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    6 views1 page

    IGD BIDAN Baru

    Uploaded by

    dellaindahwati7

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    KLINIK PERMATA BUNDA II

    Jl. Provinsi Sebamban II RT.08 RW.01, Desa Mekar Jaya


    Kec. Angsana Kab. Tanah Bumbu
    Telp. 0853-5084-4873

    STATUS PASIEN KEBIDANAN

    Nama : ………………………………… Tanggal/Jam :…………………………….............


    Alamat : ………………………………… Umur Kehamilan : …………………………………...
    Umur : ………………………………… Ketuban Pecah : …………………………………….
    No Telp : ………………………………... HIS sejak pukul : ………...………………………….
    G P A Umur Anak Terakhir : ………...………………………….
    HPHT : ………………………………... HPL : ………...………………………….

    Anamnesa :
    ……………………………………………………………………………………………………………………..
    ……………………………………………………………………………………………………………………..
    Tanda-tanda vital :
    Tekanan Darah : ................................ mmHg Suhu : ................................ oC
    Nadi : ................................ x/menit Respirasi : ................................ x/menit
    Berat Badan : ................... Kg Saturasi : ............................... %
    Pemeriksaan Fisik dan Pemeriksaan Dalam :

    L1 :…………………………………………DJJ :………………………………………TBJ :…………………………………..


    L2 :…………………………………………TFU :…………………………………………………………………………..
    L3 :…………………………………………VT :…………………………………………………………………………..
    L4 :…………………………………………HIS :…………………………………………………………………………..
    Lain-lain:.................................................................................................................................................................................
    ……………………………………………………………………………………………………………………..
    ……………………………………………………………………………………………………………………..
    ……………………………………………………………………………………………………………………..
    ……………………………………………………………………………………………………………………..
    ……………………………………………………………………………………………………………………..
    .
    Diagnosa : …………………………………………………....................................................................................

    Terapi / Tindakan :

    ……………………………………………………………………………………………………………………..
    ……………………………………………………………………………………………………………………..
    ……………………………………………………………………………………………………………………..
    ……………………………………………………………………………………………………………………..
    Sebamban II,…………….,20

    ……………………………

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