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Form Permohonan Cuti - Pusat Pendidikan SDM Kesehatan
Selamat Datang di Form Permohonan Cuti - Pusat Pendidikan SDM Kesehatan
* Indicates required question
Email
*
Your email
Nama Lengkap
*
Your answer
NIP
*
Your answer
Alamat Domisili
*
Your answer
Jenis Cuti yang diambil (Pilih Salah Satu)
*
Cuti Tahunan
Cuti Sakit
Cuti Karena Alasan Penting
Cuti Besar
Cuti Melahirkan
Cuti Diluar Tanggungan Negara
Alasan Cuti
*
Your answer
Jangka Waktu Cuti (Hari)
*
Your answer
dari Tanggal
*
MM
/
DD
/
YYYY
sampai Tanggal
*
MM
/
DD
/
YYYY
Atasan Langsung
*
Sugiyanto, S.Pd,
M.App.SC
Yetty Azriani, DCN.MPH
Hendro Saputro, S.Si
Zaeni Dahlan, S.SI.T, MPH
drg. Yana Yojana, MA
Dedy Suryadi,
S.ST
, MM
Dian Arief Hawindati, SKM, M.Pd
Keputusan Pejabat Berwenang
*
Sugiyanto, S.Pd,
M.App.SC
Yuyun Widyaningsih, S.Kp, MKM
Dra. Trini Nurwanti, M.Kes
Akemat, S.Kp, M.Kes
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