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No Dokumen : 10/SOP/KLK I/18

No Revisi : 00
SOP Tgl Terbit : 2 Januari 2018
Halaman : 1/2
UPT.PUSKESMAS drg. IDA BAGUS
KLUNGKUNG I PUTRA DWIPAYANA
1.Pengertian ……………………………………………………………………………
……………………………………………………………………………
2.Tujuan ……………………………………………………………………………
……………………………………………………………………………
3.Kebijakan ……………………………………………………………………………
……………………………………………………………………………
4. Referensi ……………………………………………………………………………
……………………………………………………………………………
5. Alat dan bahan Alat yang diperlukan :
 ………………………………………………………………………...
Bahan yang diperlukan :
 …………………………………………………………………………
 …………………………………………………………………………
6. Prosedur 1. ………………………………………………………………………..
langkah-langkah 2. ………………………………………………………………………..
3. ………………………………………………………………………..
4. ………………………………………………………………………..
5. ………………………………………………………………………..
6. ………………………………………………………………………..
7. ………………………………………………………………………..
7.Bagan Alir

8.Unit Terkait ……………………………………………………………………………

9.Dokumen Terkait ……………………………………………………………………………

1/2
10.Rekaman
Historis No Yang dirubah Isi Perubahan Tanggal Mulai
perubahan

2/2

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