LAPORAN

1. Dasar : Surat Tugas, No. 800/ / /BOK/2020

2. Tujuan Kunjungan/Rapat : ......................................................................................................

.........................................................................................................

3. Nama Petugas : ......................................................................................................

4. Hasil Kunjungan/Rapat:................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

............................................................................................................................................................

...............................................................................................................................................

5. Kesimpulan / Saran Perbaikan :

...........................................................................................................................................................

...........................................................................................................................................................

...........................................................................................................................................................

...........................................................................................................................................................

Hariang, .................................2020
Pelapor

......................................................
NIP.-
 NOTULEN

HARI :
TANGGAL :
WAKTU :
TEMPAT :
ACARA :
LAPORAN HASIL KEGIATAN

............................................................................................................................................................
............................................................................................................................................................
.........................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
............................................................................................................................................................
........................................................................................................................................
............................................................................................................................................................
..........................................................................................................................................................
NOTULIS,

……………………………….
 PEMERINTAH KABUPATEN SUMEDANG
DINAS KESEHATAN
UPT PUSKESMAS HARIANG
Jl. Raya Hariang, Buahdua–SumedangKodePos 45392
Telp.0822 1507 2707 Email : puskesmas_hariang@yahoo.co.id

DAFTAR HADIR KEGIATAN

DALAM RANGKA PEMBEKALAN KADER POSBINDU PTM
UPT PUSKESMAS HARIANG

TANGGAL :
NO NAMA ALAMAT TANDA TANGAN
Posyandu Melati I

Posyandu Melati I

Posyandu Melati I

Posyandu Melati II

Posyandu Melati II

Posyandu Melati II

Posyandu Bungur I

Posyandu Bungur I

Posyandu Bungur I

Posyandu Bungur II

Posyandu Bungur II

Posyandu Bungur II

Posyandu Bungur III

Posyandu Bungur III

Posyandu Bungur III

Posyandu Simpay Wargi I

Posyandu Simpay Wargi I

Posyandu Simpay Wargi I

Posyandu Simpay Wargi II

Posyandu Simpay Wargi II

Posyandu Simpay Wargi II

Posyandu Simpay Wargi III

Posyandu Simpay Wargi III

Posyandu Simpay Wargi III

Posyandu Simpay Wargi IV

Posyandu Simpay Wargi IV

Posyandu Simpay Wargi IV

Posyandu Simpay Wargi V

Posyandu Simpay Wargi V

Posyandu Simpay Wargi V

Posyandu Trimekar I

Posyandu Trimekar I

Posyandu Trimekar I

Posyandu Trimekar II

Posyandu Trimekar II

Posyandu Trimekar II

Posyandu Trimekar III

Posyandu Trimekar III

Posyandu Trimekar III

Posyandu Dahlia I

Posyandu Dahlia I

Posyandu Dahlia I

Posyandu Dahlia II

Posyandu Dahlia II

Posyandu Dahlia II

Posyandu Dahlia III

Posyandu Dahlia III

Posyandu Dahlia III

Posyandu Dahlia IV

Posyandu Dahlia IV

Posyandu Dahlia IV

Posyandu Dahlia V

Posyandu Dahlia V
Posyandu Dahlia V

PenanggungJawab,

(……………………………..)
NIP.
 PEMERINTAH KABUPATEN SUMEDANG
DINAS KESEHATAN
UPTD PUSKESMAS HARIANG
Jl. Raya Hariang, Buahdua–Sumedang KodePos 45392
Telp. (0261) 2140591 Email : pkmhariangcekas@gmail.com

DAFTAR HADIR KEGIATAN

TANGGAL :
TEMPAT :
KEGIATAN :

NO NAMA ALAMAT TANDA TANGAN

 Penanggung Jawab,

(……………………………..)
NIP.