FORMAT RESUME KASUS POLIKLINIK

LAPORAN PRAKTIK PROFESI

DI POLIKLINIK.....................................RSUP SANGLAH DENPASAR

NAMA MAHASISWA :

NIM :

TANGGAL PRAKTIK :

A. IDENTITAS KLIEN

Nama :

Umur :

Jenis Kelamin :

Alamat :

No. RM :

Dx. Medis :

B. PENGKAJIAN

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C. RENCANA

NoDx. Keperawatan/

Masalah KolaborasiTujuan Implementasi Evaluasi

Mengetahui,

Pembimbing,

( )

Mahasiswa,

( )