Status Coass Poli Bedah
3
STATUS POLIK DOKTER MUDA BAGIAN BEDAH Hari/ Tanggal: ........................................... Nama Coass: .............................................. I. IDENTITAS Nama : Umur : Jenis Kelamin: Berat Badan : Agama : Pekerjaan : Alamat 014 : II. ANAMNESA A. Keluhan Utama: ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ............................................................ B. Riwayat Penyakit sekarang : .............................................................. ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ......................................................................... ...................................................... KEMENTRIAN PENDIDIKAN NASIONAL FK. UNIVERSITAS CENDERAWASIH / RSUD JAYAPURA BAGIAN BEDAH Jl. Kesehatan No. 01 . 533616,533516 Fax (0967) 533781
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Transcript of Status Coass Poli Bedah
STATUS POLIKDOKTER MUDA BAGIAN BEDAH
Hari/ Tanggal: ...........................................Nama Coass: ..............................................
I. IDENTITASNama :Umur :Jenis Kelamin :Berat Badan :Agama :Pekerjaan :Alamat 014 :
II. ANAMNESAA. Keluhan Utama:
......................................................................................................................................................................................................................
...................................................................................................................................................................................................................
B. Riwayat Penyakit sekarang : ....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
C. Riwayat Penyakit Dahulu:........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
III. PEMERIKSAAN FISIK- Tanda – tanda Vital : TD : Respirasi :
Nadi : Suhu :- Kepala : .................................................................................................................................................. - Leher : ..................................................................................................................................................- Thorax : ...................................................................................................................................................
..................................................................................................................................................- Abdomen : ..................................................................................................................................................
.................................................................................................................................................. .- Extremitas : ..................................................................................................................................................- Genitalia : ...................................................................................................................................................
KEMENTRIAN PENDIDIKAN NASIONALFK. UNIVERSITAS CENDERAWASIH / RSUD JAYAPURA
BAGIAN BEDAHJl. Kesehatan No. 01 . 533616,533516 Fax (0967) 533781
- Status Lokalis : ............................................................................................................. Gambar ................................................................................................................
................................................................................................................................................................................................................................................................................................................................................................................................................................................................
IV. DIAGNOSIS KERJA :......................................................................................................................................................................................................................
V. DIAGNOSIS BANDING :................................................................................................................................................................................................................................................................................................................................................
VI. PLANNING :
