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BIODATA KEPEGAWAIAN

TAHUN ...........................

NAMA = ...............................................................................................................................................................................................

TEMPAT/ TANGGAL LAHIR =..........................................................................................................................................................................................................

STATUS = LAJANG / MENIKAH/ JANDA/ DUDA

JENIS KELAMIN ................................................................................................................................................................................................................


=

PENDIDIKAN TERAKHIR =.........................................................................................................................................................................................................

ALAMAT SEKARANG .......................................................................................................................................................................................................................


=

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

NO. TELP/ HP = ...............................................................................................................................................................................................

TANGGUNGAN KELUARGA =

NO NAMA TANGGUNGAN HUBUNGAN KELUARGA UMUR PENDIDIKAN

PENDIDIKAN / PELATIHAN /WORKSHOP/SEMINAR

NO NAMA PELATIHAN TEMPAT LAMANYA NO/ TANGGAL SERTIFIKAT

PERJALAN KARIR SELAMA BEKERJA DI RS SARI ASIH

TAHUN UNIT JABATAN

Tangerang, .............................................................
(..............................................................................)

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