PEMERINTAH KABUPATEN ACEH TAMIANG

DINAS KESEHATAN
UPTD PUSKESMAS KEJURUAN MUDA
Kecamatan Kejuruan Muda
Jl. Medan – Banda Aceh, kode Pos 24477

LAPORAN PERJALANAN DINAS

1. Dasar Penugasan : No. SPT : / 800 / 2020

2. Nama Petugas / Tim :
3. Tujuan Perjalanan : Desa Purwodadi
4. Tanggal Perjalanan : 22 September 2020
5. Maksud Perjalanan : Pemantauan Pelaksanaan Kegiatan Inovasi KANJI RANGBUTA
6. Jam Berangkat : 09.30 WIB
7. Jam Kembali : 13.30 WIB
8. Hasil kunjungan, antara lain :
a. Proses pelaksanaan :
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b. Kesimpulan :

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Desa Purwodadi, 20 September 2020

Pelapor,

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 LAMPIRAN

KEGIATAN : 0000000000007417417417417417417417412
TANGGAL :
DESA :

No Nama Alamat
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 DAFTAR HADIR

PETUGAS :
TANGGAL :
DESA :
KEGIATAN :
No Nama Balita BB Tanda Tangan
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 PEMERINTAH KABUPATEN ACEH TAMIANG
UPTD DINAS KESEHATAN
PUSKESMAS KEJURUAN MUDA
Kecamatan Kejuruan Muda
Jl. Medan – Banda Aceh, kode Pos 24477

LAPORAN PERJALANAN DINAS

1. Dasar Penugasan : No. SPT : / 800 / 2020

2. Nama Petugas / Tim : Lolita, Amd.Keb
3. Tujuan Perjalanan : Desa Bukit Rata
4. Tanggal Perjalanan : 22 Februari 2020
5. Maksud Perjalanan : Kegiatan Integrasi Pemantauan Pertumbuhan dan
Perkembangan
Serta Pemberian Vitamin A
Jam Berangkat : 09.00 wib
Jam Kembali : 17.00 wib
6. Hasil kunjungan , antara lain :
a. Proses pelaksanaan :
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PEMERINTAH KABUPATEN ACEH TAMIANG

UPTD DINAS KESEHATAN
PUSKESMAS KEJURUAN MUDA
Kecamatan Kejuruan Muda
Jl. Medan – Banda Aceh, kode Pos 24477

LAPORAN PERJALANAN DINAS

1. Dasar Penugasan : No. SPT : / 800 / 2020

2. Nama Petugas / Tim : Maimunah Yulita Siregar, S.Gz
3. Tujuan Perjalanan : Desa Gerenggam
4. Tanggal Perjalanan : 07 Februari 2020
5. Maksud Perjalanan : Kegiatan Integrasi Pemantauan Pertumbuhan dan Perkembangan
Serta
Pemberian Vitamin A
Jam Berangkat : 09.00 wib
Jam Kembali : 18.00 wib
6. Hasil kunjungan , antara lain :
a. Proses pelaksanaan :
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PEMERINTAH KABUPATEN ACEH TAMIANG

UPTD DINAS KESEHATAN
PUSKESMAS KEJURUAN MUDA
Kecamatan Kejuruan Muda
Jl. Medan – Banda Aceh, kode Pos 24477

LAPORAN PERJALANAN DINAS

1. Dasar Penugasan : No. SPT : / 800 / 2020

2. Nama Petugas / Tim : Nurainun, A.MG
3. Tujuan Perjalanan : Desa Simpang Kanan
4. Tanggal Perjalanan : 24 Februari 2020
5. Maksud Perjalanan : Kegiatan Integrasi Pemantauan Pertumbuhan dan
Perkembangan
Serta Pemberian Vitamin A
Jam Berangkat : 09.00 wib
Jam Kembali : 15.30 wib
6. Hasil kunjungan , antara lain :
a. Proses pelaksanaan :
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PEMERINTAH KABUPATEN ACEH TAMIANG

UPTD DINAS KESEHATAN
PUSKESMAS KEJURUAN MUDA
Kecamatan Kejuruan Muda
Jl. Medan – Banda Aceh, kode Pos 24477

LAPORAN PERJALANAN DINAS

1. Dasar Penugasan : No. SPT : / 800 / 2020

2. Nama Petugas / Tim : Maimunah Yulita Siregar, S.Gz
3. Tujuan Perjalanan : Desa Sidodadi
4. Tanggal Perjalanan : 13 Februari 2020
 5. Maksud Perjalanan : Kegiatan Integrasi Pemantauan Pertumbuhan dan
Perkembangan
Serta Pemberian Vitamin A
Jam Berangkat : 09.00 wib
Jam Kembali : 18.00 wib
6. Hasil kunjungan , antara lain :
a. Proses pelaksanaan :
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