Format Fu Pediatri.docx
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Nama Pasien : Jenis Kelamin : Tanggal Lahir : Ruangan : TGL
UMUR
BB
TB/PB
SG
P-H
HSKT
BDM
KELUHAN (S)
O
A
P
Tanggal : NO
IDENTITAS
STATUS GIZI
N/JK/U
(BB/TBPB)
P-H
H-S
BDM
KELUHAN (S)
O
A
P
AX
TTV / LAB
DIAGNOSIS
TERAPI / KETERANGAN
UMUR
BB
TB/PB
SG
P-H
HSKT
BDM
KELUHAN (S)
O
A
P
Tanggal : NO
IDENTITAS
STATUS GIZI
N/JK/U
(BB/TBPB)
P-H
H-S
BDM
KELUHAN (S)
O
A
P
AX
TTV / LAB
DIAGNOSIS
TERAPI / KETERANGAN
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