Berita Acara Obat.docx

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LAMPIRAN

: BERITA ACARA SERAH TERIMA DAFTAR OBAT

NOMOR

:

TANGGAL

:

NO 1

NAMA BARANG 2

Mengetahui , Kepala UPTD Puskesmas Rawat Inap Ujungjaya

Saprudin, AMK.SKM NIP. 196504101986031015

SATUAN 3

BANYAKNYA 4

KETERANGA 5

PANITIA SERAH TERIMA 1. Nama : …………………………….. Tanda tangan : ……………………………... 2. Nama : ……………………………... Tanda tangan : ……………………………... 3. Nama : ……………………………... Tanda tangan : …………………………… 4. Nama : ……………………………... Tanda tangan : ……………………………... 5. Nama : ……………………………... Tanda tangan : ……………………………...

LAMPIRAN

: BERITA ACARA SERAH TERIMA ASET

NOMOR

:

TANGGAL

:

NO 1

NAMA BARANG 2

Mengetahui , Kepala UPTD Puskesmas Rawat Inap Ujungjaya

Saprudin, AMK.SKM NIP. 196504101986031015

SATUAN 3

BANYAKNYA 4

KETERANGA 5

PANITIA SERAH TERIMA 1. Nama : …………………………….. Tanda tangan : ……………………………... 2. Nama : ……………………………... Tanda tangan : …………………………… 3. Nama : ……………………………... Tanda tangan : 4. Nama : ……………………………... Tanda tangan : ……………………………... 5. Nama : ……………………………... Tanda tangan : ……………………………...

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