LAPORAN TINDAK LANJUT KEGIATAN ......

Nama Petugas :
Jadwal Kegiatan :
Tempat Kegiatan :

Hasil Kegiatan :
A. Proses Pelaksanaan
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B. Permasalahan yang dihadapi
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C. Catatan/ Saran
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Mengetahui Penanggung Jawab UKM Petugas

Kepala UPTD Puskesmas….
1. .......................

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NIP. NIP.