Form saran-keluhan.docx

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Transcript of Form saran-keluhan.docx

Nama : _________________________________________Alamat : _________________________________________

_________________________________________No. Tlp : _________________________________________

Saran Keluhan

Isi saran/keluhan : ____________________________________________________________________________________________________________________________________________________________________

Ttd/paraf penulis :_________________________________________

Kategori (pilih salah satu dengan beri tanda " √)

Nama : _________________________________________Alamat : _________________________________________

_________________________________________No. Tlp : _________________________________________

Saran Keluhan

Isi saran/keluhan : ____________________________________________________________________________________________________________________________________________________________________

Ttd/paraf penulis :_________________________________________

Kategori (pilih salah satu dengan beri tanda " √)

Nama : _________________________________________Alamat : _________________________________________

_________________________________________No. Tlp : _________________________________________

Saran Keluhan

Isi saran/keluhan : ____________________________________________________________________________________________________________________________________________________________________

Ttd/paraf penulis :_________________________________________

Kategori (pilih salah satu dengan beri tanda " √)