Evaluasi Rm.xlsx

  • June 2020
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PEMERINTAH KABUPATEN WONOSOBO DINAS KESEHATAN PUSKESMAS WONOSOBO 1 KECAMATAN WONOSOBO Jalan. Mayjend Bambang Sugeng No 24 Telp. (0286) 321897 56314 EVALUASI KELENGKAPAN REKAM MEDIS BULAN : ...............................................2018

TANGGAL

NO SAMPEL

NAMA PASIEN

NO RM

ASAL UNIT PELAYANAN

IDENTITAS PASIEN

TANGGAL LAYANAN

S (ANAMNESA)

O (OBJEKTIF)

A (ASSESMENT) DX

KODE ICD10

P (PLANNING) TX

PENKES

KHUSUS GIGI ODONTOGRAM

PERSETUJUAN NAMA TINDAKAN PEMERIKSA

TANDA TANGAN PEMERIKSA

TANGGAL

NO SAMPEL

NAMA PASIEN

NO RM

ASAL UNIT PELAYANAN

IDENTITAS PASIEN

TANGGAL LAYANAN

S (ANAMNESA)

O (OBJEKTIF)

A (ASSESMENT) DX

KODE ICD10

P (PLANNING) TX

PENKES

KHUSUS GIGI ODONTOGRAM

Surveyor

PERSETUJUAN NAMA TINDAKAN PEMERIKSA

TANDA TANGAN PEMERIKSA

(..........................................)

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