Form Sbar

August 11, 2022 | Author: Anonymous | Category: N/A

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PEMERINTAH ACEH TAMIANG

LEMBAR KOMUNIKASI SBAR

DINAS KESEHATAN UPTD PUSKESMAS SERUWAY l. TemenggongKampungTangsi Lama KecamatanSeruwayKodePos 24473 Email : [email protected]

S SITUATION

Pelapor: Nama Pasien : Umur : Alamat : Keluhan

B

Penerima Laporan: dr.

:

Riwayat Penyakit:

BACKGROUND

Riwayat Penggunaan Obat:

Riwayat Alergi:

Pemeriksaan Tanda Vital: TD: HR:

RR : Temp:

A ASSESSMENT

R RECOMMENDATION

Paraf Dokter

Paraf Perawat

Tanggal : Pukul :

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