You are on page 1of 3

DAFTAR HADIR

Tanggal :...................................

NO NAMA JABATAN TANDA TANGAN

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

Kepala BLUD Puskesmas Kerumutan

Kepala BLUD Puskesmas Kerumutan


Harno,SKM
NIP. 19780914 200604 1 014

Harno,SKM
NIP. 19780914 200604 1 014
DINAS KESEHATAN KABUPATEN PELALAWAN
BADAN LAYANAN UMUM DAERAH
PUSKESMAS KERUMUTAN
Jl. Expan,Dusun Bukit garam, Kel. Kerumutan, KecKerumutan Kab. Pelalawan
Email : puskesmaskerumutan@gmail.com Call Center : 082391159506 Kode Pos : 28386

EVALUASI TERHADAP PENYAMPAIAN INFORMASI DI TEMPAT PENDAFTARAN

1. Hari / Tanggal :................................


2. Waktu :................................
3. Tempat :................................
4. Pemimpin Rapat:................................
5. Jumlah Peserta :................................
PEMBAHASAN

.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
DINASKESEHATANKABUPATENPELALAWAN
BADAN LAYANAN UMUM DAERAH
PUSKESMAS KERUMUTAN
Jalan Expan Bukit Garam ,Kel.Kerumutan, Kec.KerumutanKab. Pelalawan
Email: puskesmaskerumutan@gmail.com Call Center : 082391159506 Kode Pos : 28386

Kerumutan, 02 Maret 2018

Nomor : 445/PKM/2018/_____ Kepada yth


Kepala puskesmas kerumutan

Lampiran : - Di Kerumutan

Dengan Hormat,
Bersama surat ini kami mengundang seluruh staff Puskesmas Kerumutan untuk dapat mengikuti
rapat, yang akan dilaksanakan pada :
Hari : Selasa

Tanggal : 03 Maret 2018

Jam : 13.00 WIB

Tempat : Aula puskesmas kerumutan

Keperluan : Hasil evaluasi terhadap penyampaian informasi di tempat pendaftaran

Demikian atas perhatian dan kerja samanya kami mengucapkan terima kasih.

Mengetahui :
Penanggung Jawab Tim Mutu
Puskesmas Kerumutan

drg.Siti Ummaiyah
19871111 201503 2 008

You might also like