Status Rm.docx
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PEMERINTAH KABUPATEN KEPULAUAN MENTAWAI DINAS KESEHATAN PUSKESMAS BETAET Komplek Puskesmas Betaet Dusun Betaet Utara Desa Simalegi Kecamatan Siberut Barat
NAMA KK NAMA PASIEN TEMPAT/TGL. LAHIR JENIS KELAMIN PEKERJAAN ALAMAT NO
TANGGAL
: : : : : :
No. Rekam Medis No. BPJS/KIS/JKN
ANAMNESA
DIAGNOSA
: :
THERAPY
NAMA KK NAMA PASIEN TEMPAT/TGL. LAHIR JENIS KELAMIN PEKERJAAN ALAMAT NO
TANGGAL
: : : : : :
No. Rekam Medis No. BPJS/KIS/JKN
ANAMNESA
DIAGNOSA
: :
THERAPY
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