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PEMERINTAH KABUPATEN PEMALANG

DINAS KESEHATAN
UPT. PUSKESMAS PADURAKSA

Pemalang, .......tgl.........bl....thn

Nomor : Kepada
Sifat :
Lampiran : Yth. .................................................
Hal : Undangan. .................................................
di -
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Hari : .......................................................
Tanggal : .......................................................
Pukul : ......................................................
Tempat : .......................................................
Acara : .......................................................

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KEPALA PUSKESMAS PADURAKSA


KABUPATEN PEMALANG

dr. NOOR FAIZAH MAENOFIE, M.Kes


Pembina
NIP. 19701204 200212 2 004

CATATAN: (apabila ada)


1. ...............................
2. ...............................
3. dan seterusnya.
(diberi garis bawah sesuai tembusan terakhir)

Jalan Letjen DI Panjaitan Nomor 218 Paduraksa Pemalang Kode Pos 52319 Telepon (0284) 321526
Email : puskesmaspaduraksa1@gmail.com

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