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PEMERINTAH KABUPATEN PURBALINGGA /’ RSUD dr. R. GOETENG TAROENADIBRATA PURRAT INGE Jalan Tertara Pesaro. 22 Te. 025) 891018, 96645, puberngpaGyaeo ‘rt on wea puetmon461280 Lisrongciiualan DESI TAMEPUTRIANNO gay Tama 0563403, LEMBAR TRANSFER PASIEN pes ae 1102/3010 Stabe ) INTERNAL, Nea | TANALIANONOS TOANOAN a a Ta a TN ae 7 nn oe Chu noe Lae Ba aga Ta ea Kw Pte) 9 Lew) 8 Lewel? © Level? Fea eae Kail [Perawat | Bidan 9 EN je” BICLS ‘3 _PPGD. a _ APN hang sas os 7578 ae biol Sauk Phu tious wpa Gy wean, Papen Raho are : as Rt bade bi evinle fe Cae tan sn Fra yng eb diss ig ten pe n Sn AP ks epi pag ih dein cae. macs Bomcstaike Jk") eC (ANG TURUT DISERAKAN exe ‘ona FETA PONORARS ENGR TGR] PRM [Oba oa yang dimium W Hiss Latortoivm 1D Dompet Pre, [0 bat nes © Hest use ou obtain yang ows | Hail Rogen © Baan any la a o RINGKASAN KONDISI PASIEN Ssrarvsmser | KU [cseney] nem | xem [vee | 002 | Pexcrisix CATATAN rt [oscunmsrer| 07) = | oe | Ce mama! ¢| - | for | 99 | 29 ‘Nema dan tanda tangan petugas hess) 2 Yo ic fon Ay 7 iano : AR a Cn. C ee re oe KATEGORI PASIEN. 4 LEVEL KATEGOI | PENDAMING FERAL am aaa ner a eee etree Sealccmcceeem | coe ee meme rpms pave nan OO) Ties ena or ie aay a [twp yi nin tomatoe | SS = LS te pence Mi Scanned by CamScanner PEMERINTAH KABUPATEN PURBALINGGA | RSUD dr. R. GOETENG TAROEN/ "sentra Peljar No, 22-Telp. (0281) 291018. 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R. GOETENG TAROENADIBRATA PURBALINGGA Jan ere Pj No 2 Te, 28) BYTE ae etal rapotangngyatoa con, web sed Putbaingga $3019 | sRIYATUNNY Ansa Fama Pasion, O70871570(49 hun) LEMBAR TRANSFER PASIEN Mae : INTERNAL, ane ae _ STANGAN etapa Roangan Tuan Yang GnOPONET — ms aL THUAN T A oe -@-t 100 em | ob. le. Oar (ee-'9 {I i ma aap pe eer 708-5. ae © Lee? © Lewl3 Fa Perawat/ = 3 EN S—BrcLs 0 _APN ee sus Saeateenes> ea 3 ‘Anamness (Rae at Nye > Pert, pale Leet omarfrder Sze yi aegis Vunne Vrde— Abctmo——_ 1 Hrereton Tea Ra sn paridiainien | OF! 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