LAMPIRAN SK DIREKTUR NO. ..

TENTANG PENETAPAN FORMULIR REKAM MEDIS RSUD TANJUNG PRIOK

DAFTAR FORMULIR

NO NOMOR FORMULIR

1 RJ 01/RM/RSTanjungpriok/REV00/2017
2 RJ 01a/RM/RSTanjungpriok/REV00/2017
3 RJ 02/RM/RSTanjungpriok/REV00/2017
4 RJ 02a/RM/RSTanjungpriok/REV00/2017
5 RJ 03/RM/RSTanjungpriok/REV00/2017
6 RJ 03a/RM/RSTanjungpriok/REV00/2017
7 RJ 03b /RM/RSTanjungpriok/REV00/2017
8 IGD 04 /RM/RSTanjung priok /REV00/2017

9 IGD 04a /RM/RSTanjung priok /REV03/2017

10 RI 05/RM/RSTanjungpriok/REV00/2017
11 RI 06 /RM/RSTanjungpriok/REV01/2017
12 RI 06a /RM/RSTanjungpriok/REV00/2017
13 RI 06b /RM/RSTanjungpriok/REV00/2017
14 RI 07/RM/RSTanjungpriok/REV00/2017

15 RI 07a/RM/RSTanjungpriok/REV01/2017
16 RI 07b/RM/RSTanjungpriok/REV01/2017
17 RI 07c/RM/RSTanjungpriok/REV00/2017
18 RI 08/RM/RSTanjungpriok/REV00/2017
19 RI 09/RM/RSTanjungpriok/REV00/2017
20 RI 09 a /RM/RSTanjungpriok/REV01/2017
21 RI 09 b/RM/RSTanjungpriok/REV00/2017
22 RI 09 c/RM/RSTanjungpriok/REV00/2017
23 RI 10 /RM/RSTanjungpriok/REV00/2017
RI 11 /RM/RSTanjungpriok/REV00/2017
24
25 RI 12 /RM/RSTanjungpriok/REV00/2017
26 RI 12 a/RM/RSTanjungpriok/REV00/2017
27 RI 12 b /RM/RSTanjungpriok/REV00/2017
28 RI 13 /RM/RSTanjungpriok/REV00/2017
29 RI 13 a /RM/RSTanjungpriok/REV00/2017
30 RI 13 b /RM/RSTanjungpriok/REV00/2017
31 RI 14 /RM/RSTanjungpriok/REV01/2017
32 RI 14 a /RM/RSTanjungpriok/REV01/2017
33 RI 15 /RM/RSTanjungpriok/REV00/2017
34 RI 15 a/RM/RSTanjungpriok/REV00/2017
35 RI 15 b /RM/RSTanjungpriok/REV01/2017
36 RI 16/RM/RSTanjungpriok/REV00/2017
37 RI 16 a /RM/RSTanjungpriok/REV00/2017
38 RI 16 b/RM/RSTanjungpriok/REV00/2017
39 RI 16 c /RM/RSTanjungpriok/REV00/2017
40 RI 17 /RM/RSTanjungpriok/REV00/2017
41 RI 17 a/RM/RSTanjungpriok/REV00/2017
42 RI 17 b/RM/RSTanjungpriok/REV00/2017
43 RI 18 /RM/RSTanjungpriok/REV01/2017
44 RI 19/RM/RSTanjungpriok/REV00/2017
45 RI 20/RM/RSTanjungpriok/REV00/2017
46 RI 21/RM/RSTanjungpriok/REV00/2017
47 RI 21a/RM/RSTanjungpriok/REV00/2017
48 RI 21b/RM/RSTanjungpriok/REV00/2017
49 RI 21c/RM/RSTanjungpriok/REV00/2017
50 RI 22/RM/RSTanjungpriok/REV00/2017
51 RI 22a/RM/RSTanjungpriok/REV00/2017
52 RI 23/RM/RSTanjungpriok/REV00/2017
53 RI 24/RM/RSTanjungpriok/REV00/2017
54 RI 24a.1/RM/RSTanjungpriok/REV00/2017
55 RI 24a.2/RM/RSTanjungpriok/REV00/2017
56 RI 24a.3/RM/RSTanjungpriok/REV00/2017
57 RI 25/RM/RSTanjungpriok/REV00/2017
58
 LAMPIRAN SK DIREKTUR NO. ..

TAPAN FORMULIR REKAM MEDIS RSUD TANJUNG PRIOK

DAFTAR FORMULIR

NAMA FORMULIR

CATATAN RAWAT JALAN

PEMERIKSAAN AWAL MEDIS DAN PEMERIKSAAN JASMANI CANCEL

POLIKLINIK KEBIDANAN
KARTU IBU
POLIKLINIK MATA
CATATAN MATA
RIWAYAT PENYAKIT PEMERIKSAAN MATA
ASSESMEN DOKTER IGD

CATATAN KEPERAWATAN IGD

RINGKASAN MASUK DAN KELUAR

LEMBAR HAK KUASA
PERSETUJUAN UMUM GENERAL CONCENT
SURAT PERNYATAAN BPJS
SURAT PENRNYATAAN MENTAATI PERATURAN RUMAH SAKIT
TANJUNG PRIOK
SURAT PERNYATAAN RUJUKAN PASIEN
PERSETUJUAN RAWAT INAP
MEMILIH DPJD
PENGANTAR RAWAT INAP
ASSESMENT ULANG NYERI
ASSESMENT RESIKO JATUH DEWASA
ASSESMENT RESIKO JATUH ANAK
ASSESMENT RESIKO JATUH GERIATRI
CATATAN PERKEMBANGAN TERINTEGRASI
LEMBAR PERMINTAAN KONSULTASI / RAWAT JALAN / ALIH
RAWAT/LEPAS RAWAT
ASUHAN GIZI,MONITORING ,EVALUASI
SKRINING ANAK
SKRINING DEWASA
FORMULIR EDUKASI TERINTEGRASI
FORMULIR PERMINTAAN PELAYANAN KEROHANIAN
FORMULIR PETUGAS PELAYANAN KEROHANIAN
NIFAS (GRAFIK NIFAS)
GRHAFIC CHART
STATUS GINEKOLOGI
LAPORAN PARTUS
PENGKAJIAN AWAL MEDIS PASIEN RUANG BERSALIN
IDENTIFIKASI BAYI
OBSERVASI TANDA -TANDA VITAL BAYI
STATUS BAYI
SURAT KETERANGAN LAHIR BAYI
FORMULIR PERSETUJUAN TINDAKAN
FORMULIR PENOLAKAN TINDAKAN
SURAT PERNYATAAN PENOLAKAN PENGOBATAN
DNR
DAFTAR PEMBERIAN OBAT
DAFTAR INFUS SEHARI
ASSESMENT KEPERAWATAN RAWAT INAP
CATATAN PENGAWASAN KEPERAWATAN
CATATAN PENGAWASAN PASIEN KRITIS
PERENCANAAN KEPERAWATAN
SURAT RUJUKAN
FORMULIR RUJUKAN PASIEN HIV
RESUME PASIEN PULANG
FORMULIR SURVAILANS INFEKSI NOSOKOMIAL
FORMULIR IMS (NFEKSI MENULAR SEKSUAL)
FORMULIR SKRINING GEJALA DAN TANDA TB
FORMULIR TES DAN KONSELING HIV
FORMULIR SERAH TERIMA PASIEN RSUD TANJUNG PRIOK
HASIL PEMERIKSAAN PENUNJANG MEDIS