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  • Pemerintah Propinsi Jawa Timurdinas Kesehatan Rumahsakit Umum Karsa Husada Batu

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    Radiologi RSUKH
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    kritis

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    Pemerintah Propinsi Jawa Timurdinas Kesehatan Rumahsakit Umum Karsa Husada Batu

    Uploaded by

    Radiologi RSUKH
    kritis

    Copyright:

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

    PEMERINTAH PROPINSI JAWA TIMURDINAS KESEHATAN

    RUMAHSAKIT UMUM KARSA HUSADA BATU

    INSTALASI RADIOLOGI
    Jl. A. Yani 10 – 13 Batu
    TELP. ( 0341 ) 596898 - 591076 - 591036 - FAX. 596901 - 591076

    Nomor RM : No. Reg. Rad. :

    Nama : Tgl Pmx :

    Tgl Lahir/ Umur : Jam Periksa : Jam Hasil :

    Alamat : Pemeriksaan :

    Diagnosa Klinis : Pengirim :

    Hasil Kritis Radiologi :

    ……………………………………………………………………………………………………
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    ……………………………………………………………………………………………………
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    Nama Petugas Radiologi : …………………………………………………………..


    Nama Penerima Informasi/ Unit : …………………………………………………………..
    Durasi : …………………………………………………………..
    Dokter DPJP : …………………………………………………………..

    Bagian Radiologi Penerima Informasi


    Dokter Dokter/ Perawat

    ……………………. ……………………...
    *Catatan : Penyampaian Hasil Kritis Radiologi hingga DPJP ≤ 60 menit

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