FORIUUIRUSULAN SET DAN SKRINING KT DAN KONOIS SOM D PUSKESMAS PEMBANTU Provist suse Kabupaten Kota: KEP. SELAYAR Kecamatan :PASLAMBENA Kode Puskesmas 97301043301 Pushesmas = PASLAMBENA Nama eta :RAIAGTOA Nama Poshesdes: POSKESDES BARUMBUNG Keterangan 1 Keterseigan eri [24 jf, ad cadangn/iak) ToAK 2 Netersedann internet aia) vA 2: lmishakes yong teed puts :2onNG SET OAR SHRNING HT “AAT YaNG TERSEOIA suAN A woot ar ONOISTALAT NAMA ALAT D1 ASPAK pumas aunty ‘AAT YANG ASPAR rrsoie ] emma noax | [SET PEMEROESAAN UM, A GAN KS i ta Tega PEL Dok Soong Seda messbasn/ Wecbelen bear [cumting Beda agar Stand Tar IcutingSenang Agha an (cuntingvertond Ie impln ner Arter Cra er Pemegang eu JS Tom nem kocerRocherla nem Kas karen Mel Perks Greig da argon Pat res Pinst Ansar Pn [Pet Anatom Pend Pet Bayonet 9.45 PnsetBedah cm Pmt Beda [Star Xorentng Se saipel Tanga Pau [spetlumvagn [Coco Sebel Grae ear Spekaton Vagina Corr Sk eve] ack Spell Vag ir) [stnslam ontingstan [ersetor sets esc bsh Spat Hampen [Troma a a eo Ferbane Keehn [ss tego Tenpat At er er i aaa [ST SoRATORUM. [Aut Tes Oana roe [Aa OT [ia ara de oer s-roeter z i A o Hl a a a a aKepaturt0paifamasPastanben awn raifatbin aes ‘3972072199403 032‘FORMUUR SULA SE DAN SERINING KIT OAN KONDIS SDM Ot PUSKESMAS PEMBANTU bopatn/Rota HEP SLAYAR cation SPASLAMBENA ode Pusesmas 97301011101 Poakesmar PASLAMBENA, Nama Poterdes:POSHESDES KAWAWU Keerngan 1 Keteredaan th (2am, a cadanganist) moa 2Liatersedaan tent afta pak 3. Jami ates yang terse pasty ORANG ETO SRREET “RATNER OND AIAT em a00n ALA 1 ASPAX oman nar vans] ae owen | Oe eon ena Sei Taga FT sk bong Sen [messosn Wertsien ber [canting Snare Angst hon er eer Lo ie arm J Te Kier hohe cothr' [Maja Perkse Gnetalog dan un peer Pet aah 3m eeu ape Toni Psy Ope junvagina (acor bebe Goa] ar ju Vagina Si) kinda snsr if erste pashan Ua aon [empat idrPorkas Dan Perego ermomee re ert trp roma fan Se STI Jar Feet [is Logan Tangata Se ar eter peri Mj istraen/At [Tepes tpes aes DRORTORUW [a Tet Ora orb] pid pro [b Aot ROT os Gara dn ester [es celp Gucproenur [es celphctestearin [es Golegan Oar aR WNT RE H shining Rea ek meter saana imbangan Miron [sucoseneter Ta ey i Nr aSeS121 REDE / ‘KONDISITENAGA KESERAATAN HATAN Kepala UPTO PuskesfuzsPastambena WAWILTAIVEY, SERN vw. 19720712h99403 1012FORIUUI USULAN SET DAN SERPUING KI DAN KONDIS SOM DI PUSKESMAS PEMANTU Prova suse Kabupaterote_:KUP.SELAYAR KecamatanPASIAMBENA, Node Pusheamas P0101 Poshesmas =: PASUAMBENA Nama Desa GARAUPARAYA "Nama Posesdes:POSKESDES AWAWU Keterngan:1.Retersean sth (24 Ja, ada cadangan a) 2 Retereiaon terme (al) 2 urna yang teed puta ETDAN SENN RT RATAN TeRsEOT NAMA ALAT DL ASPAK una avarv pen ues | (Prmeumen/ Town [SET PEMERSALNN OMURA DAN KE [oro el Duk otng Seda [Emesstoin/ Nevbeken ee [Guning Reda ivingan Sanda Tans [cung Bena Ana aon Teoning Verband kien Pemegang fru ah Tica [er toce othe Pers Gineolgi dan Rr peer Pats reflex inset Bayonet F245 ast Beda inset Beds Sem inde oretang Se oipelTnghi Pau Ope luragins Coco bet Gave] Be lu Vana Cocr Bebe Grave Kec alu Vag (Sr fandom uniting erase ah pails Ua [erat Tid Pars Dan Pe fermometer nt iernkettare/perbendr roche roel aii ee 7SATION] estan an sat gan Teper Ast Ser ery Lamu sence unk pe 7 [Menstrual oper apart aRORATORUM: [At Te aah Pot 7 Alt ROT Gols Darah Kalesterl fa Weer es coup cucopeienu Tes Cop hGitstehs Tes Goongan Dar TASS. [Sean a PORTO skiing [io Meter ‘UsuUN UMA ‘ALATYANG, rauTUNKAN[ning pr arta Pobind Merete [lvosemeter TONDISTENNGA ESTRRTAN TES TERAGR ESERATAN [ear [Tense aia onan [tanya Menges eal Dias Ksehton rabopatenyota ple UP10 PupesmasPaulombens awn rales seo ines vo. ag720 2 Y00409 4 O12FORMULIR USULAN SET DAN SKRNING KT DAN KONDIS| SDM D1 PUSKESMAS PEMANT Prov suuse. bupaten/Kta KEP. SELAYAR ecamatan PASWAMBENA ode ostesmas :#7303011101 Nama Desa HLEMBANG RATENE Nama usta: POSKESDESTADU eterangan 1 Ketercecaan lik (24m ada cadangan/s) DAK 2 etesein tert a/v) DAK 3 rah makes yang ered pus Hromne RT YANG TERSEOT pone alert NAMA ALATOLASPAK JIMA ALAT YANG] RONDISIRLAT asa ANS) weasuncsy TAK unre [SET PEMERTNSAAN OMOM RADARS [corong eng Spoons eins PEL [caning Benang gist an [canting verbs ir impin ere Arora Rem Peregang im 8 Te er tone feacher [eras torent Me Perks Gnesi dn reper pases [net Bedsh 18 nee Bess 14S xe wo. sine Karenina Ser [spetlumagn [Coe bebk Grave] es Ispelum Vagina [Coco Bebek Grave Kel spel Vagina [Srl stand untkindston Sandan [ertestar set sud dnp Lah aga Terps Tr Pra Dan Hermomeve ints [oreser aretpembendu remota Sona Pavesi esata an toga Tera Aa Ser Be Lamu ener uk per spe ies nsruren/At fessor [oples apis aa el [SeTIABORATORUM: [Aare baron agri [5 lt ROY Gul ara dn oles fs. Hbeter [es clip cucopeatanumm es clap hcetestehaniar [es Golongon Darah (SeTaMUST accetarir [NENT PSTD [string beter ‘usuan Man rauruaeaNMengthut /e a Sing igre ar Pom Tinbangs TOWDISTTNAGARESEERTAN [ERS TERRA TESEHATAN epala UPTO Mpiesmas Faslmbens Hawi tale snes ‘uo. 19720%2 299403 012row suse ibnatnyata RP STAR Kode rneamas Ppovonioh fama sty PUSTURURANGA eterangn—:feteredan rk (24 a, ab canis) oa 2am tre elt) Ton SETAE RTE TSO Ta no | ODE AAT 1 aon nar oman nar ane] AONOTAAT ar vanc ro Masha en ecm S| wcnruncs/ non | AAT YANG EER Un, ADA sic z eon eral seh Tega PT o——p. 4 x Dee erg 4 oak bag Sain 2 7 5: [eneibnin/ Wer bene : ang . [onting dah ringan Sand Taa z eng a [contin Benarg Ang inh x ern no fering veri fibers 0 ies ere a 2 free a ie Peetng no Ta iver ar er cheer fice 7 = er fossa 2h 4 a is Perse neo in pen fo 4 3 oT 37 eros 38 rer 3 Peseta km 1 frets 20 set esa Som rer 2 [sige ogi esr Opa 1 frst Ea ekg ca Sebel Sa Da 2p % spear Vga coco eek Give] cr — 7 2 [Spek vag Ss 5 ear a [Sandan oni 2p 7 Fa tnd 3 fer 2 erator =p 7 50 cep 3 rab i a aa a oe 3 cnet a fe ‘| 3 Teng rea a agp Al sag 3 [emone ine) ca o ft eri 2 i a [onal ation em 2 3] Feria etna z ea tam Tonga Ae =I | z seen preg 7° 3] x soon a a 7 es Flite ae erg x ne rh Por open z Ala AT {ods Ona dae = 7 t ter a es cap Gaxoptee 7 7 5 res coup host] ° H & eGo rh 21 4 rR 1 ae 7 Skiing Remap TR mae) . ie 7—r7 Tera Nima [Guconereter wh ‘ = rot a eps UPTO Pu Hawi up. ss720rf2 1 sas Pasoioens Loker oa 1012‘bate KEP. SLAYAR eterna 1 Rateredao et 2 via a cafe) oak 2 teen tert oak NAMA AAT OLASPAK Jmcaar vane] AMORA | auarvans bk btn Son [soning sah igo Sans Ta RET Remometer nar ia ga Trp A Ber rex Oa ana fe sere [er taupe |[Siriing Himbangan Mico [Gucosemeter OND TERAGA KESEHATAN TERS TERAGA KESEHATAN Mengerab epaa Dias Keseitan “yatiatenota= j | VAP \s ate L |: sup 13623795631 00g epala PTO Pu awn Tare 22 Pasiambens MKes 9720714 199403 1012FORMUUR USULAN SET OAN XRINING KT DAN KONOIS SOM OY PUSKESMVAS PenABAeTY froma casts ‘choteyotst AYAR ‘cman agen ‘cerruemas ‘poor fecomes “pasta finaoes — “raonae omaha SST nao MADU a 2 ewes eae ‘row 2 Toe ogee pr Tou SORTA T RTS anuee unm no | tones wwomnuroiavax — |ramannarrane] AONB AAT | At ae Teaseoue | CAUNES/ ROA | eran Se RRERSA ERORTES i ites — 7 a coe pon Ta — Hl Dora fe 7 todas saa — zi fess Sle 1g ‘ cenit be eg aa a 7 sng beg — = ing en 1h o hating a 7 15 fee aa — = en eneay ou Tc rags = lente eee 7 5 fem — 3 it a a z = Parca — i 3 ase ona — 7 Prscnstons reat i Posen fies 3 Pe etc hog = se een — z Ss i z z Since oe — Hl = Sep rges 1 reg #e a = ae = Basten irs z [rans eats =a 7 ra [srs 7 = [rest = rl 3 rs $reg H a Sea a | H 2 Pengo — 7 3 [erie ur Peri a Peel + eg a fenonet to = | = [see entere z 3 fre t H z al pa aay = i eT z Sg eae bh H 7 [angst cP 5 haga 7 z tse — 5 Fen so ae er 1 aT aa z aor [ours Oe) — i t Perea cca — | fates accion 7 a Tesssingnrat ao i ame tr 5 Eee z sang ena fee — iSrning WX apr an Posing ensimete z ereroee zl 2 CONDI TENAGA KESEHRTN TENS TENRGA KESEHATAN [Basn Inari epaipSoer satan ON OY im | 1H. AWIL TANYE, SKM.MLKes