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8/16/2019 FORMREFLEKSIKASUS (4) 2 http://slidepdf.com/reader/full/formrefleksikasus-4-2 1/3 FORM REFLEKSI KASUS FAKULTAS KEDOKTERAN UNIVERSITAS ISLAM INDONESIA  _____________________________________________________________________________________________ Nama Dokter Muda : Resty Praharimbi NIM: 08711144 Stase : Identitas Pasien Nama / Inisia : !n"D No RM : #mur : 1$ tahun %enis keamin : aki aki Dia&nosis/ kasus : P'( Pen&ambian kasus )ada min&&u ke:**+******* %enis Re,eksi: in&kari yan& sesuai -minima )iih . as)ek untuk as)ek keIsaman si,atnya a2ib3 a" eIsaman5 b" 6tika/ mora " Medikoe&a d" Sosia 6konomi e" !s)ek ain Form uraian 1" Resume kasus yan& diambi -yan& meneritakan kondisi en&ka) )asien/ kasus yan& diambi 3" Page 1

FORMREFLEKSIKASUS (4) 2

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FORM REFLEKSI KASUS

FAKULTAS KEDOKTERAN UNIVERSITAS ISLAM INDONESIA

 _____________________________________________________________________________________________ 

Nama Dokter Muda : Resty Praharimbi NIM: 08711144

Stase :

Identitas Pasien

Nama / Inisia : !n"D No RM :

#mur : 1$ tahun %enis keamin : aki aki

Dia&nosis/ kasus : P'(

Pen&ambian kasus )ada min&&u ke:**+*******

%enis Re,eksi: in&kari yan& sesuai -minima )iih . as)ek untuk as)ek keIsaman si,atnya a2ib3

a" eIsaman5

b" 6tika/ mora

" Medikoe&a

d" Sosia 6konomi

e" !s)ek ain

Form uraian

1" Resume kasus yan& diambi -yan& meneritakan kondisi en&ka) )asien/ kasus yan& diambi 3"

Page 1

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." atar beakan& /aasan ketertarikan )emiihan kasus

$" Re,eksi dari as)ek etika mora /medikoe&a/ sosia ekonomi beserta )en2easan evidence / re,erensi yan&

sesuai 5

5)iihan minima satu

4" Re,eksi keIsaman beserta )en2easan evidence / re,erensi yan& sesuai

Page 2

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