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    Puskesmas Ketapang: Pemerintah Kabupaten Sampang Upt Dinas Kesehatan

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    samsiah
    This document is a form from the Ketapang Health Center in Sampang Regency for evaluating a health program. The form includes boxes to check whether the program started on time, met its target number of participants, was held in the planned location, and followed standard operating procedures. There is also a section for conclusions and signatures from those implementing the program.

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    Puskesmas Ketapang: Pemerintah Kabupaten Sampang Upt Dinas Kesehatan

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    samsiah
    8 views1 page
    This document is a form from the Ketapang Health Center in Sampang Regency for evaluating a health program. The form includes boxes to check whether the program started on time, met its target number of participants, was held in the planned location, and followed standard operating procedures. There is also a section for conclusions and signatures from those implementing the program.

    Original Description:

    SOP PHBS TEMPT KERJA

    Original Title

    4. Instrumen penilaian

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    This document is a form from the Ketapang Health Center in Sampang Regency for evaluating a health program. The form includes boxes to check whether the program started on time, met its target number of participants, was held in the planned location, and followed standard operating procedures. There is also a section for conclusions and signatures from those implementing the program.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    8 views1 page

    Puskesmas Ketapang: Pemerintah Kabupaten Sampang Upt Dinas Kesehatan

    Uploaded by

    samsiah
    This document is a form from the Ketapang Health Center in Sampang Regency for evaluating a health program. The form includes boxes to check whether the program started on time, met its target number of participants, was held in the planned location, and followed standard operating procedures. There is also a section for conclusions and signatures from those implementing the program.

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    of 1

    PEMERINTAH KABUPATEN SAMPANG

    UPT DINAS KESEHATAN


    PUSKESMAS KETAPANG
    Jl. Raya Ketapang Daya Ketapang Sampang Kode Pos 69261
    Email: puskesmasketapangsampang@gmail.com
    No telp; 082332554699

    INSTRUMEN PENILAIAN EVALUASI


    KEGIATAN ........................................PROGRAM ..................................

    O INSTRUMEN PENILAIAN YA TIDAK KETERANGAN/ALASAN/PENYEBAB


    1 Waktu mulai kegiatan jam
    ......
    2 Jumlah sasaran .....
    3 Tempat sesuai rencana
    4 Kegiatan yang laksanakan
    sesuai SOP

    Kesimpulan:
    Pelaksana Kegiatan....

    __________________________

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