Template Tata Naskah (SK DLL)

Lampiran 1 : Peraturan Direktur
PERATURAN DIREKTUR
NOMOR : 00/PER-DIR/RSKS/I/2017
TENTANG
XXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXX
DIREKTUR RUMAH SAKIT KURNIA SERANG
Menimbang : a. Xxxxxxxxxxxxxxxxxxxxxxxxxxx
b. Xxxxxxxxxxxxxxxxxxxxxxxxxxx
c. Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Mengingat : 1. Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
2 Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
3. Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx , dst
MEMUTUSKAN
Menetapkan :
KESATU : XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
KEDUA : Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
KETIGA : Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
KEEMPAT : xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx , dst
Ditetapkan di : Serang
Pada tanggal : xxxxxxxxxxxxxx
Direktur,
Dr. Wahyu Hapsari, MARS

Lampiran 2 : Keputusan Direktur
KEPUTUSAN DIREKTUR
NOMOR : 00/SK-DIR/RSKS/I/2017
TENTANG
XXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXX
MEMUTUSKAN
Menetapkan :
KESATU : XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
KEDUA : Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
KETIGA : Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
KEEMPAT : Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx , dst
Direktur,

Lampiran 3 : Instruksi Direktur
INSTRUKSI DIREKTUR
NOMOR : 00/I-DIR/RSKS/I/2017
TENTANG
XXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXX
MENGINSTRUKSIKAN
Kepada : 1. xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
2. xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Untuk :
PERTAMA : xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
KEDUA : dst
Direktur,

Lampiran 4 : Surat Edaran
SURAT EDARAN
Nomor :.................................
TENTANG
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Dikeluarkan di ..................................
Pada Tanggal ........................................
Direktur,
NAMA JELAS
Lampiran 5 : Standar Prosedur Operasional
XXXXXXXXXXXXXXXXXXXXXXXX
Nomor :
No. Revisi : 00 Halaman : x/x
xx/SPO/LAB/RSKS/I/2017
Ditetapkan :
STANDAR PROSEDUR
Tanggal Terbit :
OPERASIONAL
xxxxxxxxxxxxxxxxxx
Direktur
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
PENGERTIAN xxxxxxxxxxxxxxxxxxxxxxx
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
TUJUAN
KEBIJAKAN xxxxxx
PROSEDUR xxxxxx
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
UNIT TERKAIT
Lampiran 6 : Indikator Mutu
XXXXXXXXXXXXXXXXXXXXXXXXXXXX
Nomor : No. Revisi : 00 Halaman : x/x
Ditetapkan :
INDIKATOR MUTU
………………………… Tanggal Terbit :
. xxxxxxxxxxxxxxxxxx
NAMA JELAS
Direktur
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Judul
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Dimensi
xxxxx
Tujuan
xxxxxxxxxxxxxx
Definisi Operasional
xxxxxxxxxxxxxx
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Frekuensi
xxxx
Pengumpulan Data
Periode Analisa
xxxx
Numerator
xxxx
Denominator
xxxx
Sumber Data
xxxx
Standar
xxxx
Penanggung Jawab
xxxx
Lampiran 8 : Surat Biasa
Xxxxxxxxxx, .....................................
Nomor : xxxxxxxxxxxxxxxxxxxxxx
Lampiran : xxxxxxxxxxxxxxxxxxxxxx
Perihal : xxxxxxxxxxxxxxxxxxxxxx
Kepada Yth
Xxxxxxxxxxxxxxxxxxxxxxxx
Xxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxx
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxx
Nama Jelas
Jabatan
Tembusan :
Lampiran 13 : Surat Undangan
Serang, ..............................................
Nomor : xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Lampiran : xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Perihal : xxxxxxxxxxxxxxxxxxxxxxxxx
Kepada Yth,
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Hari / Tanggal : .................................................................

Waktu : ...............................................................
Tempat : ..................................................................
Acara : .................................................................
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Nama Jelas
Nama Jabatan
Lampiran 17 : Naskah Laporan
Lampiran 23 : Daftar Hadir
DAFTAR HADIR
Hal / Tentang : xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Tempat : xxxxxxxxxxxxxxxxxxxxx
Hari dan Tanggal : xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Pemimpin Rapat : xxxxxxxxxxxxxxxxxxxxxxxxx
NO NAMA BIDANG / JABATAN NO TELP/HP EMAIL PARAF

UNIT
Lampiran 25 : Naskah Notulen
NOTULEN
Rapat :
Hari / Tanggal :
Waktu :
Tempat :
No Pokok Bahasan Usulan / Keputusan Keterangan
Mengetahui,
Nama Jabatan Notulis
Nama Jelas Nama Jelas

Template Tata Naskah (SK DLL)

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Template Tata Naskah (SK DLL)

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Lampiran 1 : Peraturan Direktur

DIREKTUR RUMAH SAKIT KURNIA SERANG

Dr. Wahyu Hapsari, MARS

DIREKTUR RUMAH SAKIT KURNIA SERANG

Dr. Wahyu Hapsari, MARS

DIREKTUR RUMAH SAKIT KURNIA SERANG

Dr. Wahyu Hapsari, MARS

Nomor : No. Revisi : 00 Halaman : x/x

Hari / Tanggal : .................................................................

Hal / Tentang : xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

NO NAMA BIDANG / JABATAN NO TELP/HP EMAIL PARAF

No Pokok Bahasan Usulan / Keputusan Keterangan

Nama Jelas Nama Jelas

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