PEMERINTAH KABUPATEN KUNINGAN

DINAS KESEHATAN
UPTD PUSKESMAS MANGGARI
Jl. Raya Pancasila Nomor 001 Manggari Kec. Lebakwangi
Hotline sms : 085295917276 e-mail : pkmmanggari@gmail.com
KUNINGAN
Kode Pos 45574

DAFTAR HADIR

PERTEMUAN DALAM RANGKA MENYUSUN INDIKATOR

MUTU LAYANAN KLINIS
HARI / TANGGAL : .........................................................

NO NAMA JABATAN TANDA TANGAN

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Ciwaru, .......................................
Mengetahui Penanggung Jawab
Kepala UPTD Puskesmas Ciwaru Pokja UKP

Nani Sumarni, Am.Keb, SKM dr. Husen Nurjamin

NIP. 19820911 198302 2 001 NIP. 19740118 201001 1 002
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 PEMERINTAH KABUPATEN KUNINGAN
DINAS KESEHATAN
UPTD PUSKESMAS MANGGARI
Jl. Raya Pancasila Nomor 001 Manggari Kec. Lebakwangi
Hotline sms : 085295917276 e-mail : pkmmanggari@gmail.com
KUNINGAN
Kode Pos 45574

NOTULEN
HARI : ...............................................................................................
TANGGAL : ...............................................................................................
TEMPAT : ...............................................................................................
WAKTU : ...............................................................................................
ACARA : ...............................................................................................
PIMPINAN SIDANG / RAPAT : ...............................................................................................
KETUA : ...............................................................................................
PENCATAT : ...............................................................................................
PESERTA SIDANG / RAPAT : .............................................................................................
PEMBUKAAN :
1. Membaca “ Basmallah “
2. Sambutan :
a. ......................................................................................
b. .......................................................................................
PEMBAHASAN MATERI :
Pemaparan
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Manggari, .........................................
Mengetahui Penanggung Jawab
Kepala UPTD Puskesmas Manggari Pokja UKP

dr. Nanang Wasim

NIP. 197102015 200604 1 010