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    6 views1 page

    Formulir Lab Bidan

    Uploaded by

    sari

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    © All Rights Reserved
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    PUSKESMAS LOKPAIKAT PUSKESMAS LOKPAIKAT

    FORMULIR PEMERIKSAAN LABORATORIUM FORMULIR PEMERIKSAAN LABORATORIUM

    Nama : Nama :
    Umur : Tanggal : Umur : Tanggal :
    Alamat: Alamat:
    Hemoglobin gr/dl Hemoglobin gr/dl
    Skrining HIV Non Reaktif / Reaktif Skrining HIV Non Reaktif / Reaktif
    Syphilis Non Reaktif / Reaktif Syphilis Non Reaktif / Reaktif
    HBsAg Non Reaktif / Reaktif HBsAg Non Reaktif / Reaktif
    Protein Urine Negatif / 1+ / 2+ / 3+ Protein Urine Negatif / 1+ / 2+ / 3+
    Glukosa Urine Negatif / 1+ / 2+ / 3+ Glukosa Urine Negatif / 1+ / 2+ / 3+
    Pemeriksa, Pemeriksa,

    PUSKESMAS LOKPAIKAT PUSKESMAS LOKPAIKAT


    FORMULIR PEMERIKSAAN LABORATORIUM FORMULIR PEMERIKSAAN LABORATORIUM

    Nama : Nama :
    Umur : Tanggal : Umur : Tanggal :
    Alamat: Alamat:
    Hemoglobin gr/dl Hemoglobin gr/dl
    Skrining HIV Non Reaktif / Reaktif Skrining HIV Non Reaktif / Reaktif
    Syphilis Non Reaktif / Reaktif Syphilis Non Reaktif / Reaktif
    HBsAg Non Reaktif / Reaktif HBsAg Non Reaktif / Reaktif
    Protein Urine Negatif / 1+ / 2+ / 3+ Protein Urine Negatif / 1+ / 2+ / 3+
    Glukosa Urine Negatif / 1+ / 2+ / 3+ Glukosa Urine Negatif / 1+ / 2+ / 3+
    Pemeriksa, Pemeriksa,

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