ASUHAN KEBIDANAN PADA IBU HAMIL

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Tanggal Masuk :………………………………………….. Pukul :…………………

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I. IDENTITAS
Nama Ibu : ……………………………. Nama Suami :……………...........
Umur :……………………………… Umur :………………………
Pendidikan :……………………………… Pendidikan :………………………
Pekerjaan :……………………………… Pekerjaan :………………………
Agama :…………………………….. Agama :………………………
Golongan Darah :…………………………….. Golongan Darah :………………………
Alamat :………………………………………………………………………………………………….

A. SUBJEKTIF
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B. OBJEKTIF
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C. ANALISA

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D. PENATA LAKSANAAN

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TASIKMALAYA,.……………………..
BIDAN

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