Logbook Ptgmi

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REKAPITULASI HASIL PELAYANAN DI BP GIGI PUSKESMAS/ RUMAH SAKIT ….. BULAN …….. TAHUN ….. NO 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

TANGGAL

Mengetahui Kepala Puskesmas

……………….

NAMA PASIEN

DIAGNOSA

NAN SAKIT …..

IMPLEMENTASI/ TINDAKAN

Cirebon, ……………20 … Pelaksana

…………………….

REKAPITULASI HASIL PELAYANAN DI BP GIGI PUSKESMAS/ RUMAH SAKIT ……. TAHUN 2016 NO

BULAN

1

Januari

2

Februari

3

Maret

4

April

5

Mei

6

Juni

7

Juli

8

Agustus

9

September

10

Oktober

11

November

12

Desember

JUMLAH PASIEN

KETERANGAN

JUMLAH Cirebon,

Desember 2016

Mengetahui atasan langsung

Pelaksana

……………….

…………………….

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