WIRELESS REGISTRATION INFORMATION HOSPITAL BINTULU HBB/ICT/100/2-4 Requester Information Name : Department / Unit / Ward : Designation : Official Email (1GovUC) : Handphone : Wireless Information Hostname : MAC Address : Duration of use : Reasons (day/week/month/s) From : / / To: / / : Confirmation Requested by: Approved by : Name : Name : Date : Date : Registered by: (Data Centre Operator) Unregistered by: (Data Centre Operator) Name : Name : Date : Date : :: WIFI - Hospital Bintulu @ 2013 :: (Hospital IT Department) HBTU/form/Wifi/V02.00
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