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    Evi Aryani

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    Avrind Karo
    This document is a referral letter from a primary care physician referring a 20-year-old pregnant patient named Evi Aryani to an OBGYN specialist for further examination and treatment of "Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and (O99)". The referral is valid for a single visit until January 13, 2024.

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    Evi Aryani

    Uploaded by

    Avrind Karo
    12 views1 page
    This document is a referral letter from a primary care physician referring a 20-year-old pregnant patient named Evi Aryani to an OBGYN specialist for further examination and treatment of "Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and (O99)". The referral is valid for a single visit until January 13, 2024.

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    This document is a referral letter from a primary care physician referring a 20-year-old pregnant patient named Evi Aryani to an OBGYN specialist for further examination and treatment of "Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and (O99)". The referral is valid for a single visit until January 13, 2024.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    12 views1 page

    Evi Aryani

    Uploaded by

    Avrind Karo
    This document is a referral letter from a primary care physician referring a 20-year-old pregnant patient named Evi Aryani to an OBGYN specialist for further examination and treatment of "Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and (O99)". The referral is valid for a single visit until January 13, 2024.

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    of 1

    Kedeputian Wilayah KEDEPUTIAN WILAYAH XI

    Kantor Cabang ENDE

    Surat Rujukan FKTP

    No. Rujukan : 240908041023P000108

    *240908041023P000108*
    FKTP : KOTA BAJAWA(24090804)
    Kabupaten / Kota :
    KAB. NGADA(0253)

    Kepada Yth. TS Dokter : OBGYN

    Di : RSUD BAJAWA

    Mohon pemeriksaan dan penangan lebih lanjut pasien :

    Nama : evi aryani Umur : 20 Tahun : 20-Feb-2003

    No. Kartu BPJS : 0003545539391 Utama/Tanggunan


    Status : 3 P (L / P)
    Diagnosa : Other maternal diseases classifiable elsewhere but
    complicating pregnancy, childbirth and (O99)
    Catatan :

    Telah diberikan :

    Atas bantuannya, diucapkan terima kasih Salam sejawat,


    16 October 2023

    Tgl. Rencana Berkunjung : 16-Oct-2023

    Jadwal Praktek : Senin : 08:00 - 14:00


    ADELHEID EMILIA
    Surat rujukan berlaku 1[satu] kali kunjungan, berlaku sampai dengan : 13-Jan-2024 KARSINA,A.Md.Keb

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