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

PRODI SARJANA TERAPAN 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.......

Prodi Sarjana Terapan Keperawatan Dosen Penanggung Jawab Mata Kuliah
Ketua,

............................................................
NIP .............................................................
Dr. Anita, M.Kep., Sp.MAT.
NIP 196902101992122001
 POLITEKNIK KESEHATANTANJUNGKARANG KEMENKES RI KODE : Format/PKTjk/J.Kep/03.2/1/2015
PRODI SARJANA TERAPAN KEPERAWATAN TGL : Maret2015
Formulir REVISI :
Daftar Hadir Bimbingan Laboratorium HALAMAN : 1 dari 1 Halaman

DAFTAR HADIR MAHASISWA

BIMBINGAN PRAKTIK LABORATORIUM
Mata Kuliah : ................................................................................................................. Ruangan : ...................................................................................................................
Kode Mata Kuliah / Sks : ................................................................................................................. Kelas : ...................................................................................................................
Pj. Mata Kuliah : ................................................................................................................. Semester / Prodi : ............ / Sarjana Terapan Keperawatan
Dosen Pembimbing : ................................................................................................................. Kelompok : ...................................................................................................................

No Nama Mahasiswa Tanggal

1

10

11

12

Paraf Dosen Pembimbing

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

Ketua Prodi Sarjana Terapan Keperawatan Dosen Pembimbing

.......................................................................................
NIP .........................................................................
Dr. Anita, M.Kep., Sp.MAT.
NIP 196902101992122001