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DataPenilaianAwalMedisRalanBedahMulut.html
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<html>
<head><link href="file2.css" rel="stylesheet" type="text/css" /><table width='4100px' border='0' align='center' cellpadding='3px' cellspacing='0' class='tbl_form'><tr class='isi2'><td valign='top' align='center'><font size='4' face='Tahoma'>RS SIMRS KHANZA</font><br>GUWOSARI, Pajangan, Bantul<br>Hp: 08562675039, 085296559963, E-mail : [email protected]<br><br><font size='2' face='Tahoma'>DATA PENILAIAN AWAL MEDIS RALAN BEDAH MULUT<br><br></font></td></tr></table>
</head>
<body>
<table width="4100px" border="0" align="center" cellpadding="1px" cellspacing="0" class="tbl_form">
<tr class="isi">
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>No.Rawat</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>No.RM</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Nama Pasien</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Tgl.Lahir</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>J.K.</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Kode Dokter</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Nama Dokter</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Tanggal</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Anamnesis</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Hubungan</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Keluhan Utama</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Riwayat Penyakit Sekarang</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Riwayat Penyakit Keluarga</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Alergi</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Keadaan Umum</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Kesadaran</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Skala Nyeri</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Tensi(mmHg)</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Nadi(x/menit)</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Suhu(°C)</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>RR(x/menit)</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>BB(Kg)</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>TB(Cm)</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Status Nutrisi</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Kulit</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Keterangan Kulit</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Kepala</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Keterangan Kepala</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Mata</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Keterangan Mata</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Leher</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Keterangan Leher</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Kelenjar</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Keterangan Kelenjar</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Dada</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Keterangan Dada</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Perut</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Keterangan Perut</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Ekstremitas</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Keterangan Ekstremitas</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Wajah</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Intra</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Gigi Geligi</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Laborat</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Radiologi</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Penunjang</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Asesmen Kerja</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Asesmen Banding</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Permasalahan</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Terapi</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Tindakan</b>
</td>
<td valign="middle" bgcolor="#FFFAF8" align="center">
<b>Edukasi</b>
</td>
</tr>
<tr class="isi">
<td valign="top">
2023/05/26/000001
</td>
<td valign="top">
000013
</td>
<td valign="top">
PARAMITA RAMADANI
</td>
<td valign="top">
1990-01-01
</td>
<td valign="top">
Laki-Laki
</td>
<td valign="top">
D0000003
</td>
<td valign="top">
dr. Qotrunnada
</td>
<td valign="top">
2023-05-28 21:28:40.0
</td>
<td valign="top">
Autoanamnesis
</td>
<td valign="top">
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</td>
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</td>
<td valign="top">
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</td>
<td valign="top">
Nyeri Tak Tertahankan
</td>
<td valign="top">
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</tr>
</table>
</body>
</html>