PEMERINTAH KABUPATEN/KOTA ................................

DINAS PENDIDIKAN
LOGO NOMOR
KAB/KOTA SEKOLAH MENENGAH KEJURUAN ................................. ISO (Bila yg
Alamat: ..............................................................................................................
Telpon: ............................., Fax. : ................................... sdh ber-ISO)
e-mail: ...............................................

DAFTAR INVENTARIS SARANA PRASARANA HABIS PAKAI

Unit Kerja: Laboratorium ..................................

PerolehanTahun
Keadaan Barang Jumlah

Rusak Berat
RinganRuak
Harga Satuan
No. Nama Sarana Prasarana Spesifikasi/ Merk Kode Barang Hasil Verifikasi

Baik
(Rp) Jml. Sat.

Mengetahui/Menyetujui: ................., ......................................2015

Kepala Sekolah, WKS Bidang........................., Kaprog .........................,

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(...................................................) ( ................................................ )
NIP ...................................
NIP. .................................... NIP. ....................................