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    9 views1 page

    Format Surat Antigen

    Uploaded by

    Kld Nugraha

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    of 1

    PANGKALAN UTAMA TNI AL VIII

    PANGKALAN TNI AL TOLITOLI

    SURAT KETERANGAN DOKTER


    Nomor SKK / / XI / 2022

    Yang bertanda tangan dibawah ini, dokter TNI AL menerangkan dengan sesungguhnya
    bahwa pada hari ini telah memeriksa kesehatan dari :

    Nama :
    Umur :
    Alamat :
    Pekerjaan :

    Hasil Pemeriksaan Tanggal November 2022

    Swab Sars-Cov-2-Antigen : Positif / Negatif

    Demikian agar yang berwenang memakluminya.

    Tolitoli, November 2022


    Ka. BP Lanal Tolitoli

    dr. Rikano Lutasema


    Letda Laut (K) NRP 24451/P

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