Jl. Weelonda, Desa Watukawula, LEMBAR EKSPERTISI EKG Kec. Kota Tambolaka No. Rekam Medis :............................................................................... KabSumba Barat Daya Nama Lengkap :............................................................................... Tanggal Lahir :............................................................................... Jenis Kelamin :............................................................................... Ruangan :...............................................................................