TMP - 9848 Surat Pernyataan Melaksanakan Prolanis 1 1998297519

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TMP - 9848 Surat Pernyataan Melaksanakan Prolanis 1 1998297519

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SURAT PERNYATAAN MELAKSANAKAN PROLANIS

Saya yang bertandatangan dibawah ini:

Nama : ..............................................................

Jabatan : ..............................................................

Mewakili FKTP.......................................... menyatakan bahwa FKTP ..........................................

(SUDAH/AKAN * )) Pengelolaan Penyakit Kronis (DM&HT) di tahun 2017.

Demikian pernyataan ini dibuat tanpa ada paksaan dari pihak manapun.

Bogor, 2017

Materai 6000 & Stempel FKTP

(Nama lengkap)................................

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