Anda di halaman 1dari 2

PEMERINTAH KABUPATEN SUKABUMI

DINAS KESEHATAN
BLUD UPTD PUSKESMAS PALABUHANRATU
Jalan Raya Cangehgar KM.01 No. 1007 Telepon (0266) 433448 Email:pkmplara@gmail.com
Palabuhanratu Sukabumi Jawa Barat Kode Pos 43364

NOTULEN

Sidang / Rapat : ........................................................................................................................


Hari / Tanggal : ........................................................................................................................
Waktu Panggilan : ........................................................................................................................
Waktu Sidang / Rapat : ........................................................................................................................
Acara : ........................................................................................................................

Pimpinan Sidang Rapat

Ketua : ........................................................................................................................
Sekretaris : ........................................................................................................................
Pencatat : ........................................................................................................................
Peserta Sidang rapat : ........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................

Kegiatan Sidang Rapat :.........................................................................................................................


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

1. Kata Pembukaan : ........................................................................................................................


........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
2. Pembahasan : ........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
.......................................................................................................................
.......................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................

3. Kesimpulan : ........................................................................................................................
.........................................................................................................................
.........................................................................................................................
.........................................................................................................................
.........................................................................................................................
.........................................................................................................................
.........................................................................................................................
.........................................................................................................................
.........................................................................................................................

4. Penutup : ........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................
........................................................................................................................

Palabuhanratu,
Ketua Pokja 3

dr. Kristyawan Hendri A