PEMERINTAH KABUPATEN PIDIE

DINAS KESEHATAN
PUSKESMAS GEUMPANG
Alamat : Jl. Beureunuen – Meulaboh KM. 95, Lhok Kuala Kec. Geumpang Kode POS 24167
Telp. – Email: puskesmasgp@gmail.com

Berita Acara

Pada hari ini .......................... tanggal ...... bulan .......................... tahun dua ribu delapan
belas, kami yang bertanda tangan di bawah ini telah melaksanakan
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No. Nama Jabatan Tanda Tangan

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18

19

20

Desa............ 2018
Bidan Desa

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NIP.
 PEMERINTAH KABUPATEN PIDIE
DINAS KESEHATAN
PUSKESMAS GEUMPANG
Alamat : Jl. Beureunuen – Meulaboh KM. 95, Lhok Kuala Kec. Geumpang Kode POS 24167
Telp. – Email: puskesmasgp@gmail.com

NOTULEN RAPAT

Hari/Tanggal :
Waktu :
Tempat :
Agenda Rapat :
Peserta : Orang.

Jalannya Rapat :
Rapat dilaksanakan pukul ................... WIB bertempat di ..............................................., acara dibuka

oleh .........................................

Materi Pembahasan
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Demikian notulen rapat ini dibuat, kemudian rapat ditutup oleh .........................................................

Atas Nama Peserta

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 Photo Dokumentasi

Hari : .......................................................

Tanggal : .......................................................

Tempat : .......................................................

Agenda : .......................................................

Acara : .......................................................