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PEMERINTAH KABUPATEN KARAWANG

DINAS KESEHATAN
UPTD PUSKESMAS DTP TIRTAJAYA
Jl. Raya Pisangsambo Desa Sabajaya Kecamatan Tirtajaya Kabupaten Karawang
e-mail :pkmtirtajaya@gmail.com Kode Pos 41357

LAPORAN PELAKSANAAN TUGAS


1. Dasar Penugasan : Surat Tugas Puskesmas Tirtajaya No. 440/ /PKM.TJ/2023
2. Nama Petugas Tim :
3. Tujuan Perjalanan :
4. Maksud Perjalanan :
5. Tanggal Perjalanan :
6. Hasil Kunjungan :
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d. Kesimpulan / Saran Perbaikan
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Lokasi yang dikunjung Karawang,


Pelapor

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