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  • Kartu Rawat Jalan

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    11 tayangan1 halaman

    Kartu Rawat Jalan

    Diunggah oleh

    kasni
    thanks

    Hak Cipta:

    © All Rights Reserved
    Unduh sebagai DOCX, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 1

    PEMERINTAH KABUPATEN NUNUKAN

    PUSAT KESEHATAN MASYARAKAT NUNUKAN


    KECAMATAN NUNUKAN
    Jl. Radio RT.02 No. 65 Nunukan Kode Pos 77411 Telp.(0556) 2025228
    email: pkmnunukan@gmail.com

    KARTU RAWAT JALAN


    Nama Pasien : ................................................. Nomor Family Folder: ........................................
    Nama KK : ................................................... Pekerjaan : ..........................................
    Umur/Tanggal Lahir ...................................................: Pendidikan : ..........................................
    Alamat : ................................................. No Kartu JKN : ..........................................

    ALERGI :
    No Tgl Anamnesis, Pemeriksaan Fisik & Diagnosis Penatalaksanaan Paraf
    Pemeriksaan Penunjang (Kode Petugas
    ICD X)
    Anamnesis Terapi
    Keluhan Utama : ........................................... ...............................................................
    RPS : ...............................................................
    .............................................................. ...............................................................
    ....................................................................... ...............................................................
    ....................................................................... ...............................................................
    ....................................................................... KIE
    RPD : ...............................................................
    .............................................................. ...............................................................
    ........................................................................ Rujukan
    Pemeriksaan Fisik ...............................................................
    KU : Askep/Askeb/Asuhan Gizi/Kajian
    TD : RR : BB : Sosial
    N : S : ...............................................................
    ........................................................................ ...............................................................
    ........................................................................ ...............................................................
    ........................................................................ ...............................................................
    ....................................................................... ...............................................................
    Pemeriksaan Penunjang ...............................................................
    ........................................................................ ...............................................................
    ........................................................................ ...............................................................
    ...............................................................
    Anamnesis Terapi
    Keluhan Utama : ........................................... ...............................................................
    RPS : ...............................................................
    .............................................................. ...............................................................
    ....................................................................... ...............................................................
    ....................................................................... ...............................................................
    ....................................................................... KIE
    RPD : ...............................................................
    .............................................................. ...............................................................
    ........................................................................ Rujukan
    Pemeriksaan Fisik ...............................................................
    KU : Askep/Askeb/Asuhan Gizi/Kajian
    TD : RR : BB : Sosial
    N : S : ...............................................................
    ........................................................................ ...............................................................
    ........................................................................ ...............................................................
    ........................................................................ ...............................................................
    ....................................................................... ...............................................................
    Pemeriksaan Penunjang ...............................................................
    ........................................................................ ...............................................................
    ........................................................................ ...............................................................
    ...............................................................

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