5.1.2.3 DAFTAR TILIK Pelaksanaan Orientasi - Copy (2)

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5.1.2.3 DAFTAR TILIK Pelaksanaan Orientasi - Copy (2)

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PELAKSANAAN ORIENTASI PENANGGUNG JAWAB PELAKSANA UKM YANG BARU DITUGASKAN No. Dokumen :

DT

No. Revisi

:

Tgl. Terbit

:

Halaman

: 1/2

UPT PUSKESMAS GU

e$ala Puskesmas

PEMERINTAH A!"PATEN REM!AN#

%r. N"R H&TI! NIP. 1'(')*1+2)),)11

DAFTAR TILIK

"nit Nama Petugas Tangg anggal al Pelak Pelaksa sana naan an

: .. . .............................................................................. : ............................................................................... : .... ...... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... ..

No -angka egiatan 1.  A$aka e$ala $uskesmas $uskesmas memberikan memberikan $enelasan $enelasan ke$a%a

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$enanggung a3ab %an $elaksana $rogram "M 4ang baru %itugask %itugaskan an tentang tentang ke3aib ke3aiban an orientas orientasii serta serta $emaam $emaaman an tugas %an 5ungsi mereka. 2.

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*.

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$en7atatan setia$ kegiatan %i masing 6 masing unit 4ang a%a

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kaitann4a %engan $rogram "M. ,.

 A$aka Penanggunga3 Penanggunga3ab ab %an $elaksa

"M

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orientasi ke$a%a ke$ala $uskesmas. (.

 A$aka e$ala $uskesmas mengevaluasi asil kegiata orientasi

tera%a$

$enanggung

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$rogram "M 4ang baru %itugaskan. +.

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'.

 A$aka

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membuat

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$enanggung a3ab %an $elaksana $rogram "M 4ang baru %itugaskan.

9R: ............................ ................................... ....

Pelaksana /Au%itor

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