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PEMERINTAH KABUPATEN MAGETAN

DINAS KESEHATAN
UPTD PUSKESMAS REJOMULYO
Telepon (0351) 868153

RESUME MEDIS PASIEN PULANG

NAMA :
UMUR :
NO. RM :
TANGGAL MASUK : TANGGAL KELUAR :

* RINGKASAN RIWAYAT PENYAKIT :

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* PEMERIKSAAN FISIK :
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* PEMERIKSAAN PENUNJANG
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* DIAGNOSA PENYAKIT :

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* TERAPI PENGOBATAN SELAMA DI PUSKESMAS :


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* TERAPI SAAT PULANG :

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* SARAN :

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REJOMULYO,

PETUGAS RAWAT INAP

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