Surat Keterangan.docx

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SURAT KETERANGAN NO.800/ /PKM-KC/III/2017

Yang bertanda tangan dibawah ini: Nama

: dr. O.U. Taty Damayanty

Nip

: 197304062006042020

Jabatan

: Kepala Puskesmas Kunciran

Menerangkan bahwa : Telah lahir bayi laki-laki bernama :Rasyid Lukialamsyah, tanggal 17 Agustus 2016. Ditolong persalinn oleh ibu Hj. Munah dengan alamat : Kunciran Jaya Rt03/03 dengan BBL 2600 gr PB 47 cm. Anak pertama dari pasangan suami/istri bapak Julani dan Ibu Nuraini. Surat keterangan ini dipergunakan untuk persyaratan pembuatan Akte Kelahiran.

Tangerang, 3 maret 2017 Kepala UPT Puskesmas Kunciran

dr. O.U. Taty Damayanty Nip.197304062006042020

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