Lembar Follow Up Divisi Neuro.docx
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IDENTITAS:
S
HP: Tanggal: Demam ( ) Makan ( ) Muntah ( ) Minum ( ) Batuk ( ) Kejang ( ) Pilek ( ) Diare ( )
O HR:
x/m RR: x/m Temp: C SpO2: % O2: lpm GCS: E V M LAB Hb: Eri: Hct: Leu: Trom: Na: K: Cl:
A
P
UMUR:
Px. fisik
BB:
TB:
STATUS GIZI:
RUANG:
HP: Tanggal: Demam ( ) Makan ( ) Muntah ( ) Minum ( ) Batuk ( ) Kejang ( ) Pilek ( ) Diare ( )
HP: Tanggal: Demam ( ) Makan ( ) Muntah ( ) Minum ( ) Batuk ( ) Kejang ( ) Pilek ( ) Diare ( )
HP: Tanggal: Demam ( ) Makan ( ) Muntah ( ) Minum ( ) Batuk ( ) Kejang ( ) Pilek ( ) Diare ( )
HR: x/m RR: x/m Temp: C SpO2: % O2: lpm GCS: E V M LAB Hb: Eri: Hct: Leu: Trom: Na: K: Cl:
HR: x/m RR: x/m Temp: C SpO2: % O2: lpm GCS: E V M LAB Hb: Eri: Hct: Leu: Trom: Na: K: Cl:
HR: x/m RR: x/m Temp: C SpO2: % O2: lpm GCS: E V M LAB Hb: Eri: Hct: Leu: Trom: Na: K: Cl:
Px. fisik
Px. fisik
Px. fisik
S
HP: Tanggal: Demam ( ) Makan ( ) Muntah ( ) Minum ( ) Batuk ( ) Kejang ( ) Pilek ( ) Diare ( )
O HR:
x/m RR: x/m Temp: C SpO2: % O2: lpm GCS: E V M LAB Hb: Eri: Hct: Leu: Trom: Na: K: Cl:
A
P
UMUR:
Px. fisik
BB:
TB:
STATUS GIZI:
RUANG:
HP: Tanggal: Demam ( ) Makan ( ) Muntah ( ) Minum ( ) Batuk ( ) Kejang ( ) Pilek ( ) Diare ( )
HP: Tanggal: Demam ( ) Makan ( ) Muntah ( ) Minum ( ) Batuk ( ) Kejang ( ) Pilek ( ) Diare ( )
HP: Tanggal: Demam ( ) Makan ( ) Muntah ( ) Minum ( ) Batuk ( ) Kejang ( ) Pilek ( ) Diare ( )
HR: x/m RR: x/m Temp: C SpO2: % O2: lpm GCS: E V M LAB Hb: Eri: Hct: Leu: Trom: Na: K: Cl:
HR: x/m RR: x/m Temp: C SpO2: % O2: lpm GCS: E V M LAB Hb: Eri: Hct: Leu: Trom: Na: K: Cl:
HR: x/m RR: x/m Temp: C SpO2: % O2: lpm GCS: E V M LAB Hb: Eri: Hct: Leu: Trom: Na: K: Cl:
Px. fisik
Px. fisik
Px. fisik
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