“WELRANKY” Ds. Sumber Pasir, Pakis Malang Telp (0341) 787719 / 082234073308 SURAT KETERANGAN KELAHIRAN
Menerangkan dengan sebenarnya bahwa :
Nama : Ny. .........................................................../Tn. ...................................................................
Alamat : ............................................................................................................................................... Pada hari : ............................................................................................................................................... Tanggal : ................................................. Jam : .................................................................... Telah melahirkan seorang laki-laki / perempuan yang ke : .................................................................... Berat Badan : ......................... gram, panjang badan : .................................................................... Diberi nama : ............................................................................................................................................... BIDAN
( Sri Diati Khasanah )
503.1/15/KAB/51PB/2016
Praktek Mandiri Bidan
“WELRANKY” Ds. Sumber Pasir, Pakis Malang Telp (0341) 787719 / 082234073308 SURAT KETERANGAN KELAHIRAN
Menerangkan dengan sebenarnya bahwa :
Nama : Ny. .........................................................../Tn. ...................................................................
Alamat : ............................................................................................................................................... Pada hari : ............................................................................................................................................... Tanggal : ................................................. Jam : .................................................................... Telah melahirkan seorang laki-laki / perempuan yang ke : .................................................................... Berat Badan : ......................... gram, panjang badan : .................................................................... Diberi nama : ............................................................................................................................................... BIDAN