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    PEMERINTAH KOTA SERANG

    DINAS KESEHATAN
    UPTD PUSKESMAS SINGANDARU
    Jl. Letnan Djidun No. 04 Kel. Lontar Baru Kec. Serang Kota Serang 42115
    Telp. (0254) 201775 E-mail : puskesmas_singandaru@yahoo.com

    KEPUTUSAN
    KEPALA UPTD PUSKESMAS SINGANDARU
    Nomor : 800/No.urut/Kode/SK-PKM/Bulan/Tahun

    TENTANG

    ………………….. PUSKESMAS SINGANDARU

    DENGAN RAHMAT TUHAN YANG MAHA ESA


    KEPALA UPTD PUSKESMAS SINGANDARU,

    Menimbang a.
    : ………….................................................................................................
    ...............................................................................................................
    b.
    : ………….................................................................................................
    ...............................................................................................................
    c.
    : ………….................................................................................................
    ...............................................................................................................
    d.
    : ………….................................................................................................
    ...............................................................................................................
    Mengingat 1.
    : ………….................................................................................................
    ...............................................................................................................
    2.
    : ………….................................................................................................
    ...............................................................................................................
    3.
    : ………….................................................................................................
    ...............................................................................................................
    4.
    : ………….................................................................................................
    ...............................................................................................................
    5.
    : ………….................................................................................................
    ...............................................................................................................
    MEMUTUSKAN
    Menetapkan : ……………………..( D I T U L I S K A P I T A
    L )............................... ...........................................................................
    Kesatu : ....................................
    ………….................................................................................................
    Kedua : ...............................................................................................................
    ………….................................................................................................
    Ketiga : ...............................................................................................................
    ………….................................................................................................
    Keempat : ...............................................................................................................
    ………….................................................................................................
    ...............................................................................................................

    Ditetapkan di : Serang
    Pada tanggal : …………………..
    Kepala UPTD Puskesmas Singandaru
    PEMERINTAH KOTA SERANG
    DINAS KESEHATAN
    UPTD PUSKESMAS SINGANDARU
    Jl. Letnan Djidun No. 04 Kel. Lontar Baru Kec. Serang Kota Serang 42115
    Telp. (0254) 201775 E-mail : puskesmas_singandaru@yahoo.com

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