Download as rtf, pdf, or txt
Download as rtf, pdf, or txt
You are on page 1of 1

Nuniek Nugraheni, dr., Sp.

KFR(K), 1535/KEPK/IX/2019, Efek Threshold Inspiratory Muscle Training Terhadap


Kapasitas Fungsional, VC, FVC, Dyspneu Borg Scale, Kadar TNF-α dan Kadar HsCRP Pada Pasien Gagal Jantung
Kronis di RSUD Dr Soetomo Surabaya

Subject Initials Subject ID Date: / /


Month Day Year

Medical History (General)


Onset
Body System Diagnosis/Condition/Surgery
Date
Or
Cardiovascular

Pumonary

Genitourinaria

Gastrointestinal

Nervous

Skin

MEDICAL HISTORY OBTAINED BY: dr.Wahyu SIta /dr.Oka

You might also like