PEMERINTAH KOTA PALEMBANG

DINAS KESEHATAN
PUSKESMAS SEI BAUNG
Jl. Pertiwi Dwikora II Rt. 10 Rw. 03KelurahanDemang Lebar Daun
Kecamatan Ilir Barat I Palembang Kode Pos 30137
Tlp/WA: 0711-374036/081373265511– email : pkm.seibaung@yahoo.com

SURAT TUGAS
No : 440/ /PKM-SB/ / 2020

Yang bertanda tangan di bawah ini :

Nama : dr. Hj. Indrayati

Nip : 196010151990032002
Pangkat / Gol : Pembina/IV.b
Jabatan : Plt. Pimpinan Puskesmas Sei Baung

Memberikan tugas kepada :

No Nama / Nip Tanggal Tempat Tujuan Maksud Perjalanan

1. Inda Yuliantiza, S.Farm,Apt Instalasi Pengambilan

NIP. 198707222015032002 Farmasi Vaksin BIAS MR
KM 5
2. Mayola Indriyani S, A. Md. Keb Palembang
NIP. 199208192019022002

Demikianlah surat tugas ini dibuat untuk dapat dilaksanakan sebaik-baiknya.

Mengetahui, Plt. Puskesmas Sei Baung

...................................... dr. Hj. Indrayati

Nip.196010151990032002

PEMERINTAH KOTA PALEMBANG

DINAS KESEHATAN
 PUSKESMAS SEI BAUNG
Jl. Pertiwi Dwikora II Rt. 10 Rw. 03KelurahanDemang Lebar Daun
Kecamatan Ilir Barat I Palembang Kode Pos 30137
Tlp/WA: 0711-374036/081373265511– email : pkm.seibaung@yahoo.com

SURAT PELAKSANAAN DINAS ( SPD )

1. Dasar : 440/ /PKM-SB/ / 2020

2. Tujuan kunjungan : ………………………………………………
3. Hasil kunjungan :

NO NAMA VAKSIN SATUAN JUMLAH

1 MR + Pelarut Vial 50

4. Kesimpulan / Saran perbaikan :

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Palembang,................................
Mengetahui, Pelapor
1. Inda Yuliantiza, S.Farm, Apt
2. Mayola Indriyani S, A. Md. Keb