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Stiker Infus Stiker Infus

Nama Pasien : .................................``.............. Nama Pasien : ....................................................


Tgl dipasang : .................................................. Tgl dipasang: .....................................................
Jam mulai/selesai : ......................................... Jam mulai/selesai: ..............................................
Jenis cairan : ................................................... Jenis cairan : ...................................................
Obat tambahan : ............................................ Obat tambahan: .................................................
Jumlah tetesan : ......................... tetes/menit Jumlah tetesan: ............................. tetes/menit
Kolf ke : .......................................................... Kolf ke : ..............................................................
Nama petugas: .............................................. Nama petugas: ..................................................

Stiker Infus Stiker Infus


Nama Pasien : ................................................ Nama Pasien : ....................................................
Tgl dipasang: .............................................. Tgl dipasang: ......................................................
Jam mulai/selesa: .......................................... Jam mulai/selesai: .............................................
Jenis cairan : .................................................. Jenis cairan : .....................................................
Obat tambahan: ............................................ Obat tambahan: ................................................
Jumlah tetesan: ......................... tetes/menit Jumlah tetesan: ............................ tetes/menit
Kolf ke : ......................................................... Kolf ke : ..............................................................
Nama petugas: ............................................. Nama petugas: ..................................................

Stiker Infus Stiker Infus


Nama Pasien : .................................................... Nama Pasien : ...................................................
Tgl dipasang: .................................................... Tgl dipasang : ...................................................
Jam mulai/selesai: ................................................ Jam mulai/selesai: ..............................................
Jenis cairan : ......................................................... Jenis cairan : .......................................................
Obat tambahan: .................................................... Obat tambahan: .................................................
Jumlah tetesan: .................................tetes/menit Jumlah tetesan: .............................. tetes/menit
Kolf ke : .................................................................. Kolf ke : ..............................................................
Nama petugas: ....................................................... Nama petugas: ..................................................

Stiker Infus Stiker Infus


Nama Pasien : .................................``.............. Nama Pasien : ....................................................
Tgl dipasang : .................................................. Tgl dipasang: .....................................................
Jam mulai/selesai : ......................................... Jam mulai/selesai: ..............................................
Jenis cairan : ................................................... Jenis cairan : ...................................................
Obat tambahan : ............................................ Obat tambahan: .................................................
Jumlah tetesan : ......................... tetes/menit Jumlah tetesan: ............................. tetes/menit
Kolf ke : .......................................................... Kolf ke : ..............................................................
Nama petugas: .............................................. Nama petugas: ..................................................

Stiker Infus Stiker Infus


Nama Pasien : ................................................ Nama Pasien : ....................................................
Tgl dipasang: .............................................. Tgl dipasang: ......................................................
Jam mulai/selesa: .......................................... Jam mulai/selesai: .............................................
Jenis cairan : .................................................. Jenis cairan : .....................................................
Obat tambahan: ............................................ Obat tambahan: ................................................
Jumlah tetesan: ......................... tetes/menit Jumlah tetesan: ............................ tetes/menit
Kolf ke : ......................................................... Kolf ke : ..............................................................
Nama petugas: ............................................. Nama petugas: ..................................................

Stiker Infus Stiker Infus


Nama Pasien : .................................................... Nama Pasien : ...................................................
Tgl dipasang: .................................................... Tgl dipasang : ...................................................
Jam mulai/selesai: ................................................ Jam mulai/selesai: ..............................................
Jenis cairan : ......................................................... Jenis cairan : .......................................................
Obat tambahan: .................................................... Obat tambahan: .................................................
Jumlah tetesan: .................................tetes/menit Jumlah tetesan: .............................. tetes/menit
Kolf ke : .................................................................. Kolf ke : ..............................................................
Nama petugas: ....................................................... Nama petugas: ..................................................

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