Rujukan Ugd

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PEMERINTAH KOTA PALOPO DINAS KESEHATAN PUSKESMAS WARA BARAT JL. Lasaktiaraja Km. 4 Lebang Tlp. 082293188105 Website: Pkmwrabarat.com email:[email protected]

SURAT PENGANTAR RUJUKAN Kepada Yth.TS. Dokter Jaga UGD RS Di Palopo

Dengan ini kami merujuk pasien : Nama

:

Umur

:

Alamat

:

Terapi yang diberikan : 1. 2. 3.

Wara Barat, Dokter yang merujuk

(....................................)

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