Surat Keterangan Kematian [PDF]

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RUMAH SAKIT KH. ABDURRAHMAN SYAMSURI AL MA’HAD AL ISLAMY KARANGASEM Jl. Raya Deandles KM. 70 Paciran Lamongan 62264 Telp. (0322) 662637, (Hunting) 081232870229 / 085730845336, Fax. (0322) 666626 Email : [email protected]



SURAT KETERANGAN KEMATIAN No. /SKK/III-F/ /20



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Demikian Surat Keterangan Kematian ini dibuat dengan sebenar- benarnya.



Lamongan, ............................................. Dokter



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