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  • Form Pecatatan Fisiologi Prosedur Emergensi Rujukan Ugd

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    Lily Suhiri
    3 views2 pages
    This document is a form for recording physiological procedures and emergency referrals from the emergency department to the hospital. It includes fields to record patient identification, diagnosis, and vital signs like capillary glucose, temperature, pulse, and blood pressure at three timestamps: before referral, during the referral process, and at handover to the hospital.

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    Form Pecatatan Fisiologi Prosedur Emergensi Rujukan Ugd

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    This document is a form for recording physiological procedures and emergency referrals from the emergency department to the hospital. It includes fields to record patient identification, diagnosis, and vital signs like capillary glucose, temperature, pulse, and blood pressure at three timestamps: before referral, during the referral process, and at handover to the hospital.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    3 views2 pages

    Form Pecatatan Fisiologi Prosedur Emergensi Rujukan Ugd

    Uploaded by

    Lily Suhiri
    This document is a form for recording physiological procedures and emergency referrals from the emergency department to the hospital. It includes fields to record patient identification, diagnosis, and vital signs like capillary glucose, temperature, pulse, and blood pressure at three timestamps: before referral, during the referral process, and at handover to the hospital.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    FORM PECATATAN FISIOLOGI PROSEDUR EMERGENSI RUJUKAN UGD

    BULAN:......................

    TTV SAAT
    TTV PRA TTV PROSES SERAH
    NO IDENTITAS PASIEN DIAGNOSA
    RUJUKAN RUJUKAN TERIMA DI
    FKTL
    CGD: CGD: CGD:
    TD : TD : TD :
    N : N : N :
    S : S : S :
    CGD: CGD: CGD:
    TD : TD : TD :
    N : N : N :
    S : S : S :
    CGD: CGD: CGD:
    TD : TD : TD :
    N : N : N :
    S : S : S :
    CGD: CGD: CGD:
    TD : TD : TD :
    N : N : N :
    S : S : S :
    CGD: CGD: CGD:
    TD : TD : TD :
    N : N : N :
    S : S : S :
    CGD: CGD: CGD:
    TD : TD : TD :
    N : N : N :
    S : S : S :
    CGD: CGD: CGD:
    TD : TD : TD :
    N : N : N :
    S : S : S :
    CGD: CGD: CGD:
    TD : TD : TD :
    N : N : N :
    S : S : S :
    CGD: CGD: CGD:
    TD : TD : TD :
    N : N : N :
    S : S : S :
    .

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