OB - IGD - Pandan Wangi - Paini - 59 - 13039172 - 2.

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Ny. PAINI No. RM : 13039172 (P) - 19/09/1964 JL MANGGIS NO 40 RD2310080026 \ Baie aes wii PERSETUJUAN UMUM SAAT MASUK RUMAH SAKIT (MRL, me te a i eee ge - “Bl indiggs< 0.0" er '26, aed 2.” Wage Taman, Sidenejo. eg Ghisnaeye=- aay nomaomentain ows ‘Cus Ci” laa Compe” Cian man ae tc rn Cra CrUn IU) He Care ne 1) Is ennve Con Pea aneCa Unt Es ae usta Aner) i A LN | ze oa 08: EY FA eta HEH \ZO RAPT Ta pw ie 05 taage “Tamian Gidearye orp Bis: 9bbe aESre Examen Passe retin ASLO Sonn ah Da ‘Scremenraperonno on dno rah abana aan ann aban Neda saan seniaan ogni ponracan to an ravamrs Pesca emmys tan apenas pee Sean not trenton ongmem rng. ong Sata amo prions een ah Sah ret don sth roa Func a nan an rk erry ferns an ergata mln “ta na mmauan ua nengentnpertn na un Pat. 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