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  • Pelaksanaan Pemeliharaan Sarana Prasarana

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    PELAKSANAAN PEMELIHARAAN SARANA PRASARANA

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    8 views1 page

    Pelaksanaan Pemeliharaan Sarana Prasarana

    Uploaded by

    arya

    Copyright:

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

    PELAKSANAAN PEMELIHARAAN SARANA PRASARANA

    UPT PUSKESMAS GEGER

    BULAN :……………………………..

    Nama Ruangan : …………………………………………..


    Petugas pelaksana : …………………………………………..
    Penanggung Jawab : …………………………………………..
    NO ITEM YANG DIPELIHARA Mgg I Mgg II Mgg III Mgg IV Keterangan
    1 Atap/Plafon
    2 Dinding
    3 Ventilasi & Pencahayaan
    4 Lantai
    5 Meja/kursi
    6 Lemari
    7 Tempat tidur
    8 Kipas Angin
    9 Lampu & panel
    10 AC / Air Conditioner
    11 Lain-lain
    Paraf pelaksana
    Paraf Penanggung jawab sarana
    Keterangan : B = Baik
    K = Kotor
    R = Rusak
    PENGELOLA SARANA
    UPT PUSKESMAS GEGER

    PELAKSANAAN PEMELIHARAAN SARANA PRASARANA


    UPT PUSKESMAS GEGER

    BULAN :……………………………..

    Nama Ruangan : …………………………………………..


    Petugas pelaksana : …………………………………………..
    Penanggung Jawab : …………………………………………..
    NO ITEM YANG DIPELIHARA Mgg I Mgg II Mgg III Mgg IV Keterangan
    1 Atap/Plafon
    2 Dinding
    3 Ventilasi & Pencahayaan
    4 Lantai
    5 Meja/kursi
    6 Lemari
    7 Tempat tidur
    8 Kipas Angin
    9 Lampu & panel
    10 AC / Air Conditioner
    11 Lain-lain
    Paraf pelaksana
    Paraf Penanggung jawab sarana
    Keterangan : B = Baik
    K = Kotor
    R = Rusak
    PENGELOLA SARANA
    UPT PUSKESMAS GEGER

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