IDENTITAS PASIEN
Nomor RM : .........................
RSUD ARJAWINANGUN Nama : .........................
Jl. By Pass Palimanan Jakarta Tgl lahir : .........................
KM. 2 No. 1 Jenis Kelamin : L/P
Telp (0231) 358335 Fax. (0231)
359090
Arjawinangun – Cirebon 45162 (Label Pasien / Affix Patient Identification Label)