Resume Medis 5 Desember 2019

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PEMERINTAH KABUPATEN LUWU TIMUR

DINAS KESEHATAN
UPTD PUSKESMAS LAKAWALI
Jl. Sawerigading, Desa Lakawali, Kec. Malili, No. Hp: 0853 9400 4800
Email: pkm.lakawali@gmail.com

Resume Medis

Nama :
Tanggal Lahir/Umur :
Alamat :
Nomor BPJS :
Diagnosis :

Anamnesis & Pemeriksaan Fisik

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Tanda Vital
Waktu Tekanan Darah Frekuensi Nadi Frekuensi Pernafasan Suhu

Pemeriksaan Penunjang
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Terapi atau Tindakan Yang telah diberikan
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Rencana Tindak lanjut
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Lakawali,

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NIP.

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