DINAS KESEHATAN
UPT PUSKESMAS PURUK CAHU SEBERANG
Jl. Bhayangkara No.53B.Kel.Puruk Cahu. Kec. Murung Kode Pos 73912
Telp.081235382115, email : pkm.purukcahuseberang12@gmail.com
No ...........................................................
Pemeriksaan :
Vital sign :TD =............mmHg. Nadi =.........x/menit, Suhu : ...........c
R =............x/menit, SpO2 =..........% dengan/tanpa O2 .........lpm
Antropometri : BB............kg. TB: ............cm
Pemeriksaan fisik : ....................................................................................................
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UPT Puskesmas
Puruk Cahu Seberang,..........................
Petugas
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