Absensi Kader Pmo Tb.docx

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PEMERINTAH KABUPATEN KATINGAN DINAS KESEHATAN

UPTD KECAMATAN PETAK MALAI PUSKESMAS TUMBANG BARAOI Jalan Baraoi, Desa Tumbang Baraoi 74459 E-Mail: [email protected]

DAFTAR HADIR PERTEMUAN Hari/ tanggal : Tempat

:

Kegiatan

: Pembinaan Ibu Hamil dan Suami Siaga

NO

NAMA SUAMI

NAMA ISTRI

TANDA TANGAN SUAMI

ISTRI

1 2 3 4 5 6 7 8 9 10

Mengetahui, Plt. Kepala UPTD Kecamatan Petak Malai Puskesmas Tumbang Baraoi

Hesti Loren, A. Md. Keb NIP. 198407312009042001

Pengelola Program UPTD Kecamatan Petak Malai Puskesmas Tumbang Baraoi,

Trisnawati Siboro, Amd. Keb NRPK :15.6.0403266

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