8/18/2019 10. Daftar Penerimaan ATK Dan Materi

1/2

DAFTAR PENERIMAAN ATK

HARI :

TANGGAL :

TEMPAT :

 ACARA :

NO. NAMA PUSKESMAS JUMLAH TANDA TANGAN

1 1 Paket 1

2 1 Paket 2

3 1 Paket 3

4 1 Paket 4

5 1 Paket 5

6 1 Paket 6

7 1 Paket 7

8 1 Paket 8

9 1 Paket 9

10 1 Paket 10

11 1 Paket 11

12 1 Paket 12

13 1 Paket 13

14 1 Paket 14

15 1 Paket 15

16 1 Paket 16

17 1 Paket 17

18 1 Paket 18

19 1 Paket 19

20 1 Paket 20

21 1 Paket 21

22 1 Paket 22

23 1 Paket 23

24 1 Paket 24

25 1 Paket 2526 1 Paket 26

27 1 Paket 27

28 1 Paket 28

29 1 Paket 29

30 1 Paket 30

  Brebe!

Me"#eta$%&! Pe'aka"a!

(e)a'a P%ke*a ++++++++++++++++++++++ Be",a$ara Pe"#e'%ara" Pe*ba"t%

P%ke*a ++++++++++++++

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

NIP. .............................. NIP. ..............................

8/18/2019 10. Daftar Penerimaan ATK Dan Materi

2/2

DAFTAR PENERIMAAN MATERI

HARI :

TANGGAL :

TEMPAT :

 ACARA :

NO. NAMA PUSKESMAS JUMLAH TANDA TANGAN

1 1 Paket 1

2 1 Paket 2

3 1 Paket 3

4 1 Paket 4

5 1 Paket 5

6 1 Paket 6

7 1 Paket 7

8 1 Paket 8

9 1 Paket 9

10 1 Paket 10

11 1 Paket 11

12 1 Paket 12

13 1 Paket 13

14 1 Paket 14

15 1 Paket 15

16 1 Paket 16

17 1 Paket 17

18 1 Paket 18

19 1 Paket 19

20 1 Paket 20

21 1 Paket 21

22 1 Paket 22

23 1 Paket 23

24 1 Paket 24

25 1 Paket 2526 1 Paket 26

27 1 Paket 27

28 1 Paket 28

29 1 Paket 29

30 1 Paket 30

  Brebe!

Me"#eta$%&! Pe'aka"a!

(e)a'a P%ke*a ++++++++++++++++++++++ Be",a$ara Pe"#e'%ara" Pe*ba"t%

P%ke*a ++++++++++++++

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

NIP. .............................. NIP. ..............................