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  • Rekam Medis Family Folder: Rahasia

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    abdillah
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    This document is a family folder from Puskesmas Labanan in Berau Regency, Indonesia. It contains information such as the head of household's name, date of birth, address, occupation, as well as information for spouse and up to 7 children including their names and dates of birth. It specifies that this folder belongs to Puskesmas Labanan, must be returned in complete form after use, and is not to be folded, rolled, or removed from the health center.

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    family folder puskesmas

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    Family Folder

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    This document is a family folder from Puskesmas Labanan in Berau Regency, Indonesia. It contains information such as the head of household's name, date of birth, address, occupation, as well as information for spouse and up to 7 children including their names and dates of birth. It specifies that this folder belongs to Puskesmas Labanan, must be returned in complete form after use, and is not to be folded, rolled, or removed from the health center.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    10 views1 page

    Rekam Medis Family Folder: Rahasia

    Uploaded by

    abdillah
    This document is a family folder from Puskesmas Labanan in Berau Regency, Indonesia. It contains information such as the head of household's name, date of birth, address, occupation, as well as information for spouse and up to 7 children including their names and dates of birth. It specifies that this folder belongs to Puskesmas Labanan, must be returned in complete form after use, and is not to be folded, rolled, or removed from the health center.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    PEMERINTAH KABUPATEN BERAU DINAS KESEHATAN

    PUSKESMAS LABANAN
    Jl. Asam, Labanan Makmur Kecamatan Teluk Bayur 77353
    Email: pkm.labanan@gmail.com

    REKAM MEDIS
    FAMILY FOLDER
    RAHASIA
    No. RM : -

    Nama KK : …………………………………………………., Umum / BPJS /


    Tanggal Lahir / Umur KK : …………………………………………………………………………………..
    Alamat KK : ……………………………………………………………………………………
    Pekerjaan KK : ……………………………………………………………………………………
    Anggota KK :
    Istri : …………………………………………………………………...Tgl Lahir……………………………………., Umum/BPJS
    Anak : 1. ………………………………………………………………..Tgl Lahir……………………………………., Umum/BPJS
    2. ………………………………………………………………..Tgl Lahir……………………………………., Umum/BPJS
    3. ………………………………………………………………..Tgl Lahir……………………………………., Umum/BPJS
    4. ………………………………………………………………..Tgl Lahir ……………………………………, Umum/BPJS
    5. ………………………………………………………………..Tgl Lahir ……………………………………, Umum/BPJS
    6. ………………………………………………………………..Tgl Lahir……………………………………., Umum/BPJS
    7. ………………………………………………………………..Tgl Lahir……………………………………., Umum/BPJS

    1. Berkas ini milik PUSKESMAS LABANAN


    2. Setelah selesai harap dikembalikan ke bagian
    rekam medis dalam keadaan lengkap
    3. Mohon tidak di lipat / di gulung
    BERKAS INI TIDAK BOLEH DIBAWA KELUAR
    PUSKESMAS LABANAN

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