<table width="100%" border="1" cellpadding="5" cellspacing="0">

<tr>
<td colspan="2"><strong>Kode Puskesmas</strong></td>
<td width="137" >P1771030201</td>
</tr>
<tr>
<th width="137" rowspan="2" align="center" valign="middle">NIK(Nomor Induk
Kependudukan)</th>
<th width="118" rowspan="2" align="center"
valign="middle"><strong>ID/NIP/NRP</strong></th>

<th width="155" rowspan="2" align="center" valign="middle"><strong>Nama (Nama

Lengkap)</strong></th>
<th width="59" rowspan="2" align="center" valign="middle">Jenis Kelamin</th>
<th width="90" rowspan="2" align="center" valign="middle"><strong>Status
Kepegawaian</strong></th>
<th colspan="3" align="center" valign="middle">Pekerjaan</th>
<th colspan="3" align="center" valign="middle">Pendidikan</th>
</tr>
<tr>
<th width="76" align="center" valign="middle"><strong>Kode SDMK</strong></th>
<th width="91" align="center" valign="middle"><strong>Mulai</strong></th>
<th width="79" align="center" valign="middle"><strong>Berakhir</strong></th>
<th width="73" align="center" valign="middle"><strong>Kode Prog.
Studi</strong></th>
<th width="91" align="center" valign="middle"><strong>Tahun Lulus</strong></th>
<th width="98" align="center" valign="middle"><strong>Kode Sekolah /Perguruan
Tinggi</strong></th>
</tr>

<tr valign="middle">
<td width="137"align="center" bgcolor="#FFFF66">&nbsp;</td>
<td width="118" align="center" bgcolor="#FFFF66">&nbsp;</td>
<td width="155" align="center" bgcolor="#FFFF66">&nbsp;</td>
<td width="59" align="center" bgcolor="#FFFF66">&nbsp;</td>
<td width="90" align="center" bgcolor="#FFFF66">&nbsp;</td>
<td width="76" align="center" bgcolor="#FFFF66">&nbsp;</td>
<td width="91" align="center" bgcolor="#FFFF66">&nbsp;</td>
<td width="79" align="center" bgcolor="#FFFF66">&nbsp;</td>
<td width="73" align="center" bgcolor="#FFFF66">&nbsp;</td>
<td width="91" align="center" bgcolor="#FFFF66">&nbsp;</td>
<td width="98" align="center" bgcolor="#FFFF66">&nbsp;</td>
</tr>

</table>
<strong>Keterangan : Isi Kolom Berwarna Kuning.</strong>