Form Data Ruangan Pasien Restrain.docx
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RUMAH SAKIT MUTIARA BUNDA JL. Lintas Timur Unit II No. 1147 Banjar Agung Tulang Bawang Telp./Fax. (0726) 750248 Kode Pos 34682 email : [email protected]
DATA PASIEN PENGGUNAAN RESTRAIN RUANGAN : BULAN NO
:
NAMA PASIEN
TGL DIRAWAT
DIAGNOSA
DPJP
TGL PEMASANGAN RESTRAIN
DATA PASIEN PENGGUNAAN RESTRAIN RUANGAN : BULAN NO
:
NAMA PASIEN
TGL DIRAWAT
DIAGNOSA
DPJP
TGL PEMASANGAN RESTRAIN
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