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  • Form Timbang Terima Pasien Icu

    Загружено:

    noer urifah
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    Form Timbang Terima Pasien Icu

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    Form Timbang Terima Pasien Icu

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    © All Rights Reserved
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    7 просмотров2 страницы

    Form Timbang Terima Pasien Icu

    Загружено:

    noer urifah
    Form Timbang Terima Pasien Icu

    Авторское право:

    © All Rights Reserved
    Скачайте в формате DOCX, PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    из 2

    FORM TIMBANG TERIMA PASIEN ICU

    HARI / TGL : .............................., ..........- .........- 20.....


    IDENTITAS PASIEN DINAS
    NO ( Nama/Umur/Reg/ Alamat) DPJP BAYAR
    PAGI SORE MALAM
    ( Dx, Diit, Antibiotik )
    1
    .........................................
    .............. / ..................
    ......................................... UM/BPJS
    .........................................

    DC/Vent/Rest/Strep/PA
    2 )
    .........................................
    .............. / ..................
    ......................................... UM/BPJS
    .........................................

    DC/Vent/Rest/Strep/PA
    3 )
    .........................................
    .............. / ..................
    ......................................... UM/BPJS
    .........................................

    DC/Vent/Rest/Strep/PA
    4 )
    .........................................
    .............. / ..................
    ......................................... UM/BPJS
    .........................................

    DC/Vent/Rest/Strep/PA
    5 )
    .........................................
    .............. / ..................
    ......................................... UM/BPJS
    .........................................

    DC/Vent/Rest/Strep/PA
    6 )
    .........................................
    .............. / ..................
    ......................................... UM/BPJS
    .........................................

    DC/Vent/Rest/Strep/PA
    )
    7
    .........................................
    .............. / ..................
    ......................................... UM/BPJS
    .........................................

    DC/Vent/Rest/Strep/PA
    8 )
    .........................................
    .............. / ..................
    ......................................... UM/BPJS
    .........................................

    DC/Vent/Rest/Strep/PA
    )
    .........................................
    .............. / ..................
    ......................................... UM/BPJS
    .........................................

    DC/Vent/Rest/Strep/PA
    )
    .........................................
    .............. / ..................
    ......................................... UM/BPJS
    .........................................

    DC/Vent/Rest/Strep/PA
    )
    .........................................
    .............. / ..................
    ......................................... UM/BPJS
    .........................................

    DC/Vent/Rest/Strep/PA
    )
    .........................................
    .............. / ..................
    ......................................... UM/BPJS
    .........................................

    DC/Vent/Rest/Strep/PA
    Penanggung
    ) Jawab : TIM 1

    TIM 2

    TIM 3

    Mengetahui,
    Karu ICU

    Yeni Astuti, S.Kep. Ners.


    NIP. 19740619 199703 2 004

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