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\trpaddfb3 \trpaddfr3 {\fs22 \dbch \af2 \hich \af0 \loch \f0 \lang13321
\langnp13321 \langfe1033 \langfenp1033 \par }\pard \plain \s18 \fi-360 \li450
\ri0 \sb240 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha \aspnum
\ls1 \fs22 \dbch \af2 \hich \af0 \loch \af5 \lang13321 \langnp13321 \langfe1033
\langfenp1033 {\listtext \pard \plain \fs22 \dbch \af2 \hich \af0 \loch \af5
\lang13321 \langnp13321 \langfe1033 \langfenp1033 \f2 2.\tab }\trowd \trql \trgaph0
Pe}{\fs22 \dbch \af2 \hich \af0 \loch \f0 \lang1057 \langnp1057 \langfe1033
\langfenp1033 meriksaan fisik/kondisi umum :}{\fs22 \dbch \af2 \hich \af0 \loch \f0
\lang13321 \langnp13321 \langfe1033 \langfenp1033 \par }\pard \plain \s18 \li450
\ri0 \sb240 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha \aspnum
\adjustright \lin450 \rin0 \phmrg \pvmrg \posnegx-319 \posy1005 \intbl \itap1 \fs22
\dbch \af2 \hich \af0 \loch \af5 \lang13321 \langnp13321 \langfe1033
\langnp13321 \langfe1033 \langfenp1033 }{\fs22 \dbch \af2 \hich \af0 \loch \f0
\lang13321 \langnp13321 \langfe1033 \langfenp1033 \par }\pard \plain \s18 \fi-
360 \li450 \ri0 \sb240 \lisb0 \sa0 \lisa0 \pnrnot0 \sl240 \slmult1 \widctlpar
\aspalpha \aspnum \adjustright \lin450 \rin0 \phmrg \pvmrg \posnegx-319
\posy1005 \intbl \itap1 \ls1 \fs22 \dbch \af2 \hich \af0 \loch \af5 \lang13321
\langnp13321 \langfe1033 \langfenp1033 {\listtext \pard \plain \fs22 \dbch \af2
\hich \af0 \loch \af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033 \f2
3.\tab }\trowd \trql \trgaph0 \trleft0 \tdfrmtxtLeft180 \tdfrmtxtRight180
\langnp13321 \langfe1033 \langfenp1033 Laboratorium (bila ada) :}{\fs22 \dbch
\af2 \hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033
\par }\pard \plain \s18 \fi0 \cufi0 \li0 \culi0 \ri0 \sb240 \lisb0 \sa0 \lisa0
\sl240 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \tqc
\tx4951 \phmrg \pvmrg \posnegx-319 \posy1005 \intbl \itap1 \fs22 \dbch \af2
\hich \af0 \loch \af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033 \trowd
\trql \trgaph0 \trleft0 \tdfrmtxtLeft180 \tdfrmtxtRight180 \trautofit
\trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3
\trpaddfr3 {\fs22 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321
\langfe1033 \langfenp1033 \par }\pard \plain \s18 \fi-360 \li450 \ri0 \sb240 \lisb0
\sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin450 \rin0
\phmrg \pvmrg \posnegx-319 \posy1005 \intbl \itap1 \ls1 \fs22 \dbch \af2 \hich \af0
\loch \af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033 {\listtext \pard
\plain \fs22 \dbch \af2 \hich \af0 \loch \af5 \lang13321 \langnp13321
\langfe1033 \langfenp1033 \f2 4.\tab }\trowd \trql \trgaph0 \trleft0
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Diagnosis
kerja :}{\fs22 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321
\langfe1033 \langfenp1033 \par }\pard \plain \s18 \fi0 \cufi0 \li0 \culi0 \ri0
\sb240 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha \aspnum \adjustright
\lin0 \rin0 \phmrg \pvmrg \posnegx-319 \posy1005 \intbl \itap1 \fs22 \dbch \af2
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Alasan
pasien dirawat :}{\fs22 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321
\langfe1033 \langfenp1033 \par }\pard \plain \s18 \li450 \ri0 \sb240 \lisb0 \sa0
\phmrg \pvmrg \posnegx-319 \posy1005 \intbl \itap1 \fs22 \dbch \af2 \hich \af0
\loch \af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033 \trowd \trql
\langfenp1033 \par }\pard \plain \s18 \fi-360 \li450 \ri0 \sb240 \lisb0 \sa0 \lisa0
\sl240 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin450 \rin0 \phmrg
\pvmrg \posnegx-319 \posy1005 \intbl \itap1 \ls1 \fs22 \dbch \af2 \hich \af0
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Usul
pengobatan di ruang perawatan :}{\fs22 \dbch \af2 \hich \af0 \loch \f0
\ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha \aspnum
\langnp13321 \langfe1033
\langfenp1033 \par }\pard \plain \s18 \fi-360 \li450 \ri0 \sb240 \lisb0 \sa0
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Pengobatan
dan tindakan yang sudah diberikan :}{\fs22 \dbch \af2 \hich \af0 \loch \f0
\langnp13321 \langfe1033 \langfenp1033 \par }\pard \plain \s18 \li720 \ri0
\lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha \aspnum \adjustright
\lin720 \rin0 \phmrg \pvmrg \posnegx-319 \posy1005 \intbl \itap1 \fs22 \dbch
\af2 \hich \af0 \loch \af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033 \trowd
\langfe1033 \langfenp1033 \par }\pard \plain \s18 \fi0 \cufi0 \li0 \culi0 \ri0
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Hasil
penunjang yang diserahkan :}{\fs22 \dbch \af2 \hich \af0 \loch \f0 \lang13321
\langnp13321 \langfe1033 \langfenp1033 \par }\pard \plain \s18 \fi0 \cufi0 \li0
\culi0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha \aspnum
\langnp13321 \langfe1033 \langfenp1033 \par }\pard \plain \s18 \fi-360 \li450
\ri0 \sb240 \lisb0 \sa0 \lisa0 \pnrnot0 \sl240 \slmult1 \widctlpar \aspalpha
\aspnum \adjustright \lin450 \rin0 \phmrg \pvmrg \posnegx-319 \posy1005 \intbl
\itap1 \ls1 \fs22 \dbch \af2 \hich \af0 \loch \af5 \lang13321 \langnp13321
\langfe1033 \langfenp1033 {\listtext \pard \plain \fs22 \dbch \af2 \hich \af0 \loch
\af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033 \f2 9.\tab }\trowd \trql
Obat-obatan yang diserahkan :}{\fs22 \dbch \af2 \hich \af0 \loch \f0 \lang13321
\langnp13321 \langfe1033 \langfenp1033 \par }\pard \plain \s18 \li450 \ri0
\sb240 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha \aspnum \adjustright
\lin450 \rin0 \phmrg \pvmrg \posnegx-319 \posy1005 \intbl \itap1 \fs22 \dbch
\af2 \hich \af0 \loch \af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033 \trowd
\langfe1033 \langfenp1033 \par }\pard \plain \li90 \ri0 \sb240 \lisb0 \sa0
\phmrg \pvmrg \posnegx-319 \posy1005 \intbl \itap1 \fs22 \dbch \af2 \hich \af0
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Keterangan
kompetensi SDM untuk pasien transfer :}{\fs20 \dbch \af2 \hich \af0 \loch \f0
\lang13321 \langnp13321 \langfe1033 \langfenp1033 \par }\pard \plain \li0 \ri0
\langfe1033 \langfenp1033 Beri tanda (}{\fs20 \dbch \af2 \hich \af0 \loch \f0
\lang13321 \langnp13321 \langfe1033 \langfenp1033 {\field {\*\fldinst SYMBOL
252 \'5cf "Wingdings" \'5cs 10}{\fldrslt \f3 \fs20 }}}{\fs20 \dbch \af2 \hich
\af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 ) pada kolom untuk
kategori yang dipilih}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321
\trftsWidthB3 \trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 {\b1
\langfenp1033 Derajat}{\b1 \fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321
\langnp13321 \langfe1033 \langfenp1033 \nestcell }\pard \plain \qc \li0 \ri0 \lisb0
\langfenp1033 Pasien}{\b1 \fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321
\langnp13321 \langfe1033 \langfenp1033 \nestcell }\pard \plain \qc \li0 \ri0 \lisb0
\langfenp1033 Petugas pendamping (minimal)}{\b1 \fs20 \dbch \af2 \hich \af0
\loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 \nestcell }\pard \plain
\qc \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha \aspnum
\trpaddfb3 \trpaddfr3 {\b1 \fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321
\langnp13321 \langfe1033 \langfenp1033 kategori}{\b1 \fs20 \dbch \af2 \hich \af0
\loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 \nestcell }\pard \plain
\li0 \ri0 \lisb0 \sa160 \lisa0 \sl259 \slmult1 \widctlpar \aspalpha \aspnum
\adjustright \lin0 \rin0 \intbl \itap2 \fs22 \dbch \af2 \hich \af0 \loch \af5
\lang13321 \langnp13321 \langfe1033 \langfenp1033 {\*\nesttableprops \trowd
\trql \trgaph0 \trrh204 \trleft5 \trbrdrt \brdrs
\brdrw10 \trbrdrb \brdrs \brdrw10 \trbrdrl \brdrs \brdrw10 \trbrdrr \brdrs
\brdrw10 \trbrdrh \brdrs \brdrw10 \trbrdrv \brdrs \brdrw10 \trautofit
\trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddl108 \trpaddr108 \trpaddfl3
\trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \clbrdrl \brdrs \brdrw10 \clbrdrr
\brdrs \brdrw10 \clbrdrt \brdrs \brdrw10 \clbrdrb \brdrs \brdrw10 \cltxlrtb
\clcbpat16 \cellx1260 \clvertalb \clbrdrl \brdrs \brdrw10 \clbrdrr \brdrs
\brdrw10 \clbrdrt \brdrs \brdrw10 \clbrdrb \brdrs \brdrw10 \cltxlrtb \clcbpat16
\cellx6030 \clvertalb \clbrdrl \brdrs \brdrw10 \clbrdrr \brdrs \brdrw10 \clbrdrt
\brdrs \brdrw10 \clbrdrb \brdrs \brdrw10 \cltxlrtb \clcbpat16 \cellx9900 \clvertalb
\clbrdrl \brdrs \brdrw10 \clbrdrr \brdrs \brdrw10 \clbrdrt \brdrs \brdrw10 \clbrdrb
\brdrs \brdrw10 \cltxlrtb \clcbpat16 \cellx10915 \nestrow }\pard \plain \qc \li0
\langnp13321 \langfe1033 \langfenp1033 Derajat 0}{\fs20 \dbch \af2 \hich \af0 \loch
\f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 \nestcell }\pard \plain
\qj \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha \aspnum
\langnp13321 \langfe1033 \langfenp1033 Pasien yang dapat terpenuhi kebutuhannya di
ruang biasa}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321
\langfe1033 \langfenp1033 \nestcell }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0
\sl240 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \phmrg \pvmrg
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Petugas
pengantar}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321
\langfe1033 \langfenp1033 \nestcell }\pard \plain \qc \li0 \ri0 \sb240 \lisb0
\langfenp1033 \nestcell }\pard \plain \li0 \ri0 \lisb0 \sa160 \lisa0 \sl259
\slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \intbl \itap2
\langfenp1033 {\*\nesttableprops \trowd \trql \trgaph0 \trrh296 \trleft5
\brdrs \brdrw10 \trbrdrh \brdrs \brdrw10 \trbrdrv \brdrs \brdrw10 \trautofit
\trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalt \clbrdrl \brdrs \brdrw10 \clbrdrr
\cellx1260 \clvertalt \clbrdrl \brdrs \brdrw10 \clbrdrr \brdrs \brdrw10 \clbrdrt
\brdrs \brdrw10 \clbrdrb \brdrs \brdrw10 \cltxlrtb \cellx6030 \clvertalt
\brdrs \brdrw10 \cltxlrtb \cellx9900 \clvertalt \clbrdrl \brdrs \brdrw10
\cltxlrtb \cellx10915 \nestrow }\pard \plain \qc \li0 \ri0 \lisb0 \sa0 \lisa0
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Derajat 0,5}
\langfenp1033 \nestcell }\pard \plain \qj \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Pasien yang
dapat terpenuhi kebutuhannya di ruang biasa (pasien lansia/delirium)}{\fs20
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Petugas
pengantar}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321
\langfenp1033 {\*\nesttableprops \trowd \trql \trgaph0 \trleft5 \trbrdrt \brdrs
\brdrw10 \trbrdrb \brdrs \brdrw10 \trbrdrl \brdrs \brdrw10 \trbrdrr \brdrs \brdrw10
\trbrdrh \brdrs \brdrw10 \trbrdrv \brdrs \brdrw10 \trautofit \trftsWidth1
\trftsWidthB3 \trftsWidthA3 \trpaddl108 \trpaddr108 \trpaddfl3 \trpaddft3
\trpaddfb3 \trpaddfr3 \clvertalt \clbrdrl \brdrs \brdrw10 \clbrdrr \brdrs
\clvertalt \clbrdrl \brdrs \brdrw10 \clbrdrr \brdrs \brdrw10 \clbrdrt \brdrs
\brdrw10 \clbrdrb \brdrs \brdrw10 \cltxlrtb \cellx6030 \clvertalt \clbrdrl
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Derajat 1}
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Pasien
dengan resiko perburukan kondisi atau pasien yang sebelumnya dirawat di ruang
intensif}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Perawat /
petugas yang berpengalaman (sesuai dengan kebutuhan pasien) dan petugas pengantar}
\langfenp1033 \nestcell }\pard \plain
\qc \li0 \ri0 \sb240 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha
\langnp13321 \langfe1033 \langfenp1033 \nestcell }\pard \plain \li0 \ri0 \lisb0
\langfe1033 \langfenp1033 {\*\nesttableprops \trowd \trql \trgaph0 \trrh587
\trleft5 \trbrdrt \brdrs \brdrw10 \trbrdrb \brdrs \brdrw10 \trbrdrl \brdrs \brdrw10
\trbrdrr \brdrs \brdrw10 \trbrdrh \brdrs \brdrw10 \trbrdrv \brdrs \brdrw10
\cltxlrtb \cellx1260 \clvertalt \clbrdrl \brdrs \brdrw10 \clbrdrr \brdrs
\brdrs \brdrw10 \cltxlrtb \cellx10915 \nestrow }\pard \plain \qc \li0 \ri0
\langfe1033 \langfenp1033 Derajat 2}{\fs20 \dbch \af2 \hich \af0 \loch \f0
\lang13321 \langnp13321 \langfe1033 \langfenp1033 \nestcell }\pard \plain \qj
\li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha \aspnum
\langnp13321 \langfe1033 \langfenp1033 Pasien yang membutuhkan observasi yang lebih
ketat}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Perawat dan
petugas pengantar}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Derajat 3}
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Pasien yang
membutuhkan bantuan nafas lanjutan dan bantuan nafas dasar dengan dukungan}
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Dokter,
Perawat dan petugas pengantar}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321
\langnp13321 \langfe1033 \langfenp1033 \nestcell }\pard \plain \qc \li0 \ri0 \sb240
\langfe1033 \langfenp1033 \nestcell }\pard \plain \li0 \ri0 \lisb0 \sa160 \lisa0
\sl259 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \intbl \itap2
\cltxlrtb \cellx10915 \nestrow }\trowd \trql \trgaph0 \trrh11804 \trleft-108
\cltxlrtb \cellx11057 \pard \plain \qc \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033
\intbl \itap1 \fs22 \dbch \af2 \hich \af0 \loch \af5 \lang13321
\par }\pard \plain \qr \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar
\trpaddft3 \trpaddfb3 \trpaddfr3 {\fs20 \dbch \af2 \hich \af0 \loch \f0
\lang13321 \langnp13321 \langfe1033 \langfenp1033 \ul1 \uc1 \u8230 ?\uc1
\u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?..}{\fs20 \dbch \af2
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 \ul1
\par }\pard \plain \qr \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar
\aspalpha \aspnum \adjustright \lin0 \rin0 \tql \tx9934 \phmrg \pvmrg \posnegx-
319 \posy1005 \intbl \itap1 \fs22 \dbch \af2 \hich \af0 \loch \af5 \lang13321
\hich \af0 \loch \f0 \lang1057 \langnp1057 \langfe1033 \langfenp1033 }{\fs20 \dbch
\af2 \hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Tanda
Tangan & Nama Terang}{\fs24 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321
\langfe1033 \langfenp1033 \cell }\pard \plain \li0 \ri0 \lisb0 \sa160 \lisa0 \sl259
\langfenp1033 {\trowd \trql \trgaph0 \trrh11804 \trleft-108 \trbrdrt \brdrs
\trbrdrh \brdrs \brdrw10 \trbrdrv \brdrs \brdrw10 \tdfrmtxtLeft180
\tdfrmtxtRight180 \tpvpg \tphcol \tposnegx-319 \tposy1005 \trautofit
\cellx11057 \row }\pard \plain \qc \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1
\widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \phpg \pvpg \posnegx-319
\trftsWidthA3 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 {\b1 \fs20 \dbch \af2
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 STATUS
PRESENT}{\b1 \fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321
\langfe1033 \langfenp1033 \cell }\pard \plain \li0 \ri0 \lisb0 \sa160 \lisa0 \sl259
\langfenp1033 {\trowd \trql \trgaph0 \trrh298 \trleft-108 \trbrdrt \brdrs
\tdfrmtxtRight180 \tpvpara \tphmrg \tposnegx-319 \tposy584 \tabsnoovrlp1 \trautofit
\cellx11091 \row }\trowd \trql \trgaph0 \trrh309 \trleft-108 \trbrdrt \brdrs
\tdfrmtxtRight180 \tpvpara \tphmrg \tposnegx-319 \tposy584 \tabsnoovrlp1 \trautofit
\cellx5065 \clvertalt \clbrdrl \brdrs \brdrw10 \clbrdrr \brdrs \brdrw10 \clbrdrt
\brdrs \brdrw10 \clbrdrb \brdrs \brdrw10 \cltxlrtb \cellx11091 \pard \plain \li0
\adjustright \lin0 \rin0 \phpg \pvpg \posnegx-319 \posy584 \intbl \itap1 \fs22
\langnp13321 \langfe1033 \langfenp1033 KONDISI SAAT BERANGKAT }{\fs20 \dbch \af2
\plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240 \slmult1 \widctlpar \aspalpha \aspnum
\adjustright \lin0 \rin0 \phpg \pvpg \posnegx-319 \posy584 \intbl \itap1 \fs22
\langnp13321 \langfe1033 \langfenp1033 KONDISI SAAT TIBA DI }{\fs20 \dbch \af2
\hich \af0 \loch \f0 \lang1057 \langnp1057 \langfe1033 \langfenp1033 RUANG}
\langfenp1033 \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1
\u8230 ?}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033
\widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \intbl \itap1 \fs22 \dbch
\af2 \hich \af0 \loch \af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033
{\trowd \trql \trgaph0 \trrh309 \trleft-108 \trbrdrt \brdrs \brdrw10 \trbrdrb
\brdrs \brdrw10 \trbrdrl \brdrs \brdrw10 \trbrdrr \brdrs \brdrw10 \trbrdrh
\brdrs \brdrw10 \trbrdrv \brdrs \brdrw10 \tdfrmtxtLeft180 \tdfrmtxtRight180
\tpvpara \tphmrg \tposnegx-319 \tposy584 \tabsnoovrlp1 \trautofit \trftsWidth1
\brdrw10 \clbrdrb \brdrs \brdrw10 \cltxlrtb \cellx11091 \row }\trowd \trql \trgaph0
\brdrs \brdrw10 \tdfrmtxtLeft180 \tdfrmtxtRight180 \tpvpara \tphmrg \tposnegx-
319 \tposy584 \tabsnoovrlp1 \trautofit \trftsWidth1 \trftsWidthB3 \trftsWidthA3
\trpaddl108 \trpaddr108 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalt
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 T }
\langfe1033 \langfenp1033 : RR :
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 N :
\langfe1033 \langfenp1033 GCS :}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321
\phpg \pvpg \posnegx-319 \posy584 \intbl \itap1 \fs22 \dbch \af2 \hich \af0
Suhu :}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321
\langfe1033 \langfenp1033 \cell }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0
\sl240 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \phpg
\pvpg \posnegx-319 \posy584 \intbl \itap1 \fs22 \dbch \af2 \hich \af0 \loch \af5
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 T }
\langfe1033 \langfenp1033 : RR }{\fs20 \dbch
\af2 \hich \af0 \loch \f0 \lang1057 \langnp1057 \langfe1033 \langfenp1033 }
\langfenp1033 :}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321
\phpg \pvpg \posnegx-319 \posy584 \intbl \itap1 \fs22 \dbch \af2 \hich \af0
\dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 N
\langfe1033 \langfenp1033 : }{\fs20 \dbch \af2
\hich \af0 \loch \f0 \lang1057 \langnp1057 \langfe1033 \langfenp1033 }{\fs20 \dbch
\af2 \hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033
GCS :}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Suhu :}
\widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \intbl \itap1 \fs22 \dbch
\af2 \hich \af0 \loch \af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033
{\trowd \trql \trgaph0 \trrh815 \trleft-108 \trbrdrt \brdrs \brdrw10 \trbrdrb
\brdrs \brdrw10 \trbrdrl \brdrs \brdrw10 \trbrdrr \brdrs \brdrw10 \trbrdrh
\brdrs \brdrw10 \trbrdrv \brdrs \brdrw10 \tdfrmtxtLeft180 \tdfrmtxtRight180
\tpvpara \tphmrg \tposnegx-319 \tposy584 \tabsnoovrlp1 \trautofit \trftsWidth1
\brdrw10 \clbrdrb \brdrs \brdrw10 \cltxlrtb \cellx11091 \row }\trowd \trql \trgaph0
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Pasien
diserahkan oleh :}{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321
\langfe1033 \langfenp1033 \par }\pard \plain \li0 \ri0 \lisb0 \sa0 \lisa0 \sl240
\slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \phpg \pvpg
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 Nama Terang}
\langfenp1033 & TTD }{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321
\langnp13321 \langfe1033 \langfenp1033 :}{\fs20 \dbch \af2 \hich \af0 \loch \f0
\lang13321 \langnp13321 \langfe1033 \langfenp1033 \cell }\pard \plain \li0 \ri0
\lin0 \rin0 \phpg \pvpg \posnegx-319 \posy584 \intbl \itap1 \fs22 \dbch \af2
\langfe1033 \langfenp1033 Pasien diterima oleh }{\fs20 \dbch \af2 \hich \af0
\loch \f0 \lang1057 \langnp1057 \langfe1033 \langfenp1033 }{\fs20 \dbch \af2
\hich \af0 \loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 :}{\fs20
\langfenp1033 \line }{\fs20 \dbch \af2 \hich \af0 \loch \f0 \lang13321 \langnp13321
\langfe1033 \langfenp1033 Nama Terang}{\fs20 \dbch \af2 \hich \af0 \loch \f0
\lang1057 \langnp1057 \langfe1033 \langfenp1033 & TTD}{\fs20 \dbch \af2 \hich \af0
\loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 :}{\fs20 \dbch \af2
\plain \li0 \ri0 \lisb0 \sa160 \lisa0 \sl259 \slmult1 \widctlpar \aspalpha
\aspnum \adjustright \lin0 \rin0 \intbl \itap1 \fs22 \dbch \af2 \hich \af0 \loch
\af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033 {\trowd \trql \trgaph0
\cltxlrtb \cellx11091 \row }\pard \plain \li0 \ri0 \lisb0 \sa160 \lisa0 \sl259
\slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \itap0 \fs22
\dbch \af2 \hich \af0 \loch \af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033
\widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \itap0 \fs22 \dbch \af2 \hich
\af0 \loch \af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033 {\fs24 \dbch \af2
\aspalpha \aspnum \adjustright \lin0 \rin0 \itap0 \fs22 \dbch \af2 \hich \af0 \loch
\af5 \lang13321 \langnp13321 \langfe1033 \langfenp1033 {\fs24 \dbch \af2 \hich \af0
\loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 \par }\pard \plain \li0
\ri0 \lisb0 \sa160 \lisa0 \sl259 \slmult1 \widctlpar \aspalpha \aspnum \adjustright
\lin0 \rin0 \itap0 \fs22 \dbch \af2 \hich \af0 \loch \af5 \lang13321
\langnp13321 \langfe1033 \langfenp1033 {\fs24 \dbch \af2 \hich \af0 \loch \f0
\lisb0 \sa160 \lisa0 \sl259 \slmult1 \widctlpar \aspalpha
\aspnum \adjustright \lin0 \rin0 \itap0 \fs22 \dbch \af2 \hich \af0 \loch \af5
\lang13321 \langnp13321 \langfe1033 \langfenp1033 {\fs24 \dbch \af2 \hich \af0
\loch \f0 \lang13321 \langnp13321 \langfe1033 \langfenp1033 \par }\pard \plain \li0
\ri0 \lisb0 \sa160 \lisa0 \sl259 \slmult1 \widctlpar \aspalpha \aspnum \adjustright
\lang13321 \langnp13321 \langfe1033 \langfenp1033 \par }}

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{\rtf1 \ansi \ansicpg1252 \deff0 \stshfdbch2 \stshfloch0 \stshfhich0

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