Anda di halaman 1dari 2

ANGGOTA

1. _______________________________________________________
2. _______________________________________________________
3. _______________________________________________________
4. _______________________________________________________
5. _______________________________________________________
6. _______________________________________________________

KARTU TANDA PENGENAL KELUARGA


( KTKP )
PUSKESMAS/ PUSKESMAS PEMBANTU : ___________________________________
NAMA KEPALA KELUARGA :___________________________________
UMUR :___________________________________
ALAMAT :___________________________________
NO. INDEKS :
SETIAP BEROBAT HARUS DIBAWA

ANGGOTA
1. _______________________________________________________
2. _______________________________________________________
3. _______________________________________________________
4. _______________________________________________________
5. _______________________________________________________
6. _______________________________________________________

KARTU TANDA PENGENAL KELUARGA


( KTKP )
PUSKESMAS/ PUSKESMAS PEMBANTU : ___________________________________
NAMA KEPALA KELUARGA :___________________________________
UMUR :___________________________________
ALAMAT :___________________________________
NO. INDEKS :
SETIAP BEROBAT HARUS DIBAWA
KARTU TANDA PENGENAL KELUARGA
( KTKP )
PUSKESMAS/ PUSKESMAS PEMBANTU : ___________________________________
NAMA KEPALA KELUARGA :___________________________________
UMUR :___________________________________
ALAMAT :___________________________________
NO. INDEKS :
SETIAP BEROBAT HARUS DIBAWA

ANGGOTA
1. _______________________________________________________
2. _______________________________________________________
3. _______________________________________________________
4. _______________________________________________________
5. _______________________________________________________
6. _______________________________________________________

KARTU TANDA PENGENAL KELUARGA


( KTKP )
PUSKESMAS/ PUSKESMAS PEMBANTU : ___________________________________
NAMA KEPALA KELUARGA :___________________________________
UMUR :___________________________________
ALAMAT :___________________________________
NO. INDEKS :
SETIAP BEROBAT HARUS DIBAWA

ANGGOTA
1. _______________________________________________________
2. _______________________________________________________
3. _______________________________________________________
4. _______________________________________________________
5. _______________________________________________________
6. _______________________________________________________

Anda mungkin juga menyukai