PEMERINTAH KABUPATEN PANGANDARAN

DINAS KESEHATAN
UPTD PUSKESMAS JADIKARYA
Alamat : Jl.Bojong No...Jadikarya Langkaplancar – Pangandaran 46391
Tlp. 081395253600. Email : jadikaryapuskesmas@yahoo.com

LAPORAN PELAKSANAAN TUGAS

1. Dasar Penugasan : Surat Perintah - Tugas No. 824/ - ST/PKM/VIII/2020

2. Nama Petugas : Maman Rustaman, AMKG dan Yusep, S,Kep., Ners
3. Tujuan Perjalanan : Desa Jadimulya
4. Tanggal Perjalanan : 19 Agustus 2020
5. Maksud Perjalanan : Kegiatan Penyuluhan TB
6. Pejabat Yang Ditemui : Kepala Desa Jadimulya
7. Hasil Kunjungan :
a. Proses Pelaksanaan
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b. Permasalahan yang Dihadapi
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c. Kesimpulan / Saran Perbaikan
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Mengetahui, Jadikarya, 19 Agustus 2020

Kepala UPTD Puskesmas Jadikarya Pelapor,

M. Isnaini Pujaananda, S.Kep Maman Rustaman, AMKG

Penata Tk.I – III / d Pengatur Tk I - II / d
NIP. 19741204.199403.1.001 NIP. 19810628 201503 1 001

Yusep, S.Kep., Ners