Sa kunik pratawa KLINIK PRATAMA DIPONEGORO I
DIPONEGORO I
Jin Prof Soedarto, SH. Tembalang Semarang
Website ; www.undipmaju.com
SURAT KETERANGAN SEHAT
Yang bertanda tangan dibawah ini menerangkan bahwa
Nama
PMURT SHAGRITIA pAMAzAnT)
Jenis Kelamin : Laki~laki/Perempuan
Umur
Pekerjaan
Alamat
23. Tahun
2 PAAR MON
7S TWevaSARD pc. TeMtatarte
Telah diperiksa kesehatan badannya untuk keperluan: Peri\ELITIAN & RS.
Dengan hasil
Catatan
TD
BB
TB
Subs
Fann
* Lingkari yang benar
: SEHAT / HDAK-SEHAT
70/90 mit
45 FS
: {SS Om
L 3-9 %c.
03 JUL 2020
Ie aS ve Semarang,
Dokter Yang memeriksa
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