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  • Form Pengaduan

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    2110044 Christian A Mailoa
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    The document is a complaint form from the Mawae Community Health Center in Tobelo Timur District, North Halmahera Regency. It requests the complainant's name, address, phone number, occupation, and details of the complaint. The form must be signed and dated by the complainant when submitted.

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    4. FORM PENGADUAN

    Original Title

    4. FORM PENGADUAN

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    The document is a complaint form from the Mawae Community Health Center in Tobelo Timur District, North Halmahera Regency. It requests the complainant's name, address, phone number, occupation, and details of the complaint. The form must be signed and dated by the complainant when submitted.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    16 views2 pages

    Form Pengaduan

    Uploaded by

    2110044 Christian A Mailoa
    The document is a complaint form from the Mawae Community Health Center in Tobelo Timur District, North Halmahera Regency. It requests the complainant's name, address, phone number, occupation, and details of the complaint. The form must be signed and dated by the complainant when submitted.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 2

    PEMERINTAH KABUPATEN HALMAHERA UTARA

    PUSKESMAS MAWEA
    KECAMATAN TOBELO TIMUR
    Website : www.halmaherautarakab.go.id,
    https://dinkes.halmaherautarakab.go.id
    Email: pkmmawea@gmail.com
    Jl. Tobe – Katana KM. 10

    FORMULIR PENGADUAN
    PADA UNIT PELAYANAN PUSKESMAS MAWEA

    NAMA : …………………………………………………………………………………………………………………

    ALAMAT : …………………………………………………………………………………………………………………

    NO. TELEPON/WA : …………………………………………………………………………………………………………………

    PEKERJAAN : …………………………………………………………………………………………………………………

    HAL YANG DI ADUKAN :

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    ………………..,............................2023
    PELAPOR

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