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  • Surat Rujukan Pemeriksaan Lab Calon Jemaah Haji

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    Barlian Lian
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    SURAT RUJUKAN PEMERIKSAAN LAB CALON JEMAAH HAJI.docx

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    84 views1 page

    Surat Rujukan Pemeriksaan Lab Calon Jemaah Haji

    Uploaded by

    Barlian Lian

    Copyright:

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

    SURAT RUJUKAN PEMERIKSAAN LAB CALON JEMAAH HAJI

    Kepada Yth :
    Di -
    Padang
    Mohon dilakukan pemeriksaan Calon Jemaah Haji berikut
    Nama :
    Bin / Binti :
    Umur / tgl lahir :
    Alamat :

    Darah rutin
    Golongan darah
    Urine Rutin
    Gula Darah Sewaktu ( GDP, GD2PP )
    Kolesterol, , LDL,Trigliserida
    Ro Foto Thorak
    EKG
    Dll (sesuai indikasi)

    Padang,
    Dokter yang mengirim

    (.................................)

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