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    Hamar

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    of 1

    Divisi Regional REGIONAL VII - SURABAYA

    Kantor Cabang PAMEKASAN

    Rujukan Puskesmas / Dokter Keluarga

    No. Rujukan : 133621010217Y000057


    Puskesmas/Dokter Keluarga : GAYAM Kode : 13362101
    Kabupaten/Kota : KAB. SUMENEP Kode : 0209

    Kepada Yth. TS dr. Poli : Poli Bedah

    Di RSU : RSUD SUMENEP

    Mohon pemeriksaan dan penanganan lebih lanjut penderita :

    Nama : abd. hamar Umur : 75 Tahun 29-May-1941

    No. Kartu BPJS : 0000781838447 Status : 1 Utama/ Tanggungan L (L/P)

    Diagnosa : Unilateral or unspecified inguinal hernia, with ga

    Telah diberikan :

    Demikian atas bantuannya, diucapkan banyak terima kasih


    Salam sejawat, 21 February 2017

    dr.Anwar Lutfi

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