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  • Rumah Sakit Umum Medika Lestari: Ringkasan Pulang Pasien (Rahasia)

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    Wildan Devi Ikrom
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    This document is a summary of a patient's discharge from Rumah Sakit Umum Medika Lestari in Kemranjen, Banyumas, Indonesia. It includes the patient's name, date of birth, admission and discharge dates, diagnosis and treatment received while hospitalized. The summary lists the patient's condition at discharge including vital signs and instructions for follow up care, medications and further treatment.

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    RINGKASAN PULANG PASIEN

    Original Title

    RINGKASAN PULANG PASIEN

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    This document is a summary of a patient's discharge from Rumah Sakit Umum Medika Lestari in Kemranjen, Banyumas, Indonesia. It includes the patient's name, date of birth, admission and discharge dates, diagnosis and treatment received while hospitalized. The summary lists the patient's condition at discharge including vital signs and instructions for follow up care, medications and further treatment.

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    © All Rights Reserved
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    24 views1 page

    Rumah Sakit Umum Medika Lestari: Ringkasan Pulang Pasien (Rahasia)

    Uploaded by

    Wildan Devi Ikrom
    This document is a summary of a patient's discharge from Rumah Sakit Umum Medika Lestari in Kemranjen, Banyumas, Indonesia. It includes the patient's name, date of birth, admission and discharge dates, diagnosis and treatment received while hospitalized. The summary lists the patient's condition at discharge including vital signs and instructions for follow up care, medications and further treatment.

    Copyright:

    © All Rights Reserved
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    of 1

    RUMAH SAKIT UMUM MEDIKA LESTARI

    JL.BUNTU - GOMBONG, RT.03 RW.03 PAGERALANG


    KEMRANJEN – BANYUMAS TELP. (0282) 5291299

    RINGKASAN PULANG PASIEN


    (RAHASIA) CM.01
    No. Rekam Medis :
    Nama Pasien Ruang Perawatan : ........................ Kamar:
    Tanggal Lahir. ···················································· Tanggal Keluar/Meninggal * .
    ................ . ·································· ·················
    · ······························· ····················· Tanggal Masuk RS ..................................................... DPJP .
    .......................................................
    Diagnosa Masuk . ··············· ···································· lndikasi Rawat !nap . · ························ ····························
    ANAMNESIS
    Keluhan Utama
    Riwayat Penyakit
    Riwayat Alergi
    PEMERIKSAAN FISIK
    Keadaan Umum
    Tanda Vital Tekanan darah : Suhu: Nadi: RR:
    Pemeriksaan Fisik
    PEMERIKSAAN PENUNJANG
    1. Laboratorium
    2. Radiologi :
    3. Lain - lain
    TERAPI / TINDAKAN MEDIS SELAMA DI RUMAH SAKIT
    DIAGNOSIS UTAMA ICD 10

    DIAGNOSIS SEKUNDER ICD 10


    1.
    2.
    3.
    4. ' -- ICD 9 CM
    TIN DAKAN/ PROSEDUR
    1.
    2.
    3.
    4.

    DIET
    '

    INSTRUKSI DAN EDUKASI (TINDAK LANJUT)

    KONDISI SAAT PULANG


    Keadaan Umum
    Kesadaran
    Tanda Vital Tekanan darah : Suhu: Nadi: RR:
    Catatan penting (kondisi saat ini) :

    CARA KELUAR RS
    Pulang Atas persetujuan Dirujuk Kabur
    Pulang Atas permintaan sendiri Meninggal
    TINDAK LANJUT
    Kontrol rawat jalan
    tanggal ......................................................................
    Dirujuk ke .................................................................................................
    TERAPI PULANG
    Nama Obat Jumlah Dosis Cara Pemberian

    Kemranjen, ...........................................................

    ( ......................................................... )
    Tanda Tangan & Nam a Dokter
    MOHON UNTUK TIDAK MENGGUNAKAN SINGKATAN DALAM PENULISAN DIAGNOSIS DAN TINDAKAN
    SERTA DITULIS DENGAN RAP/

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