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  • FORM BIMB PA Niluh Nita Silfia

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    Narmin Faisal
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    This document is a form for academic advising for midwifery students at the Palu Midwifery Department, Palu Health Polytechnic. The form collects student personal details like name, date of birth, religion, semester, address, phone number, parents' names, addresses and phone numbers. It also includes columns for issues discussed in advising sessions, solutions provided, and signatures of the student and advising lecturer. The form is signed by the head of the midwifery department and academic advisor.

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    FORM BIMB PA Niluh Nita Silfia

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    This document is a form for academic advising for midwifery students at the Palu Midwifery Department, Palu Health Polytechnic. The form collects student personal details like name, date of birth, religion, semester, address, phone number, parents' names, addresses and phone numbers. It also includes columns for issues discussed in advising sessions, solutions provided, and signatures of the student and advising lecturer. The form is signed by the head of the midwifery department and academic advisor.

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    © All Rights Reserved
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    4 views7 pages

    FORM BIMB PA Niluh Nita Silfia

    Uploaded by

    Narmin Faisal
    This document is a form for academic advising for midwifery students at the Palu Midwifery Department, Palu Health Polytechnic. The form collects student personal details like name, date of birth, religion, semester, address, phone number, parents' names, addresses and phone numbers. It also includes columns for issues discussed in advising sessions, solutions provided, and signatures of the student and advising lecturer. The form is signed by the head of the midwifery department and academic advisor.

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    of 7

    BIMBINGAN AKADEMIK

    PRODI D-III KEBIDANAN PALU JURUSAN KEBIDANAN


    POLTEKKES KEMENKES PALU

    NILUH NITA SILFIA SST.,M.KEB PRODI D-III KEBIDANAN PALU


    POLTEKKES KEMENKES PALU KODE
    Jl. Thalua Konchi No.19 Mamboro Palu Utara
    SPMI-POLTEK-PLW-26.28
    Telp./Fax. (0451)491451
    E-mail: poltekkeskemenkespalu@yahoo.com REVISI : -
    Website : www.poltekkespalu.ac.id SULAWESI
    TENGAH

    DOKUMEN STANDAR FORMULIR TANGGAL : 10 NOVEMBER 2016


    SISTEM PENJAMINAN MUTU INTERNAL

    Foto

    3x4 FORMAT BIMBINGAN AKADEMIK


    cm

    Nama Mahasiswa : ………………………………………………………………………………………………………………………………..


    Tempat Tgl Lahir : ………………………………………………………………………………………………………………………………..
    NIM : ………………………………………………………………………………………………………………………………..
    Agama : ………………………………………………………………………………………………………………………………..
    Semester : ………………………………………………………………………………………………………………………………..
    Alamat : ………………………………………………………………………………………………………………………………..
    No. Telp : ………………………………………………………………………………………………………………………………..
    Alamat Email : ………………………………………………………………………………………………………………………………..
    Nama Ayah : ………………………………………………………………………………………………………………………………..
    Nama Ibu : ………………………………………………………………………………………………………………………………..
    No Telp Orang Tua : ………………………………………………………………………………………………………………………………..
    Pekerjaan Orang Tua : ………………………………………………………………………………………………………………………………..
    Alamat Orang Tua : ………………………………………………………………………………………………………………………………..

    No Hari/Tgl Permasalahan Solusi Paraf Paraf


    Dosen Mahasiswa

    1
    2

    3
    4

    5
    6

    Mengetahui Palu, ………………………………………


    Ketua Prodi D-III Kebidanan Palu Pembimbing Akademik

    Widya Pani SKM.,SST.,M.Kes Niluh Nita Silfia SST.,M.Keb


    NIP. 19720107 199102 2001 NIP. 198111062008122004

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