2. Nama Petugas/Tim : dr. Hendy Rachman B 3. Tujuan Perjalanan Dinas : Desa Karangsari 4. Tanggal Perjalanan Dinas : 15 Desember 2016 5. Maksud Perjalanan Dinas : Kunjungan Lapangan Pemicuan SBABS RT 6 6. Pejabat yang ditemui :
7. Hasil Kunjungan antara lain :
a. Proses Pelaksanaan : _______________________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ b. Permasalah yang dihadapi : _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ c. Dokumen yang didapat : _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ d. Kesimpulan / Saran Perbaikan : _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________