PEMERINTAH KOTA SURABAYA

8 DINAS KESEHATAN
UPTD PUSKESMAS DR.SOETOMO
Jl. Kupang Segunting gang II no 22
Telp. (031) 5678279

NOTULENSI KEGIATAN PERTEMUAN

1. Tanggal Kegiatan : .......................................................................................

2. Maksud Kegiatan : .......................................................................................
3. Sasaran Kegiatan : .......................................................................................
4. Hasil Kegiatan : .......................................................................................

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 Rencana Tindak Lanjut :

Mengetahui
Kepala Puskesmas Dr. Soetomo Camat Tegalsari

dr. Rahjoe Poerbanti ................................

NIP. 19580825 199001 2 001 NIP. ..........................................

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Masalah :

Rencana Tindak Lanjut :

Mengetahui
Notulen
Kepala Puskesmas Dr. Soetomo

................................
dr. Rahjoe Poerbanti
NIP. ..........................................
NIP. 19580825 199001 2 001