CONTOH LAPORAN UKS

CONTOH FORMAT LAPORAN TIM PELAKSANA UKS TENGAH TAHUNAN/TAHUNAN *) TAHUN

I.

Nama Nama Sekolah Sekolah/ma /madra draah ah

! """""" """"""""" """""" """""" """""" """""" """"" ""

Alama#

! """""""""""""""""""""" """"""""""""""""""""""" "

Ka$/Ko#a Ka$/Ko#a

! """""""""" """"""""""""""" """""""""" """""""" """

Pro%&'& Pro%&'&

! """""""""" """"""""""""""" """""""""" """""""" """

 Nomor #ele(o'

! """"""""""""""""""""""" """""""""""""""""""""""

Kode Po

! """""""""" """"""""""""""" """""""""" """""""" """

mlahS&+a

!"""""""""""""""""""""""

II. Ke,&a#a a#a' UK UKS A. Pe'd&d&ka' Keeha#a'

-. Pemer&kaa' $erkala

!kal&

. Pemer& Pemer&ka kaa' a' r#&' r#&'

!   ka kal& l&

0. Pe',kra' Pe',kra' #&',,& #&',,& $era# Peer#a Peer#a d&d&k d&d&k ! ! kal& kal& 1. Lom$a Lom$a ke$er& ke$er&ha' ha' kela kela

! !   kal& kal&

2. Ker3a Ker3a $ak#& $ak#& ke$er& ke$er&ha' ha'

!     kal&

4. Ala# Ala# (era,a (era,a UKS

! ada/#& ada/#&dak dak ada *) ! le',ka(/#&dak le',ka( *) 5l&ha# (em$aka')

6. Pela7a'a' Keeha#a'

-. Pe'7lh Pe'7lha' a'

! !   kal& kal&

. Pe'3ar Pe'3ar&', &',a' a' 58ree 58ree'&' '&',) ,)

! 9a/T&da /T&dak k

mlah Peer#a d&d&k 0. Im'&a& Im'&a& 5Kh 5Kh S:/MI) S:/MI)

! ! !  kal&

Kela I

! Peer#a d&d&k

Kela II

! Peer#a d&d&k

Kela III

!  Peer#a d&d&k

1. Pemer& Pemer&ka kaa' a' $erkal $erkalaa mlah Peer#a d&d&k

!   ka kal& l& !

2. Pe',o ',o$a# $a#a' Peer#a d&d&k d&r3k

!Peer#a d&d&k

4. ml mlah ah Peer Peer#a #a d&d& d&d&k k me'da(a# Ko'el&',

!  Peer#a d&d&k 

C. L&',k',a' Seha#

-. Ide'#& Ide'#&;&k ;&ka& a& maala maalah h

! 9a/T&da /T&dak k

. I'#e I'#er% r%e' e'&&

! 9a/T&d /T&dak  ak 

III.

:am(ak Pelaka'aa' UKS Terhada( Peer#a d&d&k -. Ke$er&ha' Peer#a d&d&k e8ara mm . Keeha#a' Peer#a d&d&k e8ara mm 0. Per$a'd&',a' #&',,& $era# ea& mr e8ara mm 1. Pere'#ae ra#ara#a a$e'& ak&# Peer#a d&d&k 2. Ka#e,or& l&',k',a' eha#

! $a&k/eda',/kra',* ! eha#/kra', eha#* ! d& $a+ah 'ormal ....... < ! ................................. . < ! ..................................

I=.Pe',elolaa' UKS -. T&m Pelaka'a UKS ! #er$e'#k/ $elm #er$e'#k . U'r'r 7a', me'3ad& A',,o#a T&m Pelaka'a a. ! ................................. b. :…………………….. c. :…………………….. d. :…………………….

0. 1. 2. 4.

Ra(a# r#&' koord&'a& ke,&a#a' Ra(a# ker3a (e'7'a' Ke,&a#a' 6&m$&',a'/(ela#&ha' ke,&a#a' Me'er&ma k'3',a'/mo'&#or&', T&m Pem$&'a >. Me',&k#& ra(a# koord&'a& ?. Pemer&kaa' ke$er&ha' @. Pem$a#a' la(ora' Tr&+la'

! ....................... kal& ! ....................... kal& ! ....................... kal& ! ....................... kal& ! ....................... kal& ! ....................... kal& ! ....................... kal&

...............................""""""".B" Pela(or Ke(ala Sekolah Selak Ke#a T&m Pelaka'a UKS