PENDAFTARAN KAMAR OPERASI
PENDAFTARAN
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Nomor Rekam Medik *
Nama Pasien *
Tanggal Lahir *
MM
/
DD
/
YYYY
Alamat Pasien *
Ruangan *
Nama DPJP *
Diagnosa
Waktu Operasi *
MM
/
DD
/
YYYY
Time
:
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