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Jl. R.A. Kartini No.1 A Makassar SULSEL, No. Telp.

(0411) 3613502 – (0411) 3620025


HP . 085 322 322 325 – Email : rsiakartini@gmail.com

LEMBAR Nama : No. RM


TRANSFER Tgl Lahir/Umur : Ruang Rawat Terakhir
PASIEN DALAM
Jenis Kelamin : LK / PR Badan Jaminan
RUMAH SAKIT
Tgl/Jam Masuk RS : Tgl. Keluar RS
Diagnosa Masuk : ...............................................................................................................
Diagnosa Sekarang : ..............................................................................................................
Tanggal dan Jam Pindah : ..............................................................................................................
Dari Ruang/ Kamar : ..............................................................................................................
Pindah Ke Ruang Kamar : ..............................................................................................................

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