Anda di halaman 1dari 1

IZIN DATANG TERLAMBAT/PULANG CEPAT

Saya atas :
Nama : .....................................................................
NIP : .....................................................................
Pangkat/ Gol. : .....................................................................
Jabatan : .....................................................................

Hari ini......................... Tgl.............. Saya datang terlambat/pulang cepat dikarenakan:


......................................................................................................................................
......................................................................................................................................

Demikian atas perhatiannya harap menjadi maklum.

Mengetahui, Hormat Kami,

Kepala UPT Puskesmas Tikung

(....................................................) (....................................................)

IZIN DATANG TERLAMBAT/PULANG CEPAT

Saya atas :
Nama : .....................................................................
NIP : .....................................................................
Pangkat/ Gol. : .....................................................................
Jabatan : .....................................................................

Hari ini......................... Tgl.............. Saya datang terlambat/pulang cepat dikarenakan:


......................................................................................................................................
......................................................................................................................................

Demikian atas perhatiannya harap menjadi maklum.

Mengetahui, Hormat Kami,

Kepala UPT Puskesmas Tikung

(....................................................) (....................................................)

Anda mungkin juga menyukai