Laporan Operasi Kosongan 1.doc

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Nama Pasien No. RM Tanggal lahir

: : :

LAPORAN OPERASI Nama Pasien : Kamar : Kelas : Nama Ahli Bedah : Nama Asisten : Nama perawat : Nama Ahli Anastesi : Jenis Anestesi : Diagnosa pra operasi : Diagnosa post operasi : Nama / Macam operasi : Komplikasi :  Tidak  Ya, ……………………………………………………………………………… Dikirim untuk pemeriksaan PA :  Ya  Tidak Kultur :  Ya  Tidak Tanggal operasi : Jam operasi : Lama operasi berlangsung : Laporan Operasi :

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Perdarahan sebelum operasi;  Tidak  Ya, Transfusi darah ……………………………cc Perdarahan selama operasi ……………………… cc Produksi urin …………………………………………….cc Ahli Bedah,

dr.. ………….…..……………..…

RM.8F

RM.8F

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