LEMBAR PENILAIAN LAPANGAN

PRAKTEK KERJA PROFESI APOTEKER

Semester .......... Tahun Ajaran ............. / .............

Bismillahirrahmannirrahim
BIODATA MAHASISWA
Nama : ...........................................................................................................................................
NPM : ...........................................................................................................................................
No. Ponsel : ...........................................................................................................................................
Alamat : ...........................................................................................................................................
BIODATA APOTEKER PEMBIMBING
Nama : ...........................................................................................................................................
Jabatan : ...........................................................................................................................................
No. Ponsel : ...........................................................................................................................................
Email : ...........................................................................................................................................
WAHANA KERJA PRAKTEK
Nama : ...........................................................................................................................................
No. Telepon : ............................................................ No. Fax. ...........................................................
Email : ...........................................................................................................................................
Alamat : ...........................................................................................................................................
Nilai
No. Komponen Penilaian
Numerik

1. Pemahaman komprehensif terhadap kerja praktek

2. Sikap dan perilaku keprofesian

3. Kemampuan komunikasi, memahami dan mengatasi masalah (KIE)

4. Rataan tugas (Tugas khusus, laporan harian dan akhir kerja praktek)

5. Rataan penilaian keseluruhan

Tanda tangan pembiimbing dan cap basah instansi :

Keterangan :
> 80,00 – 100,00 Sangat baik > 60,00 – 70,00 Cukup
> 70,00 – 80,00 Baik > 50,00 – 60,00 Kurang
Catatan khusus :