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    jawaban rujukan interna puskesmas

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    jawaban rujukan interna puskesmas

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    1 views2 pages

    Jawaban Rujukan Interna

    Uploaded by

    gung saska
    jawaban rujukan interna puskesmas

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    PEMERINTAH KABUPATEN KARANGASEM

    DINAS KESEHATAN
    PUSKESMAS RENDANG
    JAWABAN RUJUKAN INTERNAL
    Kepada
    No. / / /20 Yth : Petugas Unit
    …………………
    …………………
    Berdasarkan hasil pemeriksaan terhadap pasien :

    Nama :………………………………………………………………………....
    Umur :………………………………………………………………………….
    Jenis Kelamin : L/P
    Alamat :………………………………………………………………………….
    Diagnosa :………………………………………………………………………….
    ………………………………………………………………………….
    Hasil Pemeriksaan :…………………………………………………………………………..
    ………………………………………………………………………….
    ………………………………………………………………………….
    Kesimpulan :…………………………………………………………………………...
    ……………………………………………………………………………
    Saran :……………………………………………………………………………
    ……………………………………………………………………………
    Rendang,
    Petugas Konsultasi

    (………………………..)

    PEMERINTAH KABUPATEN KARANGASEM


    DINAS KESEHATAN
    PUSKESMAS RENDANG
    JAWABAN RUJUKAN INTERNAL
    Kepada
    No. / / /20 Yth : Petugas Unit
    …………………
    …………………
    Berdasarkan hasil pemeriksaan terhadap pasien :

    Nama :………………………………………………………………………....
    Umur :………………………………………………………………………….
    Jenis Kelamin : L/P
    Alamat :………………………………………………………………………….
    Diagnosa :………………………………………………………………………….
    ………………………………………………………………………….
    Hasil Pemeriksaan :…………………………………………………………………………..
    ………………………………………………………………………….
    ………………………………………………………………………….
    Kesimpulan :…………………………………………………………………………...
    ……………………………………………………………………………
    Saran :……………………………………………………………………………
    ……………………………………………………………………………
    Rendang,
    Petugas Konsultasi

    (………………………..)

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