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N a m a Pasien I P a t i e n t N a m e HARI TRI WIBOWO

No. RM I patient N u m
00002 255
T a n g g a l L a h i r I Date of B i rt h 09 - 0 3 - 1 9 86
J e n i s K e l a m i n I Patient Sex M

T a n g g a l p e m e r i k s a a n I V i s i t Date 30-03-202 2 11:27:04

D R . D I P D O PETRUS WIDJAYA, S P . P D
Dokter P e n g i r i m I Referral P h y s i c i a n

Nomor Foto I Photo N u m b e r

XR20 22 - 0 3 0 2 8

H A S I L P E M E R I K S AA N R A D I O L O G I I R A D I O L O G I S T R E P O R T

X foto thorax PA

Cor : CTR < SO %, konfigurasi b a i k

Kedua h i l u s b a i k

Corakan bronkovascular t i d a k t a m p a k k e l a i n a n

Sinus lancip

Diafragma l i c i n

Kesan:

Cor d a n p u l m o t i d a k t a m p a k k e l a i n a n

30-03-2020 d r Thio A n a n d a � ven V T Sp Rad

BETHSAIDA HOSPITALS RADIO GIST

JI. Boulevard Raya Gading Serpong Kav 29, Gading Serpong, Tangerang - 1 5 8 1 0 , t : (+62 2 1 ) 2930-9999, f : (+62 2 1 ) 2 30-5999, www.bethsaidahospitals.com

FORM - SEK - 05 - 00