PEMERINTAH KABUPATEN KUNINGAN

DINAS KESEHATAN
UPTD PUSKESMAS PASAWAHAN
Jl. Raya Pasawahan No. 08 Kec.Pasawahan Kab. Kuningan
Telp (0231) 8825807 email: uptdpuskesmaspasawahan@gmail.com
PASAWAHAN
Kode pos 45559

DAFTAR HADIR

KEGIATAN : .....................................................................................
HARI / TANGGAL : .....................................................................................
TEMPAT :
.....................................................................................

NO NAMA JABATAN TANDA TANGAN

1 Hj. IAR SUGIARTI, S.ST. Kepala UPTD 1.

2 MAMAN SUTRIAMAN Kasubag TU 2.
3 KASMA, S.Kep. Prawat 3.
4 NENO, S.Kep. Perawat 4.
5 Hj. SRI ANDAYASARI, Am.Keb. Bidan 5.
6 Hj. ASIH, S.Tr.Keb. Bidan 6.
7 ROHAENAH, A.Md.Keb. Bidan 7.
8 NAWAWI, A.Md.Kep. Perawat 8.
9 CAYA, S.KM. Bidan 9.
10 H. RAHADIAN, S.Kep. Perawat 10.
11 SUTARYAT Bidan 11.
12 EHA SOLEHATI Pelaksana 12.
13 dr. ASEP DEDENG WAHYUDIN Dokter Umum 13.
14 DADAN NURHAMDANI, S.Kep. Perawat 14.
15 RITA RAHMAWATI, A.MKG. Perawat Gigi 15.
16 TETI JUNIARTI, AM.Kep.. Perawat 16.
17 MAMAN SUPRIATMAN, AMKL. Kesling 17.
18 Hj. SRI HARYANTI, Am.Keb. Bidko 18.
19 NANI HERNI, A.Md.Keb. Bidan 19.
20 NITA SETIAROH, A.Md.Keb. Bidan 20.
21 SUSILAWATI, A.Md.Keb. Bidan 21.
22 IPA ROSIPAH, A.Md.Keb. Bidan 22.
23 IIT YULIANA, A.Md.Keb. Bidan 23.
24 EMA PRAMESWATI, Amd.Keb Bidan 24.
25 YUSMAENI, A.Md.Keb Bidan 25.
26 ERNI LESTARI, A.Md.Keb Bidan 26.
27 UUN YUNENGSIH A.Md.Keb Bidan 27.
28 ELIS SOLIHAH A, A.Md.Keb Bidan 28.
29 NOVI DAMAYANTI, A.Md.Keb Analis 29.
30 IMAN KHAIRUL H, S.Farm.Apt Apoteker 30.
31 IWAN RUSTANDI 31.
32 YUNI DUIHARTI, SKM 32.
33 SHELLA SINTYA KARTIKA, SE 33.
34 ENDAH KURNIASIH, S.Gz 34.

Mengetahui Pasawahan, 2019

Kepala UPTD Puskesmas Pasawahan Penanggung Jawab Pokja UKP

Hj. IAR SUGIARTI, S.St dr. ASEP DEDENG WAHYUDI

NIP. 19711014 199203 2 006 NIP. 19800405 201409 1 001
 PEMERINTAH KABUPATEN KUNINGAN
DINAS KESEHATAN
UPTD PUSKESMAS PASAWAHAN
Jl. Raya Pasawahan No. 08 Kec.Pasawahan Kab. Kuningan
Telp (0231) 8825807 email: uptdpuskesmaspasawahan@gmail.com
PASAWAHAN
Kode pos 45559

NOTULEN

Hari :
Tanggal :
Tempat : Aula Puskesmas Cigandamekar
Acara : Pertemuan dalam rangka penyusunan Rencana
Program Mutu Klinis dan keselamatan pasien di
Unit Pelayanan di UPTD Puskesmas Pasawahan
Waktu : 11.00 - Selesai WIB

Kesepakatan / Kesimpulan :
Susunan Acara :
1. Pembukaan
2. Pembahasan penyusunan Rencana Program Mutu Klinis dan keselamatan
pasien

Hasil Pertemuan :
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KEPALA UPTD PUSKESMAS

PASAWAHAN

Hj. IAR SUGIARTI, S.St

Penata Tk.I, III/d
NIP. 19711014 199203 2 006
 PEMERINTAH KABUPATEN KUNINGAN
DINAS KESEHATAN
UPTD PUSKESMAS PASAWAHAN
Jl. Raya Pasawahan No. 08 Kec.Pasawahan Kab. Kuningan
Telp (0231) 8825807 email: uptdpuskesmaspasawahan@gmail.com
PASAWAHAN
Kode pos 45559

NOTA DINAS

Kepada : Seluruh Staff Karyawan

Dari : Ka. UPTD Puskesmas Pasawahan
Tanggal :
Nomor : 005/ /PKM-PSW
Sifat : Penting
Lampiran :-
Hal :

Dalam rangka penyusunan Rencana Program Mutu Klinis dan keselamatan

pasien di UPTD Puskesmas Pasawahan maka dengan ini kami mengundang saudara untuk
menghadiri acara rapat yang akan dilaksanakan pada :

Hari / Tgl :
Waktu : 11.00 WIB
Tempat : Aula Puskesmas Pasawahan

Mengingat akan pentingnya acara tersebut maka kami mohon kehadiran saudara tepat
pada waktunya
Demikian surat undangan ini, atas perhatian dan kerja sama yang baik kami ucapkan
terima kasih.

Pasawahan,..........................2019
KEPALA UPTD PUSKESMAS PASAWAHAN

Hj. IAR SUGIARTI, S.St

Penata Tk.I, III/d
NIP. 19711014 199203 2 006
 PEMERINTAH KABUPATEN KUNINGAN
DINAS KESEHATAN
UPTD PUSKESMAS PASAWAHAN
Jl. Raya Pasawahan No. 08 Kec.Pasawahan Kab. Kuningan
Telp (0231) 8825807 email: uptdpuskesmaspasawahan@gmail.com PASAWAHAN
Kode pos 45559

POA

BERTANGGUNG
NO KEGIATAN WAKTU BIAYA INDIKATOR
JAWAB