Surat Sakit: Keterangan No:........................................
Surat Sakit: Keterangan No:........................................
BEKASI
PUSKESMAS SUKAINDAH
JL. Cabang Pulo Bambu Ds. Sukaindah
.........................................................................................
Perlu beristirahat karena sakit, selama..................... hari
terhitung tanggal : ................... ..s/d .............................
Harap yang berkepentingan maklum.
......................20.........