Lampiran VII: Peraturan Bupati Lombok Tengah

Nomor : tahun 2021

Tanggal : 2021
Tentang : Pedoman Perjalanan Dinas di Lingkungan
Pemerintah Kabupaten Lombok Tengah

LAPORAN HASIL PERJALANAN DINAS

I. Dasar Perjalanan Dinas (SPD)
1. Tanggal :3 Mei 2021
2. Nomor :090 / /BOK/2021
3. Waktu :2 ( Dua )Hari / ( Tgl. )Mei 2021
4. Tempat Tujuan :Dusun Wilayah UPTD Puskesmas Wajageseng
5. Maksud Perjalanan Dinas :Penjaringan TB Paru
II. Identitas yang melaksanakan Perjalanan Dinas
1. a. Nama :Yuliana Asri Iptihani, A.Md.Kes
b. NIP :19970712 202012 2021
c. Pangkat/Gol :Pengatur (II/c)
d. Jabatan :Analis
III. Hasil Perjalanan Dinas
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Wajageseng, 2021
Mengetahui Yang Melaksanakan
Kuasa Pengguna Anggaran Perjalanan Dinas,

H. Muh. Yusuf, S.Sos.S.Kep.Ns. Yuliana Asri Iptihani, A.Md.Kes

NIP: 19720716 199203 1 002 Nip:19970712 202012 2021