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PEMERINTAH KABUPATEN LAMPUNG SELATAN No.

RM :
RSUD dr. H. BOB BAZAR, SKM Nama :
JL. LETTU ROHANI NO. 14 B, KALIANDA. TELP. (0727) 322159. 322160 FAX. (0727) 322801 Umur :
Kamar :
K A L I A N D A - 35513

ASSESMENT PRA BEDAH


Assesment Pra Operasi :

Jam : WIB Tanggal :


Data Subyektif (Anamnesis)
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Data Obyektif (Pemeriksaan Fisik)
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Diagnosis Pra Operasi :

Estimasi waktu yang dibutuhkan : jam


Rencana Tindakan Operasi
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BERIKAN TANDA PADA GAMBAR SESUAI PENANDAAN LOKASI OPERASI PADA TUBUH PASIEN

Posisi Pasien Dalam Operasi :

Dokter Operator Pasien / Keluarga

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