PEMERINTAH KABUPATEN CIREBON

UPT PUSKESMAS KARANGSARI

Jl. Ki Sabalanang No. 01 Desa Karangsari Telp / Fax (0231)8820330,
089615109858 email : pkarangsari@gmail.com Desa Karangsari Kec.
Weru Kab. Cirebon Kode Pos 45154

Tempat, Tanggal, Bulan dan Tahun

Kepada

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SURAT EDARAN

NOMOR ........................................................................

TENTANG

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KEPALA DINAS KESEHATAN KABUPATEN CIREBON ,

NAMA GELAR
Pangkat
NIP
Tembusan:
1. Yth…………………………
2. Yth. ……………………….