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  • Form Pelimpahan Tugas

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    This document is a form for delegating nursing duties from one nurse to another. It includes fields for the name, employee ID number, job title, and reason for delegation of the nurse delegating duties as well as the name, employee ID number, and job title of the nurse receiving the delegated duties. There are also sections for specifying the details of the delegated duties and for the signatures of the nurses delegating and receiving duties as well as for acknowledgment by the head nurse and nursing manager.

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    Form Pelimpahan Tugas RSIJS

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    This document is a form for delegating nursing duties from one nurse to another. It includes fields for the name, employee ID number, job title, and reason for delegation of the nurse delegating duties as well as the name, employee ID number, and job title of the nurse receiving the delegated duties. There are also sections for specifying the details of the delegated duties and for the signatures of the nurses delegating and receiving duties as well as for acknowledgment by the head nurse and nursing manager.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    10 views1 page

    Form Pelimpahan Tugas

    Uploaded by

    dannyol
    This document is a form for delegating nursing duties from one nurse to another. It includes fields for the name, employee ID number, job title, and reason for delegation of the nurse delegating duties as well as the name, employee ID number, and job title of the nurse receiving the delegated duties. There are also sections for specifying the details of the delegated duties and for the signatures of the nurses delegating and receiving duties as well as for acknowledgment by the head nurse and nursing manager.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    of 1

    FORM PELIMPAHAN TUGAS KEPERAWATAN

    Yang menyerahkan tugas pada tanggal……………....................pukul………………s/d…………………

    Nama :

    NPP :

    Jabatan :

    Keperluan :

    Yang menerima limpahan tugas :

    Nama :

    Npp :

    Jabatan :

    Uraian limpahan tugas :

    1. ………………………………………………………………………………………………………………………………………………
    ……………………………………………………………………………………………………………………………………………..

    2. ………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………

    3. ………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………

    4. ………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………

    5. ………………………………………………………………………………………………………………………………………………
    ………………………………………………………………………………………………………………………………………………

    6. ………………………………………………………………………………………………………………………………………………
    ……………………………………………………………………………………………………………………………………………….

    Tanda Tangan Tanda Tangan

    Yang menyerahkan tugas Yang menerima limpahan tugas

    ……………………………………. …………………………………….

    Mengetahui

    Kanit Pelayanan Keperawatan Manager Keperawatan

    Wiwik Indrahati, S.Kep,Ners Siswanto, S.Kep,Ners

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