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RS MITRA MEDIKA

Jl. Jatiwangi-Cikedokan Kp. Kamurang Rt 01 Rw 01


Ds. Cikedokan Cikarang Barat-Bekasi

SURAT PENGANTAR RAWAT INAP

NAMA : .................................................

UMUR : .................................................

NO. MR : .................................................

DIAGNOSA : .................................................

(petugas IGD)

RS MITRA MEDIKA
Jl. Jatiwangi-Cikedokan Kp. Kamurang Rt 01 Rw 01
Ds. Cikedokan Cikarang Barat-Bekasi

SURAT PENGANTAR RAWAT INAP

NAMA : .................................................

UMUR : .................................................

NO. MR : .................................................

DIAGNOSA : .................................................

(petugas IGD)

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