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DataChecklistKriteriaKeluarHCU.html
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DataChecklistKriteriaKeluarHCU.html
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<html>
<head><link href="file2.css" rel="stylesheet" type="text/css" /><table width='2500px' 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 : khanzasoftmedia@gmail.com<br><br><font size='2' face='Tahoma'>DATA CHECK LIST KRITERIA KELUAR HCU<br><br></font></td></tr></table>
</head>
<body>
<table width="2500px" border="0" align="center" cellpadding="1px" cellspacing="0" class="tbl_form">
<tr class="isi">
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>No.Persetujuan</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>No.Rawat</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>No.R.M.</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Nama Pasien</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Umur</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>J.K.</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Tgl.Lahir</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Tanggal</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Kode</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Penolakan Anjuran</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Alasan Penolakan</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Risiko Penolakan</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Nama Penanggung Jawab</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Umur P.J.</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Nomor KTP P.J.</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>J.K. P.J.</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Nomor Telp/HP</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Hubungan</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>NIP</b>
</td>
<td valign="middle" bgcolor="#FFFAFA" align="center">
<b>Nama Petugas</b>
</td>
</tr>
<tr class="isi">
<td valign="top">
PAM20230618001
</td>
<td valign="top">
2023/06/10/000002
</td>
<td valign="top">
000005
</td>
<td valign="top">
ROBY ALAMSYAH
</td>
<td valign="top">
36 Th
</td>
<td valign="top">
L
</td>
<td valign="top">
1986-07-20
</td>
<td valign="top">
2023-06-18 12:59:24.0
</td>
<td valign="top">
003
</td>
<td valign="top">
Anjuran Tindakan Medis
</td>
<td valign="top">
1
</td>
<td valign="top">
2 asasa
</td>
<td valign="top">
3
</td>
<td valign="top">
4
</td>
<td valign="top">
5
</td>
<td valign="top">
L
</td>
<td valign="top">
6
</td>
<td valign="top">
Suami
</td>
<td valign="top">
D0000004
</td>
<td valign="top">
dr. Hilyatul Nadia
</td>
</tr>
</table>
</body>
</html>