Buku Homecare.docx

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A. Pemeriksaan Tanda-tanda Vital

B. Riwayat Penyakit Sekarang Jenis Pemeriksaan

Hari/Tanggal

Tekanan Darah (mmHg)

Denyut Nadi (x/menit)

Suhu Tubuh (o C)

Ket

C. Riwayat Penyakit Terdahulu

D. Riwayat Keluarga

E. Riwayat Sosial

G. Kondisi Klinis Hari/Tanggal

F. Riwayat Alergi

Demam

Batuk

Sesak Nafas

Mual/ Muntah

Lemah

Diare

Susah BAB

H. Penggunaan Obat Hari/Tanggal

Nama Obat

Dosis dan Aturan Pakai

Keterangan

Hari/Tanggal

Nama Obat

Dosis dan Aturan Pakai

Keterangan

BUKU MONITORING

HOME CARE

Nama Pasien

:

Umur

:

Jenis Kelamin : Alamat

:

TIM NUSANTARA SEHAT BATCH 4 PUSKESMAS UJUNG BATU III

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