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FORMULIR KETERANGAN DIAGNOSA AWAL KETERANGAN PASIEN RAWAT INAP
Nama Pasien
ANI FAUZYAH
Nomor Kartu JKN-KIS
0001323855134
Tanggal Masuk FKRTL
24/ 07 / 2018
Diagnosa Awal
NYERI ABDOMEN & GASTROENTERITIS LAINLAIN (RINGAN) K-4-17-I Rp 1,687,500
Keterangan
Nama Dokter Penanggung-Jawab Pasien (DPJP) ………………………………….,……../……../…………..
Nama Pasien
ANI FAUZYAH
Nomor Kartu JKN-KIS
0001323855134
Tanggal Masuk FKRTL
24/ 07 / 2018
Diagnosa Awal
NYERI ABDOMEN & GASTROENTERITIS LAINLAIN (RINGAN) K-4-17-I Rp 1,687,500
Keterangan
Nama Dokter Penanggung-Jawab Pasien (DPJP) ………………………………….,……../……../…………..
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