Patient Information

: : : :
: : : :
: : : :
: :

Diagnosis Information

Diagnosis : Category : Location:                              Delete
Diagnosis : Category : Location:                              Delete

Contact Information

: : : :

Document Information

Photo: Delete
Photo Labo Imagine Anapath Other

Patient IPD

Date In:                      Date Out:                      Remark:   Delete

Surgery Information

       2013-12-11   Delete
Surgery Procedure:       Paraclinic Confirmed: Date:        
Medicine:        
Protocol:         
       2017-06-22   Delete
Surgery Procedure:       Paraclinic Confirmed: Date:        
Medicine:        
Protocol:         

Follow Up

       2017-06-21   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2017-06-22   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2017-06-25   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2017-06-28   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2017-07-01   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2017-07-04   Delete
Date :       BP : /       Puls :         T° :       RR :