Form Support.xls

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System Support Form SIMRS Medinfras Dilaporkan oleh Nama Klien Nama Pelapor

: :

[P]Problem/[R]Request No.

Tipe (P/R)

Keterangan

Lain - lain

Tanda Tangan Pelapor

Mengetahui/Menyetujui Atasan langsung pelapor

Nama Jelas :

Nama Jelas :

Support Form SIMRS Medinfras Unit/Departemen Tanggal Lapor

Lokasi Pada Aplikasi

Mengetahui/Menyetujui

: IT : 18 Mei 2018

Prioritas (Medium, Low, High)

Modul

Mengesahkan

Nama Jelas :

Nama Jelas:

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