formulir penilaian ohi-s
DESCRIPTION
contoh form penilaian OHI-STRANSCRIPT
FORMULIR PENILAIAN OHI-STgl. Pemeriksaan : .......................................... Nama Pemeriksa: .........................................Puskesmas / BPG / Sekolah : ......................... Kab / Kecamatan :........................................Nama Pasien: .................................................. Jenis Kelamin: .........................................Umur: ..........................................................
DEBRIS INDEXKALKULUS INDEX-
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SKOR : SKOR :
OHI-S :FORMULIR PENILAIAN OHI-STgl. Pemeriksaan : .......................................... Nama Pemeriksa: .........................................Puskesmas / BPG / Sekolah : ........................ Kab / Kecamatan :........................................Nama Pasien: .................................................. Jenis Kelamin: .........................................Umur: .........................................................
DEBRIS INDEXKALKULUS INDEX-
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SKOR : SKOR :
OHI-S :