NIM :
Rumah Sakit :
Prodi Profesi Ners STIKes Hafshawaty Pesantren Zainul Hasan
Genggong-Probolinggo
I. IDENTITAS
Nama : ..................................................................................................
Umur : ..................................................................................................
Agama : ..................................................................................................
Alamat : ..................................................................................................
Pendidikan : ..................................................................................................
Pekerjaan : ..................................................................................................
Tanggal MRS : ..................................................................................................
Diagnosa Medis : ..................................................................................................
No. Register : ..................................................................................................
Tanggal Pengkajian : ..................................................................................................
c Circulation
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d Disability
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V. ANALISA DATA
VI. EVALUASI
VII. PEMERIKSAAN PENUNJANG
VIII. PENATALAKSANAAN
.......................................2021
Pembimbing Ruangan Mahasiswa
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