DR INDARWATI BUDIASTUTI [PDF]

SURAT KETERANGAN SAKIT

SURAT KETERANGAN SAKIT

Yang bertanda tangan dibawah ini menerangkan bahwa :

Yang bertanda tang

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SURAT KETERANGAN SAKIT

SURAT KETERANGAN SAKIT

Yang bertanda tangan dibawah ini menerangkan bahwa :

Yang bertanda tangan dibawah ini menerangkan bahwa :

Nama

: .....................................................................................

Nama

: .....................................................................................

Jenis Kelamin

: .....................................................................................

Jenis Kelamin

: .....................................................................................

Umur

: .....................................................................................

Umur

: .....................................................................................

Pekerjaan

: .....................................................................................

Pekerjaan

: .....................................................................................

Alamat

: .....................................................................................

Alamat

: .....................................................................................

Perlu beristirahat karena sakit selama......................................(...........................)hari. Terhitung tanggal....................................................s/d...............................................................................

Perlu beristirahat karena sakit selama......................................(...........................)hari. Terhitung tanggal....................................................s/d...............................................................................

Harap yang bekepentingan maklum.

Harap yang bekepentingan maklum.

Bolong,........./...................................../20.....

Bolong,........./...................................../20.....

Dokter Pemeriksa

Dokter Pemeriksa

Dr. Aulia Marlina

Dr. Aulia Marlina