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POLITEKNIK KESEHATAN KEMENKES KUPANG

PROGAM STUDI KESEHATAN GIGI

LABORATORIUM PRODI KESEHATAN GIGI
Jln. Adisucipto – Penfui - Kupang, Telp : (0380) 881342;

Form Peminjaman Alat

Kelas :
Hari/Tanggal :
Praktikum :

NO Nama Mahasiswa Nama Alat Jumlah satuan Waktu Paraf Waktu Paraf
Ambil Instruktur Kembali Instruktur

Mengetahui Dosen Pembimbing Penanggung jawab Laboratorium

___________________________
POLITEKNIK KESEHATAN KEMENKES KUPANG
PROGAM STUDI KESEHATAN GIGI
LABORATORIUM PRODI KESEHATAN GIGI
Jln. Adisucipto – Penfui - Kupang, Telp : (0380) 881342;

Form Peminjaman Bahan

Kelas :
Hari/Tanggal :
Praktikum :

NO Nama Mahasiswa Nama Bahan Jumlah satuan Waktu Paraf Instruktur

Ambil

Mengetahui Dosen Pembimbing Penanggung jawab Laboratorium

___________________________

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