Formulir Skp Perawat Penyelia

FORMULIR SASARAN KERJA PEGAWAI NEGERI SIPIL NO 1 2 "  !

I. PEJABAT PENILAI N am a NIP Pa#$%at&'().R*a#$ Ja+ata# #it Ke/a

NO 1 2 "  !

H. JOSRIZAL HELMAN, S.Si, Apt 1 9 6 8  6 29 1 9 9 9  ! 1   2 Pem+i#a & I a Kepa)a P*s%esmas P*s%esmas S*#$ai 3*#$%a)

II. PEGAWAI NEGERI SIPIL YANG DINILAI Nam a Ns. HENDRA HASRIANTO, S.Kep NIP 1986112 21"1 1 1 Pa#$%at&'().R*a#$ Pe#ata M*-a & III a Ja+ata# Pe/a0at #it Ke/a P*s%esmas S*#$ai 3*#$%a) TARGET

NO

III. KEGIATAN TUGAS JABATAN

AK KUANT/OUTPUT

KUAL/MUTU

WAKTU

BIAYA

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Peabat Penilai,

Sungai Penuh, 01 Maret 2015 Pegawai !egeri Sipil "ang #inilai

H. JOSRIZAL HELMAN, S.Si, Apt !$P% 1&'(0'2& 1&&&05 1 002

Ns. HENDRA HASRIANTO, S.Kep 1&('1120 201)01 1 001

PENILAIAN CAPAIAN SASARAN KERJA PEGAWAI NEGERI SIPIL *angka +aktu Penilaian % *anuari s%d% )1 #esember 20%% NO

I. Kegit! T"gs J#t!

AK

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