NAMA MAHASISWA :
LAHAN PKL :
DOSEN PEMBIMBING :
TTD
NO KEGIATAN
MHS PEMBIMBING CI
1 Hari/ Tanggal:
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Uraian Kegiatan:
2 Hari/ Tanggal:
______________________
Uraian Kegiatan:
______________________
______________________
______________________
______________________
______________________
______________________
3 Hari/ Tanggal:
______________________
Uraian Kegiatan:
______________________
______________________
______________________
______________________
______________________
______________________
4 Hari/ Tanggal:
______________________
Uraian Kegiatan:
______________________
______________________
______________________
______________________
______________________
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