11. formulir asesmen prasedasi (2)
Post on 13-Dec-2015
41 Views
Preview:
DESCRIPTION
TRANSCRIPT
RSUD dr. FAUZIAH BIREUEN UNIT PRE OPERASI Jln. Mayjen T. Hamzah Bendahara No. 13
ASESMEN PRASEDASI
Nama :
No. RM :
Tgl. Lahir : □ Laki-laki □ Perempuan
ANAMNESA:............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
PEMERIKSAAN PENUNJANG:..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................
DIAGNOSA KLINIS:..........................................................................................................................................................
RENCANA TINDAKAN:..........................................................................................................................................................
PRE MEDIKASI: ..........................................................................................................................................................
JENIS ANASTESI DIRENCANAKAN:..........................................................................................................................................................
KESIMPULAN/ INTERVENSI.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Bireuen, .......................... 2015
(.......................................) DPJP Anastesi
TECKONG/DOK/PAB/DR.FAUZIAH/2015
TECKONG/DOK/PAB/DR.FAUZIAH/2015
top related