Form Penjaringan TB

August 2, 2022 | Author: Anonymous | Category: N/A
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Form Penjaringan Suspek TB

Gejala Klinis TB (*) No. Nama Lengkap

Alamat

Note :  * = Beri tanda checklist (√)

No. Telp / HP

Batuk > terus menerus 2 mgg

Keringat malam

Riw. Kontak

Demam Dem am BB tturu urun n nafsu makan serumah dengan pasien TB (*) turun

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