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PANITIA PELAKSANA

“ NURSING CARE “

BEM AKPER YPPP TOMATINDO DILIMBORO

WONOMULYO MANDAR PERIODE 2011-2012

FORMULIR PENDAFTARANPESERTA SUNATAN MASSAL

Nama Peserta : ………………………………………………….

Tempat/Tanggal Lahir : ………………………………………………….

Alamat : ………………………………………………….

Nama Orang Tua/Wali : ………………………………………………….

Pekerjaan : ………………………………………………….

Alamat : ………………………………………………….

Sunatan massal InsyaAllah akan diadakan pada:

ari/ Tanggal : Ahad / 25 Desembe 2011

Pukul : 0!"00 W#$a - se%esa#

Tempat : Mes&#d N''% Am#( D's'( Ba('a Ka))a(* Desa Te(**e%a(* Ke+" L'),

............................! …..... "es #$%% Orang Tua Peserta

……………………………

Cp. 085393895059 (Fredy Akbar K,S.Kep.,Ns)

Lampiran 1

B! AK"# $""" %a&an 'a Sebr N. 01 *nm+&y "&ea&i !andar

-e&p. 08533/1585 mai& bemakper2yppp ya4. m

N,m, 0"""

mailto:[email protected]




PANITIA PELAKSANA




S6S6NAN ACA#A BAKS7S N6#SN' CA#: ;011

*ak+ Ke<iaan -empa

0/.00 = 0/.30

08.00

08.00 08.15

08.15 = 08.;0

08.;0 08.30

08.30 09.00

09.00 se&esai

Berk+mp+& > Beran<ka dr Kamp+s

-iba di &kasi Bakss

#e<israsi "esera

7penin< Ceremny

Lapran Ke+a "aniia > Ke+a B!

Samb+anSamb+an

?irek+r AK"# $""" *nm+&y

Cama L+y

Ka. ?inkes Kab. "&mas

Ka. BKKBN Kab. "&man

Ke+a $"""seka&is+s memb+ka aara Bakss

@N+rsin< Care ;011

BAKS7S

Kamp+s

Lkasi

Lkasi

Lkasi

Lkasi

Lkasi

Lkasi

DAFTAR NAMA-NAMA PESERTA SIRKUM B! AK"# $""" %a&an 'a Sebr N. 01 *nm+&y "&ea&i !andar


K,,d#(a$, A+aa

A(d# .am/a Sa'$a





PANITIA PELAKSANA




BAKSOS “NURSING CARE 2011’BEM AKPER YPPP WONOMULYO

Ahad, 2 D!"!#$!% 2011

N&

Na#aP!"!%'a

T!#(a' T)* Lah+%Na#a

O%'Wa*+P!.!%/aaO%'Wa*+

A*a#a'

0102030405

06070809101112131516

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RahmatAbdulGafarM. SahrilHamsah

Muslimin n!"

#!$ar...........................Halim%usurRahmatMa&arAbd

Rahman 'u(riadi)lhamAmmarHamdaniMas*udHans #+ttiAl&iSudirmanM. ,a-ir

Andr!MaulanaA. MunaraSahrulSu-riHa!dirAsri

/amun$ aru23 'uni 2000/amun$ aru 31!s!mb!r 1998/amun$ aru 01

-t+b!r 2004........................................................................................................................../amun$ aru 6%+!mb!r 2002.............................................................................................

........................./amun$ aru02 'uli 2000Ratt!mal+an 12-t+b!r 2002..........................................................Ratt!mal+an$5 !bruari 2002/amun$ aru

10 'anuari 2003/amun$ aru22 -t+b!r 1997/amun$ aru 29%+!mb!r 2001...................................................................................................... 2001

R+haniaMaidHusnaa--arHidaatAbbas

HattaSinarihuSalaisaAmb+Hasnaa*du :Amb+Husna;

<ass!Halimah+m+Ma&arAbd RahmanSamsul

SamsulHusdaRamli%asaruddinMu*inan$=daaasriau&iHasanuddinA. A>+

HasanuddinSHa-aHasanuddin/a>+. #ta-

#ani=R#

#ani..................

#ani

#ani....................................

#ani #ani

..................=R#

#ani #ani=R#

#ani?iras&asta

#ani=R#

/a. usun #ani

?iras&asta@%S #ani #ani

#ani

/amun$aru

/amun$aru

/amun$

aru................./amun$

aru/amun$

aru...................

.......................

.....

/amun$aru

Ratt!mal+an

/a--an$an@arian$an/amun$

aru/amun$

aru

/amun$aru

!t!an$!t!an$!t!an$!t!an$!t!an$!t!an$!t!an$







PANITIA PELAKSANA




3637

383940

!t!an$................................ 2000

!t!an$................................ 2001.............................................. 2001.............................................. 2000.............................................. 2000..............................................

............................................../amun$aru......................2002/amun$aru......................2002

!t!an$!t!an$

/a--an$an/a--an$an





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