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KONSIL TENAGA KESEHATAN INDONESIA

THE INDONESIAN HEALTH WORKFORCE COUNCIL


SURAT TANDA REGISTRASI BIDAN
REGISTRATION CERTIFICATE OF MIDWIFE

NOMOR REGISTRASI :
REGISTRATION NUMBER

NAMA :
NAME

TEMPAT / TANGGAL LAHIR :


PLACE / DATE OF BIRTH

JENIS KELAMIN :
SEX

NOMOR IJAZAH/SERTIFIKAT PROFESI :


DIPLOMA/PROFESSION CERTIFICATE NUMBER

TANGGAL LULUS :
DATE OF GRADUATION

PERGURUAN TINGGI :
UNIVERSITY

KOMPETENSI :
COMPETENCE

NOMOR SERTIFIKAT KOMPETENSI :


CERTIFICATE OF COMPETENCE NUMBER

BERLAKU HINGGA :
VALID UNTIL

Jak ar ta, 2 Agustus 2023


KETUA KONSIL KEBIDANAN
Head of Midwifery Council

Siti Romlah., SKM.,MKM


Registrar
Dokumen ini telah ditandatangani secara elektronik menggunakan sertifikat elektronik yang diterbitkan oleh Balai Sertifikasi
Elektronik (BSrE) BSSN, dinyatakan sah secara hukum dan tidak diperlukan legalisir
This document has been signed electronically using an electronic certificate issued by the National Cyber and Crypto Agency
(BSSN) declared legally valid and no legalization is required.
ktki.kemkes.go.id

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