Blanko Hasil Lab
Blanko Hasil Lab
DINAS KESEHATAN
PUSKESMAS SLAWE Telp. ( 0355 ) 551260
WATULIMO 66382 Unit Laboratorium
Unit Laboratorium Nama :........................................................ No. Reg :.....................................................
Nama :........................................................ No. Reg :..................................................... Alamat :........................................................ Tanggal :.....................................................
Alamat :........................................................ Tanggal :..................................................... Umur :....................................................... Dokter Pengirim :......................................................