Blangko Bpjs.xlsx

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  • November 2019
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  • Words: 103
  • Pages: 3
DAFTAR BUKTI KUNJUNGAN ASKES SOSIAL DESA BULAN NO

: SAMALAGI

TANGGAL

NOMOR KARTU PESERTA

NAMA PESERTA

JK

UMUR

BB

TB

TD

DIAGNOSA

RUJUK

THERAPY

TANDA TANGAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 18 20 SAMALAGI, BIDAN DESA SAMALAGI

2019

MUZNA HALEK, Amd.Keb

LAPORAN PENYAKIT DESA : SAMALAGI BULAN/TAHUN : UMUR NO

NAMA PENYAKIT

0-11 BULAN 1-5 TAHUN

6-12 TAHUN

13-15 TAHUN

16-18 TAHUN

19-24 TAHUN

25-44 TAHUN

45-50 TAHUN

51+ TAHUN

JUMLAH

KETERANGAN

1 2 3 4 5 6 7 8 9 10 SAMALAGI, BIDAN DESA SAMALAGI

MUZNA HALEK, Amd.Keb

2019

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