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  • Formulir Penilaian Ohi-S

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    Kelvin Bulain
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    formulir penilaian OHI-S

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    Formulir Penilaian Ohi-s

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    formulir penilaian OHI-S

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    11 views1 page

    Formulir Penilaian Ohi-S

    Uploaded by

    Kelvin Bulain
    formulir penilaian OHI-S

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    FORMULIR PENILAIAN OHI-S

    Tgl. Pemeriksaan : ..........................................

    Nama Pemeriksa: .........................................

    Puskesmas / BPG / Sekolah : .........................

    Kab / Kecamatan :........................................

    Nama Pasien: ..................................................

    Jenis Kelamin: .........................................

    Umur : ..........................................................

    DEBRIS INDEX

    KALKULUS INDEX

    SKOR :

    SKOR :

    OHI-S :

    FORMULIR PENILAIAN OHI-S

    Tgl. Pemeriksaan : ..........................................

    Nama Pemeriksa: .........................................

    Puskesmas / BPG / Sekolah : ........................

    Kab / Kecamatan :........................................

    Nama Pasien: ..................................................

    Jenis Kelamin: .........................................

    Umur : .........................................................

    DEBRIS INDEX

    KALKULUS INDEX

    SKOR :

    OHI-S :

    SKOR :

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