You are on page 1of 3

NO DIET 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 JLH

1
T.KALORI /T.PROTEIN TKTP 0

BIASA 6 6 9 6 6 6 6 6 6 6 6 3 3 3 3 9 9 12 12 18 24 21 21 6 6 9 21 249

LUNAK 6 9 12 12 9 9 3 6 21 21 33 12 33 18 24 21 21 6 6 9 21 312

SARING 3 3 3 6 6 6 6 6 6 3 3 51

DM 0

RENDAH SISA 0

RG 0
2
DIABETES MILITUS (DM) 0

BIASA 0

LUNAK 0

SARING 0

RP 0

RG 0

RGRP 0

DMRGRCHOL 0

3 RENDAH KOLESTROL 0

4 RENDAH GARAM (RG) 0

5 RENDAH KALORI 0

6 RENDAH KALSIUM 0

7 RENDAH LEMAK 0

8 RENDAH PROTEIN (RP) 0

9 RENDAH PROTEIN RG 0

10 RENDAH PROTEIN RENDAH KALIUM 0

11 RENDAH KALIUM 0

12 RENDAH SISA 0

13 JANTUNG 0

14 LAMBUNG 0

15 HATI 0

16 HIPEREMESIS 0

17 PREEKLAMSI 0

18 FRS/SONDE 3 3 3 3 3 3 3 3 3 3 30

19 EKSTRA PUTEL 0

20 PENDAMPING ASI (0-3 BLN) 0

21 BUAH/BISKUIT(0-4 BLN) 0

22 MAKANAN LUMAT (4-6 BLN) 0

23 MAKAN LEMBEK (6-12 BLN) 0

24 ANTI DIARE/PREDA* 0

25 NUTRINIDRINK 0

26 INFANTRINI 0

27 F75 1 1 1 1 1 1 1 1 1 1 1 1 12

28 F100 0

29 SUSU* 0

30 PUASA 0

JUMLAH 0 6 9 12 18 15 18 6 6 9 9 9 9 9 9 6 9 12 30 34 46 31 52 43 55 49 49 16 13 19 46 654

KETERANGAN:

KA. INSTALASI GIZI

(Samuel Bulu, S. Gz)

NIP. 199309192019021003
DAFTAR PERMINTAAN DIET PASIEN RUANG RAWAT INAP
NO DIET 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 JLH

1
T.KALORI /T.PROTEIN TKTP 0

BIASA 0

SARING 0

DM 0

RENDAH SISA 0

RG 0
2
DIABETES MILITUS (DM) 0

BIASA 0

LUNAK 0

SARING 0

RP 0

RG 0

RGRP 0

DMRGRCHOL 0

3 RENDAH KOLESTROL 0

4 RENDAH GARAM (RG) 0

5 RENDAH KALORI 0

6 RENDAH KALSIUM 0

7 RENDAH LEMAK 0

8 RENDAH PROTEIN (RP) 0

9 RENDAH PROTEIN RG 0

10 RENDAH PROTEIN RENDAH KALIUM 0

11 RENDAH KALIUM 0

12 RENDAH SISA 0

13 JANTUNG 0

14 LAMBUNG 0

15 HATI 0

16 HIPEREMESIS 0

17 PREEKLAMSI 0

18 FRS/SONDE 0

19 EKSTRA PUTEL 0

20 PENDAMPING ASI (0-3 BLN) 0

21 BUAH/BISKUIT(0-4 BLN) 0

22 MAKANAN LUMAT (4-6 BLN) 0

23 MAKAN LEMBEK (6-12 BLN) 0

24 ANTI DIARE/PREDA* 0

25 NUTRINIDRINK 0

26 INFANTRINI 0

27 F75 0

28 F100 0

29 SUSU* 0

30 PUASA 0

JUMLAH 0

KETERANGAN:

KA. INSTALASI GIZI

(Samuel Bulu, S. Gz)


NIP. 199309192019021003

You might also like