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    4 views1 page

    Surat Izn Atasan

    Uploaded by

    yandi123
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    © All Rights Reserved
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    of 1

    PEMERINTAH KABUPATEN CIANJUR

    DINAS KESEHATAN
    PUSKESMAS KADUPANDAK
    Jalan Karamat No. 1 Kec. Kadupandak- Cianjur 43268
    E-mail : pkmkdp@gmail.com

    SURAT IZIN
    NO: 800/ /PKM/III/2018

    Yang bertandatangan dibawah ini memberikan izin kepada :

    Nama : Siti Ajizah


    Jenis Kelamin : Perempuan
    Pekerjaan : Karyawan Puskesmas Kadupandak
    Alamat Tempat Tinggal : .........................................................................................................

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

    Memberikan izin kepada nama diatas untuk menjadi Petugas/Tim Enumerator Riskesdas
    2018.

    Demikian surat ini dibuat untuk dipergunakan seperlunya.

    Kadupandak, 17 Maret 2018


    Kepala Puskesmas Kadupandak

    Suryana, Amd. Kep., SKM


    NIP. 19740402 199403 1 003

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