Nama :.................................................................... Semester : ................................................................... Program Keahlian :.................................................................... Nama DU/DI/Instansi :.................................................................... Nama Pembimbing :.................................................................... Waktu PKL :.................................................................... Nilai-Nilai Hari, Tanggal Topik Pembelajaran Tanda Tangan No Karakter Budaya Pelaksanaan /Pekerjaan Pembimbing DUDI/Instansi