You are on page 1of 9
MEDICAL CHECK UP REPORT SANTOSA HOSPITAL BANDUNG CENTRAL JOINT COMMISSION INTERNATIONAL (JCI) -USA ACCREDITED (2014 - 2017) ONE OF THE FEW BEST HOSPITALS IN THE WORLD (SATU DARI SEDIKIT RUMAH SAKIT TERBAIK DI DUNIA) www.jointcommissioninternational.org/JCI-Accredited-Organizations JCIUSAACCREDITED SSRN reer SANTOSA HOSPITAL BANDUNG CENTRAL idly and Caring ‘TaCARWIN SANTOSA HOSPITAL BANDUNG CENTRAL IFICATE OF FITNES: Surat Keterangan Sehat Date a4 Oct 2017 (ad/mmiyy) Tempel Stiker Tanggal (tglbInthn) I, Dokter Maharani Risiska Utami,dr__ do hereby certify of fitness to work, and is medically : Sqva,dokier— SSS dengan in memberikan sertifikat untuk bekerja, dengan hasil medisnya AFIT 1, without any medical problem Fit tidak ditemukan problem kesehatan CIFIT 2, with MINOR medical problem Fit, ditemukan problem keschatan yang tidak serius _IFIT 3, with medical problem but LOW risk status Fit, ditemukan problem kesehatan yang dapat menjadi serius - kelompok resiko rendah COBORDERLINE 1, with medical problem and MEDIUM risk status ‘Dalam batas, ditemukan problem kesehatan yang dapat menjadi serius- kelompok resiko sedang COBORDERLINE 2,with medical problem and HIGH risk status. The medical facilities on site can not manage it properly, unfit, with disability to perfom normal job. Only suitable for light duty Dalam bata, ditemulkan problem keschatan yang dapat menjadi srius- kelompok resiko tinggi CIUNFIT 1, with physical disability to perfom normal job. Only suitable for light duty Tidak ft, ditemukan keterbatasanfisik untuk melakuken pekerjeaa secara normal, hanya cocok untuk pekerjean ringan COUNFIT 2, being hospitalized or in sick leave status ‘Tidak fit, dalam perawatan di rumah sakit atau dalam kondisi yang tidak memungkinkan untuk melakukan pekerjan (Gtatus ijn sakit) Conclusion: $17 f Kesimpulan Sugestion : Please see the attachment ‘Saran

= 240 mg/dL Men : Optimal :>=60 mg/dL Borderline : 40-89 mg/dL, High Risk : <40 mg/dL, Women : Optimal :>68 mg/dL. Borderline : 45-65 mg/dl Hligh Risk : <45 mg/dl. 1 <100 mg/dL. 100-129 mg/dL. isk :>=130 mg/dL, Optimal: <150 mg/dL. Borderline: 150-199 mg/dL High Risk : >=200 mg/dL, <4 13.0- 18.0 4.50- 5.90 40-52 30.0- 97.0 27.0- 31.0 32,0- 35,0 4.50- 11.00 50.0- 70.0 20-40 2-8 1-4 o-1 150-450 MPV URINE Routine Urine Analyze Macroscopis Color ‘Turbidity Specific Gravity pH Nitrite Protein Glucose Keton Bodies Urobilinogen bin Blood /Hb Leucocyte Microscopic RBCs WBCs Ephitel Cells Cylinder Crystals Bacter 96 Light Yellow Clear 1.018 10 Negative Negative Normal Negative Normal Negative Negative 25 Positive 1 gooet. mg/dL, mg/dL mg/dL. mg/dL, mgidL, AL, fa ‘APR (HPF /APE TLPR LPR ‘TaCARWIN 74-104 Yellow Clear 1.000- 1.050 Negative “2S: Negative 25-74 + Positive 1 75-149 : Positive 2 100-290 : Positive 2 300-990 : Positive 3 >=12 : Positive 4 <1: Negative 26:1 Positive 3 0-9: Negative 10-24 : Positive 1 <25: Negative 25.99 : Positive 1 100-499 : Positive 2 >=500 ; Positive 3

You might also like