Kegiatan : PENGAMBILAN SPESIMEN

Bulan/Tahun : JANUARI-PEMBRUARI-SEPTEMBER 2017

NO DESA TANDA TANGAN KEPALA DESA

1 DIAPATIH

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

2 BULAGIDUN

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

3 LABUTON

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

4 LOKODOKA

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

5 PANDANGAN

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

6 LRIPUBOGU

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

7 MATINAN

.......................................................
8 TAAT

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

9 LOKODIDI

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

10 NANDU

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

11 BULAGIDUN TANJUNG

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

GADUNG, .................................2018
Mengetahui,
Kepala Puskesmas

HJ. AISAH AL HABSYI, A.Md.Kep

NIP.
Kegiatan : Penemuan kasus TB
Bulan/Tahun : Januari / Agustus 2017

NO DESA TANDA TANGAN KEPALA DESA

1 DIAPATIH

NIP.......................................................

2 BULAGIDUN

NIP.......................................................

3 LABUTON

NIP.......................................................

4 LOKODOKA

NIP.......................................................

5 PANDANGAN

NIP.......................................................

6 LRIPUBOGU

NIP.......................................................

7 MATINAN

NIP.......................................................
8 TAAT

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

9 LOKODIDI

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

10 NANDU

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

11 BULAGIDUN TANJUNG

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

GADUNG, .................................2018
Mengetahui,
Kepala Puskesmas

HJ. AISAH AL HABSYI, A.Md.Kep

NIP.
Kegiatan : PELACAKAN KASUS KONTAK
Bulan/Tahun : FEBRUARI-JULI 2017

NO DESA TANDA TANGAN KEPALA DESA

1 DIAPATIH

NIP.......................................................

2 BULAGIDUN

NIP.......................................................

3 LABUTON

NIP.......................................................

4 LOKODOKA

NIP.......................................................

5 PANDANGAN

NIP.......................................................

6 LRIPUBOGU

NIP.......................................................

7 MATINAN

NIP.......................................................
8 TAAT

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

9 LOKODIDI

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

10 NANDU

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

11 BULAGIDUN TANJUNG

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

GADUNG, .................................2018
Mengetahui,
Kepala Puskesmas

HJ. AISAH AL HABSYI, A.Md.Kep

NIP.
KEGIATAN : ADVOKASI TINGKAT DESA
BULAN / TAHUN :

NO Tanggal DESA

1.
DIAPATIH

2 BULAGIDUN

3 LABUTON

4 LOKODOKA

5 PANDANGAN

6 LRIPUBOGU

8 TAAT

9 LOKODIDI

10 NANDU

11 BULAGIDUN TANJUNG
 GADUNG, .................................2018
Mengetahui,
Kepala Puskesmas

HJ. AISAH AL HABSYI, A.Md.Kep

NIP.
 TANDA TANGAN KEPALA DESA

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

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

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

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

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

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

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

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

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

.......................................................
 GADUNG, .................................2018
Mengetahui,
Kepala Puskesmas

HJ. AISAH AL HABSYI, A.Md.Kep

NIP.