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RUMAH SAKIT SITI MIRIAM (RSSM)

JL.dr. Wahidin No. 101 Lawang Telp. ( 0341 ) 426057 Fax (0341) 421865 ext 160
Email : rssitimiriam@rssitimiam.com Website : http://www.rs-sitimiriam.com

PENGKAJIAN Ruang : No. RM :


KEBIDANAN
Nama : Umur :

I. Pengkajian
1. Gravida :
2. Usia Kehamilan :
3. Palpasi :
4. Auskultasi :
5. His :
6. VT :

II. Pemeriksaan Fisik


Tanda – Tanda Vital
1. Suhu : °C
2. Pernapasan : x/mnt
3. Nadi : x/mnt
4. Tekanan Darah : mmHg

III. Lain – Lain


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IV. Diagnosa Kebidanan


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