Anda di halaman 1dari 1

LAPORAN PERJALANAN DINAS

Surat Tugas, No. / / BOK / /PKM/2021

1. Nama Petugas :

2. NIP :

3. Jabatan :

4. Tujuan Perjalanan :

5. Tanggal Perjalanan :

6. Maksud Perjalanan :

7 Hasil Kegiatan : :......................................................................................................

..............................................................................................................................................................

............................................................................................................................................................

.............................................................................................................................................................

..............................................................................................................................................................

..............................................................................................................................................................

..............................................................................................................................................................

..............................................................................................................................................................

..............................................................................................................................................................

..............................................................................................................................................................

..............................................................................................................................................................

..............................................................................................................................................................

..............................................................................................................................................................

8. Kesimpulan / Saran Perbaikan :

..............................................................................................................................................................

..............................................................................................................................................................

............................................................................................................................................... ......

Wado,...................................... 2021
Pelapor

…………………………………………..
NIP.

Anda mungkin juga menyukai