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    Traveling Pasien HD Eni Roza

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    hemodialisa rsudbatusangkar
    This document is a travel authorization letter for hemodialysis for a patient named Ny. Eni Roza. It provides key medical details about the patient including their diagnosis of CKD Stage V, hemodialysis treatment schedule of twice per week, last dialysis treatment on August 1, 2023, and medical clearance for travel dialysis with no noted complications from previous treatments. The authorizing physician is Dr. Hadianto.

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    Traveling Pasien HD Eni Roza

    Uploaded by

    hemodialisa rsudbatusangkar
    6 views1 page
    This document is a travel authorization letter for hemodialysis for a patient named Ny. Eni Roza. It provides key medical details about the patient including their diagnosis of CKD Stage V, hemodialysis treatment schedule of twice per week, last dialysis treatment on August 1, 2023, and medical clearance for travel dialysis with no noted complications from previous treatments. The authorizing physician is Dr. Hadianto.

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    TRAVELING PASIEN HD ENI ROZA

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    This document is a travel authorization letter for hemodialysis for a patient named Ny. Eni Roza. It provides key medical details about the patient including their diagnosis of CKD Stage V, hemodialysis treatment schedule of twice per week, last dialysis treatment on August 1, 2023, and medical clearance for travel dialysis with no noted complications from previous treatments. The authorizing physician is Dr. Hadianto.

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    © All Rights Reserved
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    6 views1 page

    Traveling Pasien HD Eni Roza

    Uploaded by

    hemodialisa rsudbatusangkar
    This document is a travel authorization letter for hemodialysis for a patient named Ny. Eni Roza. It provides key medical details about the patient including their diagnosis of CKD Stage V, hemodialysis treatment schedule of twice per week, last dialysis treatment on August 1, 2023, and medical clearance for travel dialysis with no noted complications from previous treatments. The authorizing physician is Dr. Hadianto.

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    of 1

    PEMERINTAH KABUPATEN TANAH DATAR

    RUMAH SAKIT UMUM DAERAH


    PROF. DR. M. ALI HANAFIAH SM BATUSANGKAR
    JALAN BUNDO KANDUNG No.1 BATUSANGKAR
    Telp/Faks (0752) 71008 Website www.rsud.tanahdatar.go.id
    Email rsud.hanafiah@yahoo.com, rsud.hanafiah31@gmail.com

    SURAT PENGANTAR HEMODIALISIS


    (TRAVELING DIALISIS)

    Nama Pasien
    Ny. ENI ROZA
    Name
    Tanggal Lahir Day of Birth 05-05-1973 (50)
    Alamat
    V KAUM, KAB TANAH DATAR
    Recent Address
    Diagnosis Diagnosis CKD Stage V
    Hemodialisis Terakhir Last
    1 Agustus 2023
    Dialysis
    Frekuensi Hemodialisis Number
    2x/weeks [SELASA DAN JUMAT SIANG]
    of runs per week
    Mesin Hemodialisis Dialysis
    Fresenius 4008S
    machine
    Dialyzer
    F8HPS
    Dialyzer
    Jenis Dialisat
    Bicarbonate
    Composition of Dialysate
    QB/QD
    150-200 ml/min /500
    Blood Flow Rate
    Lama Hemodialisis Time
    4,5 hours
    Dialysis
    Heparinisasi Heparinization Standard dosis
    Akses Vaskular Blood access CDL
    HbsAg Non reactive
    Anti HCV Non reactive
    Anti HIV Non reactive
    Penyulit HD
    -
    Complication with dialysis run
    Berat Badan Kering (BBK)
    OBSERVASI
    Patient’s dry weight
    Tekanan Darah
    140/90 mmHg
    Blood Pressure Status
    Hasil Laboratorium Laboratory
    Terlampir
    Data
    Transfusi Darah Terakhir Last
    -
    Blood Transfusion
    Lain-lain Others -

    Batusangkar, 1 Agustus 2023

    Dr. HADIANTO, Sp.PD FINASIM


    SIP/10/Yankes/VI/2018

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