PENDOKUMENTASIAN HASIL ASUHAN KEBIDANAN KEGAWAT

DARURATAN BAYI BARU LAHIR PADA BAYI NY “......”

DENGAN ........................................................................
DI PUSKESMAS MALILI, KAB LUWU TIMUR
TANGGAL ..................................... 2021

Nomor Register : ..........................................

Tanggal Masuk : ........................................... Jam : ........................
Tanggal Pegkajian : ........................................... Jam : ........................
Nama Pengkaji : MASRAH

A. Pengkajian Dan Analisa Data Dasar.

1. Identitas Bayi dan Orang Tua
a. Identitas Bayi
Nama : ................................
Umur : ................................
Tanggal Lahir : ................................
Anak Ke : ................................
b. Identitas orang tua
Nama : ........................... / ...........................
Umur : ........................... / ...........................
Nikah / Lamanya : ........................... / ...........................
Suku : ........................... / ...........................
Agama : ........................... / ...........................
Pendidikan : ........................... / ...........................
Pekerjaan : ........................... / ...........................
Alamat : ........................... / ...........................

B. Data Subjektif (S)

1. .......................................................................................................................
2. .......................................................................................................................
C. Data Objektif (O)
1. .......................................................................................................................
2. .......................................................................................................................
3. .......................................................................................................................
4. .......................................................................................................................
5. .......................................................................................................................
D. Assessment (A)
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E. Planning (P)
Tanggal : .............................. Jam: ......................
1. .......................................................................................................................
Hasil : ..........................................................................................................
2. .......................................................................................................................
Hasil : ..........................................................................................................
3. .......................................................................................................................
Hasil : ..........................................................................................................
4. .......................................................................................................................
Hasil : ..........................................................................................................
5. .......................................................................................................................
Hasil : ..........................................................................................................
6. .......................................................................................................................
Hasil : ..........................................................................................................
7. .......................................................................................................................
Hasil : ..........................................................................................................
Palopo, 2021
MENGETAHUI
Preseptor Lahan Preseptor Institusi

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