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DINAS KESEHATAN KABUPATEN BIAK NUMFOR

PUSKESMAS PERAWATAN MARAUW


DISTRIK ORIDEK
Alamat : Jln. Wor Timur Marauw

LAPORAN PELAKSANAAN TUGAS


1. Dasar Penugasan : ................................................................................
2. Nama Petugas/TIM : ................................................................................
3. Tujuan Perjalanan : ................................................................................
4. Tanggal Perjalanan : ................................................................................
5. Maksud Perjalanan : ................................................................................
6. Pejabat Yang ditemui : ................................................................................
7. Hasil Kunjungan, Antara lain :
a. Proses Pelaksanaan :
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b. Permasalahan yang dihadapi :
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c. Kesimpulan / Saran Perbaikan :
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Mengetahui Marauw,...............................2017
Kepala Sekolah .................... Pelapor
1. ...............................................
2. ...............................................
3. ...............................................
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5. ...............................................

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