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    12 views1 page

    Tanda Terima

    Uploaded by

    Mentari Handayani

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    PEMERINTAH KOTA MALANG

    DINAS KESEHATAN
    Jl. Simpang LA. Sucipto No.45 Telp. (0341) 406878, Fax (0341) 406879
    Website:www.dinkes.malangkota.go.id / e-mail:dinkes@malangkota.go.id
    MALANG Kode Pos: 65124

    TANDA TERIMA PENGURUSAN IZIN


    Nama : ................................................................................................

    Jenis Perizinan : ................................................................................................

    Kesimpulan : Lengkap / Tidak Lengkap

    Kekurangan Berkas : ................................................................................................

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

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

    Malang, ...............................
    Pemohon, Pemeriksa,

    ( ........................................................) ( ........................................................)
    NB : tanda terima harap dibawa saat pengambilan

    PEMERINTAH KOTA MALANG


    DINAS KESEHATAN
    Jl. Simpang LA. Sucipto No.45 Telp. (0341) 406878, Fax (0341) 406879
    Website:www.dinkes.malangkota.go.id / e-mail:dinkes@malangkota.go.id
    MALANG Kode Pos: 65124

    TANDA TERIMA PENGURUSAN IZIN


    Nama : ................................................................................................

    Jenis Perizinan : ................................................................................................

    Kesimpulan : Lengkap / Tidak Lengkap

    Kekurangan Berkas : ................................................................................................

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

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

    Malang, ....................................
    Pemohon, Pemeriksa,

    ( ........................................................) ( ........................................................)
    NB : tanda terima harap dibawa saat pengambilan

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