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PEMERINTAH KABUPATEN CIREBON

DINAS KESEHATAN
UPT PUSKESMAS PABUARAN
Jl. P Sutajaya No.192 Pabuaran Lor Kec.Pabuaran Kab.Cirebon
Call Center: 089507003988 Email : pkmpabuaran192@gmail.com
Kode Pos 45188

KERANGKA ACUAN PROGRAM/KEGIATAN ...............................


NOMOR : 440/000/PKMPAB/I/2018

a. Pendahuluan
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Visi UPT Puskesmas Pabuaran “.......” Misi UPT Puskesmas Pabuaran yaitu...
Program/Kegiatan ini selaras/sesuai dengan Tata Nilai Puskesmas ke... yaitu....
b. Latar belakang
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c. Tujuan umum dan tujuan 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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Pabuaran, ………………. 2018


Mengetahui, Pelaksana
Kepala UPT Puskesmas Pabuaran Program/Kegiatan……………..

.Hj.Endang Sugiati, SKM. ......................................


Penata Tk.1 NIP.
NIP. 196508291968032007

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