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PEMERINTAH KABUPATEN MALANG

DINAS KESEHATAN
UPT PUSKESMAS GEDANGAN
Jl. Hasanudin No. 60 Gedangan Telp: 085101372323
Email: pkmgedangan@yahoo.com
MALANG- 65178

LAPORAN HASIL KEGIATAN


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ISI LAPORAN
Pelaksanaan Kegiatan
Dasar : ............................................. Peserta/sasaran : .................................
Hari/tanggal : ............................................. Pelaksana : .................................
Tempat : ............................................. Kegiatan : .................................

a. Uraian Pelaksanaan kegiatan


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b. Masalah yang dihadapi
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c. Lampiran (Foto/Absensi/Askep)
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Sasaran Pelaksana: 1. .....................................

2. .....................................

3. .....................................

4. .....................................
(………………)
5. .....................................

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