JL Medan. Km. 25, No. 66 Lubuk Pukarn 20514 Kab. Deli Serdang - Sumatera Utara, Indonesia E-mail: rsgrandmedistra @gmeil.oom Tel: (061) 795 $114,795 4914Fax.: 795 0114 Website + hitn:/www.rsgrandme:.com MEDICAL CHECK UP SUMMARY NNO. : 06/SKBS/2018 IDENTITAS NAME + Novia Sopiana PLACE/ BIRTH + Sungai Kuruk, 04 November 1995 AGE 2 Tahun SEX :Female OCCUPATION lumni $4 Keperawatan Medistra Program Jepang MEDICAL HISTORY 1. HIV/AIDS 8, Leprosy :No 2. Psiciatric iliness 9. Malignancy :No 3, Malaria 1O.Heart Diseases :No 4. Diabetes Mellitus 11. Kidney Diseases :No 5. Tuberculosis 12. Hepatitis :No 6. Epilepsy 13, Sexually Transmitted Diseases :No 7. Hipertension 14. Allergy (Seafood) Yes CLINICAL EXAMINATION ‘A. GENERAL PHISYCAL EXAMINATION Height 2153em, Visualacuity —» OD: 20/20 Weight 250 kg Os : 20/20 Pulse Rate :82x/mnt Color Blind :No Blood Pressure 2110/70 mmHg ‘Anemia :No Deformities of Limbs : No ‘Audiometric : Dextra : Normal LNN enlargement — = No : Sinistra: Normal Hearing disorder: No B, ORGAN SYSTEM EXAMINATION Integumentary System : Normal Extrimities Sytem lormal Cardiovascular System : Normal Respiratory System jormal Gestrointestinal System : Normal Genitourinary System jormal Nervous System and Mental Status: Normal LABORATORY AND RADIOLOGY TEST Urin Rutin : WoRL : Negative © Protein : Negative Hbsag Non Reaktif * Sugar / Reduksi 3 Negative Blood Type 0 (+) © Blood : Negative Liver Function : SGOT : Normal Darah Rutin : Normal SGPT: Normal Chest X- Ray Normal Chest Total Cholesterol + Normal SUMMARY FIT on Job, Loate of fxam —: Toth March 2038 asta Expired Date 5 Ath june 2018 8 of,