Nomor : 445/PKM-K/BOK/…./…./2019
MEMERINTAHKAN :
Pangkat/gol : _________________________________________________
NIP : _________________________________________________
Jabatan : _________________________________________________
2. Nama : _________________________________________________
Pangkat/gol : _________________________________________________
NIP : _________________________________________________
Jabatan : _________________________________________________
_________________________________________________________________
Di ______________________________________________________________.
Tomohon, / /2019
Kepala Puskesmas Kakaskasen