PEMERINTAH DAERAH KABUPATEN TASIKMALAYA

DINAS KESEHATAN
UPT PUSKESMAS CISARUNI
Jalan Batu Beulah Nomor 90 Desa Cisaruni Telepon : 0265-542456
E-mail: puskesmascisaruni90@gmail.com
Padakembang – 46466

NOTULA
Sidang /Rapat : ...................................................................................
Hari/Tanggal : ...................................................................................
Surat : ...................................................................................
Undangan
Pukul : ....................................................................................
Sidang/rapat
Acara : 1 ...................................................................................
2 ...................................................................................
3 ...................................................................................
Pimpinan Sidang/Rapat
Ketua : .......................................................................................
Sekretaris : .......................................................................................
Pencatat : .......................................................................................
Peserta : 1. ...................................................................................
Sidang/rapat 2. ...................................................................................
3. ...................................................................................

Kegiatan :
Sidang/rapat .......................................................................................

Kepala UPT Puskesmas Cisaruni

Dadan Kurniawan, SKM

Penata Tk I
NIP. 19820226 200902 1 004
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Pencatat

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Pencatat

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