RESUME KEPERAWATANPENDERITA KELUAR RUMAH SAKIT

Nama : Ruang / No.R.M :Jenis / Umur : Tgl MRS :Alamat : Tgl KRS :

1. Masalah perawatan pada saat penderita dirawat ( DX Perawatan )-----

2. Tindakan perawatan selama dirawat-----

3. Evaluasi perawatan ( sesuai dengan rencana tujuan )-----

4. Cara penderita KRS : Sembuh / Pulang Paksa / Pindah / Melarikan Diri / Meninggal5. Keadaan waktu KRS :

- Keadaan Umum : Baik / Sedang / Jelek / Mati- Kesadaran : Sadar / Tidak Sadar- Tanda Vital : T : ............mm/Hg, S : ...............0C, N : ............X / Mnt, RR : ..........X / Mnt--

6. Nasehat pada waktu KRS :.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Kepala Ruang Rawat Perawat Pelaksana

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