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  • Monitoring Informed Consent Pro Operasi

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    Sena Yeftana
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    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
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    18 views3 pages

    Monitoring Informed Consent Pro Operasi

    Uploaded by

    Sena Yeftana
    pre op

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 3

    MONITORING INFORMED CO

    Hari/tanggal:

    Nama Pasien & Terapi/Tindakan Keuntungan


    NO Kondisi Pasien Nama DPJP
    RM yang direncanakan tindakan/ terapi
    ORING INFORMED CONSENT (pro operasi)

    Kemungkinan Akibat yang


    efek DIAGNOSA mungkin muncul
    alternatif masalah dalam
    samping/komplikasi Prognosis tanpa
    tindakan/ terapi terapi/tindakan MASUK masa perawatan/tindaka
    penyembuhan n
    KETERANGAN

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