8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

1/39

  Data Ofine Surveilans PTM berbasis F

No

1   19 November 2015

2   19 November 2015   43271-20-131 3510116805770001

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

1920

21

22

23

24

25

26

27

28

2930

31

32

33

34

35

36

37

38

3940

41

TanggalPemeriksaan *

IDENTITAS

No RekamMeis

No KTP *

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

2/39

42

43

44

45

46

47

48

49

50

xxx xxx xxx xxx

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

3/39

  TP

Nama Pasien Tem!at "a#ir Tanggal "a#ir

 YULI NESIYAM E. P BANYUAN!I

SI"I #$SAEMA P BANYUAN!I 28 M%& 1977

 $enisKelamin

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

4/39

xxx xxx xxx xxx

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

5/39

Alamat "engka! No %P No Tel!& Ruma#

'(A)AN 4*3 'ALIBA(U 'UL$N

BA(U(E)$ 2*1 'ALIBA(U MANIS

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

6/39

xxx xxx xxx

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

7/39

Status Suku Peker'aan

Me+,% )AA I("*",/% Beer%

Me+,% )AA I("*",/% Beer%

(olonganDara#

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

8/39

xxx xxx xxx xxx

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

9/39

)A)ANARA IMT

Keterangan Merokok  

 ",/% ",/% ",/% ",/% 150 55

 ",/% ",/% ",/% ",/% 150 60

KurangAktivitas

Fisik 

KurangMakan

Sa+ur

KonsumsiAlko#ol

Tinggi,aan

,erat,aan

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

10/39

xxx xxx xxx xxx xxx xxx xxx

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

11/39

Tekanan Dara# (ula Dara# Kolesterol

Sistol Diastol Trigliseria

120 80

120 80

"ingkarPerut

(ula Dara#Se-aktu

(ula Dara#Puasa

KolesterolTotal

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

12/39

xxx xxx xxx xxx xxx xxx xxx

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

13/39

"D" %D"

ArusPun.ak

Eks!irasi/APE0

KaarAlko#ol

Perna1asan

TesAm1etamin

2rin

,en'olanAbnormal

Pa+uara

Pa!Smear

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

14/39

xxx xxx xxx xxx xxx xxx xxx

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

15/39

Kriotera!i Diagnosa 3 Diagnosa 4

Po,, Y%

Po,, Y%

%asilPeriksa

I5A

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

16/39

xxx xxx xxx xxx

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

17/39

DIA(NOSA P

Diagnosa 6 Diagnosa 7 Diagnosa 8 EK(

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

18/39

xxx xxx xxx xxx

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

19/39

emeriksaan Penun'ang

Raiologi Diru'uk  Dara#

"engka!

2rin Rutin9

Mikrosko!ik 

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

20/39

xxx xxx xxx xxx

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

21/39

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

22/39

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

23/39

er,% re%mme/, +, +%m% %,r

2015-11-19   YULI NESIYA

2015-11-19 43271-20-131 3510116805770001   SI"I #$SAEM   1977-05-28

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

24/39

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

25/39

%%m% e+/er e /,%+o%1 /,%+o%2 /,%+o%3 /,%+o%4

'(A)AN 4*3 'ALIBA(U 'UL$N P

BA(U(E)$ 2*1 'ALIBA(U MANIS   P

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

26/39

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

27/39

/,%+o%5 meroo r%+%,%r%+%& m,%o b bb

2 2 2 2 150 55

2 2 2 2 150 60

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

28/39

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

29/39

,o /,%o / / %e

120 80

120 80

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

30/39

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

31/39

 o%+%& o,,,v% r,oer%, %me%r em%%,r +oerm%oo+%+/

1 1   BANYUAN!I

1 1   BANYUAN!I

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

32/39

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

33/39

% eer%%+ eer%+%+ oeeroor,,er,/%

Me+,% )AA   I("*",/%

Me+,% )AA   I("*",/%

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

34/39

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

35/39

/ / %/%r%o e%me% e r%/,oo, /%r%e+

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

36/39

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

37/39

r,+r,+ /,r

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

38/39

8/20/2019 Posbindu Kalon Hasil Iva (19.11.15)

39/39

2