Section 1 of 1
FORMULIR PELAPORAN KERUSAKAN BARANG
TEMAN TEMAN BERIKUT GFORM PELAPORAN KERUSAKAN BARANG PUSKESMAS KEBAYORAN BARU DIMANA TUJUANYA UNTUK MEMPERMUDAH TEMAN TEMAN PENANGGUNG JAWAB BARANG DAN USER DALAM PELAPORAN KERUSAKAN
Nama pelapor
Nama pelapor
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05/09/2026
05/09/2026
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Opsi 1
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PUSKESMAS
PUSKESMAS
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PKC
PUSTU CIPETE UTARA
PUSTU PULO
PUSTU GANDUT 1
PUSTU GANDUT II
PUSTU KRAMAT PELA
PUSTU GUNUNG
PUSTU SELONG
PUSTU PETOGOGAN
PUSTU RAWA BARAT
RUMAH BERSALIN
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UNIT / RUANG / PUSTU
UNIT / RUANG / PUSTU
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JENIS KERUSAKAN
JENIS KERUSAKAN
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TEMAN TEMAN SILAHKAN ISI UNTUK JENIS KERUSAKAN DISESUAIKAN DENGAN KONDISI DAN JENIS BARANG NYA
ALKES
SAPRAS UMUM
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ALKES
ALKES
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UNTUK KERUSAKAN ALKES TEMAN TEMAN BISA JELASKAN KERUSAKANYA PADA ALKES TERSEBUT CONTOH ( Alat Tensi tidak berfungsi atau Timbangan Rusak Karena Pecah )
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SAPRAS UMUM
SAPRAS UMUM
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UNTUK KERUSAKAN SAPRAS TEMAN TEMAN BISA JELASKAN KERUSAKANYA PADA SAPRAS TERSEBUT CONTOH ( Alat AC bocor, Atap Plafon Rusak, Dinding Roboh, Kursi Rusak,Printer Rusak )
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FOTO KERUSKAN
FOTO KERUSKAN
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