KARTU TAKSIRAN PARTUS KARTU TAKSIRAN PARTUS KARTU TAKSIRAN PARTUS
NAMA IBU :........................................... NAMA IBU :........................................... NAMA IBU :...........................................
NAMA SUAMI :........................................... NAMA SUAMI :........................................... NAMA SUAMI :...........................................
JENIS RESIKO :........................................... JENIS RESIKO :........................................... JENIS RESIKO :...........................................
KARTU TAKSIRAN PARTUS KARTU TAKSIRAN PARTUS KARTU TAKSIRAN PARTUS
NAMA IBU :........................................... NAMA IBU :........................................... NAMA IBU :........................................... NAMA SUAMI :........................................... NAMA SUAMI :........................................... NAMA SUAMI :........................................... ALAMAT :........................................... ALAMAT :........................................... ALAMAT :........................................... :........................................... :........................................... :........................................... GPA :........................................... GPA :........................................... GPA :........................................... HPHT :........................................... HPHT :........................................... HPHT :........................................... TP :........................................... TP :........................................... TP :........................................... JENIS RESIKO :........................................... JENIS RESIKO :........................................... JENIS RESIKO :...........................................