15. Hasil Anc Ibu

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NAMA IBU HAMIL TB : cm LiLA : cm

Tgl

Keluhan

:

ALAMAT IBU HAMIL :

Tensi (mmHg)

BB(kg)

UK (mg)

TFU

Letak janin

DJJ

Kaki bengkak

Hasil Lab dan USG

Tindakan dan Terapi

Nasihat

Tempat Periksa

Skor KSPR

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