Kartu Rawat Inap Bpjs.docx

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PUSAT KESEHATAN MASYARAKAT PUSKESMAS PEMBANTU LUBUAK BATINGKOK

NO. INDEKS ( RM ) : _________________

KARTU RAWAT INAP NAMA NAMA KK PEKERJAAN ALAMAT Tanggal / Jam

: ……………………. : ……………………. : ……………………. : …………………….

LK/PR/UMUR AGAMA

Anamnesa / Pemeriksaan Fisik / Diagnosa

: …………………… : ……………………

Therapy

Tanggal/Jam

Anamnesa / Pemeriksaan Fisik / Diagnosa

Therapy

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