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    Ahmad Zakiy Habibiy
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    anamnesis

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    © All Rights Reserved
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    24 views1 page

    Anamnesis

    Uploaded by

    Ahmad Zakiy Habibiy
    anamnesis

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    ANAMNESIS

    Nama :
    Usia : BB :
    Agama : TB :
    Suku/Asal :
    Nama Suami :
    Alamat :
    No. HP :
    Haid, Menarche : th ,Siklus : hari
    Lama Haid : hari ,HPHT/HPL :
    GPA : G P A
    Anak 1 : J.Kel : Usia: BBL:
    Keadaan: Secara: di:
    Anak 2 : J.Kel : Usia: BBL:
    Keadaan: Secara: di:
    Anak 3 : J.Kel : Usia: BBL:
    Keadaan: Secara: di:
    Perkawinan ____ Kali, Suami 1: Usia waktu kawin ____, Lama _____th
    Suami 2: Usia waktu kawin ____, Lama _____th
    Keluhan :
    ANAMNESIS
    Nama :
    Usia : BB :
    Agama : TB :
    Suku/Asal :
    Nama Suami :
    Alamat :
    No. HP :
    Haid, Menarche : th ,Siklus : hari
    Lama Haid : hari ,HPHT/HPL :
    GPA : G P A
    Anak 1 : J.Kel : Usia: BBL:
    Keadaan: Secara: di:
    Anak 2 : J.Kel : Usia: BBL:
    Keadaan: Secara: di:
    Anak 3 : J.Kel : Usia: BBL:
    Keadaan: Secara: di:
    Perkawinan ____ Kali, Suami 1: Usia waktu kawin ____, Lama _____th
    Suami 2: Usia waktu kawin ____, Lama _____th
    Keluhan :

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