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BERITA ACARA PEMINJAMAN DOKUMEN APS

SEKOLAH TINGGI ILMU KESEHATAN BAKTI UTAMA PATI

Pada hari ini……………….tanggal…………….bulan……...…….tahun…………bertempat

di STIKes Bakti Utama Pati. Berikut adalah data diri peminjam dokumen APS
1. Nama :
2. NPP :
3. Keperluan :
Dokumen-dokumen yang dipinjam antara lain:
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Demikian berita acara ini dibuat, agar dipergunakan sebagaimana mestinya.

Pati, ……………………
Pemohon,

Desi Sariyani, S.Tr.Keb., M.Keb.

Mengetahui,
NPP. 12005085
Ketua STIKes Bakti Utama Pati

Irfana Tri Wijayanti, S.Si.T., M.Kes., M.Keb.

NPP. 12005023

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