Anda di halaman 1dari 1

RUMAH SAKIT UMUM

SRI TORGAMBA
Jl. Lintas Sumut – Riau, KM. 380, Kec. Torgamba, Kab. Labusel – Sumatera Utara
Telp : 0811 623 3117 / 0811 622 5117, Email : rsu.torgamba@gmail.com

LAPORAN HASIL PEMERIKSAAN

Telah dilakukan pemeriksaan : ……………………………………………..


Kepada pasien
Nama :
No. Rekam Medis :
Alamat :
Diagnosa :

Kesimpulan hasil Pemeriksaan :


…………......................................................................................................................................................

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

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

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

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

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

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

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

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

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

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

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

RSU Sri Torgamba,……/………20


Dokter Yang Menerangkan

dr………………………………..

Anda mungkin juga menyukai