LAPORAN HASIL KEGIATAN

PELACAKAN KASUS KONTAK TBC

1 DASAR POA DAK Tahun 2020

2 TUJUAN KEGIATAN Melakukan penjaringan dini penderita TBC
3 URAIAN KEGIATAN
Tanggal Kegiatan : ________________

Pasien yang dikunjungi

 Nama : ________________
 Umur : ________________
 Alamat : _____________________________________________________
Riwayatpenyakit :
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Kontak yang diinvestigasi:

Umur/Jenis Hub. Kondisi
No Nama Kelamin Dengan
L P pasien

4 KESIMPULAN Jumlah kontak diinvestigasi :

Jumlah yang dirujuk :
5 SARAN
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6 PENUTUP

Samarinda, ........................... 2020

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