ASUHAN KEPERAWATAN PADA PASIEN.............

DENGAN................................................................................................
DI RUANG................................. RSUD
TANGGAL....................................................

I. PENGKAJIAN
A. Identitas Pasien
Nama :………………………………………………………………….
No RM :………………………………………………………………….
Umur :………………………………………………………………….
Jenis Kelamin :………………………………………………………………….
Pekerjaan :………………………………………………………………….
Agama :………………………………………………………………….
Status :………………………………………………………………….
Tanggal MRS :………………………………………………………………….
Tanggal Pengkajian :………………………………………………………………….

B. Keluhan Utama
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C. Riwayat Kesehatan
1. Riwayat Kesehatan Dahulu
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2. Riwayat Kesehatan Sekarang

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3. Riwayat Kesehatan Keluarga

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