FAKULTAS ILMU KESEHATAN

UNIVERSITAS PEKALONGAN
Jl. Sriwijaya No.3 Telp. (0285) 421096
PEKALONGAN

DAFTAR HADIR
PENYERAHAN / PENARIKAN / SEMINAR JURNAL / SEMINAR KASUS*
PRAKTIK KLINIK PROFESI NERS

Stase : _______________________________
Hari, tanggal : _______________________________
Pukul : _______________________________
Tempat : _______________________________

No. Nama Jabatan Paraf

1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
*) coret yang tidak perlu

Mengetahui
Fakultas Ilmu Kesehatan Program Studi Profesi Ners
D e k a n, Ketua

Drs. Imam Purnomo, M.Kes Isrofah, S.Kep.,Ns.,M.Kep.

FAKULTAS ILMU KESEHATAN

UNIVERSITAS PEKALONGAN
Jl. Sriwijaya No.3 Telp. (0285) 421096
PEKALONGAN

LEMBAR PENERIMAAN UANG SAKU

PENYERAHAN / PENARIKAN / SEMINAR JURNAL / SEMINAR KASUS*
 PRAKTIK KLINIK PROFESI NERS

Stase : _______________________________
Hari, tanggal : _______________________________
Pukul : _______________________________
Tempat : _______________________________

Nominal
No. Nama Jabatan (Rp) Paraf
1 35.000 1
2 35.000 2
3 35.000 3
4 35.000 4
5 35.000 5
6 35.000 6
7 35.000 7
8 35.000 8
9 35.000 9
10 35.000 10
*) coret yang tidak perlu

Mengetahui
Program Studi Profesi Ners Sekretaris
K e t u a,

Isrofah, S.Kep.,Ns.,M.Kep. Dani Prastiwi, S.Kep.,M.Sc.

FAKULTAS ILMU KESEHATAN

UNIVERSITAS PEKALONGAN
Jl. Sriwijaya No.3 Telp. (0285) 421096
PEKALONGAN

HASIL RAPAT KOORDINASI

STASE KEPERAWATAN MATERNITAS

Hari, tanggal : _________________________________________________

Pukul : _________________________________________________
Tempat : _________________________________________________
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Notulis

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