Surat Ket. Hamil

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SURAT KETERANGAN HAMIL

Nomor : 244 / PKM / XI / 2010

Yang bertanda tangan dibawah ini, selaku Dokter Puskesmas Buru Karimun, dengan
ini menerangkan bahwa :

Nama : TATI MESNORIAWATI

U mur : 27 Tahun
Alamat : Jl. Lundang Pangjang RT.01/RW.04 Kel.Buru Kec.Buru
Kab.Karimun

Diagnosa :
1. G1, P0, A0 ( 32 Minggu )
2. DJJ +, Anak Hidup + Letak Kepala
3. BB : 52 kg
4. TD : 100/70

Demikian surat keterangan ini dibuat untuk dapat dipergunakan sebagaimana

mestinya.

Buru-Karimun, 10 Nopember 2010

DOKTER

dr. KAMISAH

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