Contoh Pelaporan Formulir Nilai Kritis

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PELAPORAN HASIL KRITIS LABORATORIUM RSKD IA SITI FATIMAH MAKASSAR BULAN : TAHUN : TGL

NAMA PASIEN

DOKTER PENGIRIM

HASIL PEMERIKSAAN

JAM KELUAR HASIL

JAM HASIL DILAPORKAN

PELAPOR HASIL

PENERIMA LAPORAN/HASIL

TINDAK LANJUT

KET

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