Laporan Perjalanan Dinas (LPD) 2022

PEMERINTAH KABUPATEN KAMPAR
DINAS KESEHATAN
UPT PUSKESMAS KUOK
Alamat : Jl. Prof. M. Yamin, SH No. 044 Desa Lereng
HP. 0812 6652 7485 Kode Pos : 28463
Email:uptdpuskesmaskuok01@gmail.com
LAPORAN PERJALANAN DINAS

A. PENDAHULUAN
1. Dasar : Surat Perintah Tugas Kepala UPT Puskesmas Kuok

Nomor : 445/PKM-KUOK/ /2022/
Tanggal : ...........................................................................................
2. Tujuan : ....................................................................................................................
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B. ISI LAPORAN : ....................................................................................................................
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C. PENUTUP : ....................................................................................................................
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Lereng, 2022
Yang Melakukan Perjalanan Dinas
........................................
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DINAS KESEHATAN
UPT PUSKESMAS KUOK
HP. 0812 6652 7485 Kode Pos : 28463
LAPORAN PERJALANAN DINAS

A. PENDAHULUAN
3. Dasar : Surat Perintah Tugas Kepala UPT Puskesmas Kuok

Nomor : 445/PKM-KUOK/XI/2021/
Tanggal : ...........................................................................................
4. Tujuan : ....................................................................................................................
....................................................................................................................
D. ISI LAPORAN : ....................................................................................................................
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E. PENUTUP : ....................................................................................................................
....................................................................................................................
Lereng, November 2021

Yang Melakukan Perjalanan Dinas
DINAS KESEHATAN
UPT PUSKESMAS KUOK
HP. 0812 6652 7485 Kode Pos : 28463
DAFTAR HADIR
KEGIATAN :
HARI / TANGGAL :
TEMPAT :
NO NAMA MURID KELAS
Mengetahui :
Kepala UPT Puskesmas Kuok
dr. Santy Syahmini

NIP. 19730104 200701 2 00
DINAS KESEHATAN
UPT PUSKESMAS KUOK
HP. 0812 6652 7485 Kode Pos : 28463
DAFTAR IBU HAMIL KEK

BULAN JANUARI S/D JULI 2022
DESA :
N UMUR
NAMA IBU HAMIL NIK NAMA SUAMI KET
O (Thn)
Mengetahui :
dr. Santy Syahmini

NIP. 19730104 200701 2 003
DAFTAR IBU HAMIL MENDAPAT Fe

DINAS KESEHATAN
UPT PUSKESMAS KUOK
HP. 0812 6652 7485 Kode Pos : 28463
DESA :
UMU Jlh Tab. Fe

NAMA IBU yang diminum
NO NIK R NAMA SUAMI KET
HAMIL
(Thn) 30 60 90
Mengetahui :
dr. Santy Syahmini

NIP. 19730104 200701 2 003
DAFTAR PENIMBANGAN BALITA
DINAS KESEHATAN
UPT PUSKESMAS KUOK
HP. 0812 6652 7485 Kode Pos : 28463
DESA :
N NAMA NIK Tgl BB TB
NAMA IBU BB/U TB/U BB/TB
O BALITA BALITA Lahir (Kg) (Cm)
Mengetahui :
dr. Santy Syahmini

NIP. 19730104 200701 2 003
HASIL PENIMBANGAN BALITA
DESA :
DINAS KESEHATAN
UPT PUSKESMAS KUOK
HP. 0812 6652 7485 Kode Pos : 28463
N JUMLAH BB/U JUMLAH TB/U JUMLAH BB/TB

O Gizi Gizi Gizi Sangat
Pendek Normal Tinggi Kurus Normal Gemuk
Buruk Kurang Baik Pendek
Mengetahui :
dr. Santy Syahmini

NIP. 19730104 200701 2 003
DAFTAR NAMA ANAK BALITA

DESA :
DINAS KESEHATAN
UPT PUSKESMAS KUOK
HP. 0812 6652 7485 Kode Pos : 28463
BB
NO NAMA BALITA TANGGAL LAHIR KET
(Kg)
Mengetahui :
dr. Santy Syahmini

NIP. 19730104 200701 2 003

Laporan Perjalanan Dinas (LPD) 2022

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Laporan Perjalanan Dinas (LPD) 2022

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PEMERINTAH KABUPATEN KAMPAR

LAPORAN PERJALANAN DINAS

1. Dasar : Surat Perintah Tugas Kepala UPT Puskesmas Kuok

LAPORAN PERJALANAN DINAS

3. Dasar : Surat Perintah Tugas Kepala UPT Puskesmas Kuok

Lereng, November 2021

NO NAMA MURID KELAS

dr. Santy Syahmini

DAFTAR IBU HAMIL KEK

dr. Santy Syahmini

DAFTAR IBU HAMIL MENDAPAT Fe

BULAN JANUARI S/D JULI 2022

UMU Jlh Tab. Fe

dr. Santy Syahmini

dr. Santy Syahmini

HASIL PENIMBANGAN BALITA

N JUMLAH BB/U JUMLAH TB/U JUMLAH BB/TB

dr. Santy Syahmini

DAFTAR NAMA ANAK BALITA

dr. Santy Syahmini

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