IDENTITAS PEGAWAI

Nama
: ________________________________________________
Jabatan
: ________________________________________________
No. KTP
: ________________________________________________
NIP
: ________________________________________________
Tempat Tanggal Lahir
: ________________________________________________
Jenis Kelamin
: ________________________________________________
TMT di RSUD
: ________________________________________________
Status Karyawan
: ________________________________________________
Status Perkawinan : ________________________________________________
Unit Kerja
: ________________________________________________
No.Telpon/HP
: ________________________________________________
Pendidikan
: ________________________________________________
Tahun Lulus
: ________________________________________________

Alamat : _________________________________________________

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