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BUKU INVENTARIS

FORUM KESEHATAN DESA


DESA BRECEK KECAMATAN KALIGONDANG

NO TANGGAL TERIMA JENIS BARANG JUMLAH SUMBER DANA KONDISI KETERANGAN

Ketua FKD Desa Brecek Pengelola Inventaris


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RENCANA KEGIATAN
FORUM KESEHATAN DESA
DESA BRECEK KECAMATAN KALIGONDANG KABUPATEN PURBALINGGA

PENANGGUNG
NO KEGIATAN TUJUAN SASARAN WAKTU LOKASI SUMBER DANA
JAWAB

Kepala Desa Brecek Ketua FKD Desa Brecek


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BUKU KEUANGAN KAS UMUM
FORUM KESEHATAN DESA
DESA BRECEK KECAMATAN KALIGONDANG KABUPATEN PURBALINGGA

NO NO.BUKTI TANGGAL URAIAN PEMASUKAN PENGELUARAN SALDO

Brecek, …..........................................

Ketua FKD Desa Brecek Bendahara,


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BUKU KEGIATAN
FORUM KESEHATAN DESA
DESA BRECEK KECAMATAN KALIGONDANG KABUPATEN PURBALINGGA

TANGGAL
NO KEGIATAN SASARAN HASIL PELAKSANA TANDA TANGAN
KEGIATAN

Brecek, …......................................
Kepala Desa Brecek Ketua FKD Desa Brecek
….................................. …..................................
REKAPITULASI HASIL SURVEILANS MASALAH KESEHATAN (FAKTOR RESIKO)
FORUM KESEHATAN DESA
DESA BRECEK KECAMATAN KALIGONDANG KABUPATEN PURBALINGGA

MASALAH KESEHATAN/ FAKTOR RESIKO


NO RT/RW JUMLAH KK
MASALAH KESEHATAN FAKTOR RESIKO

Brecek, …...................................
Ketua FKD Desa Brecek
…......................................
NOTULEN RAPAT
FORUM KESEHATAN DESA
DESA Brecek KECAMATAN KALIGONDANG
KABUPATEN PURBALINGGA

Hari/Tanggal : …..................................
Waktu : …..................................
Tempat : …..................................
Agenda Rapat : …..................................

Hasil :
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Ketua FKD Desa Brecek Notulen


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