Kartu Kiup.docx
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TANGGAL MASUK
TANGGAL KELUAR
TANGGAL MASUK
TANGGAL KELUAR
No. RM KARTU INDEKS UTAMA PASIEN (KIUP) NAMA KK
:
UMUR
:
ALAMAT
:
KETERANGAN :
Tahun
L / P
TANGGAL KELUAR
TANGGAL MASUK
TANGGAL KELUAR
No. RM KARTU INDEKS UTAMA PASIEN (KIUP) NAMA KK
:
UMUR
:
ALAMAT
:
KETERANGAN :
Tahun
L / P
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