PEMERINTAH KABUPATEN CILACAP

DINAS KESEHATAN
UPT PUSKESMAS WANAREJA I
Jl. Tanjung Nomor. 6 Wanareja Telephone (0280) 6260312 Fax. (0280) 6260111
WANAREJA
Kode Pos : 53265

NOTULEN
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Plt.Kepala UPT Puskesmas Wanareja I Sekretaris

Dr. TEGUH WIBOWO KHUSNA FAIZAH, AMd.Keb.

NIP. 196911262002121002 NIP. 197601272006042009
 PEMERINTAH KABUPATEN CILACAP
DINAS KESEHATAN
UPT PUSKESMAS WANAREJA I
Jl. Tanjung Nomor. 6 Wanareja Telephone (0280) 6260312 faximile (0280) 6260111
WANAREJA
Kode Pos : 53265

DAFTAR HADIR

Hari : ................................................................
Tanggal : ................................................................
Waktu : Pukul ........................
Tempat : ................................................................
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NO NAMA JABATAN TANDA TANGAN KET.

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Plt.Kepala UPT Puskesmas Wanareja I

Dr. TEGUH WIBOWO

NIP. 196911262002121002