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RSU METHODIST SUSANNA WESLEY

Jl. Harmonika Baru Pasar 1 Padang Bulan Selayang II


Telp. (061) 8222264, Fax (061) 8222263
Medan 20132, Sumatera Utara – Indonesia
POLI :

Pemeriksaan Ultrasonografi
Nama : ..............................................................................
Tgl.Lahir : ..............................................................................
No. RM : ................................................................................

RSU METHODIST SUSANNA WESLEY


Jl. Harmonika Baru Pasar 1 Padang Bulan Selayang II
Telp. (061) 8222264, Fax (061) 8222263
Medan 20132, Sumatera Utara – Indonesia
POLI :

Pemeriksaan Ultrasonografi
Nama : ..............................................................................
Tgl.Lahir : ..............................................................................
No. RM : ..............................................................................
TANGGAL :
Hasil Pemeriksaan :

Dr.........................................................

TANGGAL :
Hasil Pemeriksaan :

Dr.........................................................

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