Format Morning Report [PDF]

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MORNING REPORT Nama



: _____________________________________



Kelompok



: _____________________________________



Tempat



: _____________________________________



Hari/Tanggal : _____________________________________ I.



Identitas Pasien No Reg



: ________________________________________________________



Nama



: ________________________________________________________



Umur



: ________________________________________________________



Jenis Kelamin : ________________________________________________________



II.



Alamat



: ________________________________________________________



Pekerjaan



: ________________________________________________________



Diagnosa Medis ______________________________________________________________________



III.



Riwayat Penyakit Sekarang ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________



IV.



Vitas Sign ______________________________________________________________________



V.



Pemeriksaan Fisik ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________



VI.



Pemeriksaan Khusus ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________



VII. Diagnosa Fisioterapi ______________________________________________________________________ ______________________________________________________________________ VIII. Tujuan Fisioterapi ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ IX.



Rencana Tindakan Fisioterapi ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________



X.



Intervensi Fisioterapi ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________



XI.



Evaluasi ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ___________, ___________ 2020 Pembimbing



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