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PEMERINTAH KABUPATEN LAMPUNG BARAT

DINAS KESEHATAN
PUSKESMAS LOMBOK
Alamat:Jalan. Wisata Lombok KM 10 Suka Maju, Lumbok Seminung 34879 (9)
SMS Center 081379316810, 082185531308, Email Puskesmaslomboklambar@gmail.com

NOTULEN

Rapat : ..................................................

Hari / Tanggal : ..................................................

Waktu : ..................................................

Acara : 1. ..................................................

2. ..................................................
Dst
Pimpinan Rapat
Ketua : ..................................................
Notulen : ..................................................

Peserta Rapat
1. ..................................................
2. ..................................................
3. ..................................................
4. ..................................................
5. ..................................................
6. Dst

Kegiatan Rapat :

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

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

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

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

....................................................................................................................
Mengetahui
KEPALA PUSKESMAS LOMBOK PEMBUAT LAPORAN

SITI MAHDALENA,SKM dr.Martia Rahmawati


NIP.199003152022032005
NIP.197904202006042019
PEMERINTAH KABUPATEN LAMPUNG BARAT
DINAS KESEHATAN
PUSKESMAS LOMBOK
Alamat:Jalan. Wisata Lombok KM 10 Suka Maju, Lumbok Seminung 34879 (9)
SMS Center 081379316810, 082185531308, Email Puskesmaslomboklambar@gmail.com

DAFTAR HADIR PERTEMUAN RAPAT

Hari / Tanggal : ..................................................

Waktu : ..................................................

Tempat : ..................................................

Acara : ..................................................

No Nama Jabatan Tanda Tangan Ket

1.

2.

3.

4.

6
Mengetahui
KEPALA PUSKESMAS LOMBOK PENANGGUNG JAWAB

SITI MAHDALENA,SKM dr.Martia Rahmawati


NIP.199003152022032005
NIP.197904202006042019

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