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PEMERINTAH KABUPATEN MOJOKERTO PEMERINTAH KABUPATEN MOJOKERTO PEMERINTAH KABUPATEN MOJOKERTO

DINAS KESEHATAN DINAS KESEHATAN DINAS KESEHATAN


UPT PUSKESMAS KUPANG UPT PUSKESMAS KUPANG UPT PUSKESMAS KUPANG
JL.PB.SOEDIRMAN 76 JETIS TELEPON (0321) 362853 JL.PB.SOEDIRMAN 76 JETIS TELEPON (0321) 362853 JL.PB.SOEDIRMAN 76 JETIS TELEPON (0321) 362853
MOJOKERTO MOJOKERTO MOJOKERTO
NAMA : L/P NAMA : L/P NAMA : L/P
ALAMAT : ALAMAT : ALAMAT :
HASIL LAB.IBU HAMIL HASIL LAB.IBU HAMIL HASIL LAB.IBU HAMIL

GOL DARAH : GOL DARAH : GOL DARAH :

DARAH NORMAL DARAH NORMAL DARAH NORMAL

Hb : .......................................... 12 16 g % Hb : .......................................... 12 16 g % Hb : .......................................... 12 16 g %

PCV : ........................................... 35 48 vol % PCV : ........................................... 35 48 vol % PCV : ........................................... 35 48 vol %

GDA : ........................................... < 180 mg / dl GDA : ........................................... < 180 mg / dl GDA : ........................................... < 180 mg / dl

PMTCT : ........................................... Non Reaktif PMTCT : ........................................... Non Reaktif PMTCT : ........................................... Non Reaktif

HBs Ag : ........................................... Non Reaktif HBs Ag : ........................................... Non Reaktif HBs Ag : ........................................... Non Reaktif

Sipilis : ........................................... Negatif Sipilis : ........................................... Negatif Sipilis : ........................................... Negatif

Reduksi Urine : ........................................... Negatif Reduksi Urine : ........................................... Negatif Reduksi Urine : ........................................... Negatif

Protein Urine : ........................................... Negatif Protein Urine : ........................................... Negatif Protein Urine : ........................................... Negatif
KUPANG, ............................. KUPANG, .................................. KUPANG, ................................

LABORAT LABORAT LABORAT

M. MUCHAIYAT M. MUCHAIYAT M. MUCHAIYAT