PEMERINTAH KABUPATEN PROBOLINGGO

DINAS KESEHATAN
PUSKESMAS JABUNGSISIR
Jl. Raya Jabungsisir Besuk KM. 0,1 Paiton
Kabupaten Probolinggo Kode Pos: 67291
Telp. 085336699223 e-mail: puskesmas.jabungsisir@probolinggokab.go.id

KERANGKA ACUAN KEGIATAN

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TAHUN 2017

I. PENDAHULUAN
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II. LATAR BELAKANG

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III. TUJUAN
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IV. KEGIATAN POKOK DAN RINCIAN KEGIATAN

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V. CARA MELAKSANAKAN KEGIATAN

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VI. SASARAN
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VII. JADWAL PELAKSANAAN KEGIATAN

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VIII. EVALUASI PELAKSANAAN KEGIATAN
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IX. PENCATATAN PELAPORAN DAN EVALUASI KEGIATAN

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Jabungsisir, Januari 2017

Mengetahui
Kepala Puskesmas Jabungsisir Pelaksana

dr. YUNIAR INDAH SAVITRI __________________________

NIP. 19701001 200604 2 008 NIP...............................................