Surat keterangan lahir bidan praktek mandiri
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Surat keterangan lahir bidan praktek mandiri
- 1. BIDAN PRAKTEK MANDIRI (BPM) Susi Rendiawati, S.Tr.Keb Desa Losarang Kecamatan Losarang – Indramayu SIPB NO : 504.04/BDN/Yankes/2016 SURAT KETERANGAN LAHIR Yang bertanda tangan dibawah ini menerangkan bahwa : N a m a : ................................................................................................................ U m u r : ................................................................................................................ Suami : ................................................................................................................ Alamat : ................................................................................................................ ................................................................................................................ Telah melahirkan anak ke : .....................................( .........................................................................) Jenis Kelamin : ........................................ pada hari ....................................................... Tanggal : .......................................................... Jam ......................................WIB Diberi nama : ................................................................. .............................................. Demikian Surat Keterangan ini saya buat untuk dapat dipergunakan sebagaimana mestinya. ………………………, .… ……………..…… 20…. Bidan Susi Rendiawati, S.Tr.Keb BIDAN PRAKTEK MANDIRI (BPM) Susi Rendiawati, S.Tr.Keb Desa Losarang Kecamatan Losarang – Indramayu SIPB NO : 504.04/BDN/Yankes/2016 SURAT KETERANGAN LAHIR Yang bertanda tangan dibawah ini menerangkan bahwa : N a m a : ................................................................................................................ U m u r : ................................................................................................................ Suami : ................................................................................................................ Alamat : ................................................................................................................ ................................................................................................................ Telah melahirkan anak ke : .....................................( .........................................................................) Jenis Kelamin : ........................................ pada hari ....................................................... Tanggal : .......................................................... Jam ......................................WIB Diberi nama : ................................................................. .............................................. Demikian Surat Keterangan ini saya buat untuk dapat dipergunakan sebagaimana mestinya. ………………………, .… ……………..…… 20…. Bidan Susi Rendiawati, S.Tr.Keb