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  • Blangko Surat Izin

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    Erna Martina
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    This document is a request for leave from work submitted to the head of the Gembor Community Health Center. It provides the applicant's name, ID number, home address, and dates for the requested leave period. The reason for the leave is not specified. It closes by respectfully requesting the leave be approved.

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    CCCV SDSD

    Original Title

    BLANGKO SURAT IZIN

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    This document is a request for leave from work submitted to the head of the Gembor Community Health Center. It provides the applicant's name, ID number, home address, and dates for the requested leave period. The reason for the leave is not specified. It closes by respectfully requesting the leave be approved.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    9 views1 page

    Blangko Surat Izin

    Uploaded by

    Erna Martina
    This document is a request for leave from work submitted to the head of the Gembor Community Health Center. It provides the applicant's name, ID number, home address, and dates for the requested leave period. The reason for the leave is not specified. It closes by respectfully requesting the leave be approved.

    Copyright:

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

    Kepada Yth :

    Kepala BLUD UPT Puskesmas Gembor

    Di

    Tempat

    Yang bertanda tangan di bawah ini :


    Nama : ……………………………………………………………….
    NIP/NIK : ……………………………………………………………….
    Alamat rumah : ……………………………………………………………………………………………………………………..
    ……………………………………………………………………………………………………………………..
    Dengan ini mengajukan izin pada tanggal ………………………………………..s/d ……………………………………………
    Karena…………………………………………………………………………………………………………………………………………………
    Demikian permohonan ini dibuat, agar dapat dimaklumi

    Tangrang,………………………………………

    Hormat saya.

    ……………………………………………………….

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