POLTEKKES TANJUNGKARANG KEMENKES RI KODE : FORM-PoltekkesTjk/C.002/..........

PRODI D III KEPERAWATAN TANJUNGKARANG TGL : Januari 2015

Formulir REVISI : 0
Berita Acara Praktik Laboratorium HALAMAN : 1 dari 1 Halaman

BERITA ACARA PRAKTIK LABORATORIUM

TAHUN AKADEMIK ................./ ..................

Mata Kuliah : ............................................................................................................................................. Ruangan : ..................................................................................................................................

Kode / SKS : ............................................................................................................................................. Hari / Jam : ..................................................................................................................................
Pj. Mata Kuliah : ............................................................................................................................................. Kelas : ..................................................................................................................................
Dosen Pembimbing : ............................................................................................................................................. Semester : ..................................................................................................................................

Pukul Paraf Keterangan

Minggu. Jumlah
. Ke Tanggal Materi Nama Dosen
Mahasiswa
Mulai Berakhir Mahasiswa Dosen
 UJIAN TENGAH SEMESTER

UJIAN AKHIR SEMESTER

Mengetahui, Bandar Lampung, ........ / ........................ / 20.......

Ketua Prodi D III Keperawatan Tanjungkarang Dosen Penanggung Jawab Mata Kuliah

Ns. Musiana, S.Kep., M.Kes. ............................................................

NIP 197404061997032001 NIP .............................................................
 POLITEKNIK KESEHATAN TANJUNGKARANG KEMENKES RI KODE : Format/PKTjk/J.Kep/03.2/1/2015
PRODI D III KEPERAWATAN TANJUNGKARANG TGL : Maret 2015
Formulir REVISI :
Daftar Hadir Bimbingan Laboratorium HALAMAN : 1 dari 1 Halaman

DAFTAR HADIR MAHASISWA

Mata Kuliah
Kode Mata Kuliah / Sks
Pj. Mata Kuliah
Dosen Pembimbing
BIMBINGAN PRAKTIK LABORATORIUM
: ................................................................................................................. Ruangan : ...................................................................................................................
: ................................................................................................................. Kelas : ...................................................................................................................
: ................................................................................................................. Semester / Prodi : ............ / D III / ST / Ners
: ................................................................................................................. Kelompok : ...................................................................................................................

No Nama Mahasiswa Tanggal

1

10

11

12

Paraf Dosen Pembimbing

Mengetahui Bandar Lampung, ........ / ........................ / 20.......

Prodi D III Keperawatan Tanjungkarang Dosen Pembimbing
Ketua,

.......................................................................................
Ns. Musiana, S.Kep., M.Kes. NIP .........................................................................
NIP 197404061997032001