Rencana Supervisi Kepala Ruangan2.docx

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RENCANA SUPERVISI KEPALA RUANGAN Ruangan : No.

Nama

Maret 1

2

3

April 4

1

2

3

Mei 4

1

2

3

4

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Catatan tentang masalah yang akan di supervise : Keterangan : a. Disesuaikan dengan jadwal dinas staf b. Supervise dilakukan saat dinas pagi

Mengetahui,

……,……,20….

Atasan Langsung

Kepala Ruangan

(………………..)

(…………………)

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