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PEMERINTAH KABUPATEN LUMAJANG

DINAS KESEHATAN

UPT PUSKESMAS KEDUNGJAJANG Jl. Puskesmas Kedungjajang 118 Telp ( 0334 ) 441627 email : [email protected]

LUMAJANG – 67358

Lumajang, 16 Januari 2019 Kepada: Yth. Kepala Dinas Kesehatan Kab. Lumajang c/q Bagian Keuangan Dinas Kesehatan Kab. Lumajang di LUMAJANG SURAT PENGANTAR NOMOR : 900 / No

1

Jenis Yang Dikirim

Laporan Bulanan Retribusi Puskesmas Kedungjajang

/ 427.55.25/ 2019 Banyaknya

Keterangan

1 Bendel

Dikirim dengan hormat untuk dijadikan periksa

KEPALA PUSKESMAS KEDUNGJAJANG Tembusan : 1. Dinas Lumajang

Kesehatan

Kabupaten

drg. NAT SUGIARTI NIP. 19670824 200604 2 008

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