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  • Form Bantu Posbindu PTM Form Bantu Posbindu PTM

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    Puskesmas Gilingan
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    The document contains a form with fields to collect patient information such as name, address, ID number, age, height, weight, blood pressure, glucose levels, cholesterol levels, and other health metrics. The form is repeated twice, likely to enable collecting this information for two separate patients.

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    form bantu

    Original Title

    Form Bantu Posbindu

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    The document contains a form with fields to collect patient information such as name, address, ID number, age, height, weight, blood pressure, glucose levels, cholesterol levels, and other health metrics. The form is repeated twice, likely to enable collecting this information for two separate patients.

    Copyright:

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

    Form Bantu Posbindu PTM Form Bantu Posbindu PTM

    Uploaded by

    Puskesmas Gilingan
    The document contains a form with fields to collect patient information such as name, address, ID number, age, height, weight, blood pressure, glucose levels, cholesterol levels, and other health metrics. The form is repeated twice, likely to enable collecting this information for two separate patients.

    Copyright:

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

    FORM BANTU FORM BANTU

    POSBINDU PTM POSBINDU PTM

    NAMA =………………………………. NAMA =……………………………….


    ALAMAT =……………………............... ALAMAT =……………………...............
    NO KTP =……………………………… NO KTP =………………………………
    UMUR =…………tahun UMUR =…………tahun
    TB =…………cm TB =…………cm
    LP =…………cm LP =…………cm
    TENSI =…………mmHg TENSI =…………mmHg
    GLUKOSA =.............. GLUKOSA =..............
    ASAM URAT =………… ASAM URAT =…………
    KHOL =………… KHOL =…………
    BB =…………Kg BB =…………Kg
    VISERAL FAT = VISERAL FAT =
    FAT = FAT =
    IMT = IMT =

    FORM BANTU FORM BANTU


    POSBINDU PTM POSBINDU PTM

    NAMA =………………………………. NAMA =……………………………….


    ALAMAT =……………………............... ALAMAT =……………………...............
    NO KTP =……………………………… NO KTP =………………………………
    UMUR =…………tahun UMUR =…………tahun
    TB =…………cm TB =…………cm
    LP =…………cm LP =…………cm
    TENSI =…………mmHg TENSI =…………mmHg
    GLUKOSA =.............. GLUKOSA =..............
    ASAM URAT =………… ASAM URAT =…………
    KHOL =………… KHOL =…………
    BB =…………Kg BB =…………Kg
    VISERAL FAT = VISERAL FAT =
    FAT = FAT =
    IMT = IMT =

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