Form Odontogram

August 13, 2022 | Author: Anonymous | Category: N/A

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INSTALASI KEDOKTERAN FORENSIK DAN MEDIKOLEGAL RSU Dr. SOETOMO SURABAYA

NIM. 0720111010

KARTU IDENTITAS GIGI DAN MULUT I. Nama Kelamin Umur Agama Pekerjaan Alamat

: : : : : :

II. Hasil Pemeriksaan

PEMERIKSAAN RO FOTO Kelainan : a. Protrusi ra rb b. Retrusi ra rb c. Gigitan terbuka Gigitan dalam Gigitan silang

PERNAH / TIDAK

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