Ns x - u Siloam's , eseles Student Record Lembar Kasus Bagian Kulit dan Kelamin DermatoVenerology Case Sheet Status Lengkap / Complete Status Identitas Pasien / Patient Identity inisial Pasien’ Patient initial murano cunt Ket Sx cee une Tanggal Lahr 08 Peers ere Status Perkawinan) Maral Status HNN ‘Agama | Religion \slam, Pendidikan / Educational Status Namat Adtroes Ketarga Yang Bisa Ding / Family Contact Number Pekejaan ! Occupation F Maret 3023 Jam/"Time : Tanggal Masuk RS / Date of Admission ‘Tanggal Pemeriksaan / Date of Examination = \? Moret 2023 Jam/Time : ’Autoanamnesis — Alloanamnesis dai... W/Autoanamnesis © Alloanamnesis from... ‘Tanggal Pulang / Date of Discharge £(% Movet 2003 Jam /Time : Anamnesis : Keluhan uama / Chief complaints Gatal pada purtggure tati dun sela errr ket i bean Seat & buon laty Riayat penyakd sckarang/ Present history Duraguag kati clon selojari Labi karan terasa getal Sept 2 bulan laly Pesiee pwengglartan yer dan oereak pel, pUroyns chin Selo pet tat! Yonan eat 3 hun lala. Dasien Wrengaky menggaruk dan terjad (uka Cada babi posie | han SHES. Pasion wengatu sering mangguratan Kaus tabi fianya untuk hebutun pencahan |For educational purpose only yeing tebal dan jarany dicuct STH 103.001MEDICINE | Smee ™* ones Silo | student Record | rion Past history , laben. i Pie menage ae TT es ghelumrypr Mier ya Gleb poser o © Rivayar ag! ape Wry dicanyeet leh pat dlaal~ nap yon ae fertonterl - Ginny entiv emails rugeye fasion vayat Sosial (ket Social history oe en sil (ke tei ie es aise pocion moved ap Solr asien aber} Ar banter Saunger hd promot Fas Gat ae int jada od Yn) pasmilibr bdubow vot kluarg / Fam to” Riva sien pensyt Lele FOborgrnys genuper = Riwcynh eneliag Manse dan oro. tnepht disang fat lal pases Riwayat alergi / Allergic history: = Rasen raanayeneyPal pivuigat Iobanan glo obat baton , Rivwayat pengobatan / Meet history: = Yasin Aelah nertytieet koluhnny wenggynertan trim sterel ee aida pore ‘Ean Yi) cigaifitan cAnstsORe, nawwl” ne Pemeriksaan Fsik/ Physical Examination + Pemertsaan uum / General examination: comps wets, GCS +B. 4. M &.. v.S. Kesadaran / consciousness Tekanan darah / blood pressure + 149/70 tam Hee Nadi pulse 2 yer /monil i ‘Suhu/ Temperature BA anya untuk ebtuan pendian For edcatonlpupese ony TH 103.0971 ie ayey Facuy PF Student Recon 2 4 Kepala da an Leher _ Head & Necy Kepab / Heag \ ee oli, telat : Fock, cies Tetene on Sect og pn * Renprypn ands oy Leher Neck sc, TINeck + LABORATORIS : Ge Kerokan Kat — oe teresurg | (Saas | com Tinta Cina rou “Tht Mets He Pemeriksaan Sekret Pemeriksaan Histopatologi_ Biopsi Kulit Reiz Serum salt (= ¥ dept for pads ceva et ine digi + 7 dey fe texjo gen mulzan Yasar base , dlisee Vsked perttes legos, yo Urs (4), ¢ lak entema, setter, berttum Smama (4), brste (4) ety tonal purpose seni For eden pron ot un rebutuhan Hanya on me ——_——_—MEDI b= er ue nis tals srudent Record is tet piagnosis Bandi! pigferential Dias a Dart bate Oe peor Diagnosis Kerja / Working piagnosis + Tinea tells (CAso-atot + $e periiaan Masala! Problems mapping : | ie egies ain ma inner pen vet el yp Sule Culcug o"* ugg take banan Sikawera ba en Serine, morgger “a Ae ee ere rece tse teri ner bins pian eer ain fasion OS Cte, em sult —p AVaST Ke stretun beenew™ - botonisast lita ren crapl) sf Hello Terattitie > Cee peradenger Onl Cizitaay cin 2x 200 My: /pen' ‘po sendiah +h ‘adem disiet & 2x 2s Me / Beat cach pokey + na WSU _Ma | hast, : eae “ te iS Ma Leet (Pe Seretl ae yroton__-taal ar iar oF — a area “yang, satel, Pa! Pen et i et... | i J Wrettonazote too mg 2*1 Selemnen | pdsanam Ditin ot ero 2 hci ~ Terbiraging 5g 2*( (os pis tis) Advitam Pen. Ad tosmetikam Yuba ae hence Nama dan ttd mahasiswa/Seudent sr ceptor/Preceptor dent's name and signature Pre 7 ‘plo! (Trays Frvan bidagar 0 ( d etcene i ects cmihes fu cs feeds 7 smear |