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DataSatuSehatClinicalImpression.html
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DataSatuSehatClinicalImpression.html
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<html>
<head><link href="file2.css" rel="stylesheet" type="text/css" /><table width='1700px' border='0' align='center' cellpadding='3px' cellspacing='0' class='tbl_form'><tr class='isi2'><td valign='top' align='center'><font size='4' face='Tahoma'>RS SIMRS KHANZA</font><br>GUWOSARI, Pajangan, Bantul<br>Hp: 08562675039, 085296559963, E-mail : [email protected]<br><br><font size='2' face='Tahoma'>DATA PENGIRIMAN SATU SEHAT CLINICAL IMPRESSION<br><br></font></td></tr></table>
</head>
<body>
<table width="1700px" border="0" align="center" cellpadding="1px" cellspacing="0" class="tbl_form">
<tr class="isi">
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Tanggal Registrasi</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>No.Rawat</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>No.RM</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Nama Pasien</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>No.KTP Pasien</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Stts Rawat</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Stts Lanjut</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Tanggal Pulang</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>ID Encounter</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Keluhan/Subjek/Objek</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Asesmen/Clinical Impression</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Petugas/Dokter/Praktisi</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>No.KTP Praktisi</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Tanggal</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Jam</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>ID Clincial Impression</b>
</td>
</tr>
</table>
</body>
</html>