Anda di halaman 1dari 2

Nama :

Tanggal lahir/jenis kelamin :

Alamat :

Diagnosis :

Persalinan :

Indikasi :

MRS :

Objektif
Tanggal Subjektif
HR RR T ATR/TGS
DL
/05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17
HB
HCT
WBC
PLT

KIMIA KLINIK
/05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17
GDS
Ureum
Kreatinin
SGOT
SGPT

FAAL HEMOSTASIS
/05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17
BT
CT
PPT
APTT

ELEKTROLIT
/05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17
Na
K
Cl

BILIRUBIN
/05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17 /05/17
TOTAL
INDIRECT

Anda mungkin juga menyukai