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  • Form Hasil Pemeriksaan Usg

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    puskesmas kadupandak
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    This ultrasound report contains information about two patients. It includes each patient's name, age, address, gravida status, and history of present illness. For each patient it describes the baby's position, gestational age, fetal movement, true birth weight, placenta, amniotic sac, and any other notes. The report is signed by the examining doctor.

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    FORM USG

    Original Title

    FORM HASIL PEMERIKSAAN USG

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    This ultrasound report contains information about two patients. It includes each patient's name, age, address, gravida status, and history of present illness. For each patient it describes the baby's position, gestational age, fetal movement, true birth weight, placenta, amniotic sac, and any other notes. The report is signed by the examining doctor.

    Copyright:

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

    Form Hasil Pemeriksaan Usg

    Uploaded by

    puskesmas kadupandak
    This ultrasound report contains information about two patients. It includes each patient's name, age, address, gravida status, and history of present illness. For each patient it describes the baby's position, gestational age, fetal movement, true birth weight, placenta, amniotic sac, and any other notes. The report is signed by the examining doctor.

    Copyright:

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

    HASIL PEMERIKSAAN USG HASIL PEMERIKSAAN USG

    NAMA : ……………………………….. NAMA : ………………………………..


    UMUR : ……………………………….. UMUR : ………………………………..
    ALAMAT : ……………………………….. ALAMAT : ………………………………..
    GRAVIDA : G……….P.....….A……….. GRAVIDA : G……….P………..A………
    HPHT : ……………………………….. HPHT : ………………………………..
    1. LETAK JANIN :
    1. LETAK JANIN : 2. USIA KEHAMILAN :
    2. USIA KEHAMILAN : 3. GERAK JANIN/ / DJJ :
    3. GERAK JANIN/ / DJJ : 4. TBJ :
    4. TBJ : 5. PLACENTA :
    5. PLACENTA : 6. KETUBAN :
    6. KETUBAN : 7. HPL :
    7. HPL :

    Kadupandak, …….Nov 2019 Kadupandak, ……Nov 2019


    Dokter Pemeriksa Dokter Pemeriksa

    (………………………..) (……………………….)

    HASIL PEMERIKSAAN USG HASIL PEMERIKSAAN USG

    NAMA : ……………………………….. NAMA : ………………………………..


    UMUR : ……………………………….. UMUR : ………………………………..
    ALAMAT : ……………………………….. ALAMAT : ………………………………..
    GRAVIDA : G…..….P……….A……….. GRAVIDA : G…..….P……….A………..
    HPHT : ……………………………….. HPHT : ………………………………..

    15. LETAK JANIN : 8. LETAK JANIN :


    16. USIA KEHAMILAN : 9. USIA KEHAMILAN :
    17. GERAK JANIN/ / DJJ : 10. GERAK JANIN/ / DJJ :
    18. TBJ : 11. TBJ :
    19. PLACENTA : 12. PLACENTA :
    20. KETUBAN : 13. KETUBAN :
    21. HPL : 14. HPL :

    Kadupandak, …….Nov 2019 Kadupandak, ……Nov 2019


    Dokter Pemeriksa Dokter Pemeriksa

    (………………………..) (………………………..)

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