Lembar Serah Terima Obat.docx
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LEMBAR SERAH TERIMA OBAT NAMA PASIEN
: ……………………………
NO. RM
: ……………………………
NO. RUANGAN/KELAS
: ……………………………
NO
NAMA OBAT/CAIRAN JENIS
1
2
3
INJEKSI CAIRAN ORAL -
JUMLAH TGL/ TGL/ TGL/ TGL/ TGL/ TGL/ TGL/ TGL/ TGL/
TGL/
PETUGAS PENERIMA PX/KELUARGA
: ……………………………
NO. RM
: ……………………………
NO. RUANGAN/KELAS
: ……………………………
NO
NAMA OBAT/CAIRAN JENIS
1
2
3
INJEKSI CAIRAN ORAL -
JUMLAH TGL/ TGL/ TGL/ TGL/ TGL/ TGL/ TGL/ TGL/ TGL/
TGL/
PETUGAS PENERIMA PX/KELUARGA
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