DAFTAR HADIR

SOSIALISASI URAIAN TUGAS

UPTD PUSKESMAS CIGASONG KABUPATEN MAJALENGKA

HARI :......................................................
TANGGAL :......................................................
TEMPAT :......................................................
MATERI :......................................................

NO NAMA JABATAN ALAMAT TANDA TANGAN

10

11

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20

Mengetahui, Cigasong,..............................
Kepala Uptd Puskesmas Cigasong Pembuat Daftar

OO TAOPIK, SKM.,MM ..............................................

NIP: 198011072008031004
 NOTULEN

Rapat : ..............................................................................................................

Hari/ tanggal : ..............................................................................................................

Tanggal undangan : ..............................................................................................................

Waktu Rapat : ...................................................WIB s.d Selesai

Acara : ...................................................agenda Terlampir

1. Isi absensi peserta
2. Materi :..................................................................
3. Diskusi/ Kesepakatan
4. Penutup/ Do’a
Pimpinan Rapat : ...................................................................................................................

Ketua : ..................................................................................................................

Sekretaris : ...................................................................................................................
Peserta rapat :
Jumlah peserta......orang absensi terlampir
Kegiatan rapat : 1. Isi absensi peserta : undangan hadir sejumlah ...........orang
Undangan terlampir
2. Persentasi :...............................................Materi Terlampir
3. Diskusi/ kesepakatan :Kesepakatan terlampir
4. Penutup /do’a
1. Kata pembukaan : ...............................................................................................................

2. Pembahasan : ..................................................................................................................

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3. Peraturan : Dibuat kesepakatan bersama dan ditindaklanjuti

Cigasong, ......................................................
Notulis

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NIP:...............................................................
 REKOMENDASI HASIL PEMBAHASAN

Rapat :....................................................................................................................

Hari/ tanggal :....................................................................................................................

Tanggal undangan :...................................................................................................................

Waktu rapat :...................................................................................................................

Cigasong,..................................
Pelaksana kegiatan

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NIP:......................................................
DOKUMENTASI KEGIATAN