YAYASAN EKA HARAP PALANGKA RAYA

SEKOLAH TINGGI ILMU KESEHATAN

Jalan Beliang No. 110 Telp/Fax.(0536) 3227707 Palangka Raya
E-Mail : stikesekaharap110@yahoo.com

LAPORAN KASUS SINGKAT

Nama Mahasiswa :

NIM :

Tempat Praktik :

Tanggal :

I. DATA UMUM PASIEN

Nama (Inisial) : ...............................................................
Jenis Kelamin : ...............................................................
Umur : ...............................................................
Alamat : ...............................................................
Pekerjaan : ...............................................................
Pendidikan : ...............................................................
Agama : ...............................................................
Suku/Bangsa : ...............................................................
Diagnosa Medis : ...............................................................

II. GAMBARAN UMUM PASIEN

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III. PROSES KEPERAWATAN
No Proses Keperawatan Hasil
.
1. Pengkajian Fokus

2. Diagnosa
No Proses Keperawatan Hasil
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3. Intervensi

4. Implementasi
5. Evaluasi S:

O:

A:

P:

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Pembimbing, Mahasiswa,

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