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  • Format Kartu INC Dan Informed Consent

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    Format Kartu INC dan Informed Consent - Copy

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    Format Kartu INC Dan Informed Consent

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    Deti Mardiana

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    © All Rights Reserved
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    BIDAN ..................................................................................................................................................

    Deti Mardiana Amd.Keb ANALISA


    Kp. Tangsimekar Rt.01/07 Desa. Tangsimekar Kec. Paseh
    Hp. 082321010719 ..................................................................................................................................................
    ..................................................................................................................................................

    ASUHAN KEBIDANAN
    SUBJEKTIF: PENATAKSANAAN

    Tanggal Masuk : ..................................................................................................................................................


    ..................................................................................................................................................
    Nama Istri : .............................................. Nama Suami : ......................................... ..................................................................................................................................................
    Umur : .............................................. Umur : ......................................... ..................................................................................................................................................
    Alamat : ....................................................................................................................... ..................................................................................................................................................
    No HP : .............................................. ..................................................................................................................................................

    Riwayat Persalinan yang lalu


    Tgl/ Bidan
    .................................................................................................................................................. Jam TTV HIS DJJ VT Ket
    Hari Jaga
    ..................................................................................................................................................
    ..................................................................................................................................................
    ..................................................................................................................................................
    ..................................................................................................................................................

    OBJEKTIF
    KU : .................. TTV : ..................................................................................
    Pemeriksaan Abdomen:
    TFU : ........ Leopold I : .......... Leopold II : .......... Leopold III : .......... Leopold IV : ...........
    DJJ : ................. HIS : .................................. Lain-lain : .......................................................
    Pemeriksaan Dalam: ................................................................................................................
    ..................................................................................................................................................

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