You are on page 1of 1

LEMBAR KONTROL PEMERIKSAAN LEMBAR KONTROL PEMERIKSAAN

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


USIA : …..................................... USIA : ….....................................
JK :L/P JK :L/P
BERAT BADAN : …..................................... BERAT BADAN : ….....................................

TEK. GULA ASAM TEK. GULA ASAM


NO TGL KOLESTEROL NO TGL KOLESTEROL
DARAH DARAH URAT DARAH DARAH URAT
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
NORMAL: NORMAL:
TENSI : GD : < 140mg/dl TENSI : GD : < 140mg/dl
<140/90 mmHg AU : L< 7, P < 6 <140/90 mmHg AU : L< 7, P < 6
CHOL : < 200mg/dl CHOL : < 200mg/dl

You might also like