2.1 PENGKAJIAN
2.1.1 Identitas
1. Identitas Pasien
Nama : .....................................................................................
Umur : .....................................................................................
Agama : .....................................................................................
Jenis Kelamin : .....................................................................................
Status Marital : .....................................................................................
Pendidikan : .....................................................................................
Pekerjaan : .....................................................................................
Asuransi : .....................................................................................
Suku Bangsa : .....................................................................................
Alamat : .....................................................................................
Tanggal Masuk : .....................................................................................
Tanggal Pengkajian : .....................................................................................
No.Register : .....................................................................................
Diagnosa Medis : .....................................................................................
Genogram :
5. Riwayat Sosiokultural dan Spiritual
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Eliminasi
Istirahat
Aktivitas
Personal
Hygiene
Kebiasaan
2. Kepala
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3. Mata
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4. Hidung
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5. Telinga
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6. Mulut
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7. Leher
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9. Abdomen
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Mahasiswa
2.2 ANALISA DATA
No. Data Etiologi Masalah Keperawatan