IDENTITAS
MAHASISWA PROGRAM PENGALAMAN LAPANGA (PPL) PRODI D4 BIDAN PENDIDIK STIKes
AISYAH PRINGSEWU LAMPUNG
TAHUN
AKADEMIK 2014/2015
Nama
Mahasiswa :
...........................................................
NPM :
...........................................................
Tempat,
Tanggal Lahir :
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Alamat :
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Telepon/HP :
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DATA TEMPAT PRAKTIK PROGRAM PENGALAMAN LAPANGAN
Nama
Institusi : .....................................................
Program
Studi :
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Alamat :
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No.
Tlp. / No. Fax : (.............)........................, /
(..............)......................
Nama
Direktur/Kaprodi :
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Nama
Dosen Pamong :
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Nama
Dosen Pembimbing : .....................................................
Tanggal
Mulai Praktik : ................/................./..................
Tanggal
Selesai Praktik : ................/................./..................
JAM KERJA
HARI
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JAM KERJA
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JAM ISTIRAHAT
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JAM PULANG
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Senin
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Selasa
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Rabu
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Kamis
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Jumat
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Sabtu
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