PEMERINTAH KOTA BATAM

DINAS KESEHATAN
UPT. PUSKESMAS BULANG
Jl Zakaria Ahmad Pulau Buluh, Kecamatan Bulang
Email :pkmbulang@gmail.comTELP. (0778) 7056988

KEPUTUSAN KEPALA UPT. PUSKESMAS BULANG

NOMOR.... TAHUN.....

TENTANG
JUDUL SK

KEPALA UPT. PUSKESMAS BULANG

Menimbang : a. bahwa .....................................................................

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b. dan seterusnya ........................................................
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Mengingat : 1. .........................................................................
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2. dan seterusnya ...................................... .................
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Memperhatikan : 1. .........................................................................
.............;
2. dan seterusnya ........................................................
........................ ..........................;

MEMUTUSKAN :

Menetapkan : ...........................................................................
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KESATU : ...................................................................................
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KEDUA : ........................................................................................
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Ditetapkan di : Batam
Pada tanggal :
KEPALA UPT. PUSKESMAS BULANG

HARRI FAJRI ZISONI