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HARI, : ....................................

TANGGAL : .......-..................- 2021


JAM SERAH TERIMA : ....................................

PIKET : SIANG / MALAM KETERANGAN


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INVENTARIS POS KEAMANAN
NAMA BARANG PARAF NAMA BARANG PARAF
1. 2 (dua) buah HT + Charger 8. 1 (satu) buah tongkat polisi
2. 2 (dua) buah tabung Damkar 9. 1 (satu) buah lampu senter
3. 2 (dua) buah kasur gulung 10. 1 (satu buah sangkur
4. 4 (empat) buah kursi besi 11. .............................................
5. 1 (satu) kipas angin dinding 12. .............................................
6. 1 (satu) buah TV 32" 13. .............................................
7. 1 (satu) buah Jam dinding 14. .............................................

PAKET LAMA :
JAM/NO UNTUK BLOK KETERANGAN T. TANGAN
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PAKET BARU :
JAM/NO UNTUK BLOK KETERANGAN T. TANGAN
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JAM URAIAN TUGAS KETERANGAN
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PETUGAS PIKET
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