Lampiran 18 : Contoh format kerangka acuan

PEMERINTAH KABUPATEN KOLAKA

DINAS KESEHATAN
PUSKESMAS KOLAKA
Jl. Pemuda No. 14 Kolaka 93518

KERANGKA ACUAN PROGRAM

PUSKESMAS KOLAKA

A. PENDAHULUAN
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B. LATAR BELAKANG
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C. TUJUAN UMUM DAN KHUSUS
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D. KEGIATAN POKOK DAN RINCIAN KEGIATAN
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E. CARA MELAKSANAKAN KEGIATAN
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F. SASARAN
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G. JADWAL PELAKSANAAN KEGIATAN
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H. EVALUASI PELAKSANAAN KEGIATAN DAN PELAPORAN
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I. PENCATATAN, PELAPORAN DAN EVALUASI KEGIATAN

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Lampiran 18 : Contoh format kerangka acuan