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PEMERINTAH KABUPATEN BOJONEGORO

DINAS KESEHATAN
RUMAH SAKIT UMUM DAERAH SUMBERREJO
Jl. Raya No. 231 Sumberrejo Bojonegoro 62191
Telepon (0353) 331530, Email rsudsumberrejobjn@gmail.com

NOTA DINAS

Yth : ...............................................
Dari : ..............................................
Tembusan : ...............................................
Tanggal : .............................................
Nomor : kodifikasi naskah/nomor naskah/kode OPD/Tahun
Sifat : ...............................................
Lampiran : .............................................
Hal : .............................................

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Nama Jabatan

Nama
Pangkat/Golongan
NIP

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