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Batas atas 1,75 cm Font: 18, arial,spasi

single

PEMERINTAH KABUPATEN JOMBANG


DINAS KESEHATAN Font: 24,
arial,bold, spasi
Font: 12, time
news romance ,
PUSKESMAS TEMBELANG single

Jl. Raya Pesantren No. 302 Kecamatan Tembelang Kabupaten Jombang


spasi 1,15
Kode Pos : 61452 Telp. (0321) 888213 Email : pkmtembelang@gmail.com

MONITORING Font: 12, arial ,


KEGIATAN................................. spasi single

Tgl/bln/thn : .............................
Tempat : ...............................
Petugas monitoring : ..............................

A. Instrumen monitoring ...............................................................................................


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B. Hasil monitoring............................
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C. RTL.......................................................
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KEPALA PUSKESMAS TEMBELANG

PUGUH HARI SUBAGIA

Batas kiri
Batas
2 cm
kanan 2
cm

Batas bawah 2,
cm

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