BERITA ACARA DAN ABSENSI

PORTOFOLIO
DOKTER INTERNSHIP
PERIODE 07 JUNI 2015 07 JUNI 1016

RSUD ACHMAD DARWIS

PUSKESMAS DAGUNG DAGUNG
KABUPATEN LIMA PULUH KOTA
2015 2016

BERITA ACARA PERSENTASI PORTOFOLIO

Pada hari ini, ......................... , tanggal ............................... telah di persentasikan portofoli

oleh :
NAMA

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No. ID Peserta : ...............................................................................................................

Judul / Topik

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Nama Pendamping / No. ID : ...................................................................................................

Nama Wahana

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Nama Peserta Persentasi

1.
2.
3.
4.
5.
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7.
8.
9.
10.
11.
12.

Tanda Tangan

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....11..............................................................................
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Berita acara ini ditulis dan disampaikan sesuai dangan yang sesungguhnya.

Pendamping

(_______________________)

PRESENTASI PORTOFOLIO RSUD ACHMAD DARWIS

Topik

: .......................................................................................

Penyaji

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Tanggal

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Tempat

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No
1
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15

Nama Peserta

Tanda Tangan
1
2
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15