FORMAT RESUME KASUS POLIKLINIK

LAPORAN PRAKTIK PROFESI

DI POLIKLINIK.....................................RSUP SANGLAH DENPASAR
NAMA MAHASISWA

NIM

TANGGAL PRAKTIK

A. IDENTITAS KLIEN
Nama

Umur

Jenis Kelamin

Alamat

No. RM

Dx. Medis

B. PENGKAJIAN
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C. RENCANA
No

Dx. Keperawatan/
Masalah Kolaborasi

Tujuan

Implementasi

Evaluasi

Mengetahui,
Pembimbing,

Mahasiswa,