Scribd Logo
Upload

Welcome to Scribd!

  • FORM LAPORAN PIHAK III New

    Uploaded by

    pemeliharaan SaranaRS
    3 views3 pages
    formulir perbaikan pihak 3

    Original Title

    FORM LAPORAN PIHAK III new

    Copyright

    © © All Rights Reserved

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    formulir perbaikan pihak 3

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    3 views3 pages

    FORM LAPORAN PIHAK III New

    Uploaded by

    pemeliharaan SaranaRS
    formulir perbaikan pihak 3

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 3

    IPS RSUD MARDI WALUYO KOTA BLITAR

    FORMULIR PERMINTAAN PERBAIKAN PIHAK III

    NAMA RUANG : ………………………………. KODE PERBAIKAN : …………………


    SARPRAS : ………………………………………………………………………………………………………………………..
    KERUSAKAN : .……………………………………………………………………………………………………………………….
    …………………………………………………………………………………………………………………….…..
    KEPALA IPS

    (SHAKTI ARGONO)

    TINDAK LANJUT
    PELAKSANA : 1. ……………………………………… TANGGAL : …………………………….
    2. ………………………………………
    3. ………………………………………
    TINDAKAN PERBAIKAN : ……………………………………………………………………………………………….
    ……………………………………………………………………………………………….
    SPARE PART YANG DIGANTI : 1. ………………………………… 4. ………………………………….
    2. …………………………………. 5. ………………………………….
    3. ………………………………….. 6. ………………………………..
    HASIL PERBAIKAN : …………………………………………………..

    MENGETAHUI PETUGAS
    KEPALA RUANG

    ( ) ( )
    TINDAKAN PERBAIKAN

    You might also like