(Dis oleh Pugs Rekpm Meds Nama Pasien| tbe ® Sle nesenen ~ Mel. | Tel Lie | No RM. | Nik — MERIXSAAN, ANALISIS RENCANA INTRUKSITENAGA. J | TANGGAL | pporesy INLAKSANAAN PASIEN KESEHATAN TERMASUK | VFRMIKAS JAN (Dini dy ast SOAPSDIME,| hon TASCA BEDAHPROSEDUR | DIP san in tpl re) ts 3h-n| Du : . u | " & “Kafe pent sli i adie. | 2B 2 bhp tala f I my Lemay af “yy | ey WAOx ort DI TX rE ofthe. ige08 IDENTITAS PASIEN (Dilsi oleh Petugas Rekam Medis) Nama Pasion Tp Lahir NoRM PROTES! | perosl JWASIL PEMERIKSAAN, ANAUSIS, DENATALARSANAAB HAS (Dota deg re sone | IETRUKSITENAGA KESEHATAN TERMASUK. | VERRKAS Fann pent | BB cur He ben wes adi C) Be laa) bow subs Heng Ts lf, yo: WM. 68 Meow 4 in he bye vee S: ne mengiatete one ate SK, ayes purl Ds We suabeg, lent Om To alt) sae) hey Mies) 5a ea fi Be cya at y- monte Tie Lndeborest to PASCA HEDAI/PROSEDUR rap \ oie oe Oh 007wn OD pwr wu A Zé . shar Rew 2021 f | CATAEAN PRRKEMIRANG AN PASEEN TERINTEGRAST 007 | ‘ : i | IDENTHAS ASIN {Wis oe gs Reka Mis) ‘Nama Pasion HeLa NoRM NIK, INTRUKSITENAGA wESHIATAN Teast | SHEIKAS tn rascaneparernast pn |" VASE EAIERIKS sts RNA TTENALATAKSAMAA tanoaat. |, MAA | PROVES War yh ¢ Drive d flat | Rar’ ar : al + ath Os (eure Pey OL, a8 oy fe Bol tek int / oa . " Rvp TORY Pevant | £: Pain agen’ aaa, | PEE Te” Abs bestest, | Tanda *Tngan Nama 0G, 60 = leur ay, \ \/ dong Jas ey f 0:5 ea | A S536 | ih ay. Spoes gF if > a P< Meiian. ce. ipy - Fetherne degen ceetrArT (Dis Peg Nama Posie Tel Laie Now Nik fey Svan sponte arent pe Cait ru ibe, G tk GEA sot ope keaeSGANSOME Roy INTROS! FFAG | RESUHATAN THRMASUR| | ¥PATIRAS AASCA MEDAN ROSE | PRP | et 8a G | feun y | fo fri eet PUlnlee %H | {a 4.0 pra! ey Gry pro aioue t ae 007