Form Monitoring GDS

August 9, 2022 | Author: Anonymous | Category: N/A
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Monitoring Gula Darah Sewaktu  Nama : Tanggal Lahir :

No. RM Regimen Insulin

Pagi Tanggal

GDS sblm mkn

gr KH

Siang

Insulin

GDS

GDS

+ koreksi

2jm stlh mkn

sblm mkn

Form yang telah diisi harap difotokopi dan dibawa saat kontrol

gr KH

: :

Malam

Insulin

GDS

GDS

+ koreksi

2jm stlh mkn

sblm mkn

gr KH

Insulin

GDS

+ koreksi

2jm stlh mkn

GDS Malam

Keterangan

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