KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN

UNIVERSITAS BRAWIJAYA Form-4

FAKULTAS KEDOKTERAN HEWAN
Puncak Dieng Eksklusif, Kalisongo, Kec. Dau, Kab.Malang
65151 Telp. +62341- 5029152, Fax. +62341- 5029152
http://www.fkh.ub.ac.id email : pskh_ub@ub.ac.id

Form Penilaian Pembimbing Lapangan

Yang bertanda tangan di bawah ini pembimbing Praktek Kerja Lapangan (PKL) mahasiwa Fakultas
Kedokteran Hewan Universitas Brawijaya Malang menerangkan dengan sebenarnya bahwa :

NIM : . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nama MHS : . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Instansi PKL :...................................................................

Tanggal Mulai PKL :...................................................................

Tanggal Akhir PKL :...................................................................

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Telah menyelesaikan Praktek Kerja Lapang (PKL) ysng berjudl :

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Nilai (Angka
N Materi
1-
O Penlaian
100)
1 Aktifitas PKL

2 Sikap (Etika, Kreatifitas, Kedisplinan, Hubungan sosial,ETOS Kerja, danlain - lain)

3 Pelaporan
Saran :

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Mengetahui,

Pimpinan Perusahaaan Pembimbing Lapangan,

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