PEMERINTAH KABUPATEN ACEH TAMIANG

DINAS KESEHATAN
UPTD PUSKESMAS KOTA KUALASIMPANG
KECAMATAN KOTA KUALASIMPANG
Jln. Puskesmas No. 10 Kotalintang Kode Pos 24475

LAPORAN KEGIATAN

1. Dasar : ST No. / 445 / 2023

2. Tujuan Kunjungan : ……………………………………………………………………………..

3. Hasil Kunjungan :

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4. Kesimpulan / Saran Perbaikan :

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Mengetahui Kualasimpang, ............................... 2023

Datok Penghulu Pelapor

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