Catatan Pengobatan Pasien.docx
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CATATAN PENGOBATAN PASIEN PUSKESMAS SILOAM TAMAKO Nama/No.Reg. : ______________________________________
Pekerjaan
Alamat
: ______________________________________
Jenis Kelamin & Umur : Lk /
No. Telp/HP
: __________________________________
TB/BB/Gol. Darah
No
Tgl
Nama Dokter
Kasus
: _____________________________________ Pr
& ____ Thn
: ______cm / ______kg /_____________
Terapi (Nama Obat/Dosis/Cara Pemberian)
Catatan Pelayanan Apoteker/Pengelola Obat
Pekerjaan
Alamat
: ______________________________________
Jenis Kelamin & Umur : Lk /
No. Telp/HP
: __________________________________
TB/BB/Gol. Darah
No
Tgl
Nama Dokter
Kasus
: _____________________________________ Pr
& ____ Thn
: ______cm / ______kg /_____________
Terapi (Nama Obat/Dosis/Cara Pemberian)
Catatan Pelayanan Apoteker/Pengelola Obat
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