SURAT RUJUKAN
Anamnesis : .................................................................................................................................
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Pemeriksaan Fisik : .................................................................................................................................
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Diagnosis Sementara : .................................................................................................................................
Terapi yang telah diberikan : .................................................................................................................................
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Klinik Kesehatan Kerja PT. Bumi Sawindo Permai : Jl. Lintas Sumatera Kecamatan Tanjung Agung Muara Enim, Sumsel