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  • Surat Kontrol PKM Wayabula

    Diunggah oleh

    Rizky Amalia Wakano
    5 tayangan1 halaman

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    SURAT KONTROL PKM WAYABULA

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    Surat Kontrol PKM Wayabula

    Diunggah oleh

    Rizky Amalia Wakano

    Hak Cipta:

    © All Rights Reserved
    Unduh sebagai DOCX, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 1

    RM 24 RM 24

    MERINTAH KABUPATEN PULAU MOROTAI PEMERINTAH KABUPATEN PULAU MOROTAI


    NAS KESEHATAN DAN KELUARGA BERENCANA DINAS KESEHATAN DAN KELUARGA BERENCANA
    SKESMAS PERAWATAN WAYABULA PUSKESMAS PERAWATAN WAYABULA
    Jl. Bhayangkara Desa Wayabula. Email : Jl. Bhayangkara Desa Wayabula. Email :
    MOROTAI SELATAN BARAT MOROTAI SELATAN BARAT

    SURAT KONTROL SURAT KONTROL


    PUSKESMAS WAYABULA PUSKESMAS WAYABULA

    NAMA : .......................................................L/P. UMUR : ................TH/BLN/HR NAMA : .......................................................L/P. UMUR : ................TH/BLN/HR


    ALAMAT : .......................................................................................................................... ALAMAT : ..........................................................................................................................
    DIAGNOSA : .......................................................................................................................... DIAGNOSA : ..........................................................................................................................
    DOKTER : ...................................................................................................................... DOKTER : ......................................................................................................................
    TERAPI : ........................................................................................................................ TERAPI : ........................................................................................................................
    ………............................................................................................................................. ……….............................................................................................................................
    .................................................................................................................. ..................................................................................................................
    ............................................................................................................................ ............................................................................................................................
    KONTROL : HARI/TANGGAL : ............................../................................................................ KONTROL : HARI/TANGGAL : ............................../................................................................
    PUKUL/.TEMPAT:..................................../ ................................................... PUKUL/.TEMPAT:..................................../ ...................................................
    SARAN-SARAN :................................................................................................................... SARAN-SARAN :...................................................................................................................
    .................................................................................................................... ....................................................................................................................

    WAYABULA, WAYABULA,
    MENGETAHUI MENGETAHUI
    DOKTER YANG MERAWAT DOKTER YANG MERAWAT

    ……………………………………………… ………………………………………………

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