Data Pasien:

Formulir B, (Khusus Pasien Operasi)

Pasien baru
Ruang/Unit: Bulan
Tanggal Nama Jenis Umur Med rec Dokter
NO kelami
n
11/1/2018 tn ahmad tohir laki 52th dr herman

1
11/1/2018 an reyhan laki 4th dr herman

2
11/1/2018 an dhea pr 7th dr herman

3
11/3/2018 ny lutfi pr 18 dr didik

4
 11/6/2018 Tn Andri yupiter laki 24th dr
Hermawan

5
11/6/2018 ny dewi pr 34th dr Hasan
handayani

6
11/6/2018 ny stevani pr 31th dr Herman

7
11/6/2018 tn Ari laki 26th dr herman

8
11/6/2018 ny bartinah pr 51th dr herman

9
 11/8/2018 tn miswanto laki 59th dr herman

10
11/8/2018 an dwi rahma pr 12th dr herman

11
11/8/2018 ny dian herliyanti pr 32th dr herman

12
11/9/2018 tn soleh laki 61th dr herman

13
11/10/2018 ny harwanti pr 36th dr didik

14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Pasien baru
Tahun
Tindakan

post amputasi 1/3 distal + carpal + debridement a/i femur dextra gangren pedis +
cruris dextra combustio + DM tipe 2 + sepsis

sircumsisi + release adhesi ... + enoucnusi spegma a/i pymesis + spegma retensio

post apendektomy a/i apendisitis akut

P1Ap post SC a/i CPD

post CWL a/i rinositis kronis

P3A0 post SC a/i bekas SC 1x

post hemoraidektomy a/i hemoroid intesna gr IV + hemporoid eksterna + G2P1A0

Hamil 32 minggu

post necrotomy + debridement + drainage a/i abses auricula sin

post eksisi + biopsi a/i tumor mamae sinistra

post necrotomy + debridement a/i abses posterior dektra ec DM tipe II

post eksisi + biopsi + recontruksi a/i tumor zyigomaticum dextra

post eksisi + biopsi a/i susp.... Atr colli anterior sinistra

post eksis radical + rekontruksi dg ... a/i tumor .... Sinistra

P3A0 post SC a/i Oligohidronium