Form_Pelaksanaan Cuci Tangan

FORMULIR PELAKSANAAN DESINFEKSI RUANGAN No

Tanggal/Jam

Nama Ruangan

Nama Petugas Desine!si

Tanda Tangan

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FORMULIR PELAKSANAAN "U"I TANGAN # LANGKA$

No

Tanggal/Jm

No RM

 Mela!u!an "u'i Tangan # lang!a%

Nama Petugas Tanda Tangan Desine!si

Suda% &elum 1 2

1 2

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3 4

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