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  • MCU Follow Up Opthalmologist Gheovanny

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    Bruakaaka Udin
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    The MCU follow up form is for 24-year old Gheovanni Methami Ayu, who was found to have decreased visual acuity upon examination. The doctor is requested to further examine Ayu and provide an opinion on his abnormal MCU results showing decreased vision that is corrected with lenses. The form provides sections for the doctor to document their consultation, physical exam findings, diagnosis, prognosis, and recommended treatment plan.

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    buat mcu follow up masyarkat

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    The MCU follow up form is for 24-year old Gheovanni Methami Ayu, who was found to have decreased visual acuity upon examination. The doctor is requested to further examine Ayu and provide an opinion on his abnormal MCU results showing decreased vision that is corrected with lenses. The form provides sections for the doctor to document their consultation, physical exam findings, diagnosis, prognosis, and recommended treatment plan.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    16 views1 page

    MCU Follow Up Opthalmologist Gheovanny

    Uploaded by

    Bruakaaka Udin
    The MCU follow up form is for 24-year old Gheovanni Methami Ayu, who was found to have decreased visual acuity upon examination. The doctor is requested to further examine Ayu and provide an opinion on his abnormal MCU results showing decreased vision that is corrected with lenses. The form provides sections for the doctor to document their consultation, physical exam findings, diagnosis, prognosis, and recommended treatment plan.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    MCU FOLLOW UP FORM

    Name :

    Gheovanni Methami Ayu

    Age

    24 tahun

    Kepada Yth / To
    Doctor / Consultant : __TS. Ophtalmologist________________________________
    Mohon konsul dan pemeriksaan selanjutnya atas hasil MCU karyawan kami yang ditemukan kelainan
    berupa/ Please advise and further examination for our employees MCU that is found abnormality;
    Penurunan tajam pelinghatan (OD 20/50, OS 20/40) pro koreksi visus.
    Atas kerja sama sejawat, kami ucapkan banyak terima kasih/

    Thank you for your cooperation.

    PT. Thiess Indonesia

    Dr. Cahyadi Ilham


    Health Services

    Consultant Opinion
    Anamnesis &

    Physical Exam

    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________

    Diagnosis

    ______________________________________________________________
    ______________________________________________________________

    Prognosis

    ______________________________________________________________

    Therapy

    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________

    _______________________________________
    Doctors name, sign and stamp
    Date

    : ______________________________

    Phone

    : ______________________________

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