UNIVERSITAS BRAWIJAYA
PROGRAM KEDOKTERAN HEWAN
Jalan Mayjen Haryono No : 169 Malang 65145
Telp. +62341- 573642, Fax. +62341- 573642, 551611 psw 362
http://www.pkh.ub.ac.id email : pkh_ub@ub.ac.id
NIM : ..............................................................
Judul : ............................................................................................................
..........................................................................................................................................
..........................................................................................................................................
Hari : ..
Tanggal : ..
Pukul : ..
Tempat Ujian : ..
Tanda
Nama Tim Penguji
Tangan
Pembimbing 1 :
NIP.
Pembimbing 2 :
NIP.
Penguji :
NIP.
Mengetahui
Malang, .....................................
Wakil Bidang Akademik
Prof.Dr.Aulanni'am,drh.,DES
NIP. 19600903 198802 2 001