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PEMERINTAH KOTA PALOPO

RSUD SAWERIGADING PALOPO


JL. DR. Ratulangi KM.7 Rampoang, Kode Pos 91914
Telp (0471) 3312133 Fax (0471) 3312144
Email. Rsu.swg@gmail.com Website. http://rsudswg.palopokota.go.id

RESULT OF MADICAL CHECK UP

Name : SAYIR ALWI


Sex : MALE Reg. Number : 2303180069
Birth Date : March 02, 1993 Date Issue : March 18, 2023
3x4
Height : 158 cm Nationality : Indonesian
Weight : 51 Kg Company : METRO TEAM LIMITED

Put Mark () Put Mark (X) Abdnormal

History of illness :

Eye Serelogy
Skin Diseaces ( )
RighEye ( ) Blood Type : ( )
Left Eye ( ) Blood Pressure ( )
Ears VDRL ( )
Righ Ear ( ) Abdomen TPHA ( )
Left Ear ( ) Hernia ( ) HbsAg ( )
Internal Diseases Tumor ( )
X-Ray ( )
Heart ( ) Urinalysis
Lungs ( )
Protein ( ) Pregnancy Test ( )
Liver ( )
Reduction ( )
Spleen ( )
Bilirubin ( ) Other Disease ( )
Kidney ( )

Dear Sir,
Mentioned above is the medical report Mr. SAYIR ALWI
He Is FIT for the mentioned job Chief Physician

Expired :

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