Post on 06-Dec-2015
description
BAKTI SOSIALJAGE KASTARE FOUNDATION
Lombok Tengah, 14 Juni 2014
LEMBAR ANAMNESIS
Nama : Umur : Jenis Kelamin :Alamat : No.Reg : Tanggal :
AnamnesisKeluhan Utama :____________________________________________________________________________________________________Riwayat Penyakit :_____________________________________________________________________________________________________________________________________________________________________________________________________________________Vital Sign
Denyut Nadi :________x/menit Tekanan Darah :________mmHg Pernapasan :________x/menit Suhu :________OC
Diagnosis __________________________________________________________________________________________________________________
R/
Catatan : _________________________________________________
BAKTI SOSIALJAGE KASTARE FOUNDATION
Lombok Tengah, 14 Juni 2014
LEMBAR ANAMNESIS
Nama : Umur : Jenis Kelamin :Alamat : No.Reg : Tanggal :
AnamnesisKeluhan Utama :____________________________________________________________________________________________________Riwayat Penyakit :_____________________________________________________________________________________________________________________________________________________________________________________________________________________Vital Sign
Denyut Nadi :________x/menit Tekanan Darah :________mmHg Pernapasan :________x/menit Suhu :________OC
Diagnosis __________________________________________________________________________________________________________________
R/
Catatan : _________________________________________________