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Klinik

SAPTA MITRA
PRAKTEK DOKTER 24 JAM
Jl. K. H. Muchtar Tabrani, RT.005/RW.005,
Perwira, Kec. Bekasi Utara, Kota Bks, Jawa Barat 17124

SURAT KETERANGAN SAKIT


Yang bertanda tangan di bawah ini
Dokter : .....................................................................................................................................................
Menerangkan bahwa
Nama : .......................................................................................................................................
Umur : ........................................................................................................................................
Alamat : ......................................................................................................................................
Perlu istirahat karna Sakit selama.....................................................................................................(Hari)
Terhitung tanggal ............................................. S/d...................................................................................
Harap yang berkepentingan maklum
Bekasi.............................20.......

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