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PEMERINTAH KOTA PALEMBANG

DINAS KESEHATAN
PUSKESMAS MERDEKA
Jalan Merdeka No. 66 Palembang Provinsi Sumatera Selatan
Telepon : (0711) 317303 Kode Pos 30135

SURAT TUGAS

Nomor : 800/ /PKM/2016


Tanggal :

Yang bertanda tangan di bawah ini :


Nama : Dr. Hj. Desty Aryani, M.Kes
NIP : 196306271989032003
Jabatan : Kepala Puskesmas Merdeka

Memberikan tugas kepada :

No Nama / NIP Tanggal Tempat Tujuan Maksud Perjalanan


1. H.Dalius Adikara AMKp
SKM

Pembiayaan perjalanan
dibebankan pada : APBD Dinas Kesehatan Kota Palembang Tahun 2016.

Demikianlah surat tugas ini dibuat untuk dapat dilaksanakan sebaik-baiknya.

Plt. Kepala Puskesmas Merdeka

Dr. Hj. Desty Aryani, M.Kes


NIP. 196306271989032003
PEMERINTAH KOTA PALEMBANG
DINAS KESEHATAN
PUSKESMAS MERDEKA
Jalan Merdeka No. 66 Palembang Provinsi Sumatera Selatan
Telepon : (0711) 317303 Kode Pos 30135

LAPORAN

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Palembang, ..................................2016
Pelapor

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