NAMA : ............................ RUANG : ..........................

UMUR : ............................ TANGGAL : ..........................

No. RM : ............................
LEMBAR OBSERVASI HCU

TD 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 KETERANGAN
220

200

180

160

140

120

100

80

60

40

20

Teraphy

Nadi
Suhu
RR
SPO 2
Urine

Nama Petugas : .............................

Tanda Tangan : .............................