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RUMAH SAKIT OTIKA MEDIKA RUMAH SAKIT OTIKA MEDIKA

Rumah Sakit Rumah Sakit

KARTU KONTROL KARTU KONTROL


Nama : .................................................................................. Nama : ..................................................................................

Alamat : .................................................................................. Alamat : ..................................................................................

.................................................................................. ..................................................................................

No.Telp : .................................................................................. No.Telp : ..................................................................................

No.RM : .................................................................................. No.RM : ..................................................................................

Poli : .................................................................................. Poli : ..................................................................................

HARAP DIBAWA SAAT PERIKSA HARAP DIBAWA SAAT PERIKSA


Tanggal Tanggal
Tindakan Hasil Laboratorium Diagnosis Paraf Tindakan Hasil Laboratorium Diagnosis Paraf
Periksa Periksa

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