 12/04/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,875 210-17-24320383 MALLQUI CRISTOBAL JESUS ALEJANDRO 20 210-2-48913528 24/03/2017 150103A101 150137A101 0.00 0.00 2.71 0.00 2.71
1,876 210-11-03730036 MALLQUI ESCOBAR IRMA 25 210-2-43521089 25/11/2011 150103A101 150132A205 0.00 0.00 45.00 0.00 45.00

Elaborado por OIE-SIS Página 67 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,877 210-16-22926004 MALLQUI HUACACHI LIONEL ADRIANO 2 210-2-78581476 15/11/2016 150103A101 150105A101 0.00 0.00 9.65 0.00 9.65
1,878 210-18-42502638 MALLQUI NAVARRO NATALY MAGALY 16 210-2-74297118 23/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
1,879 210-13-00280867 MALLQUI QUISPE LULIANA AMELIA 27 210-2-43217217 17/01/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,880 210-17-24362113 MALPARTIDA BUENO KETTY 22 210-2-75332062 31/05/2017 150103A101 150128A204 0.00 0.00 14.89 0.00 14.89
1,881 210-17-24426758 MALPARTIDA CAJAS YANET ERLAY 33 210-2-45573192 07/09/2017 150103A101 150103A101 0.00 0.00 8.33 0.00 8.33
1,882 210-11-03061054 MALPARTIDA CASO LORENA 19 210-2-47607683 17/06/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,883 210-17-24353451 MALPARTIDA EGUAVIL ARIANA PAMELA 7 170-2-62687410 17/05/2017 150103A101 150105A101 0.00 0.00 16.24 0.00 16.24
1,884 210-12-00187833 MALPARTIDA HUAQUINO ROBERT DAYIRO 0 210-2-77515242 21/06/2012 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
1,885 210-12-00184631 MALPARTIDA HUAQUINO THALIA ROXANA 23 210-2-45448211 09/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,886 210-17-24333515 MALPARTIDA MAGNO ANITA ELENA 34 210-2-41463161 12/04/2017 150103A101 150111A101 0.00 0.00 8.59 0.00 8.59
1,887 210-18-42492128 MALPARTIDA PARIONA ABELARDO POLICARPIO 67 210-2-09063386 08/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
1,888 210-18-42470691 MALQUI GUTIERREZ LESLY ESTRELLA 0 160-2-90517413 13/01/2018 150103A101 150105A101 0.00 0.00 21.60 0.00 21.60
1,889 210-18-42471135 MALQUI GUTIERREZ LESLY ESTRELLA 0 160-2-90517413 15/01/2018 150103A101 150105A101 0.00 0.00 19.76 0.00 19.76
1,890 210-12-01283727 MALQUI JAVIER AUGUSTO 60 210-2-23674038 21/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,891 210-12-03904582 MALVACEDA ARANDA SIMEON 59 210-2-06577676 31/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,892 210-11-03729353 MAMANI ALIPIO GIOVANNA SANTOS 24 210-2-44555667 12/11/2011 150103A101 150132A203 0.00 0.00 0.00 0.00 0.00
1,893 210-12-00190135 MAMANI CRUZ ISAAC 78 210-2-48502681 21/05/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,894 210-17-24276051 MAMANI MAMANI RONALD 18 110-2-75933523 08/01/2017 150103A101 150111A101 0.00 0.00 7.76 0.00 7.76
1,895 210-13-00287553 MAMANI OLIVARES BETI MARGOT 36 210-2-10173360 13/02/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,896 210-14-40068941 MAMANI QUISPE ISABEL PATRICIA 18 200-2-72745103 04/08/2014 150103A101 150137A101 0.00 0.00 2.75 0.00 2.75
1,897 210-11-03729850 MAMANI QUISPE WILMA BEATRIZ 27 210-2-42507308 22/11/2011 150103A101 150132A205 0.00 0.00 45.00 0.00 45.00
1,898 210-11-03607665 MAMANI RAMOS LUIS MIGUEL ANHELO 8 210-2-75592043 12/09/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
1,899 210-17-24413978 MAMANI RAMOS ZENAIDA 28 290-2-46585790 20/08/2017 150103A101 150111A205 0.00 0.00 11.44 0.00 11.44
1,900 210-17-24307934 MAMANI RIVERA SUSY KATIUSKA 36 210-2-41276552 02/03/2017 150103A101 150121A101 0.00 0.00 21.68 0.00 21.68
1,901 210-13-01227012 MANAYAY HEREDIA YESSICA MARISOL 21 210-2-46928493 23/07/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,902 210-17-24286180 MANCILLA ABREGU JUAN ANTONIO 48 210-2-23379963 27/01/2017 150103A101 150101A101 0.00 0.00 21.62 0.00 21.62
1,903 210-16-22939438 MANIHUARI YAHUARCANI RN 0 210-E-28639897 07/12/2016 150103A101 150111A101 0.00 0.00 8.11 0.00 8.11
1,904 210-18-42557389 MANRIQUE ARROYO JUAN FERNANDO 41 210-2-40255776 15/01/2018 150103A101 150111A101 0.00 0.00 9.20 0.00 9.20

Elaborado por OIE-SIS Página 68 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,905 210-13-01208516 MANRIQUE ARROYO LILIANA MERCEDES 39 210-2-25756735 04/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,906 210-11-03731533 MANRIQUE QUISPE LISSETE DIANA 18 210-2-47506267 22/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,907 210-16-22860825 MANSILLA SALAS JUAN FRANCISCO 52 210-2-06560511 02/08/2016 150103A101 150111A101 0.00 0.00 6.73 0.00 6.73
1,908 210-17-24479181 MANTARI AMABLE BRIGIT MELANEY 17 170-2-76754708 19/11/2017 150103A101 150111A101 0.00 0.00 7.99 0.00 7.99
1,909 210-14-40088354 MANTARI TORRES MICAELA YUDITH 24 210-2-46128663 24/09/2014 150103A101 150128A204 0.00 0.00 19.82 0.00 19.82
1,910 210-14-40064434 MANUELO CARHUANCHO GABY KARINA 17 210-2-76615819 21/07/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
1,911 210-14-40032599 MANUELO QUISPE THALIA LISBETH 13 210-2-74323687 12/04/2014 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
1,912 210-18-42471102 MANZUR BACA KLAUS ARTURO 26 210-2-72394432 14/01/2018 150103A101 150111A101 0.00 0.00 9.20 0.00 9.20
1,913 210-14-40007754 MAQUERA GALINDO VICENTE 40 210-2-16176217 28/01/2014 150103A101 150103A208 0.00 0.00 30.80 0.00 30.80
1,914 210-11-03055356 MAQUIN JESUS RN 0 210-7-45879670 30/04/2011 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
1,915 210-18-42571201 MARAVI BARJA DELMA VIANCA 28 210-2-46139594 20/05/2018 150103A101 150111A101 0.00 0.00 9.88 0.00 9.88
1,916 210-17-24336058 MARAVI ROMO NARCISO JOSE 82 210-2-19984751 18/04/2017 150103A101 150111A101 0.00 0.00 8.59 0.00 8.59
1,917 210-18-42504950 MARCAQUISPE CHAICO RN-HV 0 210-E-29064094 27/02/2018 150103A101 150105A101 0.00 0.00 18.90 0.00 18.90
1,918 210-11-03051959 MARCAS CHOQUE YOLANDA 22 210-2-45230442 09/06/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,919 210-11-03058074 MARCATINCO SEDANO NICOLE LIDIA 7 210-2-70540346 20/07/2011 150103A101 150121A101 0.00 0.00 50.00 0.00 50.00
1,920 210-12-03902994 MARCELO HUAMAN ALEXANDER PIERO 6 210-2-74923179 13/02/2012 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
1,921 210-13-01219737 MARCELO LEON MARIBEL 29 210-2-42149183 19/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,922 210-11-03060159 MARCELO QUINTANILLA LEONARDA ELIZABETH 37 210-2-41048322 25/06/2011 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,923 210-17-24457368 MARCELO VALENTIN JESUSA 35 210-2-48178647 18/10/2017 150103A101 150111A101 0.00 0.00 8.93 0.00 8.93
1,924 210-11-03054912 MARCOS SHINGARI DE CORONEL MERLINDA MEDALIT 23 210-2-45110966 04/05/2011 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
1,925 210-13-01211958 MARIANO ALVARADO CIELO FABIANA 1 210-2-77454226 19/05/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
1,926 210-11-03054404 MARIANO FERRER CLAUDIA 18 210-2-47606457 18/05/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,927 210-12-03901435 MARIN AQUINO ERIKA NANCY 33 210-2-10874898 24/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,928 210-17-24282052 MARIN PANTIGOSO FELIX 77 210-2-09065293 18/01/2017 150103A101 150111A101 0.00 0.00 11.64 0.00 11.64
1,929 210-18-42544587 MARIN RUIZ MARIA LISSETH KIMBERLY 19 210-2-74923170 16/04/2018 150103A101 150111A101 0.00 0.00 9.33 0.00 9.33
1,930 210-17-24439367 MARQUINA HUAMANI RN 0 210-E-28929757 26/09/2017 150103A101 150105A101 0.00 0.00 17.10 0.00 17.10
1,931 210-17-24506719 MARTEL FIORI ERIKA YESSENYA 29 210-2-45304751 31/12/2017 150103A101 150122A101 0.00 0.00 145.68 0.00 145.68
1,932 210-13-01251959 MARTEL MEZA BRANDON SANTIAGO 4 210-2-61906710 11/11/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20

Elaborado por OIE-SIS Página 69 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,933 210-14-40059621 MARTEL POMA XIANELLY MAYTE 4 210-2-74257045 07/07/2014 150103A101 150105A101 0.00 0.00 27.50 0.00 27.50
1,934 210-17-24337884 MARTELL ARBILDO RN 0 210-E-28783927 21/04/2017 150103A101 150111A101 0.00 0.00 8.59 0.00 8.59
1,935 210-18-42561504 MARTINEZ APARCO ARLETH BRIANNA 0 210-2-90657317 08/05/2018 150103A101 150105A101 0.00 0.00 18.16 0.00 18.16
1,936 210-18-42562409 MARTINEZ APARCO ARLETH BRIANNA 0 210-2-90657317 09/05/2018 150103A101 150105A101 0.00 0.00 18.58 0.00 18.58
1,937 210-18-42563500 MARTINEZ APARCO ARLETH BRIANNA 0 210-2-90657317 10/05/2018 150103A101 150105A101 0.00 0.00 20.69 0.00 20.69
1,938 210-12-00192293 MARTINEZ BALBOA ANA 27 210-2-42953944 12/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,939 210-11-03058733 MARTINEZ BRAÑES YESENIA VALVINA 23 210-2-44553389 11/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,940 210-13-01211399 MARTINEZ CARHUACUSMA NN 0 210-7-47837653 16/05/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
1,941 210-17-24501768 MARTINEZ CASTRO SUSAN JASMIN 21 210-2-75320773 21/12/2017 150103A101 150111A101 0.00 0.00 7.99 0.00 7.99
1,942 210-16-22872654 MARTINEZ LAZO PERCY JULIO 47 210-2-10596934 21/08/2016 150103A101 150118A101 0.00 0.00 19.12 0.00 19.12
1,943 210-13-01241477 MARTINEZ MATENCIOS NANCY KIAREM XIHOMY 19 210-2-48545425 01/10/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,944 210-14-40076202 MARTINEZ REYES JONATHAN DIEGO 1 210-2-78057553 24/08/2014 150103A101 150115A101 0.00 0.00 15.40 0.00 15.40
1,945 210-17-24335215 MARTINEZ SALAZAR GUADALUPE VICTORIA 1 200-2-79094688 17/04/2017 150103A101 150125A101 0.00 0.00 37.51 0.00 37.51
1,946 210-12-00802008 MARTINEZ SEGURA MAYDE CAMILA 31 210-2-41446844 16/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,947 210-17-24337417 MARTINEZ VALENZUELA ROSA HAYDEE 25 210-2-47616839 20/04/2017 150103A101 150137A206 0.00 0.00 5.42 0.00 5.42
1,948 210-18-42477461 MARTINEZ VARGAS YADIEL DOMINICK 1 210-2-90012281 23/01/2018 150103A101 150105A101 0.00 0.00 18.29 0.00 18.29
1,949 210-12-01283521 MARTINEZ VELASQUEZ NASHLI WENDY 24 210-2-46198014 19/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,950 210-12-00804081 MASGO NOLASCO JUANA INES 27 210-2-44677599 14/08/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
1,951 210-17-24343003 MASQUEZ MELENDEZ LUISA CAROL 25 210-2-72730732 29/04/2017 150103A101 150111A101 0.00 0.00 8.13 0.00 8.13
1,952 210-11-03607637 MATAMOROS NUÑEZ DOMITILA 26 210-2-42939852 12/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,953 210-16-22867614 MATEOS CCONISLLA LUIS ANGEL 8 030-2-61175803 12/08/2016 150103A101 150105A101 0.00 0.00 14.87 0.00 14.87
1,954 210-12-00811041 MATIENZO LAYZA NN 0 210-7-46190065 30/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,955 210-11-03610109 MAUCALLE ASTETE GIOVANNA CARMELA 21 210-2-47073738 04/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,956 210-18-42499233 MAURICIO MORALES NICOLE ADY AMELIE 6 210-2-77521926 19/02/2018 150103A101 150115A101 0.00 0.00 13.13 0.00 13.13
1,957 210-13-00286761 MAURICIO REZA ELIKA 19 210-2-48305009 11/02/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,958 210-17-24436370 MAYANGA QUINTO ALEXIS FARID 7 210-2-74336866 20/09/2017 150103A101 150115A101 0.00 0.00 11.11 0.00 11.11
1,959 210-14-40053592 MAYLLE GONZALES DIANA PAOLA 32 210-2-41335736 20/06/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
1,960 210-13-00287580 MAYMA GAMARRA KATHIA RUTH 16 210-2-76011959 14/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00

Elaborado por OIE-SIS Página 70 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,961 210-11-03608478 MAYO JULCA FAUSTINA JULIANA 27 210-2-42573165 21/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,962 210-13-01202019 MAYON LLIUYACC ESTEFANI VICTORIA 21 210-2-47000536 06/04/2013 150103A101 150107A204 0.00 0.00 42.00 0.00 42.00
1,963 210-16-22942850 MAYTA HUAMAN ANTONIO BALOTELLY 3 210-2-77962078 14/12/2016 150103A101 150111A101 0.00 0.00 7.72 0.00 7.72
1,964 210-12-00801046 MAYTA NAVARRO SONIA JANET 28 210-2-42350034 20/07/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,965 210-12-01295526 MAYTA UMIÑARI CENIA 23 210-2-48244234 12/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,966 210-13-01252627 MAYTAHUARI PACAYA GABINO 53 210-2-05396698 12/11/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,967 210-11-03060590 MAZA CHIROQUE AMALIA 53 280-6-00559128 16/06/2011 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
1,968 210-13-01236856 MAÑUICO DE LA CRUZ MARIELA 26 210-2-44004932 14/09/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
1,969 210-18-42476218 MEDINA ALBERCO HERLINDA NANCY 35 210-2-41676158 20/01/2018 150103A101 150111A101 0.00 0.00 10.06 0.00 10.06
1,970 210-13-00290401 MEDINA ARROYO LEIDY CATHERINE 19 210-2-48012944 25/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,971 210-13-01221128 MEDINA BARZOLA SUSAN KATHERINNE 20 210-2-47926369 25/06/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
1,972 210-12-00798168 MEDINA BERNEDO TEODOCIO 91 210-2-31462079 30/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,973 210-17-24500999 MEDINA CANCHARI AGRIPINA 40 210-2-10605851 19/12/2017 150103A101 070102A101 0.00 0.00 25.85 0.00 25.85
1,974 210-12-03911326 MEDINA CANCHARI LISBEA LEONOR 26 210-2-43465501 05/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,975 210-12-00800410 MEDINA DIPAZ REYNA 38 210-2-10045018 29/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,976 210-12-03900335 MEDINA GARAY SONIA SARA 33 210-2-40135517 30/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,977 210-12-00807431 MEDINA HUAYASCACHI EDITH MELISSA 20 210-2-47514171 29/07/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
1,978 210-17-24466210 MEDINA QUISPE JAVIER ORLANDO 47 210-2-09507703 01/11/2017 150103A101 150122A101 0.00 0.00 17.15 0.00 17.15
1,979 210-13-01212286 MEDINA QUISPE KARINA DEMETRIA 20 210-2-47285404 21/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,980 210-12-00192068 MEDINA RAMIREZ MERLY ROXANA 21 210-2-46778715 11/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,981 210-12-00806742 MEDINA SANCHEZ YOSMEL ALVARO 9 210-2-75298951 02/09/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
1,982 210-17-24347531 MEDINA VARGAS MARIA ANTONIA 41 210-2-10002822 07/05/2017 150103A101 150101A105 0.00 0.00 14.89 0.00 14.89
1,983 210-17-24411977 MEDRANO AMAYA THIAGO JOAN LUIS 4 200-2-77981678 17/08/2017 150103A101 150111A101 0.00 0.00 8.09 0.00 8.09
1,984 210-17-24483593 MEDRANO MEDINA ROSA MARIA 28 210-2-46303396 27/11/2017 150103A101 150101A109 0.00 0.00 14.69 0.00 14.69
1,985 210-13-01242618 MEDRANO URETA SILVIA 34 210-2-40845985 06/10/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
1,986 210-13-01230253 MEJIA AVALOS ANA 18 210-2-76804998 18/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,987 210-12-00185150 MEJIA AZABAMBA NATHALY CRISTINA 19 210-2-47370923 11/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
1,988 210-11-03727070 MEJIA FIGUEROA VIOLETA 35 210-2-10206666 04/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00

Elaborado por OIE-SIS Página 71 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

1,989 210-11-03733280 MEJIA SATURNO INES SABINA 21 210-2-46190958 17/12/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
1,990 210-17-24439048 MELCHOR MACHUCA REBECA TANIA 30 130-2-44750141 25/09/2017 150103A101 0000023159 0.00 0.00 23.77 0.00 23.77
1,991 210-14-40015660 MELENDES MERCADO MAURICIA 77 130-2-80047494 21/02/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
1,992 210-17-24343298 MELENDEZ LOPEZ CLAUDIA LIZETH 25 210-2-47091021 01/05/2017 150103A101 150137A206 0.00 0.00 6.32 0.00 6.32
1,993 210-17-24333280 MELENDEZ MORENO GEMIMA LUCERO 25 210-2-47573301 12/04/2017 150103A101 150111A205 0.00 0.00 16.27 0.00 16.27
1,994 210-13-01200101 MELENDRES TORRES YULIZA ZAMANDA 17 210-2-74730300 28/03/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
1,995 210-11-03057296 MELITON ADRIANO ALINA LUZ 25 210-2-44069053 14/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,996 210-13-01229089 MELITON QUISPE LIDIA LUZ 19 210-2-47945522 11/08/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
1,997 210-18-42578337 MELLIZO RONDON ANTUANETT PAOLA 20 210-2-77042043 28/05/2018 150103A101 150111A101 0.00 0.00 9.35 0.00 9.35
1,998 210-11-03058243 MELO VERA BACILIA 46 110-2-80077082 21/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
1,999 210-11-03056295 MELO VILLANUEVA MAURICIO DYLAND ANDREANS 0 210-2-74796607 09/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,000 210-14-40019469 MELO VIZCARRA SILVIA ESTHER 31 210-2-41331712 05/03/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,001 210-12-01295840 MENDEZ CARLOS NOEMI YESENIA 19 210-2-48464648 19/10/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,002 210-12-01295086 MENDEZ CHIPANA JEAN CARLOS 9 200-2-76521720 17/10/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,003 210-11-03728991 MENDOZA ADVINCULA BENIDICTA 29 210-2-43207997 12/11/2011 150103A101 150111A205 0.00 0.00 40.00 0.00 40.00
2,004 210-17-24281579 MENDOZA AVILA MARGARITA NICOLLE 7 210-2-77544634 17/01/2017 150103A101 150111A101 0.00 0.00 8.62 0.00 8.62
2,005 210-11-03057086 MENDOZA BALDEON TEOFILA 33 210-2-10613368 26/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,006 210-11-03051285 MENDOZA BARTOLO LIZ MAGALI 30 210-2-42444376 31/05/2011 150103A101 150111A203 0.00 0.00 0.00 0.00 0.00
2,007 210-12-00197485 MENDOZA BREÑA JACKELIN NEIDA 18 210-2-48537468 08/05/2012 150103A101 070102A101 0.00 0.00 0.00 0.00 0.00
2,008 210-11-03614842 MENDOZA CAMPOS HERLINDA 30 210-2-40869684 24/09/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
2,009 210-12-00810730 MENDOZA CANTURIN GLORIA MILAGROS 26 210-2-44978528 01/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,010 210-17-24338465 MENDOZA CHUQUILLANQUI FRISAEL AXSEL 12 210-2-74617137 23/04/2017 150103A101 150121A101 0.00 0.00 21.24 0.00 21.24
2,011 210-17-24453168 MENDOZA GABRIEL NELIDA NORMA 25 210-2-46949919 12/10/2017 150103A101 150121A101 0.00 0.00 17.88 0.00 17.88
2,012 210-11-03726098 MENDOZA LEON BEATRIZ 21 210-2-48296026 27/10/2011 150103A101 150132A205 0.00 0.00 45.00 0.00 45.00
2,013 210-18-42556416 MENDOZA LIUYACC ELSA ZENOBIA 27 210-2-60264602 01/05/2018 150103A101 150115A101 0.00 0.00 14.12 0.00 14.12
2,014 210-12-03903822 MENDOZA MEDRANO ELIZABETH MARINA 23 210-2-45443369 16/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,015 210-18-42471181 MENDOZA PALIAN MARIA PAZ 10 230-2-61270430 15/01/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
2,016 210-18-42472897 MENDOZA PALIAN MARIA PAZ 10 230-2-61270430 16/01/2018 150103A101 150111A101 0.00 0.00 10.55 0.00 10.55

Elaborado por OIE-SIS Página 72 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,017 210-11-03725702 MENDOZA PANTALEON KAREN YESSENIA 23 210-2-45384817 22/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,018 210-17-24452353 MENDOZA QUISPE ALEJANDRA 69 200-2-05399677 11/10/2017 150103A101 150111A101 0.00 0.00 8.78 0.00 8.78
2,019 210-14-40101641 MENDOZA QUISPE DE CERDA CLAUDIA 82 210-2-09063710 28/10/2014 150103A101 150111A101 0.00 0.00 60.05 0.00 60.05
2,020 210-17-24274459 MENDOZA RAMIREZ GIANCARLO MAXIMO 12 210-2-75680716 05/01/2017 150103A101 150111A101 0.00 0.00 8.52 0.00 8.52
2,021 210-12-00802491 MENDOZA VEGA LUCIA MARGARITA 26 210-2-43558829 08/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,022 210-18-42521721 MENDOZA VILCAHUAMAN GUILLEMINA 75 210-2-19860859 18/03/2018 150103A101 070102A101 0.00 0.00 29.81 0.00 29.81
2,023 210-14-40086282 MENDOZA YACHI KARINA 22 210-2-47186368 18/09/2014 150103A101 150137A206 0.00 0.00 8.75 0.00 8.75
2,024 210-12-00277186 MENESES CAJAHUAMAN ALESSANDRI BRAHNS 8 210-2-75652785 02/01/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
2,025 210-13-01249309 MENESES CASAICO RUTH ROCIO 19 210-2-48628179 30/10/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,026 210-16-22849146 MENESES PICHO VICTORIA SILVIA 3 210-2-77772776 12/07/2016 150103A101 150111A101 0.00 0.00 8.85 0.00 8.85
2,027 210-17-24494469 MENESES QUISPE ANA BERTHA 29 050-2-44876862 07/12/2017 150103A101 150101A105 0.00 0.00 12.69 0.00 12.69
2,028 210-17-24506610 MENESES QUISPE ANA BERTHA 29 050-2-44876862 31/12/2017 150103A101 150111A205 0.00 0.00 11.54 0.00 11.54
2,029 210-13-00290828 MERCADO ALDAZABAL DELY 21 210-2-70039473 28/02/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
2,030 210-12-01284228 MESCCO HUAILLAS AGRIPINA 31 210-2-40911784 14/12/2012 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,031 210-17-24491812 MESCUA MAURICIO RN-HV 0 210-E-28953846 30/11/2017 150103A101 150105A101 0.00 0.00 28.67 0.00 28.67
2,032 210-12-00188354 MESIAS MARTINEZ ANDRE GUSTAVO 0 210-2-77559325 25/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,033 210-13-01227491 MEZA CARDENAS MAGALI FLOR 36 210-2-10601898 26/07/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,034 210-12-00801909 MEZA CONTRERAS ASTERIA 37 210-2-23702044 14/09/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,035 210-12-03901672 MEZA FAUSTINO LUCILA JULIA 22 210-2-45986955 04/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,036 210-18-42493432 MEZA GARCIA GREGORIO 83 210-2-19894943 10/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
2,037 210-17-24443014 MEZA HERRERA HELI GANCI 64 210-2-19961244 01/10/2017 150103A101 150141A101 0.00 0.00 15.11 0.00 15.11
2,038 210-17-24403749 MEZA MUÑOZ MARGARITA 61 210-2-10296427 04/08/2017 150103A101 150111A101 0.00 0.00 7.66 0.00 7.66
2,039 210-11-03060993 MEZA PUCHOC MARINA 72 210-2-09358051 21/06/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,040 210-18-42521689 MEZA RAMOS JUANA LIZ 24 140-2-47683383 18/03/2018 150103A101 150111A101 0.00 0.00 9.44 0.00 9.44
2,041 210-17-24332088 MEZA SILUPU SAMUEL YADIEL 0 210-2-81682541 10/04/2017 150103A101 150115A101 0.00 0.00 11.75 0.00 11.75
2,042 210-13-01221063 MEZA USCUBILCA CELEDONIA FORTUNATA 69 210-2-20647838 25/06/2013 150103A101 150101A103 0.00 0.00 42.00 0.00 42.00
2,043 210-14-40018149 MEZA VASQUEZ DELIA NELY 26 210-2-44666141 01/03/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,044 210-11-03735444 MEZA VASQUEZ KERLI BAHMELA 26 210-2-43242758 28/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 73 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,045 210-18-42576746 MEZA VEGA THIAGO DRAEK 5 210-2-77999003 26/05/2018 150103A101 150111A101 0.00 0.00 8.04 0.00 8.04
2,046 210-12-00807586 MICUILLA CCORAHUA MARIA INES 25 210-2-44543567 24/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,047 210-12-00196921 MIGUEL RAJO ANDERSON VLADIMIRO 13 210-2-76276580 19/04/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
2,048 210-13-01230745 MILLAN YARANGA CINTHIA 29 210-2-42278685 20/08/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
2,049 210-11-02705149 MINAYA RIVERA FLOR NOEMI 44 210-2-07075991 28/03/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,050 210-13-00282416 MINAYA SALVATIERRA SUSANA MARGARITA 31 210-2-42657430 26/01/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,051 210-16-22810468 MIO CARDENAS JESUS DANIEL 2 210-2-78400381 05/05/2016 150103A101 150105A101 0.00 0.00 12.31 0.00 12.31
2,052 210-11-03051688 MIRANDA RODRIGUEZ MAXIMILIANO 60 210-2-20573620 07/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,053 210-11-03605912 MIRAVAL CANTORAL ANA CYNTHIA 28 210-2-43191029 11/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,054 210-13-01227245 MIRAVAL MALPARTIDA DORIS SALY 19 210-2-60436441 24/07/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,055 210-18-42498112 MITACC VELASQUEZ EDOFENCIA 51 210-2-28236144 16/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
2,056 210-17-24415528 MITMA TORRES EDUARDO 9 210-2-71172422 22/08/2017 150103A101 150111A101 0.00 0.00 8.09 0.00 8.09
2,057 210-16-22906890 MOLINA PEREZ JESSENIA MARGOTH 25 210-2-47137522 14/10/2016 150103A101 150103A208 0.00 0.00 10.85 0.00 10.85
2,058 210-17-24279286 MONAGO CAPCHA EDSON DAVID 8 270-2-60591213 13/01/2017 150103A101 150111A101 0.00 0.00 7.76 0.00 7.76
2,059 210-18-42517488 MONAGO ESPINOZA ENMA SILVIA 23 210-2-71990959 12/03/2018 150103A101 150111A101 0.00 0.00 5.96 0.00 5.96
2,060 210-18-42577153 MONDARGO IGUAVEL SNAYDERH SLIN 2 170-2-81734378 28/05/2018 150103A101 150105A101 0.00 0.00 17.00 0.00 17.00
2,061 210-17-24314010 MONRROY CONDORI MARTHA 45 210-2-25745008 11/03/2017 150103A101 150111A101 0.00 0.00 9.04 0.00 9.04
2,062 210-12-03904255 MONTALVAN QUISPE CARMEN ROSALIA 23 210-2-46395300 27/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,063 210-17-24299897 MONTALVAN RIVERA LORENZO PAOLO 1 210-2-79387305 18/02/2017 150103A101 150105A101 0.00 0.00 16.83 0.00 16.83
2,064 210-12-03909286 MONTALVO BENDEZU BILLY ANGIE 19 210-2-47857366 05/03/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,065 210-14-40067528 MONTEALVAN TAPULLIMA CINDY MILESSI 25 210-2-45407639 31/07/2014 150103A101 150101A105 0.00 0.00 20.99 0.00 20.99
2,066 210-18-42491129 MONTEBLANCO TORIBIO ELISABETH MARIBEL 32 210-2-43274566 07/02/2018 150103A101 150111A101 0.00 0.00 13.62 0.00 13.62
2,067 210-16-22914576 MONTERO AGUILAR ANGEL GABRIEL 0 210-2-79839531 28/10/2016 150103A101 150105A101 0.00 0.00 1.55 0.00 1.55
2,068 210-16-22915243 MONTERO AGUILAR ANGEL GABRIEL 0 210-2-79839531 26/10/2016 150103A101 0000016918 0.00 0.00 15.50 0.00 15.50
2,069 210-16-22921313 MONTERO AGUILAR ANGEL GABRIEL 0 210-2-79839531 08/11/2016 150103A101 0000016918 0.00 0.00 10.04 0.00 10.04
2,070 210-11-03062657 MONTES AYUQUE LIZBETH YESENIA 1 130-6-00245106 08/07/2011 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
2,071 210-13-01221516 MONTES ERAZO LEONARDO SEBASTIAN 1 210-2-77654171 27/06/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
2,072 210-13-01197505 MONTES GONZALO ELSA 35 210-2-10468571 16/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00

Elaborado por OIE-SIS Página 74 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,073 210-18-42482842 MONTES HUILLCAHUARI CAROL 0 220-2-90537259 30/01/2018 150103A101 150105A101 0.00 0.00 17.06 0.00 17.06
2,074 210-18-42487256 MONTES HUILLCAHUARI CAROL 0 220-2-90537259 03/02/2018 150103A101 150105A101 0.00 0.00 15.34 0.00 15.34
2,075 210-17-24347113 MONTES MOYA MARIA DEL ROSARIO 16 210-2-70626961 06/05/2017 150103A101 150111A101 0.00 0.00 10.38 0.00 10.38
2,076 210-11-03731593 MONTES YARASCA MARGARITA FAUSTINA 33 210-2-40767151 23/11/2011 150103A101 150111A101 0.00 0.00 45.00 0.00 45.00
2,077 210-17-24489614 MONTUFAR SERRANO YESSICA 35 210-2-42949990 03/12/2017 150103A101 150111A101 0.00 0.00 10.25 0.00 10.25
2,078 210-13-01214440 MORALES AGUILAR JOSSELYN MAIRA 16 210-2-75819369 29/05/2013 150103A101 150121A101 0.00 0.00 140.00 0.00 140.00
2,079 210-18-42464346 MORALES ESPERICUETA MAGALY JULIA 36 210-2-40991617 05/01/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
2,080 210-14-40030764 MORALES FRANCHINI BELGICA 18 210-2-48607172 07/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,081 210-12-03907395 MORALES GOMEZ LOURDES 25 210-2-44991901 20/03/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,082 210-12-00184790 MORALES MARIÑO LEONIDAS 61 210-2-08791532 12/04/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
2,083 210-17-24465055 MORALES MATOS GLORIA 35 210-2-42906062 31/10/2017 150103A101 150101A109 0.00 0.00 16.80 0.00 16.80
2,084 210-13-01224678 MORALES MERA PREITY JHORLEY 2 240-2-62673723 09/07/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
2,085 210-12-03910180 MORALES RAMOS ELBA ODILIA 28 210-2-41996551 11/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,086 210-13-00280207 MORALES SALVADOR MARIA ISABEL 20 210-2-72222113 09/01/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,087 210-17-24463436 MORALES SANCHEZ MARIA LUCIANA 2 210-2-78827580 28/10/2017 150103A101 150111A101 0.00 0.00 8.34 0.00 8.34
2,088 210-12-01282922 MORALES ÑACCHA AZUMI YAMILEY 2 210-2-74015903 22/09/2012 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
2,089 210-17-24432553 MORAN QUIJADA ELENA MARIA 31 210-2-44169885 15/09/2017 150103A101 150111A205 0.00 0.00 9.89 0.00 9.89
2,090 210-18-42507194 MORAN TIRACCAYA FAUSTINA 48 130-2-23710092 28/02/2018 150103A101 150115A101 0.00 0.00 12.76 0.00 12.76
2,091 210-12-01289659 MORE MONDRAGON MERLY YOVANA 28 210-2-44091166 01/11/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,092 210-17-24398742 MORENO BOZETA DE ZUÑIGA CARMEN ROSARIO 70 210-2-06592505 30/07/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
2,093 210-18-42548568 MORENO BOZETA DE ZUÑIGA CARMEN ROSARIO 71 210-2-06592505 22/04/2018 150103A101 150111A101 0.00 0.00 9.33 0.00 9.33
2,094 210-14-40073241 MORENO CALDERON YANELA BELINDA 0 210-2-78224695 15/08/2014 150103A101 150115A101 0.00 0.00 15.40 0.00 15.40
2,095 210-16-22898476 MORENO DAMIAN ANDRES SANTOS 5 210-2-77408774 01/10/2016 150103A101 150111A101 0.00 0.00 14.73 0.00 14.73
2,096 210-17-24404650 MORENO OBREGON MARLENE LUZ 27 230-2-46327243 07/08/2017 150103A101 150132A212 0.00 0.00 10.57 0.00 10.57
2,097 210-11-03604787 MORENO PRADO LOURDES 22 210-2-45863084 09/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,098 210-13-01209102 MORENO TABA DORIS VANESSA 15 210-2-75730472 07/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,099 210-11-03047697 MORI CHUCO DIANA MARIA 25 210-2-43151739 04/04/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,100 210-17-24452616 MORI GALLARDO IRMA SOLEDAD 36 210-2-41642931 12/10/2017 150103A101 150111A101 0.00 0.00 8.33 0.00 8.33

Elaborado por OIE-SIS Página 75 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,101 210-11-03604657 MORI MURAYARI JESUS DALYLA 19 210-2-47713633 09/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,102 210-11-03611148 MORI SHAPIAMA SAMMY YANINA 22 210-2-45915381 16/10/2011 150103A101 150101A105 0.00 40.00 0.00 0.00 40.00
2,103 210-12-01284238 MORON PINEDA RICARDO PABLO 56 210-2-06550573 14/12/2012 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,104 210-18-42557716 MORON RAMOS VICTOR GABRIEL 1 210-2-90074299 03/05/2018 150103A101 150105A101 0.00 0.00 18.16 0.00 18.16
2,105 210-18-42559206 MORON RAMOS VICTOR GABRIEL 1 210-2-90074299 04/05/2018 150103A101 150105A101 0.00 0.00 18.66 0.00 18.66
2,106 210-17-24404625 MOROTE TEJADA HERICA 39 210-2-80043152 07/08/2017 150103A101 150137A206 0.00 0.00 6.36 0.00 6.36
2,107 210-12-03910995 MOSCOSO INOCENTE MARILYN 29 210-2-42667469 09/03/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
2,108 210-13-01242295 MOSQUERA PONCE DIANA MILAGROS 14 210-2-76615208 04/10/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,109 210-11-03062467 MUCHA MILLAN OLIVIA ROXANA 24 210-2-44580881 22/06/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,110 210-17-24437945 MUNIVE CANO ELSA 37 210-2-40809527 23/09/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
2,111 210-13-00284156 MUNIVE PALLACA LILI LILIANA 38 210-2-10248549 30/01/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
2,112 210-18-42492396 MURAYARI CANELAO RN 0 040-E-28990430 09/02/2018 150103A101 150105A101 0.00 0.00 21.97 0.00 21.97
2,113 210-14-40060725 MURILLO VELAYARCE LESSLY LUZ MARINA 18 210-2-75497580 10/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,114 210-11-37305752 MURRIETA SAIS GISELA 20 210-2-47503230 05/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,115 210-13-01218786 MUSAJA ESCOBAR VANIA ALESSANDRA 0 210-2-78085794 16/06/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
2,116 210-14-40053942 MUÑICO SUASNABAR ESTRELLA LUCIA 26 210-2-45039095 21/06/2014 150103A101 150137A206 0.00 0.00 8.80 0.00 8.80
2,117 210-13-01200124 MUÑOZ ALEJANDRO CLADYS 20 210-2-71846753 29/03/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
2,118 210-12-00811194 MUÑOZ CAVERO JORGE VICTOR 59 150-6-00002407 25/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,119 210-12-03899610 MUÑOZ GOMEZ ANTONIA 39 210-2-09769042 19/01/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,120 210-17-24393960 MUÑOZ MURRUGARRA ELENA CLARA 47 210-2-09367014 19/07/2017 150103A101 150111A101 0.00 0.00 8.85 0.00 8.85
2,121 210-11-03056149 MUÑOZ PALOMINO ELIZABETH 39 210-2-09373125 07/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,122 210-18-42528362 MUÑOZ TORRES ROSAISELA 17 210-2-77357993 27/03/2018 150103A101 150111A101 0.00 0.00 10.43 0.00 10.43
2,123 210-17-24477288 MUÑOZ VARGAS SANTOS GIRALDO 69 210-2-10502024 16/11/2017 150103A101 150111A101 0.00 0.00 9.63 0.00 9.63
2,124 210-11-03614593 NABARRO DE PANCORBO ANDREA 71 050-6-00732528 02/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,125 210-14-40013907 NAKADA ARIZA JADE KAHORI SHANTALL 0 210-2-78180286 16/02/2014 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
2,126 210-18-42537168 NASHNATE JARAMILLO CARLOS FRANCISCO 8 240-2-61739387 07/04/2018 150103A101 150105A101 0.00 0.00 24.55 0.00 24.55
2,127 210-18-42541304 NASHNATE JARAMILLO CARLOS FRANCISCO 8 240-2-61739387 12/04/2018 150103A101 150105A101 0.00 0.00 19.15 0.00 19.15
2,128 210-18-42522751 NAVARRO ABREGU MAGDA MARLENY 39 210-2-40376865 19/03/2018 150103A101 150101A102 0.00 0.00 23.84 0.00 23.84

Elaborado por OIE-SIS Página 76 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,129 210-12-00191067 NAVARRO AUCCASI JESSICA 30 210-2-42796007 01/06/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
2,130 210-11-03063079 NAVARRO BARRERA MADELEINE 24 210-2-44800617 09/07/2011 150103A101 150111A205 0.00 0.00 25.00 0.00 25.00
2,131 210-17-24409254 NAVARRO CHURA CELESTE ARAZELI 18 210-2-75922567 12/08/2017 150103A101 150111A101 0.00 0.00 8.85 0.00 8.85
2,132 210-12-00799891 NAVARRO CONDOR BACILIA 34 210-2-40547463 08/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,133 210-18-42491196 NAVARRO DIA FLORENCIO 30 090-2-44635606 08/02/2018 150103A101 150103A101 0.00 0.00 9.20 0.00 9.20
2,134 210-11-03734855 NAVERROS RAMOS DEYSI LUISA 25 210-2-43371586 20/12/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
2,135 210-14-40118188 NEIRA MISIYAURI ANGIELY ALEXIA 1 170-2-78325618 16/11/2014 150103A101 150105A101 0.00 0.00 21.57 0.00 21.57
2,136 210-12-03900737 NEYRA CONDESO DEYSI CARMELA 29 210-2-42423781 24/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,137 210-12-03905726 NIETO GONZALES ELISA MARIA 33 210-2-10784479 29/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,138 210-11-03062665 NIETO PEREZ MARILYN GERALDINE 23 210-2-46703802 06/07/2011 150103A101 150118A101 0.00 0.00 50.00 0.00 50.00
2,139 210-17-24334105 NIETO PEREZ MARILYN GERALDINE 28 210-2-46703802 15/04/2017 150103A101 150111A101 0.00 0.00 9.04 0.00 9.04
2,140 210-12-00804783 NIMA CHIRA VICENTA 20 210-2-46733473 17/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,141 210-17-24351187 NINANYA VELASQUEZ TEOFILO 83 130-2-44127995 13/05/2017 150103A101 150111A101 0.00 0.00 11.28 0.00 11.28
2,142 210-17-24314055 NINAVILCA CARBAJAL AMERICO ANDRES 47 210-2-07496106 11/03/2017 150103A101 150111A101 0.00 0.00 8.58 0.00 8.58
2,143 210-17-24343229 NIQUIN HUAMAN YAMILE 17 210-2-76497677 01/05/2017 150103A101 150111A101 0.00 0.00 9.02 0.00 9.02
2,144 210-18-42476342 NIZAMA MARTINEZ MIGUEL RAFFIKH 20 210-2-70666453 21/01/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
2,145 210-14-40101550 NIÑO MEDINA CARLOS HUMBERTO 16 020-2-76343252 27/10/2014 150103A101 150101A109 0.00 0.00 20.35 0.00 20.35
2,146 210-18-42506234 NOA AYMACHOQUE LIZ YACLIN 26 210-2-47486004 27/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
2,147 210-11-03729340 NOA VILLANO MARIA ISABEL 17 210-2-48308536 12/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,148 210-17-24314038 NOLASCO INGA VIKY MAGALY 31 210-2-43784370 11/03/2017 150103A101 150111A205 0.00 0.00 10.62 0.00 10.62
2,149 210-17-24475406 NOLBERTO CAJAMARCA DAYSI SARA 19 210-2-74929690 13/11/2017 150103A101 150101A109 0.00 0.00 21.62 0.00 21.62
2,150 210-11-00367848 NOLBERTO MALLQUI EDWAR CALEB 9 140-6-00885834 10/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,151 210-17-24282768 NORIEGA BRAVO DE MEDINA DORA VERONICA 43 020-2-32940165 19/01/2017 150103A101 150122A101 0.00 0.00 18.11 0.00 18.11
2,152 210-18-42521955 NUÑEZ ANDIA SAORY ALEJANDRA 8 210-2-73840363 19/03/2018 150103A101 150105A101 0.00 0.00 18.38 0.00 18.38
2,153 210-17-24326860 NUÑEZ LLANAMI DE CONDORI MAXIMILIANA 71 050-2-06838429 03/04/2017 150103A101 150111A101 0.00 0.00 11.30 0.00 11.30
2,154 210-13-01248085 NUÑEZ MAMANI LUIS MARTIN 0 210-2-77901710 26/10/2013 150103A101 150133A101 0.00 0.00 70.00 0.00 70.00
2,155 210-14-40010909 NUÑEZ RICALDE NATALIA SARAID 1 210-2-77878456 06/02/2014 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
2,156 210-13-00286677 NUÑEZ TINEO ROSA VICTORIA 37 210-2-10501111 10/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00

Elaborado por OIE-SIS Página 77 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,157 210-17-24496515 OBISPO GONZALES YANELY ROCIO 15 220-2-74363250 12/12/2017 150103A101 150101A109 0.00 0.00 19.27 0.00 19.27
2,158 210-18-42522766 OBISPO JACINTO EDÍLSON ALEXANDER 11 210-2-70533643 19/03/2018 150103A101 150121A101 0.00 0.00 21.86 0.00 21.86
2,159 210-18-42541079 OBREGON ACOSTA KARLA DIANA 17 090-2-75025066 12/04/2018 150103A101 150111A101 0.00 0.00 11.66 0.00 11.66
2,160 210-11-03614771 OBREGON CCASANI RUTH 19 210-2-47317797 23/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,161 210-12-03905318 OBREGON CRISTOBAL VENERANDA MAGNA 34 210-2-20111822 28/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,162 210-17-24327210 OBREGON HUIDOBRO CECILIA 79 210-2-07407627 03/04/2017 150103A101 150101A103 0.00 0.00 10.39 0.00 10.39
2,163 210-11-03053568 OCHANTE ANANCA ALBERTINA 41 210-2-09506202 08/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,164 210-17-24355505 OCHANTE GAMARRA NICOLAS JUNIOR 1 210-2-79532863 20/05/2017 150103A101 150101A109 0.00 0.00 41.51 0.00 41.51
2,165 210-12-00810741 OCHANTE GUILLEN LUZ LUCERO 17 210-2-48548925 02/08/2012 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
2,166 210-12-00192163 OCHANTE ROJAS LUCIANA NOEMI 2 210-2-62644579 21/05/2012 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
2,167 210-17-24436427 OCHANTE SANCHEZ YAREDH DOMINIC 5 210-2-77826477 20/09/2017 150103A101 150101A101 0.00 0.00 11.55 0.00 11.55
2,168 210-13-01208316 OCHANTE TINEO ROCIO DEL PILAR 22 050-2-46788168 04/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,169 210-17-24333158 OCHAVANO LAULATE ELVA MEDALY 27 200-2-47733571 12/04/2017 150103A101 150137A206 0.00 0.00 9.04 0.00 9.04
2,170 210-14-40062647 OCHOA ANAMPA NATALI ZENOBIA 36 210-2-40120075 16/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,171 210-17-24464465 OCHOA CASTRO JARDEL ALEXIS 1 210-2-79621132 30/10/2017 150103A101 150111A101 0.00 0.00 7.99 0.00 7.99
2,172 210-13-01216155 OCHOA ORE SERAFINA 18 210-2-71553908 05/06/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
2,173 210-12-00800313 OCHOA POMA AYDE MARIBEL 25 210-2-45534972 11/07/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
2,174 210-14-40058961 OCHOA QUISPE JADHER ADRIAN 1 210-2-77986409 05/07/2014 150103A101 150105A101 0.00 0.00 23.10 0.00 23.10
2,175 210-17-24358471 OGOSI QUINTANILLA ROSMERY 30 210-2-43778274 26/05/2017 150103A101 150101A105 0.00 0.00 12.18 0.00 12.18
2,176 210-11-03057643 OLANO VILLANUEVA ERCILIA 20 110-6-20217095 16/07/2011 150103A101 150101A101 0.00 0.00 25.00 0.00 25.00
2,177 210-11-03056067 OLIVAR ORE ALIS ANGIE 0 210-2-76114655 07/05/2011 150103A101 150133A101 0.00 0.00 0.00 0.00 0.00
2,178 210-13-01217051 OLIVARES ONSEHUAY OLIMPIA HORTENCIA 24 210-2-46411970 10/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,179 210-13-01219743 OLIVAREZ SANTIAGO MARIA MERCEDES 25 210-2-45214635 20/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,180 210-11-03731324 OLIVAS EUFRACIO MARILIZ 23 210-2-44697553 20/11/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
2,181 210-13-01227614 OLIVERA GRANDA MARIA DOLORES 36 210-2-10165056 27/07/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,182 210-17-24333780 OLIVO ZUÑIGA ALEJANDRO CRISTOFER 2 210-2-78937975 14/04/2017 150103A101 150115A101 0.00 0.00 13.56 0.00 13.56
2,183 210-11-03057953 OLLERO ROMANI YOANA CAROLINA 20 210-2-46503793 20/07/2011 150103A101 070101A205 0.00 0.00 50.00 0.00 50.00
2,184 210-11-03605332 OMRRAN GONZALES SOLMAYRA YOMALLY 18 210-2-48192905 11/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00

Elaborado por OIE-SIS Página 78 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,185 210-17-24313229 ONCEBAY HUAYRA RN HV 0 170-E-28748591 10/03/2017 150103A101 150101A102 0.00 0.00 14.46 0.00 14.46
2,186 210-16-22846916 ONSIHUAY CAMAC GALA ANTONELLA 0 210-2-79716095 08/07/2016 150103A101 0000016918 0.00 0.00 14.87 0.00 14.87
2,187 210-14-40003327 ORBEZO AMBROSIO KATHERIN 26 210-2-44925566 14/01/2014 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
2,188 210-12-00802860 ORDAYA ASTUPUMA LIZ NOEMI 26 210-2-43369522 03/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,189 210-17-24354487 ORDAYA CASAS ULINDA GUDELIA 44 210-2-10184723 19/05/2017 150103A101 150101A102 0.00 0.00 20.76 0.00 20.76
2,190 210-11-03050897 ORDOÑEZ ARANCEL LIDIA PAULINA 31 210-2-41045689 26/05/2011 150103A101 150132A203 0.00 0.00 0.00 0.00 0.00
2,191 210-14-40120963 ORDOÑEZ PERALES ROSA MARIA 21 210-2-47964128 02/12/2014 150103A101 150137A206 0.00 0.00 6.60 0.00 6.60
2,192 210-17-24318532 ORDOÑEZ SUAREZ YASURY YENIFER 4 170-2-80995736 21/03/2017 150103A101 150105A101 0.00 0.00 13.10 0.00 13.10
2,193 210-18-42477368 ORE ANYAIPOMA MAYE MELINA 22 210-2-76295133 23/01/2018 150103A101 150137A206 0.00 0.00 7.24 0.00 7.24
2,194 210-17-24452360 ORE CASTRO FELICITA 23 210-2-48615518 12/10/2017 150103A101 150111A101 0.00 0.00 8.66 0.00 8.66
2,195 210-14-40053946 ORE GONZALES ANGEL 41 210-2-01187452 21/06/2014 150103A101 150101A101 0.00 0.00 14.30 0.00 14.30
2,196 210-16-22948359 ORE HUILLCAHUARI DAYANA SHEYLA 5 200-2-76716617 25/12/2016 150103A101 150111A101 0.00 0.00 10.42 0.00 10.42
2,197 210-18-42564129 ORE MANCILLA DAYANNA YAXIRA 12 210-2-75966749 10/05/2018 150103A101 150111A101 0.00 0.00 9.88 0.00 9.88
2,198 210-18-42536812 ORE MEZA PAULINA 43 210-2-10243626 06/04/2018 150103A101 150115A101 0.00 0.00 15.22 0.00 15.22
2,199 210-11-03056195 ORE OSORES TANIA OTILIA 21 210-2-45936476 07/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,200 210-11-03060561 ORE RIOS CARIT ADA 28 210-2-41718143 16/06/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
2,201 210-17-24342025 OREJON CCOICCA GERALDHINE NOELLYA 14 210-2-73724924 28/04/2017 150103A101 150115A101 0.00 0.00 14.46 0.00 14.46
2,202 210-18-42480967 OREJUELA LLANCARI JACQUELINE 17 210-2-61293387 27/01/2018 150103A101 150101A105 0.00 0.00 14.85 0.00 14.85
2,203 210-14-40101064 ORELLANA CRISTOBAL GIANA NIRLE 26 210-2-45129997 25/10/2014 150103A101 150111A101 0.00 0.00 11.00 0.00 11.00
2,204 210-11-03048693 ORIZANO CLAUDIO CLEIDY VANESA 18 210-2-48102418 13/04/2011 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
2,205 210-12-00799878 OROCHE PIZANGO KAROL VANESSA 19 210-2-47401127 08/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,206 210-13-01236216 OROSCO AYQUIPA ALEXIA YURIKO SAM 4 090-2-73166158 11/09/2013 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
2,207 210-14-40030984 OROSCO BARTOLO KENY JOEL 12 200-2-70540273 08/04/2014 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
2,208 210-14-40031879 OROSCO BARTOLO KENY JOEL 12 200-2-70540273 10/04/2014 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
2,209 210-11-03727076 OROSCO QUISPE CELESTINA 83 210-2-40451436 04/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,210 210-11-03061949 OROZCO CISNEROS ESTHER ISABEL 36 210-2-10170713 03/07/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,211 210-17-24299102 OROZCO DAVILA NICOLAS FAVIO 9 210-2-70743279 16/02/2017 150103A101 150101A101 0.00 0.00 9.10 0.00 9.10
2,212 210-14-40087924 OROZCO OLIMBO NN 0 210-7-44017484 23/09/2014 150103A101 150101A105 0.00 0.00 20.99 0.00 20.99

Elaborado por OIE-SIS Página 79 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,213 210-14-40090842 ORTEGA CAMPOS DULA 67 170-2-20553375 30/09/2014 150103A101 070103A101 0.00 0.00 28.05 0.00 28.05
2,214 210-11-03734899 ORTEGA LOA EDITH 22 210-2-46505584 21/12/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,215 210-17-24302731 ORTEGA LOA XIOMARA SHAROL 8 210-2-71366105 25/02/2017 150103A101 150111A101 0.00 0.00 8.19 0.00 8.19
2,216 210-12-00807367 ORTIZ AGUIRRE EVELYN FAVIOLA 23 210-2-45560872 26/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,217 210-17-24329206 ORTIZ LOPEZ FAUSTO 83 200-2-22869453 06/04/2017 150103A101 150111A101 0.00 0.00 9.04 0.00 9.04
2,218 210-17-24477625 ORTIZ LUNA ISABEL HILDA 36 210-2-40774829 16/11/2017 150103A101 150111A101 0.00 0.00 8.93 0.00 8.93
2,219 210-14-40012584 ORTIZ RAMIREZ JUAN CARLOS 41 210-2-09837811 12/02/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,220 210-11-03614782 ORTIZ RIVERA NELY 25 210-2-43399686 24/09/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
2,221 210-14-40076026 ORTIZ SANDOVAL ALITHU ALEXANDRA 19 210-2-48369426 23/08/2014 150103A101 150118A101 0.00 0.00 13.75 0.00 13.75
2,222 210-17-24377683 OSCANOA GAMBOA JOSTIN JULIAN 3 210-2-78451125 26/06/2017 150103A101 150115A101 0.00 0.00 13.65 0.00 13.65
2,223 210-17-24477007 OSCCO HUAMANÑAHUI CRISTHIAN 12 030-2-71334143 15/11/2017 150103A101 150111A101 0.00 0.00 8.34 0.00 8.34
2,224 210-17-24469103 OSCCO LOAYZA ROSARIO DEL PILAR 48 210-2-09505607 04/11/2017 150103A101 150111A101 0.00 0.00 8.81 0.00 8.81
2,225 210-17-24471802 OSCCO LOAYZA ROSARIO DEL PILAR 48 210-2-09505607 08/11/2017 150103A101 150111A101 0.00 0.00 8.93 0.00 8.93
2,226 210-14-40066781 OSCCO OSCCO NANCY 39 210-2-10420809 30/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,227 210-17-24407923 OSCCO SORAS VILMA 32 210-2-42961744 11/08/2017 150103A101 150111A205 0.00 0.00 8.41 0.00 8.41
2,228 210-17-24466340 OSORIO ALPUN NEHEMIAS ADRIANO 4 210-2-78301542 01/11/2017 150103A101 150111A101 0.00 0.00 7.52 0.00 7.52
2,229 210-17-24276018 OSORIO BAZAN ANGELO LUCIANO 10 210-2-70623686 08/01/2017 150103A101 150101A101 0.00 0.00 14.23 0.00 14.23
2,230 210-11-03057145 OSORIO CARDOZO CELINA 21 210-2-45995289 15/07/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,231 210-13-01240543 OSORIO CONDOR LUZ ELIDA 19 210-2-70899295 27/09/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,232 210-17-24303103 OSORIO GUERRERO KEVIN ANGEL 15 210-2-75008917 26/02/2017 150103A101 150111A101 0.00 0.00 8.64 0.00 8.64
2,233 210-11-03057447 OSORIO HERNANDEZ ANA RUTH 11 210-2-74001079 14/07/2011 150103A101 150115A101 0.00 0.00 40.00 0.00 40.00
2,234 210-14-40057299 OSORIO RETOBLO EDITH MARDONIA 24 210-2-47411879 01/07/2014 150103A101 150101A105 0.00 0.00 19.80 0.00 19.80
2,235 210-11-03059097 OSORIO ZELAYA ADA MARLENY 22 210-2-45986385 31/07/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
2,236 210-18-42471070 OTERO TORRE ADELA 33 170-2-42245059 13/01/2018 150103A101 150111A205 0.00 0.00 7.49 0.00 7.49
2,237 210-13-01211006 OTINIANO CURILLA JHAIRO NICOLAS 3 210-2-73731934 15/05/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
2,238 210-12-03907887 OTIVO QUISPE JHEYSY YOSELIN 19 210-2-72319824 25/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,239 210-17-24332281 OYOLA RODRIGUEZ ANDREA VALENTINA 0 210-2-79663255 11/04/2017 150103A101 150118A101 0.00 0.00 24.85 0.00 24.85
2,240 210-14-40020596 PABLO CAMPOS TIAGO NILTON 0 210-2-78349111 09/03/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00

Elaborado por OIE-SIS Página 80 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,241 210-11-03725916 PABLO HUACAUSI DIGNA MARIELA 26 210-2-47397019 24/10/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
2,242 210-14-40055925 PACAYA SANCHEZ WILKI DANIEL 2 210-2-63162482 27/06/2014 150103A101 150115A101 0.00 0.00 16.32 0.00 16.32
2,243 210-13-01216479 PACHAMANGO NAVARRO LILIANA 22 210-2-46391501 06/06/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,244 210-17-24369086 PACHECO BARDALES CRISTOFER JONAS 2 210-2-79469604 11/06/2017 150103A101 150115A101 0.00 0.00 12.41 0.00 12.41
2,245 210-13-01228064 PACHECO CARHUALLANQUI ADRIANA THAIS 3 210-2-61842675 01/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,246 210-18-42479727 PACHECO CHACALIAZA TATIANA DALESKA 0 210-2-90382494 21/01/2018 150103A101 0000016918 0.00 0.00 13.01 0.00 13.01
2,247 210-18-42553774 PACHECO CHAHUAYLA JESSICA ELIZABET 24 210-2-47809564 27/04/2018 150103A101 150101A105 14.63 0.00 0.00 0.00 14.63
2,248 210-16-22839698 PACHECO HUAMAN JHONY THIAGO 3 210-E-27701481 26/06/2016 150103A101 150111A101 0.00 0.00 8.85 0.00 8.85
2,249 210-18-42546014 PACHECO QUISPE ERMELINDA 37 130-2-41466435 18/04/2018 150103A101 150101A105 0.00 0.00 14.24 0.00 14.24
2,250 210-11-03613737 PACHECO ROAS GIANINA 34 210-2-10259269 04/09/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00
2,251 210-12-00805268 PACO ALVAREZ YESSABEL DUANI 14 210-2-71941940 25/08/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,252 210-12-00808550 PACO HUAMANI ROSA ELENA 57 210-2-07279453 08/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,253 210-17-24418388 PACORI GOMEZ MIGUEL ANGEL 21 210-2-48710377 27/08/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
2,254 210-12-00811016 PADILLA HUANCAS DINA 36 210-2-80508448 28/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,255 210-11-03053569 PAHUACHO FLORES LUZ DOLORES 27 210-2-42074281 08/06/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,256 210-13-01240510 PAHUACHO ROBLADILLO FABIAN 66 210-2-44973000 27/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,257 210-13-01245781 PAITA CAPCHA CLESIRIA 36 210-2-20905482 18/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,258 210-12-00194195 PAITA CORDOVA FAUSTINA MESALINA 18 210-2-48217920 21/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,259 210-11-03727782 PAITAN CONDOR JESIDA 31 210-2-40656897 11/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,260 210-18-42471111 PAITAN NOA VICTORIA 33 210-2-42778482 14/01/2018 150103A101 150111A101 0.00 0.00 9.57 0.00 9.57
2,261 210-16-22890153 PAJUELO ZEGARRA SEBASTIAN ALEXSANDER 10 210-2-60803048 18/09/2016 150103A101 150111A101 0.00 0.00 10.08 0.00 10.08
2,262 210-11-03605003 PALACIN BRAVO YESAREL BONNIE 20 210-2-46990300 04/08/2011 150103A101 150110A101 0.00 0.00 0.00 0.00 0.00
2,263 210-12-00807438 PALACIOS DE LA CRUZ NELLY GRACIELA 34 210-2-40669894 29/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,264 210-18-42488027 PALACIOS GOMEZ ERICK DRAGNETH 28 210-2-45758698 04/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
2,265 210-17-24453996 PALACIOS GUTIERREZ JUANITA 18 210-2-77687447 14/10/2017 150103A101 150111A205 0.00 0.00 9.89 0.00 9.89
2,266 210-12-03901684 PALACIOS LAZO ELIZABETH MONICA 25 210-2-44478076 04/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,267 210-13-01213894 PALACIOS MORALES GRACE KELLY 15 210-2-77147913 27/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,268 210-12-00809048 PALACIOS NAVARRO BLANCA LUZ 30 210-2-42040999 21/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 81 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,269 210-17-24316937 PALACIOS NIÑO DE GUZMAN MARIA 43 210-2-09599800 17/03/2017 150103A101 150111A101 0.00 0.00 35.25 0.00 35.25
2,270 210-12-01283740 PALANTE PACCO MAXIMILIANA CATALINA 22 210-2-61159797 21/09/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,271 210-13-01215237 PALIAN PALIAN BERTHA 34 210-2-40169073 02/06/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,272 210-17-24415630 PALLACA DIAZ CLAUDIA YAMILE 8 210-2-73564748 23/08/2017 150103A101 150105A101 0.00 0.00 15.00 0.00 15.00
2,273 210-11-03051888 PALMADERA TOLENTINO ANA PAULA 18 210-2-60647860 11/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,274 210-11-03053857 PALMADERA TOLENTINO ANA PAULA 18 210-2-60647860 14/06/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
2,275 210-11-03728721 PALOMINO ANCALLE JUANA 39 210-2-40536477 05/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,276 210-12-00188996 PALOMINO APUMAYTA EDELIZA 23 210-2-45669177 28/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,277 210-11-03060455 PALOMINO AUCCAPUMA ALICIA 26 210-2-42953814 19/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,278 210-11-03060015 PALOMINO BALBIN BERTHA 24 210-2-44129187 27/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,279 210-11-03052379 PALOMINO CRISPIN SONIA 19 210-2-47195461 21/05/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
2,280 210-11-03731046 PALOMINO GARAY TANIA 31 210-2-40679506 10/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,281 210-12-03911143 PALOMINO GARCIA SONIA 19 210-2-62086319 02/02/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,282 210-13-01201736 PALOMINO HUAMAN MARISOL 23 050-2-46266622 05/04/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,283 210-13-01235289 PALOMINO HUAMAN RAQUEL 21 210-2-47144563 08/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,284 210-13-01198617 PALOMINO MENDEZ RUT MEREY 21 210-2-47404887 21/03/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,285 210-11-03053576 PALOMINO MENESES CARLA HIBOP 17 210-2-48068259 08/06/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,286 210-12-00809898 PALOMINO PERALES DAYIRO FELIX 0 220-2-77615173 20/08/2012 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
2,287 210-17-24462801 PALOMINO PEREZ ROSA GABRIELA 47 210-2-09365804 27/10/2017 150103A101 150111A101 0.00 0.00 8.81 0.00 8.81
2,288 210-12-00191649 PALOMINO QUINTANA MARIBEL MARIA 28 210-2-42434544 07/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,289 210-13-01228980 PALOMINO RAMOS YONY OSWALDO 7 210-2-75962038 10/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,290 210-13-01235082 PALOMINO RONDINEL JOSE MARIA FELIX 13 210-2-72985196 06/09/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
2,291 210-14-40062879 PALOMINO SICHA FRESIA YASMIN 19 210-2-77439986 17/07/2014 150103A101 150118A101 0.00 0.00 30.80 0.00 30.80
2,292 210-14-40063922 PALOMINO SICHA FRESIA YASMIN 19 210-2-77439986 19/07/2014 150103A101 070103A101 0.00 0.00 30.25 0.00 30.25
2,293 210-13-01233267 PALOMINO SULCA JULIO 57 210-2-07049292 30/08/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
2,294 210-17-24480976 PALOMINO TORRES JAZMIN DEL PILAR 12 210-2-75341313 20/11/2017 150103A101 150115A101 0.00 0.00 14.33 0.00 14.33
2,295 210-14-40097897 PALOMINO VALLADOLID RN 0 210-7-74088623 15/10/2014 150103A101 150105A101 0.00 0.00 21.57 0.00 21.57
2,296 210-11-03611372 PALPA BARJA NATALI ALEJANDRINA 21 210-2-47019187 14/10/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00

Elaborado por OIE-SIS Página 82 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,297 210-11-03726320 PAMPAVILCA CHULAN RAYDA ROSARIO 25 210-2-43411198 27/10/2011 150103A101 150121A101 0.00 0.00 45.00 0.00 45.00
2,298 210-18-42569490 PANAIFO OCAMPO OLENKA EDOMILIA 31 240-2-44135892 17/05/2018 150103A101 150111A101 0.00 0.00 9.88 0.00 9.88
2,299 210-12-03903586 PANCLAS JIMENEZ JENNY 28 210-2-41636034 14/02/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,300 210-17-24427349 PANDURO LLANA YOSELIN DIANA 0 210-2-81707720 07/09/2017 150103A101 150105A101 0.00 0.00 13.88 0.00 13.88
2,301 210-17-24427831 PANDURO LLANA YOSELIN DIANA 0 210-2-81707720 08/09/2017 150103A101 150105A101 0.00 0.00 17.10 0.00 17.10
2,302 210-17-24323339 PANDURO MELO SANDY MARIELA 26 210-2-46267444 29/03/2017 150103A101 150101A109 0.00 0.00 16.72 0.00 16.72
2,303 210-17-24392512 PANDURO TACSA ANAMELVA ROSSANA 35 210-2-41765596 17/07/2017 150103A101 150101A105 0.00 0.00 13.49 0.00 13.49
2,304 210-18-42478197 PANIORA VALDIGLESIAS KARINA 18 210-2-75691970 23/01/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
2,305 210-13-01218733 PANTA CRUZ GERSON ANDRE 12 210-2-74695273 15/06/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
2,306 210-17-24471951 PANTA MELGAREJO NERCI ISABEL 24 220-2-70077516 08/11/2017 150103A101 150111A205 0.00 0.00 12.92 0.00 12.92
2,307 210-18-42572223 PANTALEON PASCUAL VILMA 38 210-2-45088120 22/05/2018 150103A101 150111A101 0.00 0.00 8.96 0.00 8.96
2,308 210-12-01282424 PAQUIYAURI APARCO YANET 21 210-2-47369976 19/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,309 210-11-03048534 PAQUIYAURI HUAIRA ROSA NOEMI 19 210-2-47295190 02/04/2011 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
2,310 210-17-24472104 PAQUIYAURI MEDRANO DIEGO FRANCO 13 210-2-72449794 08/11/2017 150103A101 150111A101 0.00 0.00 8.81 0.00 8.81
2,311 210-17-24292064 PARAGUAY CAMPOS NANCY 34 210-2-41453895 04/02/2017 150103A101 150111A101 0.00 0.00 7.33 0.00 7.33
2,312 210-17-24482683 PARAGUAY PARGO EDWIN EDILIO 38 210-2-41279769 24/11/2017 150103A101 150111A101 0.00 0.00 8.81 0.00 8.81
2,313 210-12-01883243 PARAVECINO SALCEDO LUCERO GUADALUPE 21 210-2-46910180 17/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,314 210-11-03049926 PARCO AYZANOA CELIA 24 210-2-43771990 14/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,315 210-17-24419469 PARCO CHUMBIMUNI BONIFACIO 91 210-2-08917758 28/08/2017 150103A101 150111A101 0.00 0.00 7.34 0.00 7.34
2,316 210-14-40004378 PARDAVE MONTALVO LUANNA MARJORI 0 210-2-78251874 16/01/2014 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
2,317 210-12-00276784 PARDO ESPINOZA MARIA 39 210-2-10484644 03/01/2013 150103A101 150141A101 0.00 0.00 63.00 0.00 63.00
2,318 210-18-42490492 PARDO HUERTA EMIR ADLER 0 140-2-90475762 07/02/2018 150103A101 150105A101 0.00 0.00 16.69 0.00 16.69
2,319 210-18-42497458 PARDO HUERTA EMIR ADLER 0 140-2-90475762 16/02/2018 150103A101 150101A109 0.00 0.00 21.97 0.00 21.97
2,320 210-18-42573310 PARDO HUERTA EMIR ADLER 0 140-2-90475762 08/02/2018 150103A101 150105A101 0.00 0.00 17.06 0.00 17.06
2,321 210-13-00284006 PARDO SANTANA EYDAN 4 210-2-62831255 29/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,322 210-17-24387149 PAREDES CHOQUI CELESTE SANDRA 20 170-2-76980826 09/07/2017 150103A101 150101A105 0.00 0.00 13.49 0.00 13.49
2,323 210-11-02709197 PAREDES MENIZ ATILIO DAVID 48 170-6-50006899 01/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,324 210-11-03613639 PAREDES TANGOA ELSA 58 210-2-06006838 26/09/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00

Elaborado por OIE-SIS Página 83 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,325 210-11-03725770 PAREJA LAURA FANNY TANIA 23 210-2-45550772 24/10/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
2,326 210-11-03605334 PARI MACHACA VANESSA DEL ROCIO 20 210-2-46703581 11/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,327 210-16-22920332 PARI SANTIAGO PAUL ANTHONY 8 210-2-74185647 06/11/2016 150103A101 150115A101 0.00 0.00 10.42 0.00 10.42
2,328 210-12-03898519 PARIAN MEZA MONICA 22 210-2-46197941 12/01/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,329 210-12-00809854 PARICANAZA CHAMBI REYNALDA 23 210-2-45904615 21/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,330 210-18-42470886 PARIHUAMAN OROPESA ROSA YANET 32 210-2-43237233 13/01/2018 150103A101 150101A109 0.00 0.00 17.92 0.00 17.92
2,331 210-17-24449730 PARIONA DE SOTO HONORA 67 210-2-23222458 09/10/2017 150103A101 150111A101 0.00 0.00 7.55 0.00 7.55
2,332 210-12-00804294 PARIONA HUAMAN JUANA ROSA 31 210-2-40833121 11/08/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,333 210-17-24481548 PARIONA HUAMANI RUTH KELLY 23 210-2-70110239 22/11/2017 150103A101 150111A205 0.00 0.00 12.92 0.00 12.92
2,334 210-11-03609623 PARIONA LIMA PIERO JAIR 8 210-2-73588059 29/08/2011 150103A101 150121A101 0.00 0.00 45.00 0.00 45.00
2,335 210-14-40033456 PARIONA LOAYZA ROSMERY 19 210-2-48399047 15/04/2014 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,336 210-11-03734417 PARIONA QUINTO GLORIA AYDEE 30 210-2-41175663 31/12/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,337 210-14-40029063 PARIONA RAMOS AYDEE 27 210-2-45395121 03/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,338 210-11-03055983 PARIONA SORIA NN 0 210-7-46349259 17/05/2011 150103A101 070102A101 0.00 0.00 0.00 0.00 0.00
2,339 210-11-03610594 PARIONA SUAREZ GIOVANA LUZ 25 210-2-46335993 13/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,340 210-12-00189054 PARIONA SUAREZ JESSICA SUSANA 28 210-2-46319053 22/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,341 210-11-03730121 PARIONA VILLALVA MARIA ROSA 30 210-2-41201761 27/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,342 210-17-24301946 PARVINA BALDEON KAREN YOSELIN 23 200-2-47980603 22/02/2017 150103A101 150101A105 0.00 0.00 15.92 0.00 15.92
2,343 210-18-42477333 PARVINA BALDEON KAREN YOSELIN 24 200-2-47980603 22/01/2018 150103A101 150111A101 0.00 0.00 10.92 0.00 10.92
2,344 210-12-01283558 PASTOR SULCA SOL VALERIA 0 210-2-77634537 26/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,345 210-17-24470369 PATROCINIO POMALIA ROBERT AGUILAR 36 210-2-40725074 06/11/2017 150103A101 150118A101 0.00 0.00 23.03 0.00 23.03
2,346 210-13-01227714 PAUCAR ARBAIZO DE ABAL AGRIPINA 59 210-2-09236297 29/07/2013 150103A101 150137A101 0.00 0.00 30.80 0.00 30.80
2,347 210-18-42542656 PAUCAR ARROYO FATIMA LIZ 15 210-2-76739573 12/04/2018 150103A101 150115A101 0.00 0.00 13.75 0.00 13.75
2,348 210-13-01215609 PAUCAR BECERRA YUNI LIZET 0 210-2-77861223 04/06/2013 150103A101 150135A101 0.00 0.00 112.00 0.00 112.00
2,349 210-17-24324120 PAUCAR CHAVEZ KIARA MILAGROS 2 270-2-78781652 30/03/2017 150103A101 150115A101 0.00 0.00 11.75 0.00 11.75
2,350 210-17-24327728 PAUCAR CHAVEZ KIARA MILAGROS 2 270-2-78781652 04/04/2017 150103A101 150105A101 0.00 0.00 16.27 0.00 16.27
2,351 210-17-24454924 PAUCAR GONZALES ROSA MIRELLA 26 230-2-70090644 13/10/2017 150103A101 150111A205 0.00 0.00 10.66 0.00 10.66
2,352 210-18-42485202 PAUCAR HINOSTROZA JHOJAN JEISON 10 170-2-61204175 31/01/2018 150103A101 150105A101 0.00 0.00 18.41 0.00 18.41

Elaborado por OIE-SIS Página 84 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,353 210-17-24470546 PAUCAR HUAMAN JULIO CESAR 8 210-2-74673961 07/11/2017 150103A101 150105A101 0.00 0.00 17.50 0.00 17.50
2,354 210-11-03727080 PAUCAR MAITA NORMA 32 210-2-40840757 05/12/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
2,355 210-17-24428766 PAUCAR SILVA GUISELA 21 210-2-73688698 09/09/2017 150103A101 150111A101 0.00 0.00 28.77 0.00 28.77
2,356 210-17-24413946 PAYANO VARGAS GINO ALEXANDER 2 210-2-81505594 19/08/2017 150103A101 0000016918 0.00 0.00 11.44 0.00 11.44
2,357 210-18-42498845 PAYHUA APONTE WILMER 37 050-2-41173316 17/02/2018 150103A101 150111A101 0.00 0.00 9.70 0.00 9.70
2,358 210-14-40062055 PAZ SALAZAR CELESTE ROCIO 19 210-2-76656022 14/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,359 210-17-24326610 PAZ SEBASTIAN ROMMY CYNTHIA 21 080-2-70056846 02/04/2017 150103A101 150111A101 0.00 0.00 9.40 0.00 9.40
2,360 210-17-24482816 PECHE LOZANO ROGER ANDERSON 10 210-2-70596611 24/11/2017 150103A101 150101A101 0.00 0.00 25.61 0.00 25.61
2,361 210-12-01282333 PELAEZ NAPAN MARLENE HILDA 39 210-2-10043754 25/09/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,362 210-11-02706583 PEQQUEÑA CHAÑI FRANCISCA 67 210-2-02267885 30/03/2011 150103A101 070102A101 0.00 0.00 0.00 0.00 0.00
2,363 210-13-01235601 PERALTA CERNA LUCIMAR ESTEFANIA 23 210-2-46538073 09/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,364 210-17-24333636 PERALTA QUISPE YEN SHELI 24 210-2-48274487 12/04/2017 150103A101 150111A205 0.00 0.00 10.85 0.00 10.85
2,365 210-13-01200086 PEREZ AMES MONICA 31 210-2-41491600 28/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,366 210-11-03729946 PEREZ ARONE MARFILDA MERCEDES 24 210-2-44571554 23/11/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
2,367 210-12-00184035 PEREZ BARRANTES MARIA 25 210-2-44319940 06/04/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,368 210-17-24310712 PEREZ BRAVO RUTH NOEMI 21 210-2-70910682 07/03/2017 150103A101 150111A101 0.00 0.00 7.68 0.00 7.68
2,369 210-17-24447947 PEREZ CACHIQUE DIANA CAROLINA 2 210-2-81647106 05/10/2017 150103A101 150115A101 0.00 0.00 11.55 0.00 11.55
2,370 210-14-40124677 PEREZ CCATAMAYO JEFFERSON 10 210-2-74570377 10/12/2014 150103A101 150103A208 0.00 0.00 32.35 0.00 32.35
2,371 210-17-24435675 PEREZ CHAHUAYO MARIA DEL CARMEN ABIGAIL 1 210-2-79506911 19/09/2017 150103A101 150115A101 0.00 0.00 11.88 0.00 11.88
2,372 210-17-24291837 PEREZ CHAVIL YAMILET 1 210-2-79361505 04/02/2017 150103A101 150105A101 0.00 0.00 15.52 0.00 15.52
2,373 210-17-24293232 PEREZ CHAVIL YAMILET 1 210-2-79361505 07/02/2017 150103A101 150105A101 0.00 0.00 19.40 0.00 19.40
2,374 210-11-03607363 PEREZ CORDOVA SONIA 20 210-2-46622122 07/09/2011 150103A101 150103A208 0.00 0.00 40.00 0.00 40.00
2,375 210-13-01218837 PEREZ CORO ISABEL ANA 29 210-2-44829810 16/06/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
2,376 210-17-24392574 PEREZ DE LA CRUZ JESUS ANGEL 2 200-2-79175147 18/07/2017 150103A101 150105A101 0.00 0.00 15.75 0.00 15.75
2,377 210-14-40018710 PEREZ HUAMAN GLORIA 20 210-2-48034494 03/03/2014 150103A101 150128A204 0.00 0.00 53.20 0.00 53.20
2,378 210-17-24464952 PEREZ HUAMANCHUMO KIMBERLY ALEXANDRA 14 200-2-75096849 31/10/2017 150103A101 150111A101 0.00 0.00 9.28 0.00 9.28
2,379 210-17-24417662 PEREZ HUARANCCAY SILVIA KAROL 9 210-2-74101136 25/08/2017 150103A101 150101A101 0.00 0.00 11.87 0.00 11.87
2,380 210-17-24459292 PEREZ LAYMITO JULISSA MINQUELY 7 210-2-60074395 21/10/2017 150103A101 150115A101 0.00 0.00 10.33 0.00 10.33

Elaborado por OIE-SIS Página 85 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,381 210-18-42516546 PEREZ LOPEZ CIELO MILAGROS 18 210-2-62472462 11/03/2018 150103A101 150137A101 0.00 0.00 4.97 0.00 4.97
2,382 210-17-24347092 PEREZ MANCILLA GIANELLA LUISA 16 210-2-76147578 06/05/2017 150103A101 150101A105 0.00 0.00 14.44 0.00 14.44
2,383 210-12-00191545 PEREZ NAPUCHI LILY 36 210-2-01146020 02/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,384 210-11-03051761 PEREZ OGOSI ESTHER MINERVA 24 210-2-46167300 09/06/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,385 210-11-03053896 PEREZ OROYA SONIA VIRGINA 28 210-2-47318294 16/06/2011 150103A101 150132A203 0.00 0.00 0.00 0.00 0.00
2,386 210-12-00193385 PEREZ PEREZ EVELINA 20 210-2-47412184 05/05/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
2,387 210-11-03608978 PEREZ POCCO SANAYDA 36 210-2-10240278 26/08/2011 150103A101 150101A102 0.00 0.00 45.00 0.00 45.00
2,388 210-18-42474732 PEREZ RAMOS RN-HV 0 210-E-29022018 18/01/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
2,389 210-17-24423984 PEREZ SEGURA MARCO ANTONIO 10 230-2-61170572 04/09/2017 150103A101 150105A101 0.00 0.00 16.22 0.00 16.22
2,390 210-17-24424857 PEREZ SEGURA MARCO ANTONIO 10 230-2-61170572 05/09/2017 150103A101 150105A101 0.00 0.00 15.66 0.00 15.66
2,391 210-13-01212284 PEREZ SIERRA RN 0 210-7-70094740 21/05/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
2,392 210-12-00798513 PEREZ SOTO CARMEN ROSA 22 210-2-45920372 13/07/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,393 210-17-24394310 PEREZ TANANTA HERNAN 57 340-2-00066499 20/07/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
2,394 210-13-01197065 PEREZ TORRES MELISSA SHIRLIE 23 210-2-70091724 15/03/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
2,395 210-18-42494898 PEÑA BOBIO DILMA IDELSA 32 230-2-44448100 12/02/2018 150103A101 150111A101 0.00 0.00 9.20 0.00 9.20
2,396 210-12-00195567 PEÑA FEBRE LEYLA ALEXANDRA 18 210-2-48463454 03/05/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,397 210-14-40018912 PEÑA MATIAS ALIZON NICOLE 20 210-2-72504235 04/03/2014 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,398 210-14-40019725 PEÑA NUÑEZ KEYLA ZIOMARA 7 210-2-60930456 06/03/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,399 210-11-03728662 PEÑA PALOMINO SAYDA 23 210-2-45307718 25/11/2011 150103A101 150111A205 0.00 0.00 40.00 0.00 40.00
2,400 210-12-00192588 PEÑA TARAZONA JULY ISLANDA 17 210-2-48504707 07/06/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
2,401 210-17-24503752 PFUÑO CCANTO SUSAN LIZ 21 200-2-77538863 25/12/2017 150103A101 150111A205 0.00 0.00 8.46 0.00 8.46
2,402 210-12-01288345 PHUTURI MEDINA HERMELINDA 31 210-2-44914762 29/10/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,403 210-14-40127006 PIANCHACHI MUÑOZ ANGHELO JEREMY 7 210-2-70714073 15/12/2014 150103A101 150111A101 0.00 0.00 10.45 0.00 10.45
2,404 210-14-40055042 PIANTO CHOQUE ANAHY MELANY 5 210-2-72062420 24/06/2014 150103A101 150121A101 0.00 0.00 26.40 0.00 26.40
2,405 210-18-42499064 PILCO CHOTA SANDRA ESMITH 16 210-2-81041013 18/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
2,406 210-18-42570519 PILLACA DIAZ FELICITAS 30 210-2-44837361 19/05/2018 150103A101 150111A205 0.00 0.00 10.41 0.00 10.41
2,407 210-16-40059710 PILLACA MONTENEGRO VALERIA BELÉN 0 210-2-79407861 12/04/2016 150103A101 150121A101 0.00 0.00 28.04 0.00 28.04
2,408 210-13-01236243 PILLCO MONTALVO MARIVEL 37 210-2-40708033 11/09/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00

Elaborado por OIE-SIS Página 86 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,409 210-12-00808120 PILLCO SALOMA TEOFILA 60 210-2-07115284 01/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,410 210-18-42491851 PINCHI FASABI GEANER 21 240-2-76391542 08/02/2018 150103A101 150111A101 0.00 0.00 9.20 0.00 9.20
2,411 210-14-40073462 PINCO CORDOVA TERESA 20 210-2-48005174 15/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,412 210-14-40030266 PINCOS GONZALES NATALY CAROLINA 18 210-2-77792924 06/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,413 210-13-01213775 PINCOS GONZALES NELIDA ISIDORA 23 210-2-45800253 27/05/2013 150103A101 150132A205 0.00 0.00 68.60 0.00 68.60
2,414 210-12-00798717 PINEDA CATALAN MARIA MARILU 21 210-2-46696159 02/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,415 210-14-40058297 PINEDA TORRES GIOVANNA MARIA 26 210-2-46957022 03/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,416 210-13-01202719 PINTO CABRERA MARIA JESUS 17 210-2-76602887 09/04/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
2,417 210-12-01289684 PINTO GARCIA IRENE ROSA 52 210-2-06558880 02/11/2012 150103A101 070102A101 0.00 0.00 0.00 0.00 0.00
2,418 210-14-40071167 PINTO TANGOA KATTY 16 210-2-76072759 09/08/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
2,419 210-14-40018225 PIO CARBAJAL BETSY BEATRIZ 12 200-2-74530351 02/03/2014 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
2,420 210-13-01231687 PIZAN TOVALINO JENNIFER ESTEFANIA 10 210-2-77179726 23/08/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
2,421 210-13-01195628 PIZARRO GUERRA FILDA MADAI 25 210-2-44506043 08/03/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
2,422 210-13-00288873 PIÑAN FIGUEROA SUSANA 32 210-2-40708996 19/02/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,423 210-17-24418331 PIÑAN MARTINEZ LILIANA 35 210-2-42588225 26/08/2017 150103A101 150101A105 0.00 0.00 13.49 0.00 13.49
2,424 210-13-01218239 POLO JUSTINIANI NICSON 27 210-2-43528045 14/06/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
2,425 210-17-24480960 POMA AÑAZCO DAYSI 19 170-2-71564257 21/11/2017 150103A101 150101A105 0.00 0.00 12.57 0.00 12.57
2,426 210-11-03050660 POMA BAUTISTA INMA 25 210-2-43218430 20/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,427 210-11-03062669 POMA HINOSTROZA DE LEON AURORA 68 210-2-07081085 06/07/2011 150103A101 150101A101 0.00 0.00 40.00 0.00 40.00
2,428 210-11-03053832 POMA HUAMAN ELIZABETH 25 210-2-43304798 14/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,429 210-17-24315670 POMA MAYTA DHANNA ALEXANDRA 2 230-2-78751641 15/03/2017 150103A101 150105A101 0.00 0.00 15.81 0.00 15.81
2,430 210-17-24316517 POMA MAYTA DHANNA ALEXANDRA 2 230-2-78751641 16/03/2017 150103A101 150105A101 0.00 0.00 15.82 0.00 15.82
2,431 210-17-24317013 POMA MAYTA DHANNA ALEXANDRA 2 230-2-78751641 17/03/2017 150103A101 150105A101 0.00 0.00 15.35 0.00 15.35
2,432 210-12-00801701 POMA SAMANIEGO NANCY 31 210-2-41003981 10/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,433 210-16-22846147 POMA VILLANUEVA EDINSON JOHN 0 210-2-79678335 07/07/2016 150103A101 150105A101 0.00 0.00 14.16 0.00 14.16
2,434 210-13-01224023 POMA YAPIASH YESELINDA ROCIO 20 210-2-48086855 08/07/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,435 210-14-40063142 POMACHAGUA ANCIETA KITY LUZ 39 210-2-20893833 17/07/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
2,436 210-13-01265944 POMAHUACRE MENDEZ EVELYN MILAGROS 1 050-2-60152737 01/01/2014 150103A101 150133A101 0.00 0.00 70.00 0.00 70.00

Elaborado por OIE-SIS Página 87 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,437 210-17-24420791 POMAR BONELLI JUNIOR JESUS 23 210-2-48508523 30/08/2017 150103A101 150111A101 0.00 0.00 7.66 0.00 7.66
2,438 210-18-42498998 POMARINO BARRIENTOS LUIS DAVID BALTAZAR 13 210-2-72429803 18/02/2018 150103A101 150115A101 0.00 0.00 11.41 0.00 11.41
2,439 210-17-24466255 POMASONCCO MACOTE MATHIAS 9 210-2-71366327 01/11/2017 150103A101 150111A101 0.00 0.00 7.52 0.00 7.52
2,440 210-11-03732180 POMASONCCO QUISPE KATHERINE ROCIO 19 210-2-70091708 02/12/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
2,441 210-18-42531662 PONCE CHIPANA JOSE RODRIGO 9 210-2-62019387 01/04/2018 150103A101 150111A101 0.00 0.00 9.33 0.00 9.33
2,442 210-17-24466350 PONCE CORDOVA JESSIKA LEONOR 24 210-2-47835599 02/11/2017 150103A101 150111A101 0.00 0.00 11.75 0.00 11.75
2,443 210-11-03060632 PONCE FLORES DAIRA LETICIA 17 210-2-74216056 17/06/2011 150103A101 150132A203 0.00 0.00 0.00 0.00 0.00
2,444 210-13-01198340 PONCE HERRADA SHEYLA ROSMERY 16 210-2-76472447 20/03/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,445 210-12-03907239 PONCE PAUCAR GUISELA MILUSKA 22 210-2-45933738 17/03/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
2,446 210-17-24309610 PONCE PURIS YOVANA KELY 24 210-2-48056687 05/03/2017 150103A101 150101A101 0.00 0.00 11.97 0.00 11.97
2,447 210-17-24370368 PONGO GUTIERREZ GERONIMO 60 130-2-23688074 13/06/2017 150103A101 150111A101 0.00 0.00 17.39 0.00 17.39
2,448 210-17-24411985 PONGO LAZO JEAN CARLOS 23 170-2-71924950 17/08/2017 150103A101 150101A101 0.00 0.00 12.30 0.00 12.30
2,449 210-11-03055680 PONGO VELIZ LILI MARLENY 35 210-2-10249970 17/05/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,450 210-14-40067959 PONGO VELIZ RUTH MARILY 28 210-2-44540139 01/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,451 210-13-01248975 PORRAS BRAVO LUCILA 38 210-2-20060190 29/10/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,452 210-17-24438824 PORRAS ESPINOZA RN 0 210-E-28929959 25/09/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
2,453 210-17-24475744 PORRO NUÑEZ NATALY GRACIELA 34 210-2-41695972 14/11/2017 150103A101 150111A205 0.00 0.00 12.57 0.00 12.57
2,454 210-11-03731323 PORTAL GUTIERREZ LIDIA 29 210-2-41378828 20/11/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
2,455 210-12-00810519 POTOKAR ORIHUELA OLGA YANETH 40 210-2-09836535 02/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,456 210-13-01227662 POVES ESTEBAN MIGUEL ANGEL 32 170-2-40992985 28/07/2013 150103A101 150133A101 0.00 0.00 70.00 0.00 70.00
2,457 210-13-01252635 POZO HUAMAN JENNY DORIS 35 210-2-10606791 13/11/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
2,458 210-12-03899720 POZO RAMOS ELISA VIVIANA 30 210-2-41173244 21/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,459 210-14-40062844 PRADO BERROCAL SEYLA MILDRID 18 050-2-61677211 16/07/2014 150103A101 150137A206 0.00 0.00 8.25 0.00 8.25
2,460 210-12-01285461 PRADO CISNEROS ELIZABETH 24 210-2-45581200 11/12/2012 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
2,461 210-12-01282497 PRADO GONZALES ROSA LEONOR 21 210-2-47236215 20/10/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,462 210-13-01231120 PRADO MENDOZA DE GUTIERREZ MARINA 64 210-2-09063664 21/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,463 210-17-24302003 PRADO SOTO LIZ MARIVEL 26 210-2-46276999 22/02/2017 150103A101 150132A212 0.00 0.00 16.37 0.00 16.37
2,464 210-13-01228307 PRIETO TABORI DAVID ALEJANDRO 42 210-2-07755686 02/08/2013 150103A101 150137A101 0.00 0.00 30.80 0.00 30.80

Elaborado por OIE-SIS Página 88 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,465 210-13-01229470 PRINCIPE MIRANDA KATHERINE LESLIE 19 210-2-48170248 14/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,466 210-17-24271163 PRUDENCIO MORA SANTA 47 210-2-04212274 01/01/2017 150103A101 150118A101 0.00 0.00 23.72 0.00 23.72
2,467 210-11-03730689 PRUDENCIO SANTOS TEOFILA 65 170-6-10213311 07/12/2011 150103A101 150118A101 0.00 0.00 45.00 0.00 45.00
2,468 210-17-24485049 PUCHOC PILLPE MILAGROS 13 210-2-76320747 28/11/2017 150103A101 0000023159 0.00 0.00 25.14 0.00 25.14
2,469 210-17-24311206 PUCHOC PUCHOC ESTEBAN ELIAS 1 210-2-79330915 07/03/2017 150103A101 150118A101 0.00 0.00 25.31 0.00 25.31
2,470 210-13-01209354 PUERTA CAMAN ORBILDA 18 210-2-75425060 08/05/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,471 210-12-00811349 PUJALLA MORALES LILIANA ANABEL 17 210-2-71537610 19/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,472 210-18-42565104 PULGAR RAMIREZ RN-HV 0 210-E-29139912 12/05/2018 150103A101 150105A101 0.00 0.00 10.41 0.00 10.41
2,473 210-12-03903570 PULIDO VARGAS DENY GIANINA 32 210-2-48408526 13/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,474 210-11-03047111 PULLCHS VALDIVIA NN 0 210-7-42085530 31/03/2011 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
2,475 210-11-03613578 PULLO CONDORI IVONNE DE LOS ANGELES 22 210-2-45719643 22/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,476 210-12-00800521 PUMA APAZA SABINO 63 210-2-06566842 12/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,477 210-11-03052518 PUMA BARRIONUEVO SARA 14 210-2-73284628 23/05/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,478 210-12-03899161 PUMA USCA BELEN 30 210-2-40937058 16/01/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
2,479 210-12-00190798 PUMASUPA SANTACRUZ FLORA 36 210-2-24388669 31/05/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,480 210-12-00189982 PURIS CUSI GIOVANA CARLA 18 210-2-70289422 21/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,481 210-11-03729947 PURIS RAZA DAYAN ANSHERLY 19 210-2-70993011 23/11/2011 150103A101 150111A101 0.00 0.00 45.00 0.00 45.00
2,482 210-13-01225613 PURIZACA YARLEQUE SHIRLEY DANISSA 19 210-2-48179629 13/07/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
2,483 210-18-42481248 PUSE PASACHE RUTH MEDALID 21 190-2-76784452 29/01/2018 150103A101 150111A205 0.00 0.00 10.55 0.00 10.55
2,484 210-11-03729557 QUEREVALU RETO JUAN FERNANDO 1 310-6-00458389 17/11/2011 150103A101 150101A101 0.00 0.00 40.00 0.00 40.00
2,485 210-13-01212262 QUESUS SANCHEZ CRISTINA ZALONIKA 2 210-2-76710324 20/05/2013 150103A101 150103A208 0.00 0.00 30.80 0.00 30.80
2,486 210-18-42471697 QUEVEDO DE LA CRUZ GIANELA ALEZANDRA 2 210-2-81653671 15/01/2018 150103A101 150111A101 0.00 0.00 11.05 0.00 11.05
2,487 210-12-00191734 QUEVEDO IÑIGO HERMELINDA 22 210-2-45951707 07/06/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
2,488 210-11-00191734 QUEVEDO IÑIGO HERMELINDA 22 210-2-45951707 07/06/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
2,489 210-11-03613810 QUEVEDO QUISPE CLOTILDE 31 210-2-40577849 01/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,490 210-18-42510579 QUICAÑO QUISPE JOSUÉ MOISES 0 210-2-90334437 03/03/2018 150103A101 150105A101 0.00 0.00 18.38 0.00 18.38
2,491 210-18-42523623 QUICAÑO QUISPE JOSUÉ MOISES 0 210-2-90334437 21/03/2018 150103A101 150105A101 0.00 0.00 18.38 0.00 18.38
2,492 210-13-01214150 QUICHCA FERNANDEZ ZENAIDA 18 210-2-70789536 28/05/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80

Elaborado por OIE-SIS Página 89 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,493 210-12-03904053 QUICHCA ZAMORA NATIVIDAD 19 210-2-47058542 20/02/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,494 210-17-24398505 QUIJADA PEÑALOSA MERCEDES 43 210-2-09844553 27/07/2017 150103A101 150101A102 0.00 0.00 17.80 0.00 17.80
2,495 210-12-00196194 QUIKE SULCA MARI CRUZ 18 210-2-48290994 13/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,496 210-17-24411844 QUILCA CHUCO BERNARDO 70 200-2-23672602 16/08/2017 150103A101 150111A101 0.00 0.00 7.34 0.00 7.34
2,497 210-13-01250589 QUILLATUPA ÑAUPARI KATTY MARIA 20 210-2-48286032 05/11/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,498 210-12-01282674 QUILLE JARA JUANA EVANGELINA 36 040-2-80322088 28/09/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
2,499 210-18-42517480 QUINCHO RIVERA PABLO 74 210-2-21085748 11/03/2018 150103A101 150111A101 0.00 0.00 9.94 0.00 9.94
2,500 210-18-42541997 QUINTANA GONZALES ELEODORO 71 200-2-09969903 13/04/2018 150103A101 150111A101 0.00 0.00 10.31 0.00 10.31
2,501 210-13-01225568 QUINTANILLA MEDINA CANDELARIA 82 200-2-07954499 13/07/2013 150103A101 150121A101 0.00 0.00 140.00 0.00 140.00
2,502 210-17-24350639 QUINTO MENDOZA LUIS ENRIQUE 38 210-2-80284002 12/05/2017 150103A101 150111A101 0.00 0.00 9.02 0.00 9.02
2,503 210-17-24388397 QUINTO OSORIO JULIANA MARIA 25 210-2-47383600 11/07/2017 150103A101 150111A101 0.00 0.00 14.24 0.00 14.24
2,504 210-17-24343066 QUINTO VILLANO ROSANA 31 210-2-47408432 30/04/2017 150103A101 150111A101 0.00 0.00 8.59 0.00 8.59
2,505 210-14-40059147 QUIQUIA CAPCHA JHONMY JHADI 4 210-2-62394216 03/07/2014 150103A101 150101A101 0.00 0.00 19.25 0.00 19.25
2,506 210-13-01239083 QUIROZ CERNA CHARO MIRIAN 19 210-2-72456513 22/09/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,507 210-17-24423618 QUISIYUPANQUI PANTIGOZO ROSARIO 34 210-2-41751500 02/09/2017 150103A101 150137A206 0.00 0.00 6.00 0.00 6.00
2,508 210-12-00188355 QUISPE AGUIRRE LIDIA 34 210-2-10603554 26/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,509 210-12-01285456 QUISPE ANCHELIA AMANDA 24 210-2-46335242 11/12/2012 150103A101 150103A208 0.00 0.00 30.80 0.00 30.80
2,510 210-14-40065498 QUISPE ANGULO JANNET 31 210-2-41525862 24/07/2014 150103A101 150137A206 0.00 0.00 8.25 0.00 8.25
2,511 210-11-03056134 QUISPE ANTONIO JACQUELINE MARLENE 18 210-2-47691373 08/05/2011 150103A101 150107A204 0.00 0.00 0.00 0.00 0.00
2,512 210-13-01209434 QUISPE ANYOSA DELFINA 16 210-2-71410347 08/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,513 210-12-03898868 QUISPE ARANGO ANA MARIA 28 210-2-41953993 14/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,514 210-12-00192092 QUISPE ARQUE ANGELA 28 210-2-43144791 12/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,515 210-12-00798113 QUISPE BALDEON JESSICA 19 210-2-70241360 02/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,516 210-17-24333868 QUISPE CABRERA NEREIDA DANIELA 8 210-2-61406600 14/04/2017 150103A101 150118A101 0.00 0.00 24.85 0.00 24.85
2,517 210-11-03048943 QUISPE CACERES ALICIA 39 210-2-24983410 24/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,518 210-17-24322163 QUISPE CAHUANA LUIZ DAVID 2 210-2-78913910 27/03/2017 150103A101 150105A101 0.00 0.00 15.36 0.00 15.36
2,519 210-17-24392533 QUISPE CAHUANA MARITHZA YENE 33 210-2-42637983 18/07/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
2,520 210-17-24439235 QUISPE CAMARGO THIAGO GIANLUCAS 5 210-2-80978092 25/09/2017 150103A101 150115A101 0.00 0.00 11.11 0.00 11.11

Elaborado por OIE-SIS Página 90 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,521 210-11-03048225 QUISPE CANCHAYA CYNTIA VANESSA 21 210-2-46146305 07/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,522 210-11-03055751 QUISPE CCAHUANTICO NN 0 210-7-24003469 14/05/2011 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
2,523 210-17-24296378 QUISPE CHAHUA BEATRIZ VILMA 42 210-2-40971511 11/02/2017 150103A101 150111A101 0.00 0.00 6.04 0.00 6.04
2,524 210-17-24334333 QUISPE CHUQUIVILCA MAYRA NASHA EDUVIGUES 11 210-2-76847505 15/04/2017 150103A101 150133A101 0.00 0.00 21.69 0.00 21.69
2,525 210-18-42579469 QUISPE CONDOR JUDITH OLINDA 32 210-2-44069616 29/05/2018 150103A101 150111A101 0.00 0.00 9.35 0.00 9.35
2,526 210-18-42568403 QUISPE CONISLLA NINFA GLORIA 37 130-2-40920282 16/05/2018 150103A101 150101A105 0.00 0.00 8.96 0.00 8.96
2,527 210-11-03734263 QUISPE CORNEJO GLADYS 32 210-2-45288493 31/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,528 210-17-24442922 QUISPE CRISPIN MARIELA HELEN 18 210-2-74397021 01/10/2017 150103A101 150101A105 0.00 0.00 12.33 0.00 12.33
2,529 210-18-42488068 QUISPE CRISTOBAL RENY MARIZA 22 210-2-76363473 03/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
2,530 210-12-00187632 QUISPE CRUZ ROSALIA 38 210-2-10050838 21/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,531 210-13-01218249 QUISPE DE PALOMINO JUANA 68 210-2-06811227 14/06/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
2,532 210-12-03904136 QUISPE DIONICIO MAYKER 2 210-2-61850573 22/02/2012 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
2,533 210-11-03057093 QUISPE DURAND DENNIS PAOLA 18 210-2-72472460 27/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,534 210-13-00279848 QUISPE EGOAVIL ANGIELYNA GLORIA 4 210-2-60675212 19/01/2013 150103A101 150121A101 0.00 0.00 140.00 0.00 140.00
2,535 210-16-22903518 QUISPE FERNANDEZ RN 0 210-E-27809030 07/10/2016 150103A101 150101A101 0.00 0.00 11.24 0.00 11.24
2,536 210-13-01202109 QUISPE FLORES FLORENTINA 29 210-2-42689052 07/04/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
2,537 210-17-24480117 QUISPE FLORES MARIA 31 210-2-43569525 20/11/2017 150103A101 150111A205 0.00 0.00 9.63 0.00 9.63
2,538 210-14-40072656 QUISPE GARCIA DIONICIA 28 210-2-43483249 14/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,539 210-12-03897988 QUISPE GARCIA YANITH 21 210-2-46449637 09/01/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,540 210-11-03731035 QUISPE GUERRA ISABEL 24 210-2-44056487 10/12/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
2,541 210-17-24435673 QUISPE GUTIERREZ CHRISTIAM ANGELO 30 210-2-44215653 19/09/2017 150103A101 0000023159 0.00 0.00 27.77 0.00 27.77
2,542 210-17-24440410 QUISPE GUTIERREZ CHRISTIAM ANGELO 30 210-2-44215653 27/09/2017 150103A101 150111A101 0.00 0.00 7.11 0.00 7.11
2,543 210-12-01294684 QUISPE HERRERA LUZMERY YENY 24 210-2-44792771 23/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,544 210-11-03048479 QUISPE HINOSTROZA CARLOS 40 210-2-23706008 03/04/2011 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
2,545 210-11-03729045 QUISPE HUAMAN YANET SOLITA 31 210-2-40601209 09/11/2011 150103A101 150101A109 0.00 0.00 45.00 0.00 45.00
2,546 210-17-24321317 QUISPE HUAMAN YANINA 19 110-2-71026561 26/03/2017 150103A101 150111A101 0.00 0.00 10.62 0.00 10.62
2,547 210-14-40020227 QUISPE HUAYHUARIMA NN 0 210-7-48002618 07/03/2014 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
2,548 210-16-22919644 QUISPE HUAYPAR JUVENAL MARTIN 54 230-2-07913181 04/11/2016 150103A101 150111A101 0.00 0.00 7.72 0.00 7.72

Elaborado por OIE-SIS Página 91 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,549 210-13-01200683 QUISPE JIMENEZ RUTH MARICIELO 1 210-2-77008533 01/04/2013 150103A101 150103A208 0.00 0.00 30.80 0.00 30.80
2,550 210-14-40074078 QUISPE LAUCATA YANET ROSAURA 30 210-2-42669487 18/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,551 210-11-03731211 QUISPE LEZAMETA ANA VILMA 31 210-2-40762486 17/11/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
2,552 210-12-00801908 QUISPE LLANOS SONIA CATALINA 39 210-2-25809180 13/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,553 210-11-03613860 QUISPE LLANOS YOLANDA ESTELA 33 210-2-40189072 01/09/2011 150103A101 150132A205 0.00 0.00 40.00 0.00 40.00
2,554 210-13-01247732 QUISPE LOAYZA HONORATO 63 210-2-29098646 25/10/2013 150103A101 150122A101 0.00 0.00 140.00 0.00 140.00
2,555 210-12-00191639 QUISPE MACAZANA MARILYN JESSENIA 20 210-2-47589043 08/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,556 210-18-42559675 QUISPE MANAHUACO AIXA LUANA 0 250-2-90668994 05/05/2018 150103A101 150105A101 0.00 0.00 18.28 0.00 18.28
2,557 210-12-00186296 QUISPE MENDOZA MARY LUZ 23 210-2-45478446 13/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,558 210-18-42482559 QUISPE MENDOZA MARY LUZ 29 210-2-45478446 29/01/2018 150103A101 150111A205 0.00 0.00 10.55 0.00 10.55
2,559 210-11-03604779 QUISPE MENESES LUCIA 22 210-2-45789584 09/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,560 210-11-03062845 QUISPE MEZAHUAMAN MARCELINA ELSA 24 130-2-44795921 09/07/2011 150103A101 150101A101 0.00 0.00 40.00 0.00 40.00
2,561 210-13-00289974 QUISPE MONTES YULI HILDA 34 210-2-44466170 24/02/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,562 210-14-40065508 QUISPE MOZO CINTHIA DENISSE 18 210-2-70262789 24/07/2014 150103A101 150135A101 0.00 0.00 22.55 0.00 22.55
2,563 210-11-03058494 QUISPE NALVARTE CRISTINA 31 210-2-80281775 29/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,564 210-11-03733481 QUISPE OLIVARES ALICIA 30 210-2-41006743 18/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,565 210-11-03056684 QUISPE ORELLANA KEVIN JOJALI 9 170-6-00148356 29/04/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
2,566 210-18-42467497 QUISPE ORIHUELA GLADYS NELLY 35 210-2-41224127 10/01/2018 150103A101 150111A205 0.00 0.00 12.52 0.00 12.52
2,567 210-11-03056429 QUISPE ORTIZ NN 0 210-7-42419767 05/05/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,568 210-17-24384991 QUISPE PALOMINO RUTH JULIANA 13 080-2-75346145 06/07/2017 150103A101 150121A101 0.00 0.00 16.94 0.00 16.94
2,569 210-12-00801039 QUISPE PAQUIYAURI FIORELA 24 210-2-44813625 19/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,570 210-11-03061871 QUISPE PARI YENI 23 210-2-45216598 02/07/2011 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
2,571 210-13-01219142 QUISPE PARIONA KATHERIN ROSMERY 1 210-2-77455784 17/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,572 210-12-00195152 QUISPE PEREZ RN 0 210-7-44471303 24/04/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,573 210-11-03606386 QUISPE PILLPA JULIA SABINA 61 210-2-09504043 16/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,574 210-12-00192161 QUISPE PRADO BEATRIZ 23 210-2-45340820 20/05/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,575 210-17-24437893 QUISPE PURIHUAMAN ROSA MARGARITA 27 210-2-46217386 23/09/2017 150103A101 150111A101 0.00 0.00 10.66 0.00 10.66
2,576 210-14-40068940 QUISPE QUILCA MARLENI 15 050-2-74081211 04/08/2014 150103A101 150137A101 0.00 0.00 2.75 0.00 2.75

Elaborado por OIE-SIS Página 92 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,577 210-13-01240293 QUISPE QUIQUIA AUGUSTO ROLANDO ADRIAN 10 210-2-70941138 26/09/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
2,578 210-16-22911573 QUISPE QUIQUIA FRANCO VALENTINO 5 210-2-77256634 22/10/2016 150103A101 150121A101 0.00 0.00 15.89 0.00 15.89
2,579 210-14-40120937 QUISPE QUIROZ ZAMIRA GIULIANA ELIZABET 5 210-2-77901223 01/12/2014 150103A101 150115A101 0.00 0.00 14.30 0.00 14.30
2,580 210-18-42487990 QUISPE QUISPE ALBINA 22 210-2-77094881 04/02/2018 150103A101 150111A205 0.00 0.00 10.55 0.00 10.55
2,581 210-12-03904668 QUISPE QUISPE VICKY LUCY 32 210-2-40252542 30/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,582 210-18-42480534 QUISPE RIVA ELIZABETH 21 130-2-71377954 27/01/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
2,583 210-14-40053943 QUISPE RIVA LIDIA 24 210-2-45922579 21/06/2014 150103A101 150132A203 0.00 0.00 16.50 0.00 16.50
2,584 210-14-40033160 QUISPE ROJAS FELICIANO 65 210-2-23690220 15/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,585 210-11-03611785 QUISPE ROMERO MARIBEL 18 210-2-47872392 06/10/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00
2,586 210-11-03735112 QUISPE ROMERO NORMA ILUMINADA 23 210-2-45449499 20/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,587 210-11-03055878 QUISPE SAENZ IRMA MERY 18 210-2-47853366 14/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,588 210-12-03901434 QUISPE SALVADOR JANET JESSICA 33 210-2-80651908 29/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,589 210-16-22938165 QUISPE SANCHEZ ANYELO LISSANDRO 7 050-2-61911487 05/12/2016 150103A101 150111A101 0.00 0.00 7.72 0.00 7.72
2,590 210-17-24414635 QUISPE SANCHEZ GENESIS AKORY 7 210-2-61931104 21/08/2017 150103A101 150111A101 0.00 0.00 9.71 0.00 9.71
2,591 210-18-42486160 QUISPE SHANKI GUISELA 21 210-2-61558427 01/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
2,592 210-12-00187071 QUISPE SULLUCHUCO YUDITH 19 210-2-48092037 14/06/2012 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
2,593 210-11-03058741 QUISPE TAIPE JUANA 36 210-2-23564645 11/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,594 210-11-03610847 QUISPE TAIPE JUANA 37 210-2-23564645 14/10/2011 150103A101 150111A205 0.00 0.00 25.00 0.00 25.00
2,595 210-12-00186885 QUISPE TECSI NANCY 19 210-2-47784153 18/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,596 210-14-40103135 QUISPE TICSE CLARISA JASMIN 14 210-2-70066731 30/10/2014 150103A101 150121A101 0.00 0.00 27.98 0.00 27.98
2,597 210-18-42515690 QUISPE TRUJILLO YOSEF JAMES 4 210-2-78121523 09/03/2018 150103A101 150111A101 0.00 0.00 9.94 0.00 9.94
2,598 210-11-03610567 QUISPE TUPIA FLOR LILIANA 38 210-2-20563259 12/10/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00
2,599 210-11-03057172 QUISPE VARGAS NN 0 210-7-42477200 12/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,600 210-14-40031608 QUISPE YUCRA RINA YZABEL 40 210-2-01541412 09/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,601 210-13-01199767 QUISPE YUPA JULIA 23 210-2-46968731 27/03/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,602 210-11-03615025 QUISPE ZAPANA JULIAN 71 210-2-06045014 02/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,603 210-11-03730886 QUIÑA GODOY FRANKLIN RENY 9 210-2-75603135 09/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,604 210-12-00195559 QUIÑA LAZARO HECTOR 19 130-2-47143241 02/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 93 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,605 210-13-01226510 QUIÑONES ALBERCO CARMEN LUISA 26 210-2-44354295 19/07/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
2,606 210-13-01239044 QUIÑONES VILLANUEVA BRIYITH THALIA 18 210-2-77353811 22/09/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
2,607 210-17-24353116 QUIÑONEZ ORTEGA YADIRA LUCERO 2 210-2-79757196 16/05/2017 150103A101 150105A101 0.00 0.00 17.52 0.00 17.52
2,608 210-11-03053129 RAFAEL LEON ESMERALDA LISBETH 1 210-2-74111847 01/06/2011 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
2,609 210-11-03611792 RAIMUNDEZ LAURA MARILUZ 19 210-2-47499653 06/10/2011 150103A101 150101A105 0.00 40.00 0.00 0.00 40.00
2,610 210-12-00189263 RAJO BERROSPI MILANDA VICTORIA 19 210-2-48379044 25/05/2012 150103A101 150107A204 0.00 0.00 0.00 0.00 0.00
2,611 210-16-22883091 RAJO MARTINEZ SANDRA ADITA 18 270-2-70220450 06/09/2016 150103A101 150111A101 0.00 0.00 8.93 0.00 8.93
2,612 210-17-24354956 RAMIRES MAYTAHUARI RN 0 340-E-28745668 20/05/2017 150103A101 150105A101 0.00 0.00 23.19 0.00 23.19
2,613 210-17-24394658 RAMIREZ ANDY RUTH PAMELA 24 240-2-71255677 20/07/2017 150103A101 150101A105 0.00 0.00 10.36 0.00 10.36
2,614 210-17-24409429 RAMIREZ AQUINO VICTOR 41 210-2-20903588 14/08/2017 150103A101 150111A101 0.00 0.00 9.28 0.00 9.28
2,615 210-14-40075128 RAMIREZ CABANILLAS JANET 36 210-2-46600108 20/08/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
2,616 210-13-01213368 RAMIREZ CONDEZO ELENA 29 210-2-42664702 25/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,617 210-13-01224153 RAMIREZ CONDORI CANDY THALIA 17 210-2-74597270 08/07/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
2,618 210-11-03607494 RAMIREZ CONDORI CANDY THALIA 15 210-2-74597270 06/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,619 210-13-01211988 RAMIREZ DELGADO SAIRA MILENA 0 210-2-77788485 20/05/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
2,620 210-17-24332779 RAMIREZ DIAZ SOFIA DANIELA 0 210-2-90128489 11/04/2017 150103A101 150111A101 0.00 0.00 8.57 0.00 8.57
2,621 210-17-24331371 RAMIREZ GASTELU AMY SOPHIA 0 210-2-79895833 10/04/2017 150103A101 150101A109 0.00 0.00 15.82 0.00 15.82
2,622 210-11-03050716 RAMIREZ JIHUALLANCA VERONICA 30 210-2-40613243 22/05/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,623 210-13-00285395 RAMIREZ LAYME MIRIAM MIRELLA 23 210-2-46274647 04/02/2013 150103A101 150110A101 0.00 0.00 140.00 0.00 140.00
2,624 210-11-03609960 RAMIREZ LLAMOCA CARMEN ASTRID 36 210-2-10230926 01/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,625 210-11-03052089 RAMIREZ NINA JACKELINE DEL PILAR 23 210-2-46156168 11/06/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,626 210-17-24503454 RAMIREZ QUIÑONES BRIGITTE KIMBERLEY 22 210-2-77088838 23/12/2017 150103A101 150111A101 0.00 0.00 9.40 0.00 9.40
2,627 210-12-00192162 RAMIREZ SAMAME EMERITA 25 210-2-44327178 20/05/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,628 210-11-03062470 RAMIREZ TANTA CHRIS LORENA 28 210-2-42393625 23/06/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,629 210-14-40066143 RAMOS ALBORNOZ KARINA SISARA 22 210-2-47819808 27/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,630 210-13-00287538 RAMOS ALVINO YANETH NORMA 27 210-2-46547742 13/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,631 210-14-40055770 RAMOS ASTETE RUT 16 210-2-73740678 26/06/2014 150103A101 150101A105 0.00 0.00 20.90 0.00 20.90
2,632 210-18-42471739 RAMOS BARRETON ELIZABETH 21 210-2-78198223 15/01/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71

Elaborado por OIE-SIS Página 94 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,633 210-11-03733886 RAMOS CAPARACHIN SUSANA MARGARET 21 210-2-47944025 25/12/2011 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
2,634 210-13-01218538 RAMOS CASTRO MARIA VICTORIA 26 210-2-44541274 15/06/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,635 210-17-24437838 RAMOS CAYAMPI SONICA 28 210-2-45749109 22/09/2017 150103A101 150111A205 0.00 0.00 11.33 0.00 11.33
2,636 210-14-40117623 RAMOS CHAVEZ DANA SHANDEL 1 210-2-78327820 25/11/2014 150103A101 150115A101 0.00 0.00 14.85 0.00 14.85
2,637 210-12-00191648 RAMOS CHAVEZ FELICITA 24 210-2-70301110 07/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,638 210-11-03060450 RAMOS FALCON ESTHER FELICITA 49 210-2-09621431 19/06/2011 150103A101 150141A101 0.00 0.00 0.00 0.00 0.00
2,639 210-12-00805320 RAMOS GONZALES KARIN JAMILET 25 210-2-43828948 26/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,640 210-17-24477694 RAMOS HUARINGA FLOR MARIA 24 210-2-47975961 17/11/2017 150103A101 150101A109 0.00 0.00 19.27 0.00 19.27
2,641 210-13-01228930 RAMOS HUAYTA RISHELL GAELA 0 210-2-78092847 10/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,642 210-16-22924013 RAMOS JUSTO ANTONHY MAURICIO 6 210-2-74116694 11/11/2016 150103A101 150111A101 0.00 0.00 10.04 0.00 10.04
2,643 210-16-22831971 RAMOS LAZARO CONSTANTINA 41 210-2-22517252 11/06/2016 150103A101 150111A101 0.00 0.00 10.45 0.00 10.45
2,644 210-17-24478075 RAMOS LIMAYMANTA DEREK BENJAMIN 2 210-2-79085474 17/11/2017 150103A101 150115A101 0.00 0.00 12.22 0.00 12.22
2,645 210-11-03055670 RAMOS LLANO JESSICA REBECA 20 210-2-47702601 16/05/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,646 210-11-03728145 RAMOS MAURICIO JOSELYN BRIGET 18 210-2-48002696 05/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,647 210-13-01208593 RAMOS MINAYA JENNIFER ANGY 0 210-2-77937817 05/05/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
2,648 210-14-40034519 RAMOS NOA VICTORIA 74 210-2-31158062 20/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,649 210-17-24481099 RAMOS PACHECO AMY KHALEESI 1 210-2-79938907 16/11/2017 150103A101 0000016918 0.00 0.00 12.92 0.00 12.92
2,650 210-17-24483114 RAMOS PACHECO AMY KHALEESI 1 210-2-79938907 25/11/2017 150103A101 150105A101 0.00 0.00 16.09 0.00 16.09
2,651 210-16-22914253 RAMOS PACHECO RN 0 210-E-27822852 27/10/2016 150103A101 150105A101 0.00 0.00 14.34 0.00 14.34
2,652 210-13-01211088 RAMOS QUISPE DIANE SHEILA 21 210-2-47585133 15/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,653 210-11-03607946 RAMOS QUISPE MILKA CINTHIA 20 210-2-47263947 08/09/2011 150103A101 150101A101 0.00 0.00 40.00 0.00 40.00
2,654 210-18-42507699 RAMOS RIVEROS MONICA 32 210-2-46095880 28/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
2,655 210-14-40060603 RAMOS RUIZ VICTORIA 32 210-2-41330770 10/07/2014 150103A101 150128A204 0.00 0.00 18.70 0.00 18.70
2,656 210-14-40066177 RAMOS SANCHEZ JHONEEL FERNANDO 9 210-2-74174992 28/07/2014 150103A101 150105A101 0.00 0.00 23.10 0.00 23.10
2,657 210-11-03063082 RAMOS SANCHEZ ZARAGOSA NORMA 23 210-2-45224145 10/07/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
2,658 210-13-01252948 RAMOS SANDOVAL ANGELLO RAUL 12 210-2-75603133 13/11/2013 150103A101 150101A109 0.00 0.00 53.20 0.00 53.20
2,659 210-12-00191828 RAMOS SANTIVAÑEZ GISELA EDITH 22 210-2-46514672 04/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,660 210-18-42571153 RAMOS TICSIHUA OSCAR JAIME 51 210-2-20003749 20/05/2018 150103A101 150137A101 0.00 0.00 5.14 0.00 5.14

Elaborado por OIE-SIS Página 95 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,661 210-17-24430665 RAMOS TUPAC ANGEL SABINO 43 210-2-10051271 12/09/2017 150103A101 150141A101 0.00 0.00 13.11 0.00 13.11
2,662 210-12-03901600 RAMOS VILLANO YOBANA 22 210-2-46589488 04/02/2012 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
2,663 210-17-24302783 RAMOS VILLAVICENCIO ANDRE GAEL 0 210-2-79890374 25/02/2017 150103A101 150105A101 0.00 0.00 16.37 0.00 16.37
2,664 210-17-24307199 RAMOS VILLAVICENCIO ANDRE GAEL 0 210-2-79890374 02/03/2017 150103A101 150115A101 0.00 0.00 12.54 0.00 12.54
2,665 210-12-03900624 RAVINES RAMOS ROSA ELVIRA 18 210-2-73936097 25/01/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
2,666 210-17-24465747 RAYA TACO DORIS 30 210-2-44264696 31/10/2017 150103A101 150101A105 0.00 0.00 16.80 0.00 16.80
2,667 210-12-03899522 RAYMUNDO ASTETE NN 0 210-7-42515813 17/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,668 210-14-40055432 RAYMUNDO BELITO JUAN CELESTINO 43 210-2-80281846 25/06/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,669 210-14-40056089 RAYMUNDO BELITO JUAN CELESTINO 43 210-2-80281846 28/06/2014 150103A101 150101A103 0.00 0.00 27.56 0.00 27.56
2,670 210-11-03732496 RAZA PAITA SHEYLA RUTH 3 170-2-60705151 08/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,671 210-18-42557642 RAZA PEREZ GRACIELA NAYELY 16 230-2-74181279 02/05/2018 150103A101 150111A101 0.00 0.00 9.08 0.00 9.08
2,672 210-18-42578320 RAZA PEREZ GRACIELA NAYELY 16 230-2-74181279 28/05/2018 150103A101 150101A101 0.00 0.00 11.73 0.00 11.73
2,673 210-12-03903585 REATEGUI MUÑOZ DORIS 33 210-2-80233346 13/02/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,674 210-18-42514737 REBELO QUISPE RN-HV 0 210-E-29074049 08/03/2018 150103A101 070102A101 0.00 0.00 27.32 0.00 27.32
2,675 210-18-42565034 REBOLLEDO MORENO MAIA KATALEYA 0 210-2-90314600 12/05/2018 150103A101 150105A101 0.00 0.00 17.92 0.00 17.92
2,676 210-18-42565425 REBOLLEDO MORENO MAIA KATALEYA 0 210-2-90314600 12/05/2018 150103A101 150105A101 0.00 0.00 19.76 0.00 19.76
2,677 210-11-03731985 REGALADO MENDEZ MARGARITA ROSA 37 210-2-09848606 30/11/2011 150103A101 150111A205 0.00 0.00 25.00 0.00 25.00
2,678 210-12-00193376 REIMUNDES QUISPE MARIA TERESA 5 210-2-60988071 05/05/2012 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
2,679 210-12-00195700 REIMUNDES QUISPE MARIA TERESA 5 210-2-60988071 03/05/2012 150103A101 150135A101 0.00 0.00 0.00 0.00 0.00
2,680 210-18-42465331 REJAS BERMEJO ROBERTO ARISTIDES 63 210-2-06583290 06/01/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
2,681 210-17-24401537 RELAYZA SERRATE JACOBA 78 210-2-17430944 02/08/2017 150103A101 150111A101 0.00 0.00 7.66 0.00 7.66
2,682 210-17-24436497 RELAYZA SERRATE JACOBA 78 210-2-17430944 21/09/2017 150103A101 150111A101 0.00 0.00 9.55 0.00 9.55
2,683 210-13-01211703 REMIGIO CORTEZ AMPARO NOEMI 26 210-2-44053349 18/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,684 210-13-01239576 REMON OCHOA YUDI ROXANA 30 210-2-42146795 24/09/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
2,685 210-18-42520253 REMUZGO ENRIQUEZ RN 0 036-E-29082641 16/03/2018 150103A101 150111A101 0.00 0.00 9.44 0.00 9.44
2,686 210-14-40054301 REMUZGO TANGE JADEN ALEXANDER 3 210-2-75043867 22/06/2014 150103A101 150115A101 0.00 0.00 20.90 0.00 20.90
2,687 210-18-42545496 RENGIFO AMASIFUEN DANIEL 37 230-2-48672563 17/04/2018 150103A101 150115A101 0.00 0.00 14.24 0.00 14.24
2,688 210-12-03902950 RENGIFO MEZA KARINA 28 210-2-46408554 11/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 96 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,689 210-12-00190363 REQUEJO PEREZ CELINDA 30 210-2-45650281 30/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,690 210-13-01245245 REQUENA RUIZ SANTOS BACILIO 47 210-2-10175306 17/10/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
2,691 210-17-24408287 REYES CORONEL BRENDA KALESSY 1 210-2-79628469 11/08/2017 150103A101 150105A101 0.00 0.00 17.80 0.00 17.80
2,692 210-16-22939398 REYES DE LA CRUZ RUTH ANGELICA 3 210-E-28637558 07/12/2016 150103A101 150111A101 0.00 0.00 13.90 0.00 13.90
2,693 210-17-24286646 REYES HUARACA KRISTSEL LIILAN 3 220-2-63710802 28/01/2017 150103A101 150105A101 0.00 0.00 15.09 0.00 15.09
2,694 210-17-24287101 REYES HUARACA KRISTSEL LIILAN 3 220-2-63710802 30/01/2017 150103A101 150105A101 0.00 0.00 17.25 0.00 17.25
2,695 210-17-24405198 REYES INCA JOSÉ ELIAS 0 210-2-90042032 07/08/2017 150103A101 150111A101 0.00 0.00 9.28 0.00 9.28
2,696 210-17-24489563 REYES QUISPE ANDREA XIOMARA 5 210-2-77549890 03/12/2017 150103A101 150105A101 0.00 0.00 16.92 0.00 16.92
2,697 210-11-03055343 REYES RIVERA GRACE GERALDINE 17 210-2-47961832 30/04/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,698 210-11-03726895 REYES TUDELANO ERLINDA 20 210-2-48238467 09/11/2011 150103A101 070103A101 0.00 0.00 45.00 0.00 45.00
2,699 210-12-00193368 REYES TUDELANO YOLANDA 31 210-2-40746775 04/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,700 210-17-24397661 REYES ZAVALA AYDE MARILUZ 26 210-2-47692198 26/07/2017 150103A101 150111A101 0.00 0.00 9.28 0.00 9.28
2,701 210-11-03057445 REYNA CHAVEZ REILLY EDSON 19 210-2-46779887 14/07/2011 150103A101 150122A101 0.00 0.00 50.00 0.00 50.00
2,702 210-13-00278286 REYNA DAVILA HEYDI JUDITH 15 210-2-75431405 21/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,703 210-18-42545391 REYNOSO BRICEÑO NATALI LISBETH 22 220-2-76406327 17/04/2018 150103A101 150101A102 0.00 0.00 21.60 0.00 21.60
2,704 210-11-03062988 RICALDE GALLARDO ZAIDA KETY 19 210-2-46723370 10/07/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
2,705 210-13-01216481 RICALDI BARRIGA DIANA 18 210-2-48617581 07/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,706 210-11-03048244 RICALDI CARHUAS EMPERATRIZ CLARA 19 210-2-47295660 08/04/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,707 210-13-01198779 RICARDO CAMACHO EDITH NIDIA 20 210-2-71831197 22/03/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
2,708 210-14-40063017 RICOPA MELENDEZ RUBI LICEÑA 27 210-2-44068182 17/07/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
2,709 210-17-24303071 RICRA CASAFRANCA SHEYLA ANDREA 6 050-2-62622810 25/02/2017 150103A101 150111A101 0.00 0.00 8.64 0.00 8.64
2,710 210-12-00803773 RICRA NOLBERTO VIVIANA 20 210-2-47632741 12/09/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,711 210-12-03898977 RICSE PINAUD EIJY EDINIO 9 210-2-73602502 15/01/2012 150103A101 150137A101 0.00 0.00 0.00 0.00 0.00
2,712 210-14-40055037 RIMACHI CASAS MARIA LUZ 40 210-2-09847242 24/06/2014 150103A101 150101A102 0.00 0.00 21.45 0.00 21.45
2,713 210-14-40021069 RIMACHI CASTRO LURDES 28 210-2-43287935 10/03/2014 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,714 210-17-24433267 RIMACHI GUTIERREZ SILVIA 25 210-2-48240148 15/09/2017 150103A101 150137A206 0.00 0.00 6.00 0.00 6.00
2,715 210-18-42474797 RIMARACHIN BURGA SHEYLLA LIZ DEL MILAGRO 25 200-2-47586810 18/01/2018 150103A101 150111A205 0.00 0.00 13.13 0.00 13.13
2,716 210-12-03898650 RIMARI YURIVILCA MARIA NOEMI 18 210-2-48087234 12/01/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 97 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,717 210-14-40015643 RIMAS CABRERA NEHUBELD BENJAMIN 2 210-2-77880773 21/02/2014 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
2,718 210-13-01228048 RIMAVAQUE BARDALES MILCA 48 210-2-00152098 01/08/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
2,719 210-14-40063154 RINCON CUADROS MELANI JAZMIN 18 210-2-70567537 17/07/2014 150103A101 150107A204 0.00 0.00 13.75 0.00 13.75
2,720 210-11-03612550 RIOS ALEGRIA GUINA 19 210-2-47517556 01/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,721 210-17-24347641 RIOS CHAVEZ GINA LLERALDINA 25 240-2-47537191 07/05/2017 150103A101 150101A105 0.00 0.00 15.34 0.00 15.34
2,722 210-17-24502549 RIOS GUERRA JHOBANS GRIEZMANN 0 210-2-90427515 22/12/2017 150103A101 150105A101 0.00 0.00 18.33 0.00 18.33
2,723 210-17-24503059 RIOS GUERRA JHOBANS GRIEZMANN 0 210-2-90427515 23/12/2017 150103A101 150105A101 0.00 0.00 18.80 0.00 18.80
2,724 210-17-24506339 RIOS GUERRA JHOBANS GRIEZMANN 0 210-2-90427515 30/12/2017 150103A101 150105A101 0.00 0.00 16.45 0.00 16.45
2,725 210-18-42460323 RIOS GUERRA JHOBANS GRIEZMANN 0 210-2-90427515 02/01/2018 150103A101 150111A101 0.00 0.00 10.55 0.00 10.55
2,726 210-18-42462729 RIOS GUERRA JHOBANS GRIEZMANN 0 210-2-90427515 04/01/2018 150103A101 150115A101 0.00 0.00 10.55 0.00 10.55
2,727 210-18-42468512 RIOS GUERRA JHOBANS GRIEZMANN 0 210-2-90427515 11/01/2018 150103A101 150105A101 0.00 0.00 17.30 0.00 17.30
2,728 210-18-42469357 RIOS GUERRA JHOBANS GRIEZMANN 0 210-2-90427515 12/01/2018 150103A101 150105A101 0.00 0.00 18.29 0.00 18.29
2,729 210-18-42507233 RIOS MEZA GRICELDA 42 210-2-44626775 28/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
2,730 210-17-24442923 RIOS PALOMINO REGINA CELIA 18 210-2-72207293 01/10/2017 150103A101 150103A208 0.00 0.00 9.89 0.00 9.89
2,731 210-17-24433653 RIOS QUISPE IAN HARUKI 0 210-2-90316268 16/09/2017 150103A101 150105A101 0.00 0.00 16.55 0.00 16.55
2,732 210-11-03604926 RIOS ROMERO BRAYAN 4 200-2-70626095 04/08/2011 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
2,733 210-11-03056838 RIOS RUA JOSEPH ALEJANDRO 10 210-2-74125056 28/04/2011 150103A101 150105A101 0.00 0.00 0.00 0.00 0.00
2,734 210-17-24312345 RIOS TORRES KALEESY ARIANEE 0 200-2-79742958 08/03/2017 150103A101 150105A101 0.00 0.00 19.88 0.00 19.88
2,735 210-17-24317932 RIOS TORRES KALEESY ARIANEE 0 200-2-79742958 20/03/2017 150103A101 150105A101 0.00 0.00 16.72 0.00 16.72
2,736 210-11-03056138 RISCO ATALAYA NANCY YOVANA 21 210-2-45875066 08/05/2011 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
2,737 210-17-24395836 RIVAS LUNA MARIA ISABEL 31 210-2-43568061 23/07/2017 150103A101 150111A101 0.00 0.00 7.34 0.00 7.34
2,738 210-11-03056227 RIVERA ALBINO ANALI 18 210-2-48083251 07/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,739 210-18-42503286 RIVERA BURGOS MARLWIN IVAN 13 180-2-70940923 25/02/2018 150103A101 150115A101 0.00 0.00 15.34 0.00 15.34
2,740 210-14-40030407 RIVERA HINOSTROZA ANDERSON JEREMY 11 210-2-75830923 07/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,741 210-17-24332888 RIVERA HINOSTROZA RISHBAN DILAND 2 210-2-79084237 12/04/2017 150103A101 150105A101 0.00 0.00 9.04 0.00 9.04
2,742 210-17-24333932 RIVERA HINOSTROZA RISHBAN DILAND 2 210-2-79084237 15/04/2017 150103A101 150105A101 0.00 0.00 15.82 0.00 15.82
2,743 210-17-24390710 RIVERA JARA ALANNA ROXAN 1 210-2-79573803 14/07/2017 150103A101 150111A101 0.00 0.00 7.34 0.00 7.34
2,744 210-18-42554937 RIVERA LOPEZ GILVER HILDEBRANDO 1 020-2-90153314 29/04/2018 150103A101 150111A101 0.00 0.00 10.09 0.00 10.09

Elaborado por OIE-SIS Página 98 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,745 210-18-42561438 RIVERA MAMANI ROLANDO GONZALO 13 210-2-73676803 07/05/2018 150103A101 150111A101 0.00 0.00 10.09 0.00 10.09
2,746 210-11-03607362 RIVERA PAUCAR JOESSY KATERIN 16 210-2-76793227 08/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,747 210-17-24407932 RIVERA RAMIREZ MARI CARMEN 18 210-2-77797615 11/08/2017 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
2,748 210-17-24473755 RIVERA TEJEDA ESTEFANY ROSLIN 21 210-2-71716040 11/11/2017 150103A101 150137A206 0.00 0.00 6.58 0.00 6.58
2,749 210-17-24420742 RIVEROS IGNACIO JOHAN ANDERSON 5 210-2-77364457 29/08/2017 150103A101 150101A104 0.00 0.00 18.23 0.00 18.23
2,750 210-11-03731425 RIVEROS MESCUA YUSY LIZSETH 21 210-2-46589967 22/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,751 210-13-01195979 ROBLES ALBORNOZ JUANA CARMEN 28 210-2-42693101 11/03/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,752 210-13-01214416 ROBLES MEZA NOEMI 27 210-2-48459993 29/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,753 210-17-24359930 ROCA VICAÑA NORMA 22 050-2-74154212 29/05/2017 150103A101 150111A101 0.00 0.00 9.48 0.00 9.48
2,754 210-18-42498665 ROCHA MEMENZA CAMILA RAFAELA 6 200-2-77527421 16/02/2018 150103A101 150111A101 0.00 0.00 9.70 0.00 9.70
2,755 210-14-43747078 RODAS CORONEL FLOR MARINA 32 210-2-43747078 25/08/2014 150103A101 150111A101 0.00 0.00 11.08 0.00 11.08
2,756 210-17-24393992 RODRIGO ÑAHUI LIA ROCIO 23 210-2-48268002 20/07/2017 150103A101 150137A206 0.00 0.00 5.39 0.00 5.39
2,757 210-12-03908743 RODRIGO ÑAHUI LUZ EDITH 29 210-2-44997517 25/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,758 210-11-03611683 RODRIGUEZ ANGULO CYNDI NENA 22 210-2-45783366 04/10/2011 150103A101 150132A203 0.00 0.00 40.00 0.00 40.00
2,759 210-14-40007914 RODRIGUEZ APAESTEGUI FAUSTINO 85 210-2-07927361 27/01/2014 150103A101 150122A101 0.00 0.00 140.00 0.00 140.00
2,760 210-11-03062238 RODRIGUEZ BAUTISTA YENI 16 210-2-76775058 05/07/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
2,761 210-12-00184833 RODRIGUEZ BELLIDO YUDY 31 210-2-40641943 12/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,762 210-17-24503830 RODRIGUEZ CAMARGO DORCAS CESIA 17 210-2-77500011 25/12/2017 150103A101 150111A101 0.00 0.00 11.28 0.00 11.28
2,763 210-17-24424499 RODRIGUEZ CANCHANYA JOSELIN LIDIA 14 210-2-75700585 04/09/2017 150103A101 150111A101 0.00 0.00 9.55 0.00 9.55
2,764 210-11-03053588 RODRIGUEZ CORDOVA EIDY ELUBYC 22 210-2-45415107 10/06/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,765 210-18-42469099 RODRIGUEZ DE SANCHEZ CONSUELO CLAIRE 79 210-2-19965669 11/01/2018 150103A101 150111A101 0.00 0.00 11.41 0.00 11.41
2,766 210-14-40097304 RODRIGUEZ GOMEZ JHOMIRA ARACELI DANITZA 5 210-2-73394873 16/10/2014 150103A101 150115A101 0.00 0.00 17.60 0.00 17.60
2,767 210-17-24423628 RODRIGUEZ GUZMAN RN 0 210-E-28910292 02/09/2017 150103A101 0000016918 0.00 0.00 11.33 0.00 11.33
2,768 210-17-24334488 RODRIGUEZ MAJINO AIMEE AMANDA 11 210-2-75260722 16/04/2017 150103A101 150115A101 0.00 0.00 14.46 0.00 14.46
2,769 210-16-22832693 RODRIGUEZ MAYTAHUARI OLGA 43 210-2-80272612 13/06/2016 150103A101 150115A101 0.00 0.00 10.27 0.00 10.27
2,770 210-14-40032739 RODRIGUEZ MENDOZA ROSA ELVIRA 30 210-2-42351089 13/04/2014 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
2,771 210-17-24464820 RODRIGUEZ PARADO KIARA ALICIA 8 210-2-62577918 06/10/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
2,772 210-17-24339071 RODRIGUEZ PIZANGO GLENDY ISABEL 24 210-2-48865510 25/04/2017 150103A101 150111A205 0.00 0.00 9.94 0.00 9.94

Elaborado por OIE-SIS Página 99 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,773 210-11-03055879 RODRIGUEZ QUISPE FLOR DE LUZ 28 210-2-41771787 13/05/2011 150103A101 150132A203 0.00 0.00 0.00 0.00 0.00
2,774 210-14-40074550 RODRIGUEZ QUISPE RUTH ENAIDA 18 210-2-76625000 19/08/2014 150103A101 150101A109 0.00 0.00 23.10 0.00 23.10
2,775 210-11-03730106 RODRIGUEZ RAFAEL GIULIANA ROSA 21 210-2-46659753 26/11/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
2,776 210-13-01199097 RODRIGUEZ RAFAEL HELEN ROSS MARY 30 210-2-41548438 23/03/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,777 210-18-42500656 RODRIGUEZ RAMIREZ ARELY NAYARA 0 210-2-90372282 20/02/2018 150103A101 150115A101 0.00 0.00 11.41 0.00 11.41
2,778 210-18-42502758 RODRIGUEZ RAMIREZ ARELY NAYARA 0 210-2-90372282 24/02/2018 150103A101 150105A101 0.00 0.00 16.69 0.00 16.69
2,779 210-14-40073075 RODRIGUEZ SANCHEZ LUZ ESMERALDA 22 210-2-46715941 14/08/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
2,780 210-17-24481515 RODRIGUEZ SULCA ANA MARIA 49 210-2-80567668 21/11/2017 150103A101 150111A101 0.00 0.00 8.93 0.00 8.93
2,781 210-17-24487263 RODRIGUEZ TORRES JOSE LUIS 35 210-2-48087188 30/11/2017 150103A101 150101A102 0.00 0.00 19.27 0.00 19.27
2,782 210-11-03731651 RODRIGUEZ VELARDE MARIA ANTONIETA 37 210-2-10048376 04/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,783 210-11-03060426 RODRIGUEZ VILLEGAS SAMUEL SMITH 3 210-2-70725033 18/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,784 210-11-03052370 RODRIGUEZ ÑAÑA ELIZABETH 19 210-2-47757493 21/05/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,785 210-14-40016000 RODRÍGUEZ RIVERA NORMALINDA 20 210-2-48490125 22/02/2014 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,786 210-18-42499107 ROJAS AGUIRRE ROSALY 25 210-2-47589119 18/02/2018 150103A101 150111A205 0.00 0.00 11.78 0.00 11.78
2,787 210-14-40067497 ROJAS ALBERTO NN 0 210-7-10084207 31/07/2014 150103A101 150101A102 0.00 0.00 25.30 0.00 25.30
2,788 210-16-22933304 ROJAS ALVINO EFERSON CARLOS 5 300-2-62833428 29/11/2016 150103A101 150111A101 0.00 0.00 7.33 0.00 7.33
2,789 210-12-03899166 ROJAS ARROYO ROSA 17 210-2-73609555 17/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,790 210-17-24427594 ROJAS BECERRA LUZ MARIA 35 210-2-41387593 07/09/2017 150103A101 150101A105 0.00 0.00 16.11 0.00 16.11
2,791 210-12-00197316 ROJAS BERROCAL NN 0 210-7-45539759 28/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,792 210-13-01223464 ROJAS CARRASCO VEANET GRACIELA 26 210-2-43712793 05/07/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
2,793 210-17-24504557 ROJAS CCANTO JEIDY YHOMAIRA HERLINDA 3 210-2-78579890 26/12/2017 150103A101 150115A101 0.00 0.00 13.16 0.00 13.16
2,794 210-12-00184787 ROJAS CHAVEZ ROMAN MANUEL 13 210-2-71332281 12/04/2012 150103A101 150135A101 0.00 0.00 0.00 0.00 0.00
2,795 210-14-40055837 ROJAS CORDOVA MARILI 17 210-2-71561076 27/06/2014 150103A101 150101A105 0.00 0.00 20.90 0.00 20.90
2,796 210-14-40098786 ROJAS CORDOVA NN 0 210-7-76414765 19/10/2014 150103A101 150101A105 0.00 0.00 15.40 0.00 15.40
2,797 210-12-01283321 ROJAS CORONEL CARMEN ROSA 20 210-2-47433468 18/09/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,798 210-17-24357212 ROJAS ESPINAL NONA AMANCIA 30 130-2-45539394 25/05/2017 150103A101 150111A101 0.00 0.00 15.34 0.00 15.34
2,799 210-18-42549648 ROJAS ESTRADA EDGAR MATTHEW 0 210-2-90401628 24/04/2018 150103A101 150105A101 0.00 0.00 17.67 0.00 17.67
2,800 210-11-03605614 ROJAS FABIAN BEATRIZ YOLANDA 23 210-2-45188951 15/08/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00

Elaborado por OIE-SIS Página 100 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,801 210-11-03056045 ROJAS GRIMALDO DAYANA OFELIA 35 210-2-10165604 21/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,802 210-16-22930790 ROJAS GUERRA CARLOS ANTONIO 36 210-2-47782210 24/11/2016 150103A101 150141A101 0.00 0.00 18.91 0.00 18.91
2,803 210-13-00283230 ROJAS GUTIERREZ ENAIDA 28 210-2-44128512 08/09/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,804 210-13-01246192 ROJAS HERAS MODESTO ANTONIO 54 210-2-10465739 20/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,805 210-11-03056326 ROJAS HUANCAHUARI TRIFONIA 27 210-2-44980492 06/05/2011 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
2,806 210-12-00800911 ROJAS JANAMPA ESTHER 35 210-2-10732347 16/07/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,807 210-11-03735955 ROJAS JOSE SONIA ELVIRA 20 210-2-47321615 02/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,808 210-11-03606154 ROJAS JULCA NANCY MAGDALENA 28 210-2-41862367 15/09/2011 150103A101 150111A101 0.00 45.00 0.00 0.00 45.00
2,809 210-17-24483524 ROJAS LLACTAHUAMAN ALFREDO ALEJANDRO 51 050-2-07115030 26/11/2017 150103A101 150111A101 0.00 0.00 8.34 0.00 8.34
2,810 210-11-03049595 ROJAS LLAZA ROFILIA 23 210-2-46018243 22/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,811 210-11-03730299 ROJAS LOPEZ MARITZA NANCY 28 210-2-45989368 30/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,812 210-13-01252284 ROJAS MARTINEZ ADALIZ GRANDY 13 210-2-74633935 11/11/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,813 210-13-01218835 ROJAS MEZA ZORAIDA 30 210-2-43755777 16/06/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,814 210-17-24441903 ROJAS PAITAN ALEXANDRO DEL PIERO 8 210-2-72986689 29/09/2017 150103A101 150115A101 0.00 0.00 9.11 0.00 9.11
2,815 210-17-24355405 ROJAS PALACIN GISELA MIGUME 22 210-2-70758847 21/05/2017 150103A101 150107A204 0.00 0.00 20.30 0.00 20.30
2,816 210-14-40060398 ROJAS PAREJA MIGUEL ALBERTO 66 210-2-06565474 15/07/2014 150103A101 150101A101 0.00 0.00 14.30 0.00 14.30
2,817 210-12-03911260 ROJAS QUISPE JULIA TEODORA 55 210-2-19932196 03/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,818 210-12-03899196 ROJAS RAFAELO JOVANA MAGALLY 22 210-2-46450074 17/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,819 210-11-03728523 ROJAS RIVERA VANESA 23 210-2-44974258 15/11/2011 150103A101 150135A101 0.00 0.00 45.00 0.00 45.00
2,820 210-11-03055871 ROJAS RIVERA ZAIDA 25 210-2-43287937 13/05/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
2,821 210-11-03613911 ROJAS RODRIGUEZ KATTY ISABEL 28 210-2-41561174 13/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,822 210-14-40055758 ROJAS SILVA LUISA 31 210-2-41528343 26/06/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,823 210-18-42489201 ROJAS YAURI FELICIANO 66 170-2-20976200 05/02/2018 150103A101 150111A101 0.00 0.00 12.27 0.00 12.27
2,824 210-14-40094303 ROLDAN CALDERON VICTOR JULIAN 39 210-2-10247627 09/10/2014 150103A101 150101A101 0.00 0.00 13.75 0.00 13.75
2,825 210-17-24441147 ROMAINA SINTI DEBORA MARIA 21 340-2-61245963 28/09/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
2,826 210-17-24393454 ROMAN CASTRO ANGELINA 77 210-2-16167911 19/07/2017 150103A101 150103A208 0.00 0.00 11.44 0.00 11.44
2,827 210-11-03725245 ROMAN HERHUAY JESSICA MARIBEL 29 210-2-42360871 21/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,828 210-11-03062472 ROMAN HUILLCAMISA YESSICA 20 210-2-46551472 23/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 101 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,829 210-12-01283738 ROMANI AVILA ELIZABETH BEATRIZ 19 210-2-47768934 21/09/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,830 210-13-00281412 ROMANI QUISPE DAVID 21 210-2-47006149 25/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,831 210-17-24498469 ROMANI RAMOS ANABEL YASMIN 25 210-2-70101373 15/12/2017 150103A101 150137A206 0.00 0.00 7.52 0.00 7.52
2,832 210-17-24369071 ROMAYNA PAYAHUA ROMARY MIRELLY 22 240-2-75978296 11/06/2017 150103A101 150111A101 0.00 0.00 7.67 0.00 7.67
2,833 210-17-24505701 ROMERO CERNA ITTAN SAMIR 0 210-2-90444854 28/12/2017 150103A101 150105A101 0.00 0.00 17.86 0.00 17.86
2,834 210-12-00191077 ROMERO CLEMENTE CYNTHIA ROSMERI 17 210-2-71070051 02/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,835 210-12-03907298 ROMERO CORDOVA GUIAN LUIGI 4 210-2-70696537 19/03/2012 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
2,836 210-12-00804512 ROMERO CRUZ MARIANELA 23 210-2-46808638 17/08/2012 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
2,837 210-13-01242542 ROMERO ESCOBAR KATHERYN YELENA 23 170-2-46508264 06/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,838 210-13-01198611 ROMERO GUTIERREZ ARON ANTHONY 1 210-2-63036741 21/03/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
2,839 210-12-03901130 ROMERO HILARIO LISBETH MARISOL 27 210-2-44218005 31/01/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,840 210-18-42473093 ROMERO HUAMAN PERSIDAY 58 210-2-10421777 17/01/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
2,841 210-16-22820996 ROMERO MANSILLA JULIO CESAR 47 210-2-47976134 24/05/2016 150103A101 150115A101 0.00 0.00 9.58 0.00 9.58
2,842 210-17-24408606 ROMERO MAYTA YENY OLINDA 37 210-2-40344707 11/08/2017 150103A101 150111A101 0.00 0.00 9.28 0.00 9.28
2,843 210-17-24469204 ROMERO PISCO ASHLEY NARUMI 2 210-2-81628148 04/12/2017 150103A101 150111A101 0.00 0.00 8.34 0.00 8.34
2,844 210-17-24406289 ROMERO PUMA MIREYÁ GÉRALDINE 4 210-2-77949432 08/08/2017 150103A101 150105A101 0.00 0.00 17.69 0.00 17.69
2,845 210-12-00806699 ROMERO RAMOS ROSA LUZ 21 210-2-47628148 02/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,846 210-18-42573193 ROMERO RAMOS ROSILMA 22 130-2-73541210 22/05/2018 150103A101 150111A205 0.00 0.00 9.35 0.00 9.35
2,847 210-17-24409410 ROMERO VASQUEZ MARCO ANTONIO 41 210-2-06796366 13/08/2017 150103A101 150111A101 0.00 0.00 8.85 0.00 8.85
2,848 210-12-00188016 ROMERO VILLANUEVA MARIA ISABEL 28 210-2-42179496 22/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,849 210-18-42579575 ROMERO ÑAHUI JHEYNS REISHELL GENESIS 1 210-2-90268543 30/05/2018 150103A101 150105A101 0.00 0.00 17.00 0.00 17.00
2,850 210-11-03052052 ROMO CASTRO KAREN VICTORIA 20 210-2-47353005 11/06/2011 150103A101 150132A203 0.00 0.00 0.00 0.00 0.00
2,851 210-13-01197686 RONDO SANTOS CLEMENCIA 26 210-2-43980205 18/03/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,852 210-18-42493369 RONDON CASTRO ARIANA 6 210-2-77457359 10/02/2018 150103A101 150115A101 0.00 0.00 13.13 0.00 13.13
2,853 210-18-42493657 RONDON CASTRO ARIANA 6 210-2-77457359 10/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
2,854 210-14-40063354 RONDON YALLE MAXIMO LUCIANO 66 210-2-07853103 18/07/2014 150103A101 150121A101 0.00 0.00 26.40 0.00 26.40
2,855 210-12-03911297 ROOM NEYRA NN 0 210-7-42423781 03/02/2012 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
2,856 210-12-00807137 ROSADO HUAMAN VIDA KARINA 31 210-2-41093363 30/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 102 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,857 210-13-01238050 ROSADO PACULIA WILMER PACIDIO 38 210-2-80597725 18/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,858 210-13-01213769 ROSALES BRAVO VILMA 59 210-2-06220123 27/05/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
2,859 210-18-42576860 ROSALES DE GARCIA GABINA MARCELA 62 210-2-20573524 27/05/2018 150103A101 150101A101 0.00 0.00 13.18 0.00 13.18
2,860 210-17-24462886 ROSALES GONZALES DARLENE JACCIRI 8 170-2-61824600 28/10/2017 150103A101 150105A101 0.00 0.00 14.33 0.00 14.33
2,861 210-12-00184632 ROSALES JULCA MARYBEL NANCY 29 210-2-41512280 09/04/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,862 210-12-00802165 ROSALES MATOS LAURA CRISTINA 18 210-2-76752648 03/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,863 210-12-03907268 ROSALES MINAYA JHAIR ALCIDES 1 210-2-76702317 19/03/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,864 210-18-42469975 ROSALES ZELADITA EMMA LUZ 60 270-2-04003416 12/01/2018 150103A101 150111A101 0.00 0.00 6.35 0.00 6.35
2,865 210-18-42505787 ROSAS CRUZ RN 0 210-E-29065075 27/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
2,866 210-12-00184634 ROSAS LUCAS NANCY LIDA 32 210-2-80506037 09/04/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,867 210-11-03055790 ROSAS MARTINEZ MADI MELISSA 23 210-2-44468547 16/05/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,868 210-17-24479210 ROSAS SOTO OCTAVIA SOFIA 23 210-2-75818751 19/11/2017 150103A101 150111A101 0.00 0.00 9.16 0.00 9.16
2,869 210-13-01202101 ROÑA ALVAREZ WENDY JENNYFFER 16 210-2-74401981 06/04/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,870 210-12-03903769 RUA CARDENAS NOEMI 26 210-2-43557355 17/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,871 210-12-00802313 RUA GUTIERREZ YOLANDA 35 210-2-10599460 08/09/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,872 210-18-42547830 RUBIÑOS SAMANIEGO RAQUEL LUZMILA 46 210-2-20047360 20/04/2018 150103A101 150103A208 0.00 0.00 13.25 0.00 13.25
2,873 210-17-24458571 RUEDA PONCE ANTONIO 87 210-2-04302174 20/10/2017 150103A101 150111A101 0.00 0.00 8.33 0.00 8.33
2,874 210-13-00291503 RUIZ ASTOCHADO MARIA FERNANDA 18 210-2-76195352 02/03/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,875 210-18-42498849 RUIZ CARBAJAL REBECA LUCILA 15 140-2-61582031 17/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
2,876 210-17-24416919 RUIZ CASTILLO CINTHIA VANESSA 27 210-2-46431756 24/08/2017 150103A101 150111A205 0.00 0.00 11.87 0.00 11.87
2,877 210-14-40054749 RUIZ DE SALAZAR MARIA 66 210-2-23667605 23/06/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,878 210-14-40075568 RUIZ GERONIMO NILA 28 210-2-43348919 21/08/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
2,879 210-12-00188911 RUIZ GOMEZ TEODORO WALTER 66 210-2-06640923 27/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,880 210-11-03055654 RUIZ HUAMANI JESUS ALDAIR 0 210-2-74673740 16/05/2011 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00
2,881 210-18-42469397 RUIZ LOPEZ MEI LUJANA 0 210-2-81802182 12/01/2018 150103A101 150105A101 0.00 0.00 18.29 0.00 18.29
2,882 210-13-01224406 RUIZ MARTINEZ ESTRELLA CELESTE 2 240-2-76107522 09/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,883 210-11-03728674 RUIZ MERGE IRAIDA 29 210-2-41188322 25/11/2011 150103A101 150118A101 0.00 0.00 45.00 0.00 45.00
2,884 210-11-03058090 RUIZ NEYRA NATIVIDAD MADELEINE 15 210-2-72662115 21/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00

Elaborado por OIE-SIS Página 103 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,885 210-11-03606420 RUIZ PIZANGO ELIZABETH 30 210-2-40985955 16/09/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00
2,886 210-11-03610513 RUIZ PIZANGO ELIZABETH 30 210-2-40985955 12/10/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00
2,887 210-18-42565607 RUIZ RAMIREZ HILDA 96 300-2-00842866 13/05/2018 150103A101 150111A101 0.00 0.00 8.96 0.00 8.96
2,888 210-12-00800399 RUIZ RAMIREZ YULIANA DE LOS MILAGROS 28 210-2-44817916 29/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,889 210-18-42474129 RUIZ SANCHEZ KIRAM JOART 2 210-2-79386972 18/01/2018 150103A101 150105A101 0.00 0.00 21.60 0.00 21.60
2,890 210-18-42474862 RUIZ SANCHEZ KIRAM JOART 2 210-2-79386972 18/01/2018 150103A101 150105A101 0.00 0.00 15.34 0.00 15.34
2,891 210-18-42570384 RUIZ SANCHEZ KIRAM JOART 2 210-2-79386972 19/05/2018 150103A101 150105A101 0.00 0.00 18.58 0.00 18.58
2,892 210-18-42493570 RUIZ TUANAMA REIDER ALBERTO 10 240-2-81030335 10/02/2018 150103A101 150115A101 0.00 0.00 8.35 0.00 8.35
2,893 210-11-02705047 RUPAY HUARCAYA NN 0 210-7-70786256 27/03/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,894 210-17-24412700 RUPIRE RUIZ SILVIA NATIVIDAD 31 210-2-43655588 17/08/2017 150103A101 150101A105 0.00 0.00 13.16 0.00 13.16
2,895 210-11-03733964 RUTTI MUNIVE NILDA ALICIA 21 210-2-46452276 26/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,896 210-17-24298475 SAAVEDRA ISUIZA JULER 23 210-2-71062929 15/02/2017 150103A101 150101A101 0.00 0.00 13.37 0.00 13.37
2,897 210-16-22908943 SAAVEDRA MAZA ANNIE SOFIA 0 210-2-79870029 17/10/2016 150103A101 150115A101 0.00 0.00 10.47 0.00 10.47
2,898 210-16-22944121 SAAVEDRA SOLDEVILLA KAZUMY MARIA FE 0 210-2-79587096 16/12/2016 150103A101 0000016918 0.00 0.00 14.30 0.00 14.30
2,899 210-18-42526277 SACRAMENTO SANDOVAL KIM YURA SHINA 0 210-2-81707439 24/03/2018 150103A101 150111A101 0.00 0.00 9.44 0.00 9.44
2,900 210-14-40018331 SAENZ PAULINO JESSICA 38 210-2-10502592 03/03/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,901 210-18-42573224 SAENZ PEÑALOZA LINDA JENIFER 17 210-2-62603154 14/01/2018 150103A101 150111A101 0.00 0.00 10.06 0.00 10.06
2,902 210-17-24432234 SAENZ RAMOS ANDREA ALEJANDRA 18 210-2-76817078 14/09/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
2,903 210-13-00286211 SAFORAS MACHOA EDWIN 40 210-2-20042697 07/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,904 210-14-40075114 SAIRE QUISPE ISABEL 40 230-2-25759226 20/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,905 210-13-01246084 SAJAMI LOPEZ MARTHA MARIA 33 210-2-42840346 19/10/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,906 210-11-03050077 SALAS BORJA YESICA 21 210-2-45959818 14/04/2011 150103A101 150103A308 0.00 0.00 0.00 0.00 0.00
2,907 210-18-42494098 SALAS CAMPOS MARIA ISABELLA 1 210-2-90058436 09/02/2018 150103A101 150105A101 0.00 0.00 14.85 0.00 14.85
2,908 210-18-42462178 SALAS MONTENEGRO MARITZA 25 080-2-71782419 02/01/2018 150103A101 150137A101 0.00 0.00 5.28 0.00 5.28
2,909 210-13-01195884 SALAS PARIONA NERY GARDENIA 17 210-2-76597238 09/03/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,910 210-12-00811961 SALAS SANTOS NN 0 210-7-45820577 05/09/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
2,911 210-13-00289195 SALAZAR ALVARADO MERARDA 36 210-2-10286399 21/02/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,912 210-17-24378121 SALAZAR APAZA RN-HV 0 210-E-28847095 28/06/2017 150103A101 150105A101 0.00 0.00 19.51 0.00 19.51

Elaborado por OIE-SIS Página 104 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,913 210-12-00800106 SALAZAR CHANCAFE MARLENE ROXANA 35 210-2-10593707 11/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,914 210-17-24395260 SALAZAR CHUQUILLANQUI JUNIOR SMITH 8 210-2-77359226 21/07/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
2,915 210-12-00192294 SALAZAR CRISOSTOMO BIATRIZ 25 210-2-43694010 12/06/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,916 210-17-24357797 SALAZAR DE LA CRUZ MARIA KRISTELL 0 210-2-90133102 26/05/2017 150103A101 150141A101 0.00 0.00 16.24 0.00 16.24
2,917 210-13-01247403 SALAZAR GUTIERREZ SULEMA YORLEY 2 210-2-76715317 24/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,918 210-18-42536566 SALAZAR MONTALVO SANTOS CLEOPE 54 140-2-00034101 06/04/2018 150103A101 150115A101 0.00 0.00 14.24 0.00 14.24
2,919 210-13-00284011 SALAZAR OBREGON HERLINDA 35 210-2-10699704 29/01/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,920 210-12-00807690 SALAZAR PAIBA YENNIFER NOHELIA 27 210-2-43751071 21/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,921 210-13-01224168 SALAZAR RIVAS NICOLÁS FRANCO 2 210-2-77002404 08/07/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
2,922 210-12-00811577 SALAZAR VALDEZ MARIELE DENNYSA 17 210-2-74397033 21/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,923 210-17-24476918 SALAZAR ZUMAETA JAIME 40 010-2-45796652 15/11/2017 150103A101 150111A101 0.00 0.00 9.63 0.00 9.63
2,924 210-12-00189806 SALCEDO ALHUAYA MARIANA 6 210-2-74733946 25/05/2012 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
2,925 210-13-01241790 SALCEDO HUAMANI ALICIA 32 210-2-40896049 02/10/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
2,926 210-18-42470808 SALCEDO RAMIREZ JUAN UBALDO 76 200-2-07386566 13/01/2018 150103A101 150809A302 0.00 0.00 8.71 0.00 8.71
2,927 210-12-03901735 SALCEDO RETAMOZO AQUILES 46 200-2-23016286 04/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,928 210-13-01197871 SALCEDO VELASQUEZ HUGO ALEXANDER 0 210-2-77718077 18/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,929 210-18-42462043 SALDAÑA LAUREANO MAYER ANTONY 5 210-2-77725913 03/01/2018 150103A101 150809A302 0.00 0.00 9.20 0.00 9.20
2,930 210-18-42509385 SALDAÑA LUJAN PATRICIA DEL PILAR 48 210-2-09364381 02/03/2018 150103A101 150115A101 0.00 0.00 10.43 0.00 10.43
2,931 210-18-42468860 SALDAÑA ROQUI JOSETH JUAN 25 230-2-48366288 11/01/2018 150103A101 150111A101 0.00 0.00 10.06 0.00 10.06
2,932 210-14-40072646 SALGUERO CARRASCO ZANDRA PATRICIA 25 210-2-45736852 13/08/2014 150103A101 150137A206 0.00 0.00 8.25 0.00 8.25
2,933 210-13-01253551 SALGUERO VILLA PEDRO WILLIANS 27 210-2-48710945 15/11/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
2,934 210-12-00184415 SALOME ROJAS DE GOMEZ FRANCISCA 84 210-2-06565026 09/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,935 210-16-22916976 SALVADOR JIMENEZ YIRAELA YASMIN 27 210-2-45983619 01/11/2016 150103A101 150101A103 0.00 0.00 4.23 0.00 4.23
2,936 210-18-42469046 SALVADOR MARIÑAS ALLISON NICOLE 8 210-2-73731339 11/01/2018 150103A101 150115A101 0.00 0.00 13.50 0.00 13.50
2,937 210-12-00191573 SALVADOR OSORES LILIANA 26 210-2-43887453 02/06/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,938 210-13-01213555 SALVADOR RAMOS MARIA 41 210-2-04205924 25/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,939 210-17-24387038 SALVADOR RODRIGUEZ MARIA ISABEL 18 210-2-77154703 09/07/2017 150103A101 150121A101 0.00 0.00 18.12 0.00 18.12
2,940 210-11-03608453 SALVATIERRA MENDOZA MARITE 23 210-2-45057303 20/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00

Elaborado por OIE-SIS Página 105 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,941 210-13-01227355 SALVATIERRA SULCA FELICIANO 70 200-2-07348950 25/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,942 210-11-03732183 SAMAME YERREN MARIA ANGELICA 19 210-2-47464771 02/12/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
2,943 210-17-24391072 SAMANIEGO CHUQUIN LUZ MERY 20 170-2-77345660 15/07/2017 150103A101 150101A109 0.00 0.00 25.35 0.00 25.35
2,944 210-13-01233232 SAMANIEGO JORGE MADINSON RUTH 21 210-2-48154008 30/08/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,945 210-18-42477323 SAMANIEGO TELLO MOISÉS ALONSO 10 210-2-70730083 22/01/2018 150103A101 150115A101 0.00 0.00 13.50 0.00 13.50
2,946 210-17-24488635 SANCHEZ ASCANOA KATHERINE CONY 29 210-2-45978445 02/12/2017 150103A101 150111A205 0.00 0.00 12.69 0.00 12.69
2,947 210-13-00288815 SANCHEZ BARRANTES LUZMELIA 20 210-2-48002555 19/02/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,948 210-12-03902224 SANCHEZ CABEZAS EMILIA FLORIDA 31 210-2-40504223 06/02/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,949 210-16-40062213 SANCHEZ CARRANZA GADIL YOSHUA 11 210-2-77917849 17/04/2016 150103A101 150111A101 0.00 0.00 6.84 0.00 6.84
2,950 210-13-01214415 SANCHEZ CASTILLO ELIANA INES 33 210-2-40542763 29/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,951 210-12-03908337 SANCHEZ CASTRO MILUSKA ALEXANDRA 20 210-2-46990451 22/02/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
2,952 210-12-00808548 SANCHEZ CUTTI RUTH EDITH 18 210-2-48513384 07/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,953 210-11-03731188 SANCHEZ DE TICSE FELICIANA 80 210-2-16135353 20/11/2011 150103A101 150110A210 0.00 0.00 45.00 0.00 45.00
2,954 210-13-01249330 SANCHEZ GONZALES DANIXA 23 210-2-70497912 31/10/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
2,955 210-16-22931827 SANCHEZ GUTIERREZ DIONISIO PEDRO 54 210-2-06575225 25/11/2016 150103A101 150101A101 0.00 0.00 10.04 0.00 10.04
2,956 210-12-01295126 SANCHEZ HERRERA LOURDES 23 210-2-45866096 16/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,957 210-17-24505263 SANCHEZ HUALLPA JANET ROCIO 22 210-2-74284162 27/12/2017 150103A101 150101A102 0.00 0.00 17.86 0.00 17.86
2,958 210-12-00197796 SANCHEZ HURTADO KEVIN 7 210-2-60573076 09/05/2012 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
2,959 210-13-01221508 SANCHEZ IRRAZABAL VALERIA MILAGROS 7 210-2-75477548 27/06/2013 150103A101 150121A101 0.00 0.00 140.00 0.00 140.00
2,960 210-13-01226452 SANCHEZ LEIVA FARID FRANCYS 4 230-2-61575422 18/07/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
2,961 210-18-42492106 SANCHEZ LEON LILIANA PAOLA 34 210-2-42151331 08/02/2018 150103A101 150111A205 0.00 0.00 14.85 0.00 14.85
2,962 210-12-03902662 SANCHEZ LLACTA YAJHAIRA CINTHYA 21 210-2-47033987 10/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,963 210-17-24463127 SANCHEZ LOPEZ ANA CRISTEL 1 210-2-79588714 04/11/2017 150103A101 150115A101 0.00 0.00 13.86 0.00 13.86
2,964 210-17-24433911 SANCHEZ MAGALLANES CARINA 37 210-2-46772289 17/09/2017 150103A101 150101A105 0.00 0.00 11.11 0.00 11.11
2,965 210-18-42553073 SANCHEZ MIRADA NANCY 30 140-2-44509173 27/04/2018 150103A101 150111A205 0.00 0.00 17.65 0.00 17.65
2,966 210-11-03051534 SANCHEZ PALACIOS VIVIAN JACKELINE 27 210-2-43314490 03/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,967 210-12-01283356 SANCHEZ PALOMINO CELIA 35 210-2-28486500 19/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,968 210-13-01250543 SANCHEZ PISCOYA DEYSI MARIBEL 25 210-2-44964816 05/11/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80

Elaborado por OIE-SIS Página 106 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,969 210-14-40014641 SANCHEZ POZO YNES 32 200-2-41614395 18/02/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,970 210-12-00810729 SANCHEZ RIOS MARIA LEONOR 34 210-2-40906012 01/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,971 210-13-01250706 SANCHEZ RIVERO LUIS ANTONIO 13 210-2-73863565 05/11/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,972 210-11-03052560 SANCHEZ RODRIGUEZ JUANA MARGARITA 25 210-2-43022974 24/05/2011 150103A101 150101A101 0.00 0.00 0.00 0.00 0.00
2,973 210-11-03048355 SANCHEZ ROMERO DEBORA 20 210-2-47379194 03/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,974 210-12-00800316 SANCHEZ SAMANIEGO MARIA DEL PILAR 24 210-2-45872194 12/07/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,975 210-12-00194051 SANCHEZ SANCHEZ DYLAND JOSUE 1 210-2-75640474 23/04/2012 150103A101 150135A101 0.00 0.00 0.00 0.00 0.00
2,976 210-17-24343001 SANCHEZ SIAS GLUBY ANGRIELA 22 190-2-76214682 29/04/2017 150103A101 150111A101 0.00 0.00 8.12 0.00 8.12
2,977 210-17-24455752 SANCHEZ SILUPU CAMILA ABIGAIL 7 210-2-74196419 16/10/2017 150103A101 150115A101 0.00 0.00 13.44 0.00 13.44
2,978 210-12-00803769 SANCHEZ TORRES ROSA MILAGROS 28 210-2-48435568 12/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,979 210-18-42473135 SANCHEZ TRIGOSO DAIRO ALVEIRO 21 240-2-72233932 17/01/2018 150103A101 150101A101 0.00 0.00 13.99 0.00 13.99
2,980 210-17-24494296 SANCHEZ TUANAMA ROSITA 26 210-2-47783352 09/12/2017 150103A101 150103A101 0.00 0.00 9.40 0.00 9.40
2,981 210-14-40097770 SANCHEZ UGARTE FABIOLA NATHALY 23 210-2-48795370 17/10/2014 150103A101 150128A204 0.00 0.00 22.55 0.00 22.55
2,982 210-13-01223589 SANCHEZ URBANO LEANDRA ALEJANDRA 56 210-2-07668829 05/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,983 210-13-01198071 SANDOVAL INOCENCIO GUILLERMINA 21 210-2-46997469 19/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
2,984 210-14-40069649 SANDOVAL ROJAS ALEX JHON 22 210-2-70759440 06/08/2014 150103A101 150137A101 0.00 0.00 2.75 0.00 2.75
2,985 210-18-42516494 SANDOVAL VALIENTE NADIA YACORY 27 070-2-47852783 11/03/2018 150103A101 150111A205 0.00 0.00 12.42 0.00 12.42
2,986 210-14-40018949 SANTA CRUZ CCORA GABRIEL SEBASTIAN 3 210-2-75648912 04/03/2014 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
2,987 210-12-00184062 SANTA CRUZ GOTARATE ROSMERY YOLANDA 23 210-2-45451949 06/04/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
2,988 210-18-42584585 SANTA CRUZ RAFAELO VIVIANA ISAURA 31 210-2-44632084 05/06/2018 150103A101 150105A101 0.00 0.00 19.11 0.00 19.11
2,989 210-12-00190615 SANTANA GALVEZ ESTHER NATALY 25 210-2-46547738 31/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
2,990 210-11-03730479 SANTANA TUNQUE DIANA 24 210-2-44540527 02/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
2,991 210-11-03733210 SANTANA ZEVALLOS SILVIA PATRICIA 21 210-2-46682957 15/12/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
2,992 210-14-40074243 SANTIAGO LAVERIANO JOSE ALVARO 10 210-2-74399242 18/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
2,993 210-18-42575975 SANTILLAN DELGADO VIRGINIA ALEXANDRA 4 210-2-78381074 23/05/2018 150103A101 150111A101 0.00 0.00 9.88 0.00 9.88
2,994 210-12-00807683 SANTILLAN QUISPE CECILIA CLELIA 32 210-2-43788930 20/07/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
2,995 210-17-24292326 SANTOS CHAVEZ BRAYCHEL 5 230-2-76482933 06/02/2017 150103A101 150101A109 0.00 0.00 15.09 0.00 15.09
2,996 210-12-01294861 SANTOS CORREA JENIFER MICHELLE 20 210-2-70492840 21/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 107 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

2,997 210-17-24285535 SANTOS MENDIZABAL LUIS ADRIANO 4 210-2-77871924 25/01/2017 150103A101 150111A101 0.00 0.00 8.62 0.00 8.62
2,998 210-13-01241792 SANTOS MENDOZA LUCY LIDIA 37 210-2-21136840 02/10/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
2,999 210-11-03609855 SANTOS MEZA REVECA 23 210-2-44731010 28/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,000 210-11-03614959 SANTOS MEZA REVECA 23 210-2-44731010 04/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
3,001 210-17-24359033 SANTOS SANTIAGO JHAN POOL 3 140-2-63430605 27/05/2017 150103A101 150115A101 0.00 0.00 12.63 0.00 12.63
3,002 210-12-00280395 SANTOS TORRES BEATRIZ CINDHYA 20 210-2-70108031 08/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,003 210-13-01238861 SANTOS VERASTEGUI DANIEL ANGEL 12 210-2-77115976 21/09/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
3,004 210-18-42563219 SANTOS VILCHEZ WILLIAM MARTIN 54 210-2-06615457 09/05/2018 150103A101 150111A101 0.00 0.00 10.09 0.00 10.09
3,005 210-18-42465472 SAQUIRAY AHUANARI CARMIN CORALI 27 210-2-46772857 08/01/2018 150103A101 150111A101 0.00 0.00 9.57 0.00 9.57
3,006 210-11-03729195 SARABIA PELAIZA INES VIRGEN 20 210-2-46765084 13/11/2011 150103A101 150110A101 0.00 0.00 47.00 0.00 47.00
3,007 210-13-01248654 SARMIENTO CHAHUARA ARIEL ALESSANDER 4 210-2-74015103 28/10/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
3,008 210-12-00190760 SAYAS ROMERO ESTEFANY FIORELA 24 210-2-46676293 30/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,009 210-02-00809913 SAYCO MICHUY ISABEL 44 210-2-80603422 22/08/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
3,010 210-14-40062851 SEA PALANTE DAVID 32 210-2-41568677 16/07/2014 150103A101 150118A101 0.00 0.00 30.80 0.00 30.80
3,011 210-11-03049660 SEBASTIAN ACOSTA NN 0 210-7-43339812 15/04/2011 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
3,012 210-17-24412728 SEDANO AGUADO GLENDA DAYANA 20 170-2-71381894 18/08/2017 150103A101 150111A205 0.00 0.00 10.36 0.00 10.36
3,013 210-13-00288620 SEDANO CRUZ RUDY 20 210-2-47599026 18/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,014 210-11-03608818 SEDANO NECOCHEA NN 0 210-7-10249558 24/08/2011 150103A101 150101A109 0.00 0.00 40.00 0.00 40.00
3,015 210-12-00197139 SEDANO NECOCHEA VICTORIA 0 210-2-77442395 26/04/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,016 210-11-03055783 SEDANO TAIPE BERTHA 18 210-2-48005362 15/05/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
3,017 210-18-42565012 SEGAMA CONTRERAS YAEL DILAN 0 210-2-81708065 12/05/2018 150103A101 150105A101 0.00 0.00 20.16 0.00 20.16
3,018 210-18-42528634 SEGURA JAHUIN MELODY BRIZETH 15 210-2-61297889 27/03/2018 150103A101 150101A105 0.00 0.00 16.39 0.00 16.39
3,019 210-17-24273833 SEGURA NUÑEZ ANGELICA MILAGROS 40 210-2-21136779 04/01/2017 150103A101 150111A101 0.00 0.00 9.40 0.00 9.40
3,020 210-12-01287885 SEGURA PARRA CLAUDIA ALEJANDRA 22 210-2-46376030 27/11/2012 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,021 210-13-01196791 SEGURA SAENZ ANGEL FERNANDO 12 210-2-75889540 13/03/2013 150103A101 070102A101 0.00 0.00 168.00 0.00 168.00
3,022 210-13-01252609 SEGURA YANCE RUSSEL CHEQUES 29 210-2-42280319 12/11/2013 150103A101 150103A208 0.00 0.00 30.80 0.00 30.80
3,023 210-13-01223605 SEMINARIO PEÑA DOLORES MARISOL 30 310-2-48247658 05/07/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,024 210-13-00291470 SEOPA FLORES MILAGROS 20 210-2-48293242 02/03/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80

Elaborado por OIE-SIS Página 108 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,025 210-13-01228590 SERALAYAN LEDESMA JHON EDWARD 8 210-2-71876422 06/08/2013 150103A101 150101A104 0.00 0.00 42.00 0.00 42.00
3,026 210-13-01220138 SERNA SALDARRIAGA FREISY ANALY 18 210-2-76930933 21/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,027 210-13-01217038 SERNAQUE SILVA MARITZA JANET 31 210-2-40968140 09/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,028 210-12-00188213 SERNAQUE ZAPATA NATALI ANDREA 22 210-2-46286192 24/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,029 210-11-03614958 SERRANO CAMAVILCA NATALLY KARLA 23 210-2-45558457 04/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
3,030 210-18-42526371 SERVA CANCHANYA GIOVANI 20 210-2-77668321 25/03/2018 150103A101 150137A101 0.00 0.00 5.96 0.00 5.96
3,031 210-18-42473703 SEVILLANO JABA MARJORIE IVONNE 30 210-2-44808840 07/01/2018 150103A101 150111A205 0.00 0.00 10.55 0.00 10.55
3,032 210-11-03728194 SHAHUANO ACUÑA MAYUMI 18 210-2-48045628 10/11/2011 150103A101 150132A203 0.00 0.00 45.00 0.00 45.00
3,033 210-14-40075368 SHAHUANO HUILLCA ARACELY TESHIRA 17 210-2-75254965 21/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
3,034 210-13-01200180 SHARIGUA PUCHUÑO ELIZABETH 28 210-2-42654786 29/03/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
3,035 210-18-42465503 SHUPINGAHUA MARTINEZ RN-HV 0 210-E-28842864 08/01/2018 150103A101 150105A101 0.00 0.00 17.80 0.00 17.80
3,036 210-14-40074240 SHUPINGAHUA PINEDO NEFITA 26 210-2-45338765 18/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
3,037 210-18-42523314 SHUPINGAHUA SINCHE RN 0 210-E-29088779 20/03/2018 150103A101 150111A101 0.00 0.00 10.43 0.00 10.43
3,038 210-18-42508854 SICHA LIZANA ELIAS 60 210-2-06878204 02/03/2018 150103A101 150111A101 0.00 0.00 9.44 0.00 9.44
3,039 210-11-03609845 SIERRA VELASQUEZ IVONNE ROCIO 20 210-2-46719846 28/08/2011 150103A101 150101A109 0.00 0.00 40.00 0.00 40.00
3,040 210-11-03734449 SIESQUEN TUÑOQUE DOLORES 34 210-2-17634806 01/01/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,041 210-13-01224127 SIGUAS TRILLO JELINA KARINA 20 210-2-47907487 08/07/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
3,042 210-12-00185555 SIHUINCHA CONTRERAS ENMA 48 210-2-06576954 25/05/2012 150103A101 150101A103 0.00 0.00 0.00 0.00 0.00
3,043 210-11-03052088 SIKUS PALOMINO MARLENI 27 210-2-43010906 11/06/2011 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
3,044 210-13-01247568 SILVA CASHU CLOTILDE 26 210-2-44165941 25/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,045 210-11-03726391 SILVA LOZA FABIOLA SHIRLEY 25 210-2-43759644 29/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,046 210-17-24397651 SILVA PAREJAS KELLY 23 210-2-70099519 26/07/2017 150103A101 150137A206 0.00 0.00 5.50 0.00 5.50
3,047 210-12-03902120 SILVA RONDAN NOELI BEIRUT 19 210-2-47423051 06/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,048 210-18-42577149 SILVESTRE FLORES LILIANA DALILA 0 210-2-81707441 28/05/2018 150103A101 150105A101 0.00 0.00 31.49 0.00 31.49
3,049 210-17-24389638 SIMON AGUILAR DIANA CAROLINA 30 210-2-45049872 13/07/2017 150103A101 150111A101 0.00 0.00 8.09 0.00 8.09
3,050 210-12-00188907 SIMON ANTONIO CARMELA 35 210-2-41868531 27/06/2012 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
3,051 210-16-22936738 SIMON CANDIA MATHIU GAEL 2 210-2-79131839 03/12/2016 150103A101 150105A101 0.00 0.00 12.74 0.00 12.74
3,052 210-18-42498926 SIMON CANDIA MATHIU GAEL 3 210-2-79131839 18/02/2018 150103A101 150115A101 0.00 0.00 11.78 0.00 11.78

Elaborado por OIE-SIS Página 109 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,053 210-17-24298681 SIMON CCAHUANA ANGELICA 24 210-2-47231435 16/02/2017 150103A101 150111A101 0.00 0.00 8.02 0.00 8.02
3,054 210-18-42531340 SINARAHUA MORALES NANCY 41 240-2-80395070 16/03/2018 150103A101 150101A102 0.00 0.00 18.90 0.00 18.90
3,055 210-12-03905713 SINCHE ALVAREZ EVA 38 210-2-04073970 29/03/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
3,056 210-18-42477709 SINCHE QUISPE MELINA SARED 16 210-2-76399297 23/01/2018 150103A101 150809A302 0.00 0.00 12.76 0.00 12.76
3,057 210-17-24330602 SINCHE ROMAN RN 0 210-E-28736232 07/04/2017 150103A101 0000016918 0.00 0.00 11.30 0.00 11.30
3,058 210-17-24330750 SINCHE ROMAN RN 0 210-E-28736232 07/04/2017 150103A101 150105A101 0.00 0.00 18.53 0.00 18.53
3,059 210-17-24331314 SINCHE ROMAN RN 0 210-E-28736232 10/04/2017 150103A101 150111A101 0.00 0.00 10.39 0.00 10.39
3,060 210-12-00188225 SINCHI QUISPE GLADYS 26 210-2-43453633 24/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,061 210-12-03908903 SINCHI RAMOS MARILUZ 31 210-2-40616126 28/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,062 210-17-24446976 SINTI MANUYAMA KARINA ESTHER 37 240-2-41021356 04/10/2017 150103A101 150111A101 0.00 0.00 9.11 0.00 9.11
3,063 210-17-24332801 SINUIRI CANAYO ADRIANO DELPIERO 11 210-2-75908066 12/04/2017 150103A101 150111A101 0.00 0.00 18.08 0.00 18.08
3,064 210-11-03611145 SIPION CHAPOÑAN ELIZABETH DEL ROCIO 35 210-2-16743966 16/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,065 210-18-42492167 SISO ALDANA YESMAR NOHELY 26 210-E-29024154 04/04/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
3,066 210-18-42511272 SOBERO SILVA DE SANCHEZ HILDA 70 210-2-09364803 05/03/2018 150103A101 150115A101 0.00 0.00 13.91 0.00 13.91
3,067 210-13-00288347 SOBRADO CARRILLO GINA 4 210-2-72071205 18/02/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
3,068 210-16-22941810 SOLANO ARIAS RN 0 210-E-27717315 12/12/2016 150103A101 150111A101 0.00 0.00 7.33 0.00 7.33
3,069 210-13-01212828 SOLANO BARRETO ROSA EVA 20 210-2-47420215 22/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,070 210-18-42478148 SOLANO DE LA CRUZ KARIN NADIA 14 170-2-75457937 23/01/2018 150103A101 150115A101 0.00 0.00 12.27 0.00 12.27
3,071 210-18-42478761 SOLANO DE LA CRUZ KARIN NADIA 14 170-2-75457937 24/01/2018 150103A101 150115A101 0.00 0.00 7.85 0.00 7.85
3,072 210-17-24356709 SOLANO HINOSTROZA JESUS ROGER 19 220-2-73682919 24/05/2017 150103A101 150137A101 0.00 0.00 4.51 0.00 4.51
3,073 210-13-01230921 SOLANO ROMERO ESTEFANY MARIELA 20 210-2-47639197 21/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,074 210-13-01228617 SOLANO YAÑAC KATHERIN FABIOLA 21 210-2-47533181 07/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,075 210-12-00187595 SOLIER HUAMACCTO CINDDY ANGELICA 22 210-2-46177198 14/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,076 210-13-01229096 SOLIER PAUCAR YOVANA 24 210-2-46120511 12/08/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
3,077 210-14-40070982 SOLIER PAUCCAR NN 0 210-7-47860756 09/08/2014 150103A101 150101A101 0.00 0.00 14.30 0.00 14.30
3,078 210-17-24500349 SOLIS ALCANTARA ELSA RAQUEL 30 210-2-45048777 18/12/2017 150103A101 150137A101 0.00 0.00 4.70 0.00 4.70
3,079 210-11-03613746 SOLIS BERAUN JENI CARMEN 17 210-2-73497705 04/09/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
3,080 210-18-42495863 SOLIS HUAMAN ARABIA ATHENAS 24 210-2-47900229 14/02/2018 150103A101 150111A205 0.00 0.00 8.35 0.00 8.35

Elaborado por OIE-SIS Página 110 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,081 210-14-40028450 SOLIS ORTIZ CANDY LUCERO 21 210-2-48151973 01/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,082 210-18-42468410 SOLORZANO BARRETO DANNY WILBER 14 210-2-75127185 10/01/2018 150103A101 0000016918 0.00 0.00 8.71 0.00 8.71
3,083 210-18-42521252 SOLORZANO ESPINOZA GAMANIEL 39 210-2-40180116 17/03/2018 150103A101 150101A101 0.00 0.00 13.91 0.00 13.91
3,084 210-18-42529157 SOLORZANO ESPINOZA GAMANIEL 39 210-2-40180116 28/03/2018 150103A101 150111A101 0.00 0.00 9.44 0.00 9.44
3,085 210-12-00184113 SORIA HIDALGO MILUSKA ESTRELLA 20 210-2-47602856 07/04/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
3,086 210-17-24503506 SORIA NUÑEZ KATHERINE ELIZABETH 29 210-2-45870819 24/12/2017 150103A101 150101A105 0.00 0.00 16.92 0.00 16.92
3,087 210-12-03902189 SOSA CARAMANTIN GRACE KELLY 24 210-2-46027712 08/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,088 210-11-03053731 SOSA SULCA ELIZABETH 34 210-2-16176868 13/06/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,089 210-14-40061727 SOTACURO ESCOBAR RN 0 210-7-71386259 13/07/2014 150103A101 150105A101 0.00 0.00 23.10 0.00 23.10
3,090 210-12-03909579 SOTACURO HUARCAYA EUDOSIA 23 210-2-45879665 29/02/2012 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
3,091 210-17-24413470 SOTACURO HUARCAYA EUDOSIA 28 210-2-45879665 19/08/2017 150103A101 150111A205 0.00 0.00 10.57 0.00 10.57
3,092 210-12-00187078 SOTELO SIMEON DIANA MARIALENI 21 210-2-47079225 15/06/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,093 210-11-03606593 SOTO BARRERA KATHERINE DEYANIRA 17 210-2-48124750 18/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,094 210-12-03898878 SOTO CACERES BERTHA RAQUEL 19 210-2-47667047 15/01/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
3,095 210-11-03609962 SOTO CAMAC KATERINE 19 210-2-47078808 01/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,096 210-13-01220614 SOTO CUELLAR NILSON ALDAIR 12 210-2-75967676 23/06/2013 150103A101 150121A101 0.00 0.00 140.00 0.00 140.00
3,097 210-18-42543578 SOTO DE LA CRUZ YESSICA AMALIA 29 210-2-45336815 16/04/2018 150103A101 150101A105 0.00 0.00 12.27 0.00 12.27
3,098 210-11-03052380 SOTO GALA NORMA 22 210-2-45105561 21/05/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
3,099 210-12-00195442 SOTO HUARANGO ELIZABETH 14 210-2-77469801 18/04/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,100 210-12-01283879 SOTO INOCENTE INES ROXANA 29 210-2-41786525 15/09/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
3,101 210-17-24331148 SOTO QUISPE ANAHI RUTH 6 210-2-74258393 09/04/2017 150103A101 150115A101 0.00 0.00 12.20 0.00 12.20
3,102 210-11-03051374 SOTO SULCA CARMEN ROSA 20 210-2-71003665 03/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,103 210-11-03726827 SOTO TAPIA YAEL ANDRE 4 210-2-70951225 08/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,104 210-14-40017225 SOTO VICENTE GISELA YOVANA 24 210-2-47651920 26/02/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,105 210-12-00194264 SOTO YANCCEHUALLPA EULOGIO 42 210-2-07466476 18/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,106 210-12-00803778 SOTOMAYOR ANAYA YAMELA GIOVANNA 19 210-2-73443948 13/09/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
3,107 210-12-00807366 SOVERO MARTEL YANET MARIBEL 31 210-2-40836009 26/07/2012 150103A101 150111A205 0.00 0.00 0.00 0.00 0.00
3,108 210-17-24474341 SOVERO MOZOMBITE KELY ARELI 30 210-2-44555515 12/11/2017 150103A101 150111A101 0.00 0.00 9.40 0.00 9.40

Elaborado por OIE-SIS Página 111 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,109 210-17-24329918 SUAMUT LOPEZ SHEYDY NHYCOLY 18 060-2-77811400 06/04/2017 150103A101 150111A101 0.00 0.00 8.46 0.00 8.46
3,110 210-12-01283531 SUAREZ GUILLEN ERIKA MABEL 26 210-2-43616117 20/09/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,111 210-13-01234973 SUAREZ ROJAS VALENTIN 91 210-2-28472422 06/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,112 210-12-03910472 SUCA MENDOZA ANGELICA 57 210-2-29618482 09/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,113 210-13-00287819 SUIRI PALACIOS SOLEDAD 18 210-2-60508634 15/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,114 210-17-24498135 SULCA ANCHAYHUA CARMEN ROSA 20 210-2-74661517 15/12/2017 150103A101 150111A205 0.00 0.00 11.28 0.00 11.28
3,115 210-14-40103144 SULCA BASILIO HAYDE ELIZABET 26 210-2-44647197 31/10/2014 150103A101 150110A101 0.00 0.00 38.50 0.00 38.50
3,116 210-13-01224970 SULCA CHATE KATERE CLAUDIA 18 210-2-76736930 11/07/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
3,117 210-12-03903358 SULCA DE LA CRUZ NN 0 210-7-45711618 14/02/2012 150103A101 150103A208 0.00 0.00 0.00 0.00 0.00
3,118 210-18-42532951 SULCA FERRER JUAN FELIPE 1 210-2-79952966 02/04/2018 150103A101 0000016918 0.00 0.00 10.80 0.00 10.80
3,119 210-13-00287428 SULCA QUINO LILIANA AYDEE 20 210-2-47934539 13/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,120 210-17-24340821 SULCA QUISPE GABRIELLA DAMILU LISI 5 210-2-77180576 27/04/2017 150103A101 150111A101 0.00 0.00 9.04 0.00 9.04
3,121 210-11-03732568 SULCA RODRIGUEZ LIDIA 32 210-2-40230153 08/12/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,122 210-11-03056680 SULCA SILVERA YENI ADELI 22 210-2-45909808 29/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,123 210-14-40029848 SULLCA CABEZAS ABIGAIL 24 210-2-70322492 05/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,124 210-14-40032294 SULLCA DE LA CRUZ YANET 29 210-2-42379622 12/04/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,125 210-18-42469319 SULLCARAY RUPAY EULOGIA 36 170-2-43283217 11/01/2018 150103A101 150137A206 0.00 0.00 6.26 0.00 6.26
3,126 210-11-03604878 SUSANIVAR BRAVO YERALDIN SIOMARA 11 210-6-00385852 05/08/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,127 210-14-40054971 SUSANIVAR TRUJILLO MERCEDES ELVIRA 31 210-2-41460321 24/06/2014 150103A101 150128A204 0.00 0.00 18.70 0.00 18.70
3,128 210-14-40031506 SUTTA GONZALES VERONICA 27 210-2-45633520 09/04/2014 150103A101 150128A204 0.00 0.00 53.20 0.00 53.20
3,129 210-13-01251503 SUYON MORILLOS JOSE ALBERTO 56 060-2-33590575 08/11/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
3,130 210-11-03051368 TABOADA CARDENAS NORMA 22 210-2-70115743 02/06/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
3,131 210-12-00276690 TABOADA GUTIERREZ HECTOR LUIS 13 210-2-75781734 03/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,132 210-17-24430112 TABOADA SULCA PABLO 61 220-2-06557183 11/09/2017 150103A101 070102A101 0.00 0.00 24.44 0.00 24.44
3,133 210-12-00185048 TACO TACAS JACKELIN MILAGROS 15 210-2-74452367 11/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,134 210-12-00195432 TAFUR RIVERO MARIA VICTORIA 22 210-2-47241686 17/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,135 210-17-24483383 TAGLE GRADOS MARTHA GLORIA 64 210-2-06579804 25/11/2017 150103A101 150111A101 0.00 0.00 8.81 0.00 8.81
3,136 210-12-00195980 TAIPE BELITO JOSEFINA 41 210-2-09769794 14/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 112 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,137 210-17-24336600 TAIPE ESPINOZA RN 0 210-E-28781169 19/04/2017 150103A101 0000016918 0.00 0.00 11.30 0.00 11.30
3,138 210-17-24337205 TAIPE ESPINOZA RN 0 210-E-28781169 20/04/2017 150103A101 150111A101 0.00 0.00 4.52 0.00 4.52
3,139 210-12-00804061 TAIPE REYNOSO GULISSA CLARIBEL 23 210-2-45350331 14/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,140 210-17-24413416 TAIPE SOTO CLARA INES 25 210-2-46994681 18/08/2017 150103A101 150111A101 0.00 0.00 8.09 0.00 8.09
3,141 210-17-24358449 TAIPE VALLEJOS SANDRA VERONICA 32 210-2-42817561 26/05/2017 150103A101 150121A101 0.00 0.00 18.50 0.00 18.50
3,142 210-11-03059375 TAIPE YAURI TERESA 31 210-2-40331549 22/07/2011 150103A101 150101A109 0.00 0.00 40.00 0.00 40.00
3,143 210-18-42497954 TALAVERANO ESPINOZA GERALDINE ISABEL 20 210-2-48986456 16/02/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
3,144 210-16-22890805 TALAVERANO NIEVES KAREN ABIGAIL 4 210-2-78250555 19/09/2016 150103A101 150101A109 0.00 0.00 17.88 0.00 17.88
3,145 210-13-01201362 TALLA VERA JHADY ISABEL 18 210-2-76189081 03/04/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
3,146 210-17-24346871 TAMAYO SAMAME ISABEL CAROLINA 25 210-2-47196730 06/05/2017 150103A101 150111A101 0.00 0.00 9.93 0.00 9.93
3,147 210-17-24506731 TAMBRACC SEDANO SAM SKAYLAM 1 210-2-79649149 02/01/2018 150103A101 150105A101 0.00 0.00 18.29 0.00 18.29
3,148 210-18-42461194 TAMBRACC SEDANO SAM SKAYLAM 1 210-2-79649149 03/01/2018 150103A101 150105A101 0.00 0.00 18.78 0.00 18.78
3,149 210-17-24322928 TAMBRACC YULGO ELI 35 210-2-42830885 28/03/2017 150103A101 150103A208 0.00 0.00 11.75 0.00 11.75
3,150 210-17-24376879 TAME VELASQUEZ CAMILA ALESSANDRA 0 210-2-90148381 24/06/2017 150103A101 150105A101 0.00 0.00 15.45 0.00 15.45
3,151 210-16-22932855 TANTA BOLAÑOS JOSE LUIS 30 210-2-44247975 27/11/2016 150103A101 150111A101 0.00 0.00 7.72 0.00 7.72
3,152 210-17-24343135 TANTALEAN SAAVEDRA TERESITA DE JESUS 17 060-2-74893143 30/04/2017 150103A101 150111A101 0.00 0.00 10.39 0.00 10.39
3,153 210-17-24354709 TAPARA GONZALES ROLAN ANGEL 20 210-2-77666192 19/05/2017 150103A101 150137A101 0.00 0.00 2.71 0.00 2.71
3,154 210-11-03606424 TAPARA PEREZ MARGARITA 25 210-2-44062788 08/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,155 210-12-00805387 TAPIA AVILA FELICITA NORMA 52 210-2-06594609 24/08/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,156 210-11-03731689 TAPIA CHALCO YOBANA 21 210-2-46540602 25/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,157 210-11-03731494 TAPIA FLORES VIRGINIA 30 210-2-41480483 24/11/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,158 210-11-03613855 TAPIA SOLORZANO MELISSA JACQUELINE 26 210-2-43015128 03/09/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
3,159 210-11-03614899 TAPIA SOLORZANO MELISSA JACQUELINE 26 210-2-43015128 23/09/2011 150103A101 150101A105 0.00 0.00 45.00 0.00 45.00
3,160 210-11-03057179 TARAZONA GUILLERMO ELIZABETH LILIANA 36 210-2-04033928 13/05/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,161 210-14-40066376 TARAZONA MELENDEZ JESSICA KARINA 15 210-2-72246965 30/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
3,162 210-17-24420942 TARDEO NAVARRO CARMEN 18 210-2-72449911 31/08/2017 150103A101 150111A101 0.00 0.00 14.57 0.00 14.57
3,163 210-18-42488173 TARDEO QUISPE SILVIA 26 210-2-47137711 05/02/2018 150103A101 150111A205 0.00 0.00 8.35 0.00 8.35
3,164 210-11-03062989 TARQUI YAJA RUTH ELICIA 19 210-2-47255412 10/07/2011 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 113 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,165 210-18-42478954 TARRILLO TANGOA KEYKO SOFIA 20 210-2-74402051 24/01/2018 150103A101 150133A101 0.00 0.00 24.06 0.00 24.06
3,166 210-12-00196639 TASAYCO DE LA CRUZ ANA LUISA 33 210-2-80615828 25/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,167 210-17-24407559 TASAYCO TASAYCO LUIS ENRIQUE 53 150-2-21804796 10/08/2017 150103A101 150101A103 0.00 0.00 10.14 0.00 10.14
3,168 210-13-00278111 TASILLA CHAVEZ NICOLAS 79 210-2-01028565 19/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,169 210-17-24318474 TAXA INCA JENIFER SOFIA 20 200-2-72914067 21/03/2017 150103A101 150111A101 0.00 0.00 8.47 0.00 8.47
3,170 210-11-03055087 TAYPE ORE MELISSA 16 210-2-76397081 05/05/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,171 210-14-40031888 TAYPE QUISHCA ESPIRITA 74 200-2-20971152 10/04/2014 150103A101 150122A101 0.00 0.00 140.00 0.00 140.00
3,172 210-13-01208045 TAYPE QUISPE ISAIAS 0 350-7-80209173 03/05/2013 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
3,173 210-12-00191574 TEJADA SOLLASE MARGARITA 20 210-2-46858517 02/06/2012 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
3,174 210-12-03902229 TELLO BENDEZU ANA MARIA 32 210-2-80260065 06/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,175 210-16-22946022 TELLO GOMES RN 1 210-E-27484628 20/12/2016 150103A101 0000016918 0.00 0.00 10.81 0.00 10.81
3,176 210-17-24499502 TELLO GOMEZ OMAR ALEXANDER 12 210-2-62670398 17/12/2017 150103A101 0000016918 0.00 0.00 11.75 0.00 11.75
3,177 210-17-24506559 TELLO LLATA LUCY HILDA 23 210-2-70752644 30/12/2017 150103A101 150137A206 0.00 0.00 7.52 0.00 7.52
3,178 210-18-42496301 TELLO MEDINA YSIDORA 38 070-2-45343533 14/02/2018 150103A101 150111A101 0.00 0.00 8.35 0.00 8.35
3,179 210-18-42537682 TELLO RUIZ RN-HV 0 210-E-29108173 07/04/2018 150103A101 150105A101 0.00 0.00 17.67 0.00 17.67
3,180 210-13-01217953 TELLO SALCEDO YESEBEL WENLY 17 210-2-76940219 12/06/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,181 210-11-03735145 TELLO SANCHEZ MARIBEL MILAGROS 33 210-2-80080780 21/12/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,182 210-18-42469325 TELLO SANTIAGO CRISTIANO RONALDO 10 210-2-61078708 11/01/2018 150103A101 150111A101 0.00 0.00 7.85 0.00 7.85
3,183 210-17-24386109 TENAZOA SHUÑA LUCELI ISABEL 25 210-2-47070347 07/07/2017 150103A101 150101A105 0.00 0.00 11.97 0.00 11.97
3,184 210-11-03058610 TENORIO ROJAS ESPERANZA 78 210-2-10259490 12/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,185 210-11-03048690 TEREZO HUARANGA YUDI 22 210-2-45683798 13/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,186 210-12-03909736 TERREL ALCANTARA JUAN MANUEL 3 210-2-72992743 11/03/2012 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
3,187 210-13-01233889 TERREROS ALBINO KARINA ANA 23 210-2-46287832 03/09/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
3,188 210-17-24437215 TERREROS GUTARRA OLGA ROCIO 25 210-2-48012120 22/09/2017 150103A101 150111A101 0.00 0.00 10.34 0.00 10.34
3,189 210-18-42474822 TERRONES ESPINOZA LUIS ROIDER 21 070-2-77680440 18/01/2018 150103A101 150111A101 0.00 0.00 9.20 0.00 9.20
3,190 210-13-01197587 TERRY ALVAREZ GABRIELA ISABEL 20 210-2-72913965 18/03/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
3,191 210-17-24415563 TERRY FIGUEROA MARGARITA 43 210-2-08164811 23/08/2017 150103A101 150111A101 0.00 0.00 8.85 0.00 8.85
3,192 210-13-01241204 TICLLA CANDIOTTI CINDIA CAMILA 5 210-2-72342882 30/09/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00

Elaborado por OIE-SIS Página 114 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,193 210-18-42572488 TIMOTEO CHAGUA NEIL PIERO 2 210-2-79518713 22/05/2018 150103A101 150111A101 0.00 0.00 9.35 0.00 9.35
3,194 210-18-42543291 TINEO ALVARADO DE NORES ROSA ANTONIA 33 210-2-42849607 14/04/2018 150103A101 150111A101 0.00 0.00 10.31 0.00 10.31
3,195 210-12-00808118 TINEO ESPINOZA RN 0 210-7-42963196 01/09/2012 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
3,196 210-16-40062199 TINEO PILLACA JAVIER 81 210-2-08190178 17/04/2016 150103A101 150111A101 0.00 0.00 6.16 0.00 6.16
3,197 210-11-03056328 TIPULA MUÑOZ JENNY MARILU 29 210-2-42646645 06/05/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
3,198 210-12-00277450 TITO CAYSAHUANA BANESA YESELA 17 210-2-60698104 07/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,199 210-17-24431733 TITO OSORIO BRIGITTE FABIOLA 18 210-2-74604620 13/09/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
3,200 210-17-24320226 TITO PACHAS JULIA ANTONIA 32 210-2-44230935 23/03/2017 150103A101 150101A105 0.00 0.00 12.88 0.00 12.88
3,201 210-11-03728670 TITO SULLCA JULIANA 41 210-2-09367684 26/11/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
3,202 210-17-24385633 TOCCAS ARANYA MARIVEL 28 210-2-46188385 06/07/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
3,203 210-17-24324723 TOLEDO CUADROS ANGEL JEFERSON 4 130-2-81090383 30/03/2017 150103A101 150111A101 0.00 0.00 10.85 0.00 10.85
3,204 210-12-00192572 TOLEDO LOAYZA SHEYLA JUDITH 20 210-2-47278019 06/06/2012 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
3,205 210-12-00805817 TOLEDO PACHECO JOANNA CHRISTINE 24 210-2-45526072 19/08/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
3,206 210-13-01226800 TOLENTINO SAMANEZ CINDY YOSSELYN 24 210-2-45307336 21/07/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
3,207 210-11-03609893 TOMA HUAMANI RUTH MIRIAM 28 210-2-41645747 29/08/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,208 210-17-24344442 TOMAS AYALA MANUEL ALEJANDRO 13 270-2-77498866 02/05/2017 150103A101 150111A101 0.00 0.00 31.58 0.00 31.58
3,209 210-13-01223153 TOMAS PECHE MARCO ANTONIO 7 210-2-60800614 03/07/2013 150103A101 150105A101 0.00 0.00 63.00 0.00 63.00
3,210 210-18-42509886 TORDOCILLO TAIPE LIANA DARLYN 1 210-2-79635461 03/03/2018 150103A101 150105A101 0.00 0.00 18.38 0.00 18.38
3,211 210-18-42510778 TORIBIO BENITES KIARA MARIFER 18 210-2-76226357 04/03/2018 150103A101 150101A105 0.00 0.00 14.41 0.00 14.41
3,212 210-12-00806663 TORIBIO CARDENAS ROGER JHAILSON 4 210-2-61249809 01/09/2012 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
3,213 210-14-40075127 TORIBIO RIVERA YANINA 32 210-2-41258450 20/08/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
3,214 210-17-24498155 TORIBIO TAIPE ERIKA SIOMARA 17 210-2-75781759 15/12/2017 150103A101 150111A101 0.00 0.00 8.93 0.00 8.93
3,215 210-14-40054334 TORIBIO TAIPE YUDITH GRACIELA 16 210-2-75781758 23/06/2014 150103A101 150111A101 0.00 0.00 20.14 0.00 20.14
3,216 210-14-40031887 TORPOCO ORTIZ JOSELYN PATRICIA 18 210-2-76309637 11/04/2014 150103A101 150132A205 0.00 0.00 68.60 0.00 68.60
3,217 210-17-24473724 TORPOCO POVIS MEDALY JAQUELIN 27 210-2-48114276 10/11/2017 150103A101 150111A101 0.00 0.00 7.99 0.00 7.99
3,218 210-11-03061390 TORREJON GOMEZ FORTUNATO 82 210-2-17905438 29/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,219 210-18-42465432 TORRES BENITO EDITH 18 210-2-74537234 07/01/2018 150103A101 150137A101 0.00 0.00 4.79 0.00 4.79
3,220 210-12-00195856 TORRES CALDERON YANINA MARITZA 23 210-2-45222607 07/05/2012 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 115 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,221 210-17-24438604 TORRES CALLUPE JIMMY JEAN PIER 7 210-2-78158401 24/09/2017 150103A101 150115A101 0.00 0.00 7.89 0.00 7.89
3,222 210-12-03910917 TORRES CARPIO OSWALDO SANTODOMINGO 64 210-2-09061604 07/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,223 210-11-03062615 TORRES CHUMPE STEFANY KIMBERLY 15 210-2-77024248 07/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,224 210-11-03049893 TORRES CORDOVA MILAGROS DEL PILAR 25 210-2-43232150 09/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,225 210-18-42559491 TORRES ENCISO ALFREDO ANTONIO 63 210-2-07114880 05/05/2018 150103A101 150101A102 0.00 0.00 20.69 0.00 20.69
3,226 210-11-03056136 TORRES GAMARRA SOYMI 17 210-2-48005377 08/05/2011 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
3,227 210-18-42578346 TORRES GONZALES LENA MARGARITA 25 200-2-70792533 28/05/2018 150103A101 150137A206 0.00 0.00 6.59 0.00 6.59
3,228 210-17-24408639 TORRES MARTINEZ GENNY MARIA 34 210-2-42266361 11/08/2017 150103A101 150111A101 0.00 0.00 8.41 0.00 8.41
3,229 210-17-24344556 TORRES ORDAYA BENJAMÍN LEONARDO 0 210-2-79661136 03/05/2017 150103A101 150105A101 0.00 0.00 32.04 0.00 32.04
3,230 210-17-24343252 TORRES PAYANO ROXANA PATRICIA 28 210-2-45315706 01/05/2017 150103A101 150137A206 0.00 0.00 6.32 0.00 6.32
3,231 210-16-22868878 TORRES PEREZ YOMERTH ADERLY 1 210-2-78812183 15/08/2016 150103A101 150111A101 0.00 0.00 6.37 0.00 6.37
3,232 210-14-40112786 TORRES PEÑA JILIAN 17 200-2-48833907 13/11/2014 150103A101 150111A101 0.00 0.00 11.00 0.00 11.00
3,233 210-18-42523608 TORRES PINEDO RAUL RUBEN 2 210-2-79152371 21/03/2018 150103A101 150111A101 0.00 0.00 9.94 0.00 9.94
3,234 210-11-03059906 TORRES QUISPE LIDIA 46 210-2-10169972 31/07/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,235 210-11-03061458 TORRES QUISPE LIDIA 46 210-2-10169972 30/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,236 210-18-42535472 TORRES QUISPE LIDIA 53 210-2-10169972 05/04/2018 150103A101 150115A101 0.00 0.00 13.25 0.00 13.25
3,237 210-17-24355586 TORRES SAENZ CAROLYN JACINTA 27 210-2-46853594 22/05/2017 150103A101 150111A101 0.00 0.00 9.02 0.00 9.02
3,238 210-11-03060633 TORRES SANTA CRUZ DELFINA 24 210-2-44081924 17/06/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
3,239 210-11-03732338 TORRES SOLANO YESICA 23 200-2-46022973 06/12/2011 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
3,240 210-11-03052519 TORRES SOLLER JESSICA 34 210-2-10599754 24/05/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,241 210-12-00185760 TORRES SUCA NOE 24 210-2-44989623 16/04/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,242 210-14-40055437 TORRES TELLO HERMINIA CAROLA 47 210-2-10423186 25/06/2014 150103A101 150118A101 0.00 0.00 30.80 0.00 30.80
3,243 210-13-00287482 TORRES TORRES MARIA DEL PILAR 25 210-2-44710136 13/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,244 210-17-24474416 TORRES TORRES MARIELA SARITA 9 210-2-71672208 12/11/2017 150103A101 0000023159 0.00 0.00 23.03 0.00 23.03
3,245 210-14-40085958 TORRES VILLACREZ FRANCISCA JANNET 41 210-2-05357094 16/09/2014 150103A101 150133A101 0.00 0.00 15.95 0.00 15.95
3,246 210-14-40090857 TORRES VILLACREZ FRANCISCA JANNET 41 210-2-05357094 01/10/2014 150103A101 150101A102 0.00 0.00 22.15 0.00 22.15
3,247 210-12-00802918 TOVAR CORONEL ANDY ESMITH 9 210-2-62602733 05/10/2012 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
3,248 210-11-03736048 TOVAR NAVARRO RODRIGO FRANCO 13 210-2-70908541 04/01/2012 150103A101 150118A101 0.00 0.00 0.00 0.00 0.00

Elaborado por OIE-SIS Página 116 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,249 210-12-01289682 TOVAR ROJAS ESTHER YOBANA 36 210-2-20081895 02/11/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,250 210-17-24478969 TOVAR ROJAS ESTHER YOBANA 41 210-2-20081895 18/11/2017 150103A101 150111A101 0.00 0.00 8.34 0.00 8.34
3,251 210-12-00197491 TRELLES PACHERRES ANA MARIA 20 210-2-46996699 08/05/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
3,252 210-13-01244007 TRILLO TAIPE SONIA 25 210-2-45500007 12/10/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
3,253 210-17-24456607 TRINIDAD CERVANTES YACK LIAM 0 210-E-28948470 18/10/2017 150103A101 150105A101 0.00 0.00 13.89 0.00 13.89
3,254 210-17-24356153 TRINIDAD PALACIN JOSUE DONAYRE 12 210-2-74903370 22/05/2017 150103A101 150101A109 0.00 0.00 16.69 0.00 16.69
3,255 210-18-42493744 TRINIDAD RAMOS JAMES SNAYDER 0 210-2-90190374 11/02/2018 150103A101 150115A101 0.00 0.00 17.06 0.00 17.06
3,256 210-14-40019459 TRINIDAD RIVERA NATACHA 21 210-2-48089947 05/03/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,257 210-11-03611536 TRISTAN LAZON GICENIA 37 210-2-20102123 03/10/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00
3,258 210-11-03061917 TRISTAN QUIROZ YESSICA VIOLETA 24 210-2-44393184 03/07/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
3,259 210-17-24454273 TRUJILLO BULEJE RN-HV 0 210-E-28947534 14/10/2017 150103A101 150101A102 0.00 0.00 16.22 0.00 16.22
3,260 210-18-42556307 TRUJILLO RUIZ BENIGNA GREGORIA 18 140-2-76007452 30/04/2018 150103A101 150111A205 0.00 0.00 21.11 0.00 21.11
3,261 210-14-40018207 TRUJILLO TIRAPO AURELIA 41 210-2-80139633 01/03/2014 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
3,262 210-14-40066968 TTITO ARROYO EDISON YORTINO 34 210-2-40767138 30/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
3,263 210-14-40076659 TTITO TAIRO HILDA 36 210-2-24719153 26/08/2014 150103A101 150111A205 0.00 0.00 11.00 0.00 11.00
3,264 210-11-03060869 TUANAMA TUANAMA ESTEFANI 15 210-2-75487104 15/06/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,265 210-11-03732068 TUCTO PUSARI CYNTHIA KINVERLY 23 210-2-45722565 01/12/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00
3,266 210-12-00802624 TUDELANO AGUILAR DE ROMERO ELIANA 36 210-2-10253503 10/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,267 210-14-40055798 TUDELANO CONDE LUCY 34 210-2-41518412 27/06/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
3,268 210-13-01217464 TUESTA SANTOS JANET ERICKA 32 210-2-45268868 11/06/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
3,269 210-17-24412684 TUIREZ ROMERO NANCY 37 210-2-41005874 17/08/2017 150103A101 150111A101 0.00 0.00 8.09 0.00 8.09
3,270 210-11-03054869 TULLUME HUAMAN JOHAU JEFERSON 0 210-2-76706003 19/05/2011 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
3,271 210-18-42530974 UCEDA CABALLERO RUBEN ALEXANDER 6 210-2-77200007 31/03/2018 150103A101 150115A101 0.00 0.00 15.90 0.00 15.90
3,272 210-13-01229214 UGARTE HERNANDEZ HORTENCIA MILAGROS 30 210-2-42152482 12/08/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,273 210-11-03614827 UNOCC APUMAITA HAYDEE VILMA 25 210-2-43205922 23/09/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,274 210-11-03610011 UNOCC QUISPE CARMEN 21 210-2-47690423 01/09/2011 150103A101 150101A109 0.00 0.00 40.00 0.00 40.00
3,275 210-18-42490243 URBANO MIRANDA JEFFERSON JHENCY 13 210-2-75435312 06/02/2018 150103A101 150115A101 0.00 0.00 11.78 0.00 11.78
3,276 210-11-03731738 URBINA ENRIQUEZ NATIVIDAD 39 210-2-06810196 26/11/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00

Elaborado por OIE-SIS Página 117 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,277 210-14-40070297 URBINA ILLANES JAQUELIN YOANA 18 210-2-72764438 07/08/2014 150103A101 150137A206 0.00 0.00 8.25 0.00 8.25
3,278 210-18-42569971 URETA SOTELO MARISELA 33 210-2-42673460 18/05/2018 150103A101 150111A101 0.00 0.00 8.96 0.00 8.96
3,279 210-11-03731545 URIARTE GARCIA CARITO MAGALY 18 210-2-47974929 23/11/2011 150103A101 150101A105 0.00 0.00 40.00 0.00 40.00
3,280 210-11-03061461 URIBE ROSAS HERMINIA 89 210-2-23255033 30/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,281 210-11-03061298 URPAY CHAVEZ SINDY MARITZA 19 210-2-46758629 28/06/2011 150103A101 150111A203 0.00 0.00 0.00 0.00 0.00
3,282 210-17-24359097 URRUTIA BULEJE SILVIA 64 210-2-07674614 28/05/2017 150103A101 150101A102 0.00 0.00 14.89 0.00 14.89
3,283 210-12-00195854 USCA LLIMPI MARILUZ 19 210-2-61502108 07/05/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,284 210-11-03058261 UZURIAGA DAZA LIZELA 20 210-2-47199749 22/07/2011 150103A101 150121A101 0.00 0.00 50.00 0.00 50.00
3,285 210-18-42550470 UZURIAGA GARCILAZO GIANCARLOS 29 210-2-45315700 24/04/2018 150103A101 150101A101 0.00 0.00 13.75 0.00 13.75
3,286 210-12-01294847 VALCARCEL ENRIQUEZ MARTIN JOHN 27 210-2-43254412 21/10/2012 150103A101 150122A101 0.00 0.00 0.00 0.00 0.00
3,287 210-14-40073074 VALCARCEL RUIZ MELISSA NATHALY 28 210-2-44275951 14/08/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
3,288 210-17-24431633 VALDEZ CONDOR VIOLETA MELISA 29 210-2-44628016 13/09/2017 150103A101 150111A101 0.00 0.00 7.55 0.00 7.55
3,289 210-11-03735185 VALDEZ VERASTEGUI RN 0 210-7-09845628 21/12/2011 150103A101 150121A101 0.00 0.00 0.00 0.00 0.00
3,290 210-11-03050383 VALDEZ ZUÑIGA MIRELLA LIZETH 18 210-2-47750096 24/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,291 210-11-03735348 VALDIVIA QUISPE ROSA NOEMI 24 210-2-44630653 24/12/2011 150103A101 150101A105 0.00 0.00 0.00 0.00 0.00
3,292 210-17-24392076 VALENCIA DE NUÑEZ DELIA 71 170-2-20684900 17/07/2017 150103A101 150101A101 0.00 0.00 15.43 0.00 15.43
3,293 210-17-24395374 VALENCIA DE NUÑEZ DELIA 71 170-2-20684900 22/07/2017 150103A101 150101A101 0.00 0.00 11.00 0.00 11.00
3,294 210-13-01222182 VALENCIA HUARACA FLOR DE MARIA 25 210-2-44466168 30/06/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
3,295 210-11-03061884 VALENCIA VILLANUEVA GRICELDA LIDIA 65 210-2-10494598 03/07/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,296 210-16-22840206 VALENTIN FRANCIA ESTEBAN TRINIDAD 78 210-2-04017106 28/06/2016 150103A101 150101A102 0.00 0.00 11.68 0.00 11.68
3,297 210-11-03057047 VALENTIN VASQUEZ DAIRA ARACELI 1 210-2-62545887 26/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,298 210-16-22926586 VALENZUELA ESPINOZA ADRIANA VALENTINA 5 210-2-76104742 16/11/2016 150103A101 0000016918 0.00 0.00 11.58 0.00 11.58
3,299 210-14-40028584 VALENZUELA MUÑOZ JEAN PIERRE 17 210-2-75496458 01/04/2014 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
3,300 210-17-24315040 VALENZUELA OLARTE JOSÉ MANUEL 0 210-2-90016165 14/03/2017 150103A101 150103A101 0.00 0.00 21.66 0.00 21.66
3,301 210-17-24432533 VALERA PARDO YSELA DOLORES 17 020-2-71943564 14/09/2017 150103A101 150111A101 0.00 0.00 8.33 0.00 8.33
3,302 210-11-03049667 VALERO GARCIA YESSENIA JUSTINA 18 210-2-47901333 15/04/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,303 210-18-42530375 VALLADOLID ARROYO RUTH KATHERINE 23 210-2-74088623 29/03/2018 150103A101 150111A101 0.00 0.00 9.44 0.00 9.44
3,304 210-11-03727287 VALLEJOS PALOMINO LUCY 25 210-2-45170674 31/10/2011 150103A101 150137A206 0.00 0.00 25.00 0.00 25.00

Elaborado por OIE-SIS Página 118 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,305 210-17-24498804 VALLEJOS RODRIGUEZ LUZ NERI 21 100-2-70846418 15/12/2017 150103A101 150111A101 0.00 0.00 11.28 0.00 11.28
3,306 210-17-24459043 VALLES INUMA LLERLY 34 210-2-43472872 21/10/2017 150103A101 150111A101 0.00 0.00 8.33 0.00 8.33
3,307 210-12-03905523 VALLES RODAS MARLENY 26 210-2-43097756 25/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,308 210-11-03732766 VALVERDE OCHOA VERONICA 21 210-2-47071434 14/12/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
3,309 210-11-03731535 VALVERDE PAREDES AMELIA ESTHER 43 210-2-10604181 22/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,310 210-18-42470078 VARGAS BARRANZUELA JOHANA MABEL 21 280-2-74588506 12/01/2018 150103A101 150111A101 0.00 0.00 8.71 0.00 8.71
3,311 210-13-01242300 VARGAS CABEZA NANCY MILAGROS 26 210-2-43827221 04/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,312 210-14-40053944 VARGAS CAÑARI SEBASTIAN WILFREDO 2 210-2-77398034 20/06/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
3,313 210-14-40063944 VARGAS CAÑARI SEBASTIAN WILFREDO 2 210-2-77398034 20/06/2014 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,314 210-12-03903770 VARGAS CUBAS MARIA AYDA 39 210-2-01123468 16/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,315 210-17-24344357 VARGAS CUTTI BILLY JHOEL ALDO 12 210-2-75969416 02/05/2017 150103A101 150111A101 0.00 0.00 9.02 0.00 9.02
3,316 210-12-00808247 VARGAS EGAS MIRIAM SARA 33 210-2-40220630 09/08/2012 150103A101 150101A102 0.00 0.00 0.00 0.00 0.00
3,317 210-11-03729354 VARGAS GUILLEN ANITA 29 210-2-41399310 12/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,318 210-14-40062366 VARGAS MOSQUERA GODOFREDO 80 210-2-06109568 15/07/2014 150103A101 150111A101 0.00 0.00 9.90 0.00 9.90
3,319 210-14-40054065 VARGAS PUENTE BRACK SMITH 2 270-2-63036052 21/06/2014 150103A101 150135A101 0.00 0.00 22.55 0.00 22.55
3,320 210-14-40064065 VARGAS PUENTE BRACK SMITH 2 270-2-63036052 21/06/2014 150103A101 150135A101 0.00 0.00 112.00 0.00 112.00
3,321 210-12-03902227 VARGAS TORREJON ROSABELL 18 210-2-61820496 06/02/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,322 210-12-00197545 VARGAS VARGAS ROCIO SANTOSA 20 210-2-47629007 06/05/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,323 210-13-01199481 VASQUEZ ALAYO VIVIANA 45 210-2-80087432 25/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,324 210-18-42510626 VASQUEZ ARIAS ESTHEFANY JENNYFER 19 170-2-73464566 03/03/2018 150103A101 150111A101 0.00 0.00 9.94 0.00 9.94
3,325 210-13-01252307 VASQUEZ CCOLLANA GERALDINE OLIMPIA 19 210-2-73547473 12/11/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
3,326 210-17-24393261 VASQUEZ CENTENO SHIRLEY KAREN 33 210-2-42459830 18/07/2017 150103A101 150111A101 0.00 0.00 7.34 0.00 7.34
3,327 210-13-01200381 VASQUEZ CUSTODIO MARCOS ANTONIO 34 210-2-80613684 30/03/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,328 210-12-01282928 VASQUEZ DE LOPEZ ABADEZA 86 210-2-19829588 22/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,329 210-17-24453404 VASQUEZ DIAZ ANGELA MIRLEY 25 210-2-71715537 13/10/2017 150103A101 150111A101 0.00 0.00 8.33 0.00 8.33
3,330 210-13-01223668 VASQUEZ GOMEZ MEDJAI ALEXANDER 9 210-2-76672769 05/07/2013 150103A101 150115A101 0.00 0.00 42.00 0.00 42.00
3,331 210-14-40068964 VASQUEZ GONZALES ROCIO PAMELA 17 210-2-76342584 05/08/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
3,332 210-18-42479764 VASQUEZ JAIMES SELENE SCARLETT 8 210-2-74003976 25/01/2018 150103A101 0000016918 0.00 0.00 9.57 0.00 9.57

Elaborado por OIE-SIS Página 119 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,333 210-11-03727295 VASQUEZ MEJIA ANA ESTHER 22 210-2-46007347 31/10/2011 150103A101 150111A101 0.00 25.00 0.00 0.00 25.00
3,334 210-17-24438337 VASQUEZ MONDALGO ROSA 42 210-2-10209224 23/09/2017 150103A101 150137A101 0.00 0.00 4.78 0.00 4.78
3,335 210-11-03053827 VASQUEZ ROCHA JHOSELIN LUCELINA 19 210-2-47355733 14/06/2011 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,336 210-17-24493645 VASQUEZ ROJAS SEBASTIAN CRISTOPHER 1 210-2-79830685 08/12/2017 150103A101 150115A101 0.00 0.00 13.16 0.00 13.16
3,337 210-17-24495636 VASQUEZ SUMA ELIZA 27 210-2-46364317 12/12/2017 150103A101 150111A205 0.00 0.00 11.28 0.00 11.28
3,338 210-13-01214324 VEGA ARMUTO MILISSA 22 210-2-46904415 29/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,339 210-13-01237952 VEGA MAGAN JUAN ALBERT 13 210-2-70909159 18/09/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,340 210-13-01251464 VEGA MALPARTIDA DANITZA DAYANA 26 210-2-46980035 08/11/2013 150103A101 150111A205 0.00 0.00 30.80 0.00 30.80
3,341 210-13-01213107 VELA CURO MARLENE EDITH 36 210-2-42490461 23/05/2013 150103A101 150101A105 0.00 0.00 42.00 0.00 42.00
3,342 210-18-42568473 VELA UPIACHIGUA LUCI ROCIO 44 180-2-80635719 15/05/2018 150103A101 150111A101 0.00 0.00 9.35 0.00 9.35
3,343 210-12-03906071 VELARDE MALPARTIDA JHAIRO EMANUEL 6 210-2-77003440 02/04/2012 150103A101 150115A101 0.00 0.00 0.00 0.00 0.00
3,344 210-11-03726331 VELARDE MARMOL ALLINSON REBECA 27 210-2-42244695 28/10/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,345 210-12-00197554 VELASCO CUNIA MARITZA MARYLIN 22 210-2-46686515 07/05/2012 150103A101 150132A205 0.00 0.00 0.00 0.00 0.00
3,346 210-12-03909704 VELASQUE HUAMAN REYNA ANGELICA 23 210-2-45460553 10/03/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,347 210-12-00803893 VELASQUE MEDINA ROSA YOLANDA 36 210-2-20590661 07/09/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,348 210-17-24425799 VELASQUE NUÑEZ JACKELINE ALEXANDRA 21 210-2-60682111 05/09/2017 150103A101 150111A101 0.00 0.00 16.66 0.00 16.66
3,349 210-17-24504123 VELASQUE TABOADA YASURI YHAMILET 0 210-2-90281224 26/12/2017 150103A101 150105A101 0.00 0.00 15.98 0.00 15.98
3,350 210-12-01294852 VELASQUEZ ALVARADO ANTONIA ISOLINA 37 210-2-80257493 20/10/2012 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,351 210-12-00197669 VELASQUEZ CAJALEON EVA ELAM 29 210-2-41695694 10/04/2012 150103A101 150107A204 0.00 0.00 0.00 0.00 0.00
3,352 210-17-24473098 VELASQUEZ CHURA ABIGAIL DORCA 0 210-2-81711879 10/11/2017 150103A101 150105A101 0.00 0.00 17.15 0.00 17.15
3,353 210-17-24431015 VELASQUEZ CHURA RN-HV 0 210-E-28916758 13/09/2017 150103A101 150105A101 0.00 0.00 13.44 0.00 13.44
3,354 210-14-40098240 VELASQUEZ ROJAS ZORAYDA 25 210-2-45908712 19/10/2014 150103A101 150101A101 0.00 0.00 13.75 0.00 13.75
3,355 210-11-03052169 VELASQUEZ ZACARI FACUNDO 35 210-2-29706909 13/06/2011 150103A101 150111A101 0.00 0.00 0.00 0.00 0.00
3,356 210-13-01209775 VELI PACHAS ISABEL ANDREA 21 210-2-47144782 10/05/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,357 210-14-40011282 VELIZ HUARCAYA LISSET GINA 34 210-2-40360036 07/02/2014 150103A101 150101A101 0.00 0.00 39.20 0.00 39.20
3,358 210-17-24337811 VELIZ MARTINEZ DANIEL MAKAY 10 210-2-70648367 21/04/2017 150103A101 150111A101 0.00 0.00 10.39 0.00 10.39
3,359 210-11-03729363 VELIZ TANTA RUTH JOSHELIN 16 210-2-72664772 27/10/2011 150103A101 070103A101 0.00 0.00 45.00 0.00 45.00
3,360 210-13-00287734 VENANCINO RODRIGUEZ LUCILA 25 210-2-45009184 14/02/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00

Elaborado por OIE-SIS Página 120 de 127


REPORTE DE SERVICIOS POR TRASLADO NO CERRADO
COMPONENTE: SUBSIDIADO

Periodo Calendario: OCTUBRE/2018

DISA: 210
Fecha de Impresion : 08/08/2018 11:03:36a.m.

NroFormato Afiliado EDAD CONTRATO Fec.Traslado Origen Dstino PASAJE VIATICOS COMBUSTIBLE ALIMENTOS TOTAL

3,361 210-13-01218244 VENEGAS GOMEZ BETTY 31 210-2-40948825 14/06/2013 150103A101 150137A206 0.00 0.00 30.80 0.00 30.80
3,362 210-17-24321429 VENEGAS TUPAC INGRI YURI 19 230-2-75082206 26/03/2017 150103A101 150111A101 0.00 0.00 14.85 0.00 14.85
3,363 210-16-22935415 VENERO CORITOMA JENYFER CAROL 31 210-2-43139342 01/12/2016 150103A101 150101A103 0.00 0.00 11.97 0.00 11.97
3,364 210-13-01212261 VENTOCILLA HUARCA CIELO AVRIL 1 210-2-77549989 20/05/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
3,365 210-18-42509836 VENTURA CANAHUALPA RN 0 220-E-28905457 02/03/2018 150103A101 150111A101 0.00 0.00 9.44 0.00 9.44
3,366 210-11-03062987 VENTURA CASAS SANDRA MARIA 27 210-2-42093484 10/07/2011 150103A101 150135A101 0.00 0.00 0.00 0.00 0.00
3,367 210-11-03051479 VERA MEDINA GLADYS 24 210-2-44166235 04/06/2011 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
3,368 210-13-01245258 VERA PALOMINO JERSON 26 210-2-44015605 17/10/2013 150103A101 150118A101 0.00 0.00 77.00 0.00 77.00
3,369 210-17-24322272 VERA POZO MILCA ESTEFANIA 18 210-2-76294201 28/03/2017 150103A101 150111A101 0.00 0.00 8.59 0.00 8.59
3,370 210-13-01227505 VERAMENDI ZELAYA MARIA DEL PILAR 24 210-2-45288246 26/07/2013 150103A101 150121A101 0.00 0.00 140.00 0.00 140.00
3,371 210-12-01295358 VERANO PUCLLAS OLINDA 26 210-2-43501263 19/10/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,372 210-17-24430155 VERDE CAMACLLANQUI MAYUMI 7 170-2-62384582 12/09/2017 150103A101 150111A101 0.00 0.00 7.55 0.00 7.55
3,373 210-18-42548479 VERGARA BARTOLO GLADIS JACINTA 24 210-2-74393781 21/04/2018 150103A101 150111A205 0.00 0.00 17.67 0.00 17.67
3,374 210-14-40116843 VICHARRA GABRIEL ADELINA ENMA 30 210-2-44107443 22/11/2014 150103A101 150118A101 0.00 0.00 32.65 0.00 32.65
3,375 210-17-24428955 VICTORIO BENANCIO JULIA SUSANA 19 210-2-77088867 09/09/2017 150103A101 150111A101 0.00 0.00 7.89 0.00 7.89
3,376 210-18-42465473 VICTORIO DE CAHUANA MARIA 52 150-2-21839161 08/01/2018 150103A101 150111A101 0.00 0.00 11.41 0.00 11.41
3,377 210-12-00800770 VIDAL GASPAR MILAGROS 32 210-2-40340088 14/07/2012 150103A101 150101A109 0.00 0.00 0.00 0.00 0.00
3,378 210-11-03729157 VIDAL ROJAS KATHERINE YOHAIRA 18 210-2-48261277 11/11/2011 150103A101 150111A101 0.00 0.00 25.00 0.00 25.00
3,379 210-13-01195115 VIDALON SIRLUPU YULISSE MARIA 41 210-2-07881928 06/03/2013 150103A101 150101A102 0.00 0.00 53.20 0.00 53.20
3,380 210-16-22810431 VIDARTE VERGARAY WILLIAMS FERNANDO ROYER 1 210-2-78822260 04/05/2016 150103A101 150105A101 0.00 0.00 14.71 0.00 14.71
3,381 210-12-01288692 VIGURIA ESCOBAR JENNY 28 210-2-42244553 28/10/2012 150103A101 150137A206 0.00 0.00 0.00 0.00 0.00
3,382 210-17-24476290 VILA SOTO PAOLA 23 210-2-48706045 14/11/2017 150103A101 150111A101 0.00 0.00 9.57 0.00 9.57
3,383 210-13-01247904 VILCA COCHACHI LUCAS ABRAHAM 7 210-2-75456351 26/10/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,384 210-14-40063885 VILCA MACEDO MARTHA MARIA 22 210-2-70792591 19/07/2014 150103A101 150101A105 0.00 0.00 20.35 0.00 20.35
3,385 210-13-00278494 VILCA NINA MARIA ANGELICA 25 210-2-44276191 21/01/2013 150103A101 150111A101 0.00 0.00 35.00 0.00 35.00
3,386 210-18-42534196 VILCA ÑAUPARI GAEL YERICO 0 210-2-81700870 04/04/2018 150103A101 150105A101 0.00 0.00 17.67 0.00 17.67
3,387 210-18-42517481 VILCAHUAMAN ALHUAYA DAYANA ELIZABETH 1 210-2-81686171 12/03/2018 150103A101 150111A101 0.00 0.00 9.94 0.00 9.94
3,388 210-11-03730382 VILCAHUAMAN TINTAYO ANA LUZ 26 210-2-42896035