Rekam Medik
Rekam Medik
DINAS KESEHATAN
PUSKESMAS LAWA
Jalan Poros Lawa-Matakidi Kel. Wamelai Kec. Lawa
Email : puskesmaslawa01@gmail.com
REKAM MEDIS
Nama Pasien : ........................................................... Jenis Jaminan
Nama KK : ........................................................... Umum
Umur/JK : ........................................................... BPJS
Agama : ........................................................... KIS
Pekerjaan : ........................................................... Lainnya
Alamat : ........................................................... No. Kartu Jaminan :
No. Tlpn/HP : ...........................................................
TGL, SUBYEKTIF, ASSESMENT,
PROFESI PLANNING Paraf
JAM OBJEKTIF CODE ICD
TGL, SUBYEKTIF, ASSESMENT,
PROFESI PLANNING Paraf
JAM OBJEKTIF CODE ICD