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DEPARTEMENT OF EDUCATION

UDAYANA UNIVERSITY
FACULTY OF MEDICINE

ELECTIVE STUDY PROGRAM

Head of Program : Dr.dr. I W. P. Sutirta Yasa, M.Si


Secretary : dr P. A. Asri Damayanti, M.Kes
Student’s Name : Sheryl Elita Tanjaya (1202005108)
Supervisor : dr. Luh Putu Ratna Sundari, M. Biomed
Elective Study Program for 2 weeks

SUPERVISOR’S
NO. DATE ACTIVITY
SIGN
1. 29 September 2014 Introduction

2. 3 Oktober 2014 Konsul I: Diskusi Ide dan Bab I

3. 19 Januari 2015 Konsul II : Revisi dan Bab II

4. 27 Januari 2015 Konsul III: Revisi dan Bab III

5. 4 Februari 2015 Konsul IV: Revisi dan Bab IV

6. 11 Februari 2015 Konsul V: Penyelesaian Proposal

7. 13 Februari 2015 Persetujuan dan Persiapan Ujian

Denpasar,

Verified by

Head of Program Secretary,

Dr.dr. I W. P. Sutirta Yasa, M.Si dr P. A. Asri Damayanti, M.Kes


NIP 131 570 629 NIP 132 304 120
Elective Study Process Final Assessment
By Supervisor

Title : Hubungan Antara Kualitas Tidur dengan Indeks Massa Tubuh pada Pelajar
SMA “X” di Denpasar Tahun 2015

Exam Date/Time : Jumat, 13 Februari 2015


Student Name : Sheryl Elita Tanjaya
Student ID Number : 12020050108
Supervisor : dr. Luh Putu Ratna Sundari, M. Biomed
Assessment :
The process are approximately as follows :

No. Item Assesment Range Score


1. Log Book 0-30
2. Observation : 0-40
- Communication
- Attendance
- Gesture and Posture
3. Ability to find literature 0-30
Total 0-100

Final Result (Score) :


Criteria :A B C D E (please circling the criteria)
Results Range :
A : 80-100
B : 70-79
C : 55-69
D : 45-54
E : 0-44

Supervisor,

(dr. Luh Putu Ratna Sundari, M. Biomed)


NIP. 19750904 2008
Elective Study Process Final Assessment
By Evaluator

Title : Hubungan Antara Kualitas Tidur dengan Indeks Massa Tubuh pada Pelajar
SMA “X” di Denpasar Tahun 2015

Exam Date/Time : Jumat, 13 Februari 2015


Student Name : Sheryl Elita Tanjaya
Student ID Number : 1202005108
Supervisor : dr. Luh Putu Ratna Sundari, M. Biomed

Assessment :
The final exam are approximately as follows :

No. Item Assesment Range Score


1. Quality of material 0-60
2. Student’s interest and motivation 0-10
3. Critical thinking 0-10
4. Capability fo information searching 0-10
5. Reliability 0-10
Total 0-100

Final Result (Score) :


Criteria :A B C D E (please circling the criteria)
Results Range :
A : 80-100
B : 70-79
C : 55-69
D : 45-54
E : 0-44

Evaluator,

(dr. I Made Krisna Dinata, M. Erg.)


NIP. 19840401 201404 1 001
Elective Study Process Final Assessment
By Evaluator

Title : Hubungan Antara Kualitas Tidur dengan Indeks Massa Tubuh pada Pelajar
SMA “X” di Denpasar Tahun 2015

Exam Date/Time : Jumat, 13 Februari 2015


Student Name : Sheryl Elita Tanjaya
Student ID Number : 1202005108
Supervisor : dr. Luh Putu Ratna Sundari, M. Biomed

Assessment :
The final exam are approximately as follows :

No. Item Assesment Range Score


1. Quality of material 0-60
2. Student’s interest and motivation 0-10
3. Critical thinking 0-10
4. Capability fo information searching 0-10
5. Reliability 0-10
Total 0-100

Final Result (Score) :


Criteria :A B C D E (please circling the criteria)
Results Range :
A : 80-100
B : 70-79
C : 55-69
D : 45-54
E : 0-44

Evaluator,

( )
NIP.