PUSKESMAS KERTOSARI
Nama :
Umur :
Jenis Kelamin :
No. Kartu JKN :
Alamat :
Mohon agar dilakukan pemeriksaan skrining. Adapun yang kami inginkan adalah pemeriksaan :
1. Skrining DM
2. IVA
3. Papsmear
Keterangan :
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Banyuwangi,
Dokter Puskesmas Kertosari
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