Print-lembar Kegiatan Ikgm Amel.docx

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LEMBAR KEGIATAN MAHASISWA PRAKTEK KERJA LAPANGAN ILMU KESEHATAN GIGI MASYARAKAT FAKULTAS KEDOKTERAN GIGI UNIVERSITAS JEMBER NAMA

:

NIM

:

2. KEGIATAN DI RUMAH SAKIT (………………………….)

Tanggal :

1. Kegiatan/Bimbingan tatap muka Tanggal

Kegiatan

Tanda Tangan Pembimbing

2. Bimbingan Diskusi Tanggal

Kegiatan

Tanda Tangan Pembimbing

3. Kegiatan Bimbingan/Pelayanan Kesehatan Tanggal

Kegiatan

Tanda Tangan Pembimbing

4. Kegiatan Praktek Tanggal

Kegiatan

Tanda Tangan Pembimbing

Mengetahui, Direktur RSUD Blambangan Banyuwangi

Hj. dr. Siti Asiyah Anggraeni, MMRS NIP. 197105052002122004

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