PENG
‘URUS CABANG
IKATAN BIDAN INDONESIA
KABUPATEN MALAKA
JLKletekNo....
Desa Kletek, Kec. Malaka Tengah
Kode Pos : 85762
Format Rekapitulasi Kegiatan Praktik Profesi / Pelayanan Kebidanan
‘Nama Bidan Serlyana Daria Bere,AMd.Keb Pelayanan 1; WeWAcGa qenencania CHS)
NoSTR 2 1902521 16-1245555 Periode Kegiatan_ : 14 september 2020 S/D 13 September 2021
No KTA 2 $321.2208.0007 Unit/Lokasi Pely : Ruang KB/Puskesmas Nurobo
No] _ Hari Nama Pasien | Umur Diagnosa Tindakan/Asuhan
‘Tanggal (Tahun)
T | Sam,
M4 tena & Noe Dee 446 = WH
Ne Vande 2A | Meugtor ee cae 4 buen [Retnerian "W-Oepe
2 | Saasa,
caifos/acas En 2 | Mesegtor eR Fuubte S Lauten HRouteicun Ww5 Deke 30-44
3 | Yours,
25 Joa facos [NS Mere Moe | 26 | bccegtor ee WE totem [Rentrcrew wy: DeRe 3% -
4 | tam,
os /orsacas [WS Nermetvon ke | 39 [teagioe eb Sable Soran Freusiesrenn toy. Vege 3EE> 1H
3 | Seam. =
a foas reas [S Roestne Mee] 24 | Nesecor tes PASE Noman Newilnercun ewe YAH!
6 ramet,
as pensacas fy: Meanie whoo | 2% | heager ke Set # Nexen Redmon Vy: ae 26
T | toe, :
os fos/ don [ts Won Comom| 2 | Buagtor eb aicle 3 Toten [Reatevew Wh Ore BL =m
8 | We.
pyfob/acar My-Nidepeds Serr | 3 Aesegor ks ove 3 Men Roworion fa: Deyo St =
O | Sckae,
XY fer) 034 MY Martie hte | AG | Avcegor eS Brame 2 ten, Newtearen WS, -Qego $e WA
10 | Sow, ts
28/08 /2e1 [NS Yustine et 3 | Rewer tee Seite Bom [eullensenn “Ha “Dege BE- IM
iT fabs,
eryog reas [MY Veeuous Car | 25 | Mentor YR save > DOr [Rentoentenn Wy RRS HENS
TZ] tas. | we ~~
nfoarans, [SY a Reamer RSE 3 ton [Reeder wd Oepe Set~
Betun, 13 September 2021
Kepala Puskesmas Bidag Pelaksana
yA
Gerardus ik Serlyana Daria Bere, AMd.Keb
NIP:19761028 199603 1 003 ‘NO. KTA : 5321.2208.0007
Mengetahui
Ketua Pe IBI Malaka
te,
NO.KTA : 5321.1
Tr.Keb
910.0157