Surat Perintah Mondok.docx
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PEMERINTAH KABUPATEN BLORA DINAS KESEHATAN UPTD PUSKESMAS JIKEN Jl. Raya Blora – Cepu Km. 13 Telp. (0296) 525275, 5300521 Email : [email protected] JIKEN – BLORA 58372 Jiken,..............................2019 Kepada : Yth. Di BLORA
SURAT PERINTAH MONDOK Kami kirimkan penderita untuk mondok, Nama
:
Umur
:
Jenis Kelamin
:
No.Kepesertaan
:
Diagnosa Sementara : Atas perhatian teman sejawat diucapkan terima kasih.
Dokter yang merawat
dr.Syurdiyanti M.Kengo NIP. 19770108 200904 2 002
SURAT PERINTAH MONDOK Kami kirimkan penderita untuk mondok, Nama
:
Umur
:
Jenis Kelamin
:
No.Kepesertaan
:
Diagnosa Sementara : Atas perhatian teman sejawat diucapkan terima kasih.
Dokter yang merawat
dr.Syurdiyanti M.Kengo NIP. 19770108 200904 2 002
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