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Formulir Permohonan Informasi Publik - Balai Besa Pelatihan Kesehatan Makassar
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Email
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Your email
Nama Pemohon Informasi
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Your answer
Nomor Identitas/KTP Pemohon Informasi
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Your answer
Alamat Pemohon Informasi
*
Your answer
Nomor Telepon Pemohon Informasi
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Your answer
Email Pemohon Informasi
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Your answer
Informasi yang dimohon
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Your answer
Tujuan Penggunaan Informasi
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Your answer
Cara Memperoleh Salinan Informasi
*
Melihat/membaca/mendengar/mencatat
Mendapatkan salinan dokumen (Hardcopy/Softcopy)
Cara Mendapatkan Salinan Informasi
*
Mengambil Langsung
Dikirim Lewat Pos
Email
Tanggal Permintaan
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MM
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DD
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YYYY
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