Form Askep Keluarga

 

BNYLMQ SDK@FMEOMK FDHTMY@M O. AMQM TLTL =. Kmlm Fdpmhm Fdhumr`m 9. Mhmlmt amk Qdhdpnk :. Fnlpnsoso Fdhumr`m

 Kn

Kmlm

Edkos Fdhmlok

5 5 5 Guiuk`mk

Qdlpmt Qmk``mh

FF 

Hmgor 

=. 9. :. 1. 4.

@dkn`rml

Fdtdrmk`mk

5

1.

Qopd Fdhumr`m

5

4.

Zufu

5

2. 0.

M` M`mlm Ztmtus Znsdf Fdhumr`m

5 5

7.

Mftovotms Yd Ydfrdmso Fd Fdhumr`m

5

OO. Yowmymt amk Qmgmp Sdrfdlimk`mk Fdhumr`m

?.

Qmgmp Sdrfdlimk`mk fdhumr`m smmt oko

5

=3.

Qmgmp Fdhumr`m Qdrpdkugo

5

==.

Yowmymt Fdhumr`m Okto

Sdrfdlimk`mk _mk` Idhul

5

Sdfdremmk

Sdkaoaofmk

 

=9.

Yowmymt sdidhulkym

Fdhumr`m

5

OOO. Hok`fuk`mk

=:.

Fmrmftdrostof Yulmg

5

=1 =1..

Fmrm Fmrmft ftdr dros osto tof f Qd Qdtm tmk` k``m `m amk amk Fnlukotms YP

5

=4.

Lniohotms @dn`rm rmbbo Fdhumr`m

5

=2. =2.

Sd Sdrf rfu ulpuh lpuhmk mk Fdh dhum umr` r`mm amk Oktdrmfso Adk`mk Lmsymrmfmt

5

=0.

Zostdl Sdkaufuk` Fdhumr`m

5

OR. Ztruftur Fdhumr`m =7. Snhm Fnlukofmso Fdhumr`m

5

=?.

Ztruftur Fdfumtmk Fdhumr`m

5

93.

Ztruftur Sdrmk

5

9=.

Kohmo amk Knrlm Iuamym

5

R. Buk`so Fdhumr`m

99.

Buk`so Mbdftob

5

9:.

Buk`so Znsomhosmso

5

91.

Buk`so Ydprnaufso

5

94.

Buk`so Dfnknlo

5

92.

Buk`so Sdrmwmtmk Fdhumr`m

5

RO. Ztrdss amk Fnpok` Fdhumr`m

90.

Ztrds Emk`fm Sdkadf

5

97.

Ztrds Emk`fm Smkemk`

5

9?.

Fdlmlpumk Fdhumr`m Idrdspnk Qdrgmamp Lmsmhmg

5

ROO. Gmrmpmk Fdhumr`m tdrgmamp Sdhmymkmk Fdsdgmtmk

 

ROOO. Sdldrofsmmk Bosof  m. Sdld Sdldro rofs fsmm mmk k Tlul Tlul

Gmsoh Sdldrofsmmk Bosof 

Zostdl Quiug Zostdl Ydspormso Zostdl fmraonvmsfuhdr

YY < GY < Q/A < Fnkeukjtovm <

YY < GY < Q/A < Fnkeukjtovm <

Zostdl Ydprnaufso Zostdl Oktd`uldk Zostdl Lusfuhnsfdhdtmh Zostdl Trokmrom Zostdl @mstrnoktdstokmh

Yowmymt Olukosmso i.

Sdl dldr drof ofsm smmk mk Fgus Fgusus us

Sdldrofsmmk…….. Q/A GY  QI II Fdhugmk Ttmlm

5 5 5 5

Yowmymt Sdkymfot Zdfmrmk`

5

Yowmymt Sdkymfot Fdhumr`m

5

YY < GY < Q/A < Fnkeukjtovm <

YY < GY < Q/A < Fnkeukjtovm

YY < GY < Q/A < Fnkeukjtovm

<

<

 

Yowmymt Sdk`nimtmk

5